Dr Priya Sastry

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