2003 IRISH SCIENTIST YEAR BOOK

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Dublin Institute of Technology
Matt Hussey, Pat Goodman & James Walsh
Clinical Measurement Science postgraduate research

The School of Physics at DIT is involved in joint research projects with a range of hospitals around the country. A DIT supervision team and a hospital-based colleague are directing hospital-based scientists and technologists who are registered for PGDip, MPhil or PhD degrees. Apart from the intrinsic value of the research projects in question, the idea is to provide hospital-based scientists with a means to obtain higher degrees, in the light of the new Clinical Measurement degree programme underway in DIT.

Examples of the research projects currently underway are:

� investigation of the effect of variation in surface electrode type and placement on action potentials elicited by peripheral nerve stimulation

� effects of posture on quantitative EEG (electroencephalograph) using multivariate analysis, during optimal hyperventilation activation in healthy adults

� use of transcranial Doppler ultrasound in the detection of cerebral microemboli in patients with >50% internal carotid aretery stenosis who may be at risk of stroke

� validation and clinical application of a new method for determining flow limitation (negative expired pressure - NEP) in patients with chronic obstructive airways disease

� doppler tissue imaging in pathological and physiological hearts

� toleration of auto-adjusting positive airways pressure compared to that of continuous positive airways in patients with mild to moderate obstructive sleep apnoea/hypopnoea syndrome

� uses and evaluation of acoustic pharyngometry

� muscle weakness in patients with motor neuron disease

� evaluation of the effects of new non-smoking legislation on the health of bar workers in Dublin.

As a specific detailed example of one of the above research projects, Mr Gerard King of the Cardiology Department in St James's Hospital is carrying out PhD research into the use of Tissue Doppler imaging (TDI) to differentiate between physiological and pathological hypertrophy in the heart.

Sudden death in apparently healthy athletes is a shocking and catastrophic event in sport because of its unexpectedness. Athletes who train heavily develop a thickened heart muscle (hypertrophy) as a normal response to training. Hypertrophic cardiomyopathy, an inherited disease condition, also produces abnormal thickening of heart muscle and can cause chest pain, breathlessness, palpitations or collapse. It is important to differentiate between those two forms of hypertrophy.

A sensitive technique is required to differentiate the borderline diseased heart from the athletically conditioned heart. Standard Echocardiography, the routine ultrasound scan of the heart, is unable to reliably differentiate between these groups. TDI is a new addition to Echocardiography that allows us to make measurements of how the heart muscle contracts and relaxes. It has been shown in the literature that TDI alone is sensitive at differentiating patients with increased heart muscle due to a disease process from patients with a normal heart. Indications are that these new non-invasive measurements of heart tissue movement, combined with measured time intervals between tissue and blood velocities, can detect those athletes at risk from sudden death. The main aim of this research is to determine the sensitivity of this differentiation technique and so help with the mission of the Irish Heart Foundation to help reduce the incidence of premature death in our community.

Contact: Dr James Walsh; Tel: 01-402 4928; Fax: 01-402 4928; E-mail: [email protected]