Gestational hypertensive disorders, with preeclampsia (PE, incidence 4-7%) at their extreme end, are a leading cause of maternal death and a major cause of perinatal mortality and morbidity. They also come with a lifelong increased risk for cardiovascular disease. The aetiology of PE remains largely unknown, hampering early diagnosis and prediction of long-term risks. The poor understanding and subsequent inferior diagnostic and therapeutic capacities might be a consequence of single organ studies and reliance on system-level biomarkers.
The aim of this PhD proposal is to non-invasively characterise unifying elements between the observed organ changes and the order of events resulting in PE and later cardio vascular disease risk. Advanced Magnetic Resonance Imaging, building upon previous efforts shown to reveal early signs of both placental and cardiac pathophysiology, will provide the novel comprehensive multi-organ characterization required to translate the imaging into a risk prediction for each woman -a core step towards more effective diagnosis and therapy.
Training skills: Assessment cardiac and placental MRI data, experience with fetal and maternal MRI, knowledge about how to correlate and how to assess causality between observations based on physiology.
Year 1: Assessment of acquired cardiac data; calculations of essential flow and cardiac quantities (eg stroke volume, cardiac work, cardiac index, strain); assessment of placental data (eg density of the villous tree)
Year 2: Observe and describe disease phenotypes; assess vascularity changes in both placenta and heart.
Year 3/Year 4: Correlate findings as per before with post-partum cardiac outcome; work towards identification of common risk factors.