Led by Professor John Deanfield, the Vascular Physiology Unit based at Great Ormond Street Hospital researches the pathophysiology of the pre-clinical phase of atherosclerosis from childhood. The aim of this work has been to understand the genetic and novel environmental influences on initiation and progression of disease and the potential for prevention. Traditional clinical endpoints cannot be used to evaluate early disease. We have therefore continued to develop robust measurements of intermediate atherosclerosis phenotypes as outcome variables. In parallel, we are evaluating the relationship of these measures to the progression of arterial disease and to clinical cardiovascular events. Non-invasive techniques have been developed and are now established as the gold standard method of evaluating endothelial function in children and young adults who have not yet developed any clinical manifestations of disease.
Key research activities
- The Study of Inflammation, Lipid Functionality (including HDL cholesterol)
An emerging topic of interest to clinicians and scientist has been the contribution of High Density Lipoproteins (HDL) to atherosclerosis and heart disease. HDL’s are fat molecules that circulate in your blood and have long been termed ‘Good Cholesterol’ with many medical treatments have sought to increase blood levels of HDL. However, recent studies have reported that under certain conditions within the body, HDL function may become compromised and actually contribute to disease progression.
The primary aim of this study is to understand if HDL function is altered in patients with clinically relevant RA. Using a new technique to intricately measure the effect of HDL on human cells we can determine if HDL function contributes to the elevated CV risk recorded in RA. A better understanding of how HDL contributes to CV disease should allow development of more effective clinical treatments and preventative measures for atherosclerosis and RA in the future.
- Investigation of the Role of Obesity and Body Composition
We are looking at the factors that influence fat deposition and the impact this has on the heart and arteries. To do this, we will look at the changes in (fatness) body composition and measure structure and function of the arteries. Diseases of the main blood vessels in the body, especially those supplying the heart, are the largest cause of death worldwide. We know that changes are seen in the blood vessels a long time before symptoms such as heart attack or stroke occur.
We will also perform detailed studies of the amount and distribution of fat using Magnetic Resonance Imaging (MRI). We will look at the response of the heart and blood vessels when a person is at rest and when they are undergoing a challenge. With this information we can see how your body responds, and the effects that this response has on the functions of the heart and blood vessels. The findings from this study will provide important information about how your lifestyle and health affect your arteries and how this might be used to prevent heart diseases.
- Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT)
Despite improvements in management, patients with childhood onset Type 1 Diabetes have reduced life expectancy often occurring as a result of renal and arterial complications. We are studying the relationship between albumin excretion and carotid intima media thickness (cIMT), in a well characterised cohort of adolescents with Type-1 Diabetes.
This study is a multi-centre, multinational collaboration across Australia, Canada and the UK and is being funded by the British Heart Foundation, Diabetes UK and the Juvenile Diabetes Research Fund.