Vascular Physiology​ Research Group

Advanced heart failure (HF) is a growing health problem in the European Union. Consequently, a growing number of (HF) patients now depend on state-of-the-art continuous flow Left Ventricular Assist Devices (cf-LVAD) as a bridge to transplant or as a means of destination therapy. Since the introduction and usage of cf-LVADs rather than traditional pulsatile LVADs, survival rates have significantly improved. However, an increased number of side effects, including stroke and microvascular bleeding have been reported. Lack of pulsatile pressure and flow throughout the system has been suggested as a causative mechanism for these side effects however, there are currently no data on macro/micro haemodynamics in these patients.

Our objective therefore is to provide 5 work packages to understand the consequences of decreased pulsatile blood pressure and flow haemodynamics in cf-LVAD patients compared to HF patients and age-matched controls.

Cardiovascular disease is now the leading cause of death worldwide, with myocardial infarction and stroke accounting for over 20% of all deaths. As part of the Anglo-Cardiff Collaborative Trial (ACCT) in collaboration with the University of Cambridge, we now know that arterial stiffness is an independent predictor of heart attack and stroke. There is a general consensus that arterial stiffening  in the Western population is an inevitable consequence of growing old and until relatively recently, 'hardening of the arteries' was recorded on death certificates. However, stiffening of the arteries is not inevitable and we are following the time course of arterial stiffness in a large population-based cohort in order to help identify the causes of this problem. This study aims to identify potential new targets for drug treatment to reverse or slow down arterial stiffening, which should then lead to major reductions in the incidence of diseases such as heart attack and stroke.

Chronic Obstructive Pulmonary Disease (COPD) is a multisystem disease. In addition to respiratory diseases, the causes and development of complications such as cardiovascular disease, osteoporosis, and loss of muscle mass and function are not well understood. The ARCADE study commenced in 2011 at Cardiff University to investigate these problems, and with the help of the British Lung Foundation, GP's and respiratory consultants, over 500 volunteers with COPD and 150 individuals without lung problems have been recruited. The ARCADE cohort has been set at baseline visit and a 2 year follow-up visit, where in-depth cardiovascular and respiratory measurements are assessed. The study has now transferred to Cardiff Metropolitan University, where a further 5 year follow-up of these volunteers will take place.

The heart and vasculature operate as an integrated and dynamic system in order to satisfy the circulatory demands of the body. The main focus of this research is how this heart-vasculature interaction changes with age and disease. In particular, how left ventricular mechanics (which describe the twisting, untwisting and deformation of the left ventricle as it contracts and relaxes) are affected by age- and disease-related changes to arterial haemodynamics and stiffness. We are currently exploring these relationships in younger and middle-aged healthy adults via data collected from Cardiff Metropolitan University staff and student health MOT's, and in patients with hypertension in collaboration with clinical colleagues and University Hospital Llandough, Cardiff.

The research group provides "Health MOT's" (assessment of office and 24 hour blood pressure, arterial stiffness, respiratory function, cardiac function together with retinal, cerebral and renal blood flow, and blood samples assessing cholesterol and glucose) to Cardiff Metropolitan staff and students as part of our research programme and to provide cardiovascular risk awareness. This easily administered template of evaluating and investigating individuals or institutions' "health" has previously been undertaken and can be provided to local company workforces or clients.

These MOT's are performed in collaboration with the University's Health and Wellbeing Strategy, co-ordinated through Laura Watkeys and Chris Deacy and the British Heart Foundation. In 2016, our health MOT's not only raised cardiovascular awareness, but also provided data towards understanding the relationships between aortic blood pressure and cardiac function in a student population.

The group are currently investigating the interactions between large artery stiffness, central haemodynamics and peripheral organ flow pulsatility (in the eye, brain and kidney). This study investigates these relationships and interactions across different age ranges, in hypertensive patients and during pharmacological interventions. Understanding the complex interaction between the heart, large arteries and the flow being transmitted into the periphery enables the focused treatment and management of risk in ageing and patient populations.