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Title: Multimodality imaging of the abdominal aortic aneurysm
Author: Abbas, Abeera
ISNI:       0000 0004 5372 0589
Awarding Body: King's College London
Current Institution: King's College London (University of London)
Date of Award: 2015
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Age and hypertension lead to aortic remodeling and stiffness and are also major risk factors for abdominal aortic aneurysms (AAA). This study aimed to investigate: (i) the use of multimodal imaging to test the hypothesis that aneurysmal disease of the abdominal aorta is a remodeling response to aortic stiffness and systolic hypertension; (ii) the utility of a novel ultrasound-based device (AortaScan) for detection of AAA in the community setting. We used multimodality imaging tonometry and cardiovascular magnetic resonance imaging (CMR) to quantify pulse wave velocity (PWV, a measure of stiffness), in the aortic arch (Arch), thoracic aorta (TA) and the abdominal aorta (AA). Stiffness was also correlated with measures of calcification and metabolic activity measured on CT and PET/CT respectively. The thoracic aortae of patients with AAA were stiffer than those of sex matched controls. Although systolic hypertension was more common in AAA patients, multivariate analysis revealed that aortic stiffness and mean arterial pressure were associated with AAA disease. The likelihood of developing AAA disease increases >3-fold for 1m/sec increase in PWV. This data suggests that segmental stiffness is modified in the presence of AAA and provides further evidence that aneurysm formation may be an adaptive remodeling response to hypertension. The AortaScan can detect AAA without the need for a trained operator and has potential in a community-based screening programme. It would, however, need further technical improvement to increase sensitivity before it could be considered a replacement for trained screening personnel.
Supervisor: Waltham, Matthew ; Smith, Alberto ; Modarai, Bijan Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available