Clinical Research Fellow in Cardiology

Summary of Job Purpose and Principal Duties

The project will be ideal for an MD Thesis.

The background to the project is as follows. Left ventricular hypertrophy (LVH) is a major cardiovascular culprit for four reasons: it reduces coronary reserve, it is intrinsically arrhythmogenic, it causes diastolic heart failure and it leads to left atrial dilatation which triggers AF. LVH is also very common in patients with resistant hypertension. Regressing LVH is known to reduce risk and we need to discover new ways of doing this.

Xanthine oxidase inhibitors such as allopurinol are a promising option to regress LVH for two reasons. Firstly, oxidative stress (OS) is a major cause of LVH and allopurinol reduces OS markedly (Circulation 2006, 114: 2508-2516). Secondly, allopurinol reduces augmentation index which represents LV afterload and is also a major determinant of LVH (just like BP is). In fact, we have already shown that allopurinol regresses LVH in patients with diabetes, coronary artery disease and mild renal disease. We now wish to see if allopurinol regresses LV hypertrophy in patients with resistant hypertension and LVH.

The research fellow will firstly learn the very basic echo skill of screening for LV mass. He will also be taught to assess vascular function by FMD (see below). He/she will then recruit 66 patients with resistant hypertension and LVH. They will be randomised for one year to allopurinol or placebo. At the beginning and end of the year, they will undergo two procedures: cardiac MRI and flow mediated dilatation to assess LV mass and vascular function respectively.

If allopurinol produces the expected benefit, this study will lead to a multicentre trial to see if allopurinol reduces CV events in such patients.

There is funding for a support nurse to assist the research fellow as well as a trial manager, who will start 5 months before the research fellow in order to process applications such as ethics, MHRA applications and study protocols. There will be study-specific funded statistical support to assist with data analysis at the end of the study also.

The team supervising the research are

Dr Jacob George (http://medicine.dundee.ac.uk/staff-member/dr-jacob-george),

Professor Allan Struthers (http://medicine.dundee.ac.uk/staff-member/professor-allan-d-struthers)

Professor Graeme Houston (http://medicine.dundee.ac.uk/staff-member/professor-graeme-j-houston)

Any Additional Information

Informal enquiries should be directed to Dr Jacob George (Tel 01382 383204), email j.george@dundee.ac.uk

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