Leighton Kearney
Leighton Kearney
My PhD topic is: “Aortic Stenosis: Mechanisms and prognostic markers in man.”
Aortic Stenosis is a narrowing of the aortic valve, the valve through which blood flows from the heart to the aorta and subsequently to all the body’s vital organs, including the brain. This narrowing places stress on the heart muscle causing it to thicken and can result in chest pain, shortness of breath, collapse and even sudden death.
Doctors used to think that aortic stenosis was caused by the common wear and tear that comes with aging, but now we know that it results from an active inflammatory process similar to atherosclerosis.
Increased blood pressure, cholesterol, smoking and kidney disease are known risk factors that damage the lining of the aortic valve, causing fibrosis, or scarring. Deposits of cholesterol and even bone can form on this scar tissue causing the valves to become stiff. Unlike other tissue in the body, scarring in the heart causes permanent damage. The heart is unable to repair itself and when the valve can’t retract properly it places extra stress on the heart muscle and can ultimately weaken the heart function.
Aortic Stenosis can be easily diagnosed by a General Practitioner using a stethoscope. Instead of the rhythmic “lub dub” sound that a healthy heart makes, you hear a buzzing, raspy sound caused by turbulent blood flow. The patient may also complain of symptoms such as breathlessness, dizziness and chest pain, but these can have other causes and can be ambiguous.
We think that if we were able to detect the onset of Aortic Stenosis and the resultant stress on the heart muscle earlier, we may be able to prevent many more deaths.
Why is it importantAortic stenosis is a serious condition, affecting up to 25% of people over 65 years of age. Once severe narrowing develops, over 50% of people die within two to three years. The condition is curable with open heart surgery to replace the valve, but to date no medication is available to treat this condition.
I have just finished the recruitment phase of the study and have early follow up data on patients at one and six months. I expect to have completed my research by May or June 2010.
I currently spend three and a half days per week with patients, allocating one and a half hours per patient. The patients benefit from being part of the study, by gaining more time with the clinician.
I gained exposure to research during my cardiology training and enjoyed the opportunity to define a research question, evaluate the data and find answers that potentially improve my clinical practice.
A higher research degree creates opportunities to work in university affiliated tertiary hospitals and to practice both clinical medicine as well as continue academic pursuits.
Highlights..
The research has enriched my clinical skills and it is something that I would like to continue. I really appreciate the clinical contact that I have with patients. I think it makes you a better clinician.
A research degree can help you develop expertise in new medical techniques, for example in my case Speckle-Tracking Echocardiography (cardiac ultrasound) and cardiac MRI.
Challenges..
Scanning the background literature, summarising the wealth of knowledge in this area and formulating my own questions, have been the most challenging aspects of my medical doctorate so far.