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

儿童肥胖最近在世界范围内成为流行病，成为本世纪的主要挑战之一。青少年肥胖最初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首批临床症状。此外，超重儿童在成年后保持肥胖的可能性很高，同时患高风险心血管疾病和其他慢性非传染性疾病的倾向也随之增加，这反过来又可能增加过早死亡的风险。解决儿童肥胖问题是英国近期政策的优先事项，与欧洲和全球战略优先事项一致。肥胖主要是一种饮食疾病，被认为加速内皮功能障碍的发生和进展，内皮功能障碍是大多数心血管疾病的基础动脉粥样硬化病变的早期生物学标志物之一。病变在动脉网络内的分布空间不同，目前尚不清楚为什么内皮细胞有时容易或免疫疾病，特别是随着年龄的增长。脂质积累的证据最早可以在三岁时在全身动脉内膜被检测到。完善的医学成像模式，如高分辨率超声成像和磁共振成像，可以在儿科实践中对脂肪条纹沉积进行非侵入性评估。已经提出了一些标志物来帮助临床评估高危患者的内皮损伤。在肥胖儿童中，通过测量主动脉和颈动脉内膜-中膜厚度（IMT）以及肱动脉、桡动脉和股动脉的血流介导扩张（FMD），可以无痛地评估动脉的变化。脉搏波分析还用于评估动脉僵硬度、扩张性和顺应性。在本研究项目中，实验和数学建模方法将用于评估与儿童肥胖有关的儿科早期血管变化。这些研究的信息将被检查，正常动脉和病变动脉之间的数据将被比较。这将允许对患者进行特定的数值模拟，并分析通过动脉血管的血液流动质量。这种诊断工具将是监测肥胖引起的年轻人群血管变化的基础。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。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，他们在与工程师合作开发新医疗技术方面拥有丰富而成熟的经验。

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.