Nick Talbot - Cardiac Sciences - 'Novel non-invasive physiological phenotyping in patients with unexplained breathlessness'

Exertional breathlessness is extremely common, and is a hallmark of heart and lung disease. However, many patients experience breathlessness in the absence of known cardiorespiratory disease, or they have symptoms that are out of proportional to the known pathophysiology. This ‘unexplained breathlessness’ can be distressing and disabling for patients, and places a considerable burden on healthcare resources. Although standard clinical investigations may be normal, some patients with unexplained breathlessness display an abnormal ventilatory response during exercise, without a fall in arterial oxygen levels. The aetiology of this abnormal response is unclear, but similar findings are seen in those exercising at high altitude, in whom chemoreceptor sensitivity is increased, and in those with heart failure, in whom tissue oxygenation is reduced due to reduced tissue perfusion. Currently, our ability to detect abormal chemoreceptor sensitivity and/or tissue hypoxia is limited by the methodological approaches available. In collaboration with physical scientists, physiologists and clinicians in Oxford, we are developing technologies for novel non-invasive physiological assessments. This doctoral project will involve working within a multi-disciplinary group to continue technology development, and to test these novel approaches in cohorts of patients with unexplained breathlessness.