London Aortic Mechanobiology Working Group

What we do

The vision of our research group is to improve the diagnostic and treatment process of patients with thoracic aortic aneurysms at risk of a life-threatening type A aortic dissection.  Our research brings together advanced imaging technology with tissue biomechanics, genomics, metabolomics and computational modelling.

Why it is important

Guidelines for the management of proximal thoracic aortic aneurysms are limited to size criteria only, and our understanding of which aneurysms are more vulnerable to suffer from acute dissection/rupture is very limited. Most clinical studies tend to be anecdotal, poorly controlled and lack the scientific backing to make ground-breaking conclusions that may change clinical practice.

Biomechanically, acute aortic events occur due to tears occurring spontaneously in the aortic intima/media, leading to formation of a false lumen, which propagates under the aortic pulse pressure to dissect. The failure of the aortic tissue at the dissection entry site occurs as a result of the haemodynamic loads (from blood flow) exceeding its strength

The current gold standard treatment is surgical replacement of the aneurysmal aorta to ward off the life-threatening complications, although it is reserved for at-risk patients owing to the significant burden of surgery. Endovascular management of the proximal thoracic aorta also shows promise, although is not yet established.

How it can benefit patients

Our research aims to create patient-specific computational models to predict how enlarged thoracic aortas will behave over time and assess the risk of aortic dissection.

Our work provides vital data that will be applied to clinical decision support software systems utilising patient specific algorithms that can be used in the hospital setting. This will be vital for patients coming through the multi-disciplinary team in predicting acute aortic events and making important decisions regarding treatment and its timing.

Our research

AI-based aortic image prediction

This project is led by Professor O’Regan and his team, funded by the Heart Research UK. The team uses artificial intelligence (AI) technology to analyse CT scans of thoracic aortas and generate 3D images. Not only will this enable more accurate measurement of aneurysms, but it will also allow clinicians to establish which section of the aorta is under the most stress. Additionally, using data from thousands of patients with TAAs, the team hopes that the AI technology will be able to predict which aneurysms are at the greatest risk of dissection or rupture.

Find out more.

Exploring the role of the proteome in aortic disease

Our research aims to analyse the molecular composition of the aorta in various groups of subjects: syndromic disease, sporadic disease, normal controls. Our group analyses the proteoglycan composition of the aortic wall and the associated plasma circulating levels of these molecules. This cross-collaborative research is led by Dr Salvatore Santamaria (BHF Fellow).

 Aortic tissue banking

As part of our commitment to investigating aortic wall phenotypes, and linking structure to function, we collect and store aortic samples obtained from surgical procedures. This allows us to categorise aortopathy and identify proteomic signatures of various aortic phenotypes, in addition to the measurement of material propteries (tensile strength, microstructrual features).

Our researchers