Oxford BHF CRE Intermediate Clinical Transition Fellow
- Start Date: 01/04/2020
- End Date: 31/03/2022
- BHF CRE Mentors: Hugh Watkins & Jane Armitage
Research project title: Exploring the role of deep cardiac magnetic resonance phenotyping to stage genotype positive hypertrophy negative sarcomeric mutation carriers
My research seeks to elucidate the pathophysiological basis of common diseases (hypertrophic cardiomyopathy, COVID-19) using modern imaging technology such as magnetic resonance imaging and to provide a platform to reliably measure disease activity in humans. Such measures can greatly accelerate therapeutic development by reducing the sample size needed to test drug efficacy. These efforts will also refine our ability to predict the risk of negative outcomes in patients and motivate drug discovery and development with the ultimate goal of reversing the pathological phenotype.
As the most common cause of sudden death in young adults and athletes, Hypertrophic Cardiomyopathy or HCM is an important genetic disease which affects one in 500 people globally. It is characterised by an abnormally thick heart, narrowing of the small blood vessels, chaotic arrangement of cardiomyocytes and increased energy demand. At present, we are still not good at determining who are likely to have a serious cardiac complication and who would benefit most from therapy.
With my research I hope to answer the following questions: How can we prevent a serious cardiac event from occuring in patients with HCM? if you carry the gene for this disease and have not yet developed the disease, how can we predict your risk of developing the disease in the future? Among those who have HCM, who will most benefit from newer therapies (small molecule inhibitor, gene therapies)?
In recent times, I have also been researching the medium-long term effects of COVID-19 in patients recovering from moderate to severe infections. I am leading a national multiorgan phenotyping study of post-hospitalised COVID-19 patients (along with Prof Stefan Neubauer) called the C-MORE study and I am also a co-investigator in two other nationally funded Long-COVID studies. We are still trying to unravel the pathophysiological basis for Long COVID which will not doubt be important in identifying an effective therapy for 2 million individuals across the UK who are currently suffering from this debilitating condition.
The Oxford British Heart Foundation Centre of Research Excellence Transition Fellowship has been fundamentally important to build my publication profile, develop valuable collaborations, secure funding, and demonstrate independence in my research area. All these are extremely helpful when applying for an intermediate fellowship, which I plan to do this year.
Lung Abnormalities Depicted with Hyperpolarized Xenon MRI in Patients with Long COVID.
Grist JT. et al, (2022), Radiology
Incremental value of left atrial booster and reservoir strain in predicting atrial fibrillation in patients with hypertrophic cardiomyopathy: a cardiovascular magnetic resonance study.
Raman B. et al, (2021), J Cardiovasc Magn Reson, 23
Physical, cognitive, and mental health impacts of COVID-19 after hospitalisation (PHOSP-COVID): a UK multicentre, prospective cohort study.
Evans RA. et al, (2021), Lancet Respir Med
Association of Preterm Birth with Myocardial Fibrosis and Diastolic Dysfunction in Young Adulthood
LEWANDOWSKI A. et al, (2021), Journal of the American College of Cardiology
Maximal Wall Thickness Measurement in Hypertrophic Cardiomyopathy: Biomarker Variability and its Impact on Clinical Care.
Captur G. et al, (2021), JACC Cardiovasc Imaging