Developing a noninvasive marker CVD risk and treatment effect
Research type
Research Study
Full title
Method validation of an ultrasound approach to estimate endothelial shear stress as a marker of atherosclerotic burden.
IRAS ID
164662
Contact name
Sudarshan Ramachandran
Contact email
Sponsor organisation
MIDRU Building, Heart of England NHS Foundation Trust
Duration of Study in the UK
1 years, 0 months, 7 days
Research summary
Cardiovascular disease (CVD) accounted for nearly a third of deaths in the UK in 2008. CVD is associated with modifiable risk factors such as hypertension and diabetes and treating each of these factors lowers the risk of CVD. It is impossible to estimate the benefit of risk factor modification as clustering of factors is often present in the same patient with benefits seen in randomised controlled studies not translating to such patients encountered in the routine setting. It would be useful to have a measurable modifiable marker of risk that could be used to evaluate therapeutic effectiveness instead of imperfect measures such as coronary angiography (invasive) and CT calcium (radiation and low specificity).
The pathophysiology of atherosclerosis results in changes to the vessel wall and hence the fluid dynamics, complex models existing to estimate the size of sequelae such as shear stress from data available from noninvasive ultrasonography. An easily accessible blood vessel with flow characteristics suitable for the resolution, precision and accuracy of ultrasound flow estimation is required such as the carotid artery.
We would initially like to validate carotid ultrasound with fluid dynamic modelling in an outpatient setting to optimise the methodology. If this initial study is successful we would then like to determine the correlation between data obtained by using coronary angiograms and the shear stress estimated by the model, and subsequently monitor shear stress in relevant patient groups (e.g. hypertension, diabetes). Individual conditions, having adjusted for confounders, would then be studied and values compared with the currently used “risk calculators”. Sequential measurements would then be taken over a 3 year period (every 6 months) in both different disease states and in “treatment naïve” patients who are then started on CVD drugs. These subsequent projects would be submitted for approval later if pilot successful.
REC name
West Midlands - Solihull Research Ethics Committee
REC reference
15/WM/0164
Date of REC Opinion
29 May 2015
REC opinion
Further Information Favourable Opinion