Sympathetic nerve activation and inflammation in hypertension
Research type
Research Study
Full title
Investigating the link between inflammation and sympathetic nerve activation in the progression of hypertensive heart disease
IRAS ID
271538
Contact name
Angus, K Nightingale
Contact email
Sponsor organisation
University of Bristol
Duration of Study in the UK
2 years, 6 months, 1 days
Research summary
Heart failure is a debilitating condition affecting over 900,000 individuals in the UK. High blood pressure (hypertension) is a major risk factor for developing heart failure and affects one in four adults. The mechanisms that contribute to the progression from hypertension to heart failure are incompletely understood. Recent studies highlighted a potential role of the sympathetic nervous system and the immune system on cardiomyocyte signalling pathways resulting in cardiac fibrosis and left ventricular hypertrophy. Myocardial fibrosis is considered a key contributor to the progression from hypertension and left ventricular hypertrophy to heart failure. The aim of this project is to determine whether muscle sympathetic nerve activity is different in hypertensive patients with and without fibrosis, and identify if there are any inflammatory or fibrotic biomarkers in the blood associated with these changes, that may play a role in the development of left ventricular hypertrophy and cardiac fibrosis development. This will be achieved by recruiting two groups of hypertensive patients from our hypertension clinic (with and without fibrosis), who undergo a comprehensive cardiac MRI scan to assess left ventricular function, hypertrophy and fibrosis. Healthy controls will be recruited from the University and public. We will make direct recordings of sympathetic nerve activity at rest using microneurography and during a stress test, the cold pressor test, which involves participants putting their hand in ice cold water for 3 minutes. Blood will be collected in the two Clinical Research and Imaging Centre (CRIC-Bristol), visits to measure blood markers of immune activation and fibrosis to identify a unique “fingerprint” for patients with evidence of left ventricular hypertrophy at risk of developing fibrosis. The study involves two visits to the CRIC, lasting 1.5 hours and 2.25 hours for visits 1 and 3 respectively, and a cardiac MRI visit (visit 2), lasting up to 1 hour.
REC name
South West - Central Bristol Research Ethics Committee
REC reference
20/SW/0006
Date of REC Opinion
7 May 2020
REC opinion
Further Information Favourable Opinion