Aortic arch haemodynamics in adult women with Turner syndrome: A numerical investigation into obesity-related factors

EPSRC : Lauren Johnston : EP/R513349/1

Girls with Turner syndrome (TS), a chromosomal condition in which a female has complete or partial absence of the second sex chromosome, present a unique group of patients, with an increased risk of cardiovascular disease. Mortality rates are three times higher in TS women compared with the general population, and life expectancy is reduced by up to 13 years - the most common cause of death being from cardiovascular disease. Children with TS also have a greater underlying predisposition to obesity, which is found to increase with age. Since the mid 1900s extensive research has led to advancements in the treatment of Turner syndrome: growth hormone therapy can increase final adult height, and reproductive treatment can assist with infertility. However, cardiovascular diseases affecting girls and women with TS remain under-researched, and remains the leading cause of death. Our research aims to contribute to one of the key cardiovascular research priorities outlined in a scientific statement from the American Heart Association, which is to elucidate the pathogenesis of increased cardiovascular morbidity and mortality in women with TS compared with the general population and determine the contributions of atherosclerotic disease, hypertension, and obesity.

The proposed project will increase our understanding of the haemodynamic environment and, ultimately, flow-related cardiovascular disease markers in patients with Turner syndrome by reconstructing 3D models of the aorta and performing blood flow simulations, using computational fluid dynamic methods. Current research in the UK has highlighted some aspects of the aortic haemodynamics in children with Turner syndrome. The project proposed for the Mitacs Globalink placement complements the scope of this research by addressing questions relating to the adult Turner syndrome population. Without the proposed new collaboration between the UK and Canadian research groups, the student would not be able to extend the study cohort to adult TS patients. The research carried out at the University of Strathclyde combined with the prospective research to be carried out at the University of Toronto will provide the first ever analysis of blood flow in both paediatric and adult Turner syndrome patients. The project is highly multi-disciplinary within the broad fields of Biomedical Engineering, Fluid Mechanics, and Paediatric Medicine, and in close collaboration with clinicians at both Scottish and Canadian hospitals. This research could have an immeasurable impact for Turner syndrome patients in both the UK and Canada, improving significantly their personalised care and quality of life.