Improved Cardio Risk Assessment - Image Analysis of ultrasound derived Carotid Intima-media thickness in correlation with associated cardiac biomarkers.

Summary

Cardiovascular disease is one of the major causes of death worldwide. Substantial data indicate that CVD is a life course disease that begins with the evolution of risk factors that in turn contribute to the development of subclinical atherosclerosis. Assessing the risk for cardiovascular disease is an important aspect in clinical decision making and setting a diagnostic strategy that includes Ultrasound Intima-media thickness analysis in combination with specific biomarkers could be a way forward. In particular, assessing cardiovascular risk in primary care will be very important, as prioritising screening in the form of point-of-care diagnostics will improve patient pathways.

Intima-media thickness (IMT) is a measurement of the thickness of tunica intima and tunica media, the innermost two layers of the wall of an artery. The measurement is usually made by external ultrasound. IMT is used to detect the presence of atherosclerosis in humans and, more contentiously, to track the regression, arrest or progression of atherosclerosis. The carotid artery is the usual site of measurement of IMT. Although IMT is predictive of future cardiovascular events, the usefulness of measuring change in IMT over time is disputed, as meta-analyses have not found that change in IMT is predictive of cardiovascular events.

However, in 2003 the European Society of Hypertension–European Society of Cardiology guidelines for the management of arterial hypertension recommended the use of IMT measurements in high-risk patients to help identify target organ damage and in 2010 the American Heart Association and the American College of Cardiology advocated the use of IMT on intermediate risk patients if usual risk classification was not satisfactory. Carotid IMT has been used in many epidemiological and clinical studies and these have shown associations with several risk factors, including type 2 diabetes, high-density lipoprotein cholesterol (HDLC), triglycerides, rheumatoid arthritis, non-alcoholic fatty liver disease etc.

Biomarkers are a common route to assessing cardiovascular risk. Markers for primary cardiovascular events include, from high to low result: C-reactive protein (CRP), fibrinogen, cholesterol, apolipoprotein-B, the apolipoprotein A/apolipoprotein B ratio, high-density lipoprotein and vitamin D. Biomarkers for secondary cardiovascular events include, from high to low result: cardiac troponins I and T, CRP, serum creatinine, and cystatin C. For primary stroke, fibrinogen and serum uric acid are strong risk markers also.

Aim - The PhD will study the ability to collate critical dimensions from Ultrasound scans for the IMT and cross correlate this data with a set of determined biomarkers. Datasets will be collated from open data-sets; collated via patient trails and analysed in order to determine improved routes to evaluating cardiovascular risk in primary care scenarios.

Skills and Background: Either – Image Analysis; Data Scientist; Bio-Engineering or Clinician

Essential criteria

Upper Second Class Honours (2:1) Degree or equivalent from a UK institution (or overseas award deemed to be equivalent via UK NARIC)

Funding

This project is funded by: the EU INTERREG VA Programme

This project is supported by the European Union's INTERREG VA Programme, managed by the Special EU Programmes Body (SEUPB).

The scholarships will cover tuition fees and a maintenance award of not less than £14,553 per annum for three years (subject to satisfactory academic performance). Applications are invited from UK, European Union and overseas students.