Mr Christopher Wild, Research Scientist at Royal United Hospitals Bath NHS Foundation Trust and winner of Investigator of the Year 2024, shares his experience.
I am an early-career researcher, having just completed the first year of my PhD, which is based on the assessment of pulmonary hypertension using transthoracic echocardiography. To be asked to present, let alone be shortlisted for Investigator of the Year (and then win!) was a great honour.
I am really grateful to the BSE for actively supporting research in echocardiography. The encouragement, feedback and critical appraisal of my work by peers whom I hold in very high regard has been invaluable. This will certainly assist me in the rest of my work on my PhD as I develop my skills in writing and presenting scientific findings.
Pulmonary hypertension (PH) is a clinical and pathophysiological disorder found as the cause or consequence of many different conditions. Life expectancy in patients with PH ranges from months to years.
Mortality in PH is directly influenced by time-to-treatment. Research has shown that it can take 2-4 years to receive a diagnosis following the onset of symptoms. Formal diagnosis of PH comes only from invasive right heart catheter (RHC), but this is costly and carries significant risk. Echocardiography is one part of a suite of screening tests used to determine the clinical likelihood of PH in patients before their RHC. It provides a wealth of valuable information which is of great benefit to clinicians in deciding on the next steps in the clinical pathway.
My overarching PhD thesis is based on the assessment of pulmonary hypertension (PH) via transthoracic echocardiography. One of the chapters is centred around the non-invasive differentiation of pre- and post-capillary pulmonary hypertension. This was the work presented at the BSEcho 2024 conference which went on to win Investigator of the Year.
Post-capillary PH describes a form of PH manifested secondary to left heart disease. It is the most common form of the condition (around 70% of all cases) and is not directly treatable with PH-specific drugs. Numerous methods of assessing PH subtypes non-invasively have been proposed over the last few decades, but given the fundamental changes to formal PH diagnosis, the evidence base surrounding these methods is in flux.
My work thus far has focused on:
- Auditing one of the most recent proposed methods against the current haemodynamic definition of PH, and
- Reviewing other echocardiographic measurements to allow sonographers and clinicians to obtain as much information as possible in non-specialist centres prior to referral to hospitals with dedicated PH services.
The work I presented is in its infancy and will be developed further, but these early results are very positive. They demonstrate that it is possible for echo to provide vital information in these specific conditions which could reduce the time it takes patients to receive a formal diagnosis as they move through the diagnostic pathway.
Abstracts from BSEcho 2024 will be published in Echo Research in Practice in 2025.