Aortic arch haemodynamics in adult women with Turner syndrome: A numerical investigation into obesity-related factors

EPSRC：Lauren Johnston：EP/R513349/1 Turner综合征(TS)，一种女性完全或部分缺乏第二性染色体的染色体状况，呈现出一组独特的患者，心血管疾病的风险增加。与普通人群相比，TS女性的死亡率高出三倍，预期寿命减少了13岁--最常见的死亡原因是心血管疾病。患有TS的儿童也有更大的潜在肥胖倾向，据发现，肥胖倾向随着年龄的增长而增加。自20世纪中期以来，广泛的研究导致了特纳综合征的治疗进展：生长激素治疗可以增加成年后的最终身高，生殖治疗可以帮助治疗不孕不育。然而，影响患有TS的女孩和妇女的心血管疾病仍然没有得到充分的研究，仍然是主要的死亡原因。我们的研究旨在为美国心脏协会的一份科学声明中概述的心血管研究重点之一做出贡献，即阐明与普通人群相比，患有TS的女性心血管发病率和死亡率增加的原因，并确定动脉粥样硬化性疾病、高血压和肥胖症的贡献。拟议的项目将增加我们对血流动力学环境的了解，并最终通过重建主动脉的3D模型并使用计算流体动力学方法进行血流模拟，最终了解Turner综合征患者的血流相关心血管疾病标记物。英国目前的研究强调了特纳综合征儿童主动脉血流动力学的某些方面。为Mitacs Globalink安置提出的项目通过解决与成年特纳综合征人群有关的问题来补充这项研究的范围。如果没有英国和加拿大研究小组之间拟议的新合作，这名学生将无法将研究队列扩大到成年TS患者。斯特拉斯克莱德大学进行的这项研究与多伦多大学即将进行的前瞻性研究相结合，将提供有史以来第一次对儿童和成人特纳综合征患者的血液流动进行分析。该项目涉及生物医学工程、流体力学和儿科医学等广泛领域，并与苏格兰和加拿大医院的临床医生密切合作。这项研究可能会对英国和加拿大的特纳综合征患者产生不可估量的影响，显著改善他们的个性化护理和生活质量。

EPSRC : Lauren Johnston : EP/R513349/1Girls with Turner syndrome (TS), a chromosomal condition in which a female has complete or partial absence of the second sex chromosome, present a unique group of patients, with an increased risk of cardiovascular disease. Mortality rates are three times higher in TS women compared with the general population, and life expectancy is reduced by up to 13 years - the most common cause of death being from cardiovascular disease. Children with TS also have a greater underlying predisposition to obesity, which is found to increase with age. Since the mid 1900s extensive research has led to advancements in the treatment of Turner syndrome: growth hormone therapy can increase final adult height, and reproductive treatment can assist with infertility. However, cardiovascular diseases affecting girls and women with TS remain under-researched, and remains the leading cause of death. Our research aims to contribute to one of the key cardiovascular research priorities outlined in a scientific statement from the American Heart Association, which is to elucidate the pathogenesis of increased cardiovascular morbidity and mortality in women with TS compared with the general population and determine the contributions of atherosclerotic disease, hypertension, and obesity. The proposed project will increase our understanding of the haemodynamic environment and, ultimately, flow-related cardiovascular disease markers in patients with Turner syndrome by reconstructing 3D models of the aorta and performing blood flow simulations, using computational fluid dynamic methods. Current research in the UK has highlighted some aspects of the aortic haemodynamics in children with Turner syndrome. The project proposed for the Mitacs Globalink placement complements the scope of this research by addressing questions relating to the adult Turner syndrome population. Without the proposed new collaboration between the UK and Canadian research groups, the student would not be able to extend the study cohort to adult TS patients. The research carried out at the University of Strathclyde combined with the prospective research to be carried out at the University of Toronto will provide the first ever analysis of blood flow in both paediatric and adult Turner syndrome patients. The project is highly multi-disciplinary within the broad fields of Biomedical Engineering, Fluid Mechanics, and Paediatric Medicine, and in close collaboration with clinicians at both Scottish and Canadian hospitals. This research could have an immeasurable impact for Turner syndrome patients in both the UK and Canada, improving significantly their personalised care and quality of life.