Blood flow studies in normal and diseased arteries in relation to early vascular changes and paediatric obesity

儿童肥胖症最近在世界范围内流行，成为本世纪的主要挑战之一。肥胖原本是高收入国家的问题，现在在低收入和中等收入国家也很普遍。在其他健康问题中，血液胆固醇水平升高和早期心血管疾病(CVD)是将超重儿童与正常体重儿童区分开来的第一批临床症状。此外，超重儿童成年后继续肥胖的可能性很高，同时增加了患高危心血管疾病和其他慢性非传染性疾病的倾向，这反过来可能会增加过早死亡的风险。解决儿童肥胖问题是英国最近政策中的优先事项，符合欧洲和全球的战略优先事项。肥胖主要是一种饮食疾病，被认为会加速内皮功能障碍的发生和发展，内皮功能障碍是大多数心血管疾病背后的动脉粥样硬化病变的早期生物标志物之一。病变在动脉网络内的空间分布各不相同，目前尚不清楚为什么内皮细胞有时容易或对疾病免疫，特别是随着年龄的增长。脂肪堆积的证据早在三岁时就可以在系统动脉的内膜层检测到。成熟的医学成像方式，如高分辨率超声和磁共振成像，允许对儿科实践中的脂肪条纹沉积进行非侵入性评估。已经提出了几个标记物来帮助临床评估高危患者的内皮损伤。在肥胖儿童中，动脉变化可以通过测量主动脉和颈动脉内中膜厚度(IMT)和臂动脉、桡动脉和股动脉的血流介导的扩张(FMD)来无痛地评估。脉搏波分析还被用来评估动脉僵硬、扩张性和顺应性。在这项研究项目中，将使用实验和数学建模方法来评估儿科与儿童肥胖有关的早期血管变化。这些研究的信息将被检查，然后将正常动脉和病变动脉之间的数据进行比较。这将允许稍后执行特定于患者的数值模拟，并分析通过动脉血管的血液流动的质量。这一诊断工具将是监测肥胖导致的年轻人群血管变化的基础。该项目在生物医学工程、流体力学和儿科医学等广泛领域内是高度多学科的。这位被提名的候选人将获得生物流体动力学方法方面的专业知识，并与格拉斯哥皇家儿童医院的儿科心脏外科医生密切合作，这些医生在与工程师合作开发新医疗技术方面拥有丰富和成熟的经验。

Paediatric obesity has recently taken epidemic proportions worldwide, becoming one of this century's major challenges. Originally a high-income countries' problem, obesity at young age is now prevailing also in low- and middle-income countries. Increased levels of blood cholesterol and early cardiovascular diseases (CVDs) are-among other health problems-, the first clinical symptoms that disparate overweight from normal-weight children. In addition, the likelihood of overweight children to remain obese in adulthood is high, along with an associated increased propensity for developing high-risk CVDs and other chronic non-communicable diseases, which in turn may increase the risk for premature death. Tackling paediatric obesity is a priority in recent UK policies, in line with European and worldwide strategic priorities. Primarily a dietary disease, obesity is believed to accelerate the initiation and progression of endothelial dysfunction, one of the early biological markers for atherosclerotic lesions that underlie most cardiovascular diseases. Lesion distribution varies in space within the arterial network and it is yet unclear why the endothelium is at times prone or immune to disease, particularly with increasing age. Evidence of lipid accumulation can first be detected at the intima layer of the systemic arteries as early as the age of three. Well-established medical imaging modalities, such as high-resolution ultrasonography and magnetic resonance imaging, allow for the non-invasive assessment of fatty streak deposition in paediatric practice. Several markers have been proposed to help the clinical assessment of endothelial damage in high-risk patients. In obese children, arterial changes can painlessly be evaluated with measurements of the aortic and carotid intima-media thickness (IMT) and flow-mediated dilatation (FMD) of the brachial, radial and femoral arteries. Pulse wave analysis is additionally utilised to assess arterial stiffness, distensibility and compliance.In this research project, both experimental and mathematical modelling methods will be used to assess early vascular changes in paediatrics, in relation to childhood obesity. The information from these studies will be examined and the data between normal and diseased arteries will then be compared. This will later allow patient-specific numerical simulations to be performed and the quality of blood flow through arterial vessels to be analysed. This diagnostic tool will be fundamental in monitoring obesity-induced vascular changes in the young population. The project is highly multi-disciplinary within the broad fields of Biomedical Engineering, Fluid Mechanics, and Paediatric Medicine. The named candidate will gain expertise in biofluid dynamics methods and be in close collaboration with paediatric cardiac surgeons from the Royal Hospital for Children, Glasgow, who have an extended and proven experience in working with engineers for the development of new medical technologies.