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Cambridge Cardiovascular



Predicting risk of progression in patients with arch or descending thoracic aortic aneurysm

Thoracic aortic aneurysm (TAA) is typically a silent disease, diagnosed incidentally. The condition carries a continuous risk of fatality due to aortic rupture or dissection but treatment - by surgery or stent-grafting - also carries significant risks of death or permanent disability, which are well quantified from clinical results.

Judging when to intervene is difficult since the risk of events without intervention is not really known. Aneurysm size is proportional to the risk of dissection/death above certain thresholds (6cm for the ascending aorta, 7cm for the descending), but on a population level, most clinical events occur in aneurysms below these thresholds.

This project seeks to investigate the potential of blood-borne messenger- and micro-RNAs (mRNA and miR) as biomarkers of TAA progression. We will map mRNA/miR expression longitudinally in a cohort of TAA patients under clinical surveillance to seek association with TAA progression (growth rate, incidence of rupture, dissection or death).  To extend the study further, we later plan to explore the upstream pathways generating these mRNA/miR signals by performing a transcriptomics and proteomics study of explanted aortic tissue.

Supervisors: Dr Sanjay Sinha & Prof Ziad Mallat


Key publications: 

An iPSC-derived vascular model of Marfan syndrome identifies key mediators of smooth muscle cell death. Granata A, Serrano F, Bernard WG, McNamara M, Low L, Sastry P, Sinha S. Nat Genet. 2017 Jan;49(1):97-109.

The ETTAA study protocol: a UK-wide observational study of 'Effective Treatments for Thoracic Aortic Aneurysm'. Sastry P, Hughes V, Hayes P, Vallabhaneni S, Sharples L, Thompson M, Catarino P, Moorjani N, Vale L, Gray J, Cook A, Elefteriades JA, Large SR; ETTAA Collaborators. BMJ Open. 2015 Jun 2;5(6):e008147.

Mesenteric ischaemia following cardiac surgery: the influence of intraoperative perfusion parameters. Sastry P, Hardman G, Page A, Parker R, Goddard M, Large S, Jenkins DP. Interact Cardiovasc Thorac Surg. 2014 Sep;19(3):419-24.

Evaluation of a robot-assisted video-assisted thoracoscopic surgery programme. He Y, Coonar A, Gelvez-Zapata S, Sastry P, Page A. Exp Ther Med. 2014 Apr;7(4):873-876.

Adrenalectomy for isolated metastasis from operable non-small-cell lung cancer. Sastry P, Tocock A, Coonar AS. Interact Cardiovasc Thorac Surg. 2014 Apr;18(4):495-7.

The influence of endoscopic vein harvesting on outcomes after coronary bypass grafting: a meta-analysis of 267,525 patients. Sastry P, Rivinius R, Harvey R, Parker RA, Rahm AK, Thomas D, Nair S, Large SR. Eur J Cardiothorac Surg. 2013 Dec;44(6):980-9.

Defining acute aortic syndrome after trauma: Are Abbreviated Injury Scale codes a useful surrogate descriptor? Leach R, McNally D, Bashir M, Sastry P, Cuerden R, Richens D, Field M. J Trauma Acute Care Surg. 2012 Oct;73(4):977-82.


BHF Centre of Excellence Clinical Research Training Fellow
SpR Cardiothoracic Surgeon
ETTAA Research Fellow
Dr Priya  Sastry


Person keywords: 
gene expression profiling