PhD Studentship An analysis of the physiological and biomedical adaptations to supervised aerobic exercise training in patients with symptomatic lower limb atherosclerosis.

To celebrate the University’s research successes the University of Hull is offering six UK/EU PhD Scholarships, or International Fees Bursaries, for projects at the Hull York Medical School, open to candidates with or expecting a 1st, 2(i), or equivalent degree. They include the following

Closing date 3rd February 2014. Studentships will start in September 2014

Primary Supervisors: Prof Ian Chetter, Email: ian.chetter@hyms.ac.uk
Co Supervisors: Mr Paul Renwick, Mr Carradice

Summary:
Intermittent claudication affects 5-10% of population over 65 years. Evidence supports a supervised exercise programme (SEP) as a clinically and cost effective treatment. However, the mechanisms by which these benefits are achieved remain unclear. This project aims to investigate the mechanism by which SEP improves outcome in claudication.

Potential contributory factors include:

• Muscle fibre morphology; endurance increases proportion of slow type I aerobic fibres to fast type II anaerobic fibres and cell hypertrophy
• Cardiorespiratory physiology; The VO2 at the point of change from aerobic to anaerobic metabolism is termed the Ventilatory Anaerobic Threshold (VAT), and is an index used to estimate exercise capacity. Endurance training increases VO2 max and raises VAT
• Endothelial function; patients with IC have significant endothelial dysfunction. Exercise training augments nitric oxide dependant endothelial flow mediated vasodilatation.
• Thrombogenesis; moderate exercise (50-74% VO2max), suppresses platelet reactivity and enhances fibrinolysis.
• Angiogenesis; the development of collateral arterioles would appear angiographically to be an important mechanism by which exercise improves functional ability in IC.

Patients with intermittent claudication listed for surgical revascularisation will be randomised to a 4-week preoperative supervised exercise programme (SEP group) or usual care (control). Assessments will be performed at baseline, immediately preoperative and at 3, 6, and 12 months post revascularisation. The following outcomes will be measured:

a) Clinical indicators of lower limb ischaemia.

b) Quality of life (Disease specific – VascuQol & Generic – SF36 & EQ5D)

c) Cardiopulmonary exercise testing – FEV1 & FVC; VO2 max & anaerobic threshold

d) Endothelial function – flow mediated vasodilatation

e) Intraoperative muscle biopsy- to assess  architectural (fibre type, capillary density) and biochemical (mitochondrial density & activity)

f)  Markers of angiogenesis- VEGF, TGF beta1, VCAM, Endothelial Progenitor cells.

g) Thrombogenesis – platelet activation, fibrinogen, vWF, tPA.

To apply click on the ‘Apply’ button below.

To make an application you should apply for a PhD through the HYMS online application system before the deadline. Further information on the application and selection process can be found on the HYMS Current Opportunities webpage.

A full-time UK/EU PhD Scholarship will include fees at the ‘home/EU’ student rate and maintenance (£13,726 in 2014/15, subject to final confirmation) for three years, depending on satisfactory progress. Full-time International Fee PhD Studentships will include full fees at the International student rate for three years, dependant on satisfactory progress, but no living expenses.

PhD students at HYMS have access to PGTS modules at the Universities of Hull and York for research modules and transferable skills development and gain a Masters level Certificate, or Diploma, in Research Training, in addition to their research degree.