Leeson Group: Preventive Cardiology Research Group

paul.leeson@cardiov.ox.ac.uk

Our aim is to develop better ways to identify early cardiovascular disease and improve long-term heart, vascular and brain health across the life course. This is achieved by undertaking work in three areas: (1) Identifying early markers and mechanisms of cardiovascular disease using advanced imaging and deeply characterised cohorts. (2) Conducting prevention-focused studies to understand how early cardiovascular changes can be modified to improve future health. (3) Applying artificial intelligence to imaging and clinical data to develop next-generation tools for early detection, risk assessment and disease monitoring.

Preventive Cardiology

Based in the Cardiovascular Clinical Research Facilty, we conduct clinical studies that utilise multimodality imaging (including echocardiography, magnetic resonance and microvascular imaging) to identify the unique differences in cardiac, vascular and cerebrovascular systems that predispose individuals to cardiovascular disease.

HyPrevent, a platform facilitated by the MRC, helps us understand how hypertension during pregnancy affects the heart, brain and blood vessels throughout the life of women, as well as the children born after such a pregnancy.

The HyPrevent cohort is a deeply phenotyped longitudinal dataset and biobank designed to advance understanding of hypertension-related organ damage across the life course, including more than 3600 participants. Available modalities include blood samples, blood pressure measurements, electrocardiography, echocardiography, and multimodal MRI of the heart, brain, kidney, and liver. We have developed a computational framework that characterises multi-organ damage in hypertension by introducing a unified global organ-damage risk score (HyperScore) and identifies distinct organ-specific disease progression pathways (HyperTrajectories). Each HyperTrajectory is associated with different clinical outcomes, including mortality and advanced damage in the heart, brain, and vascular system.

Our work forms an integral component of the NIHR Oxford BRC Cardiovascular Theme and we co-lead the Oxford Cardiovascular Disease and Pregnancy Research Collaborative (CDPRC), a cross-disciplinary network spanning basic science, imaging, clinical research, and global health. The collaborative focuses on understanding how cardiovascular conditions arising in pregnancy relate to long-term heart and vascular disease, with the goal of informing better prevention and management across the life course. In addition, we run a clinical postnatal hypertension service in the OUH Trust. In combination with supplementary BRC funding, the service is also recruiting to our FLOWER study, which is exploring cardiovascular health after a new diagnosis of a range of cardiovascular conditions in pregnancy.

Patient and Public Involvement & Engagement (PPIE) is integral to our cardiovascular research. By involving individuals with lived experience and members of the public who have an interest in shaping research, we gain valuable insight into what matters to those affected and the practical challenges of participating in research.

We work closely with the Lapidaire Group, which specialises in brain health and microvascular imaging, to understand how early-life and pregnancy-related cardiovascular factors influence long-term brain and vascular outcomes.

Echocardiography Data Resources

EchoVision

The EchoVision dataset contains all clinical reports from routine transthoracic echocardiograms performed across the Oxford University Hospitals NHS Foundation Trust from 2017 to present. These reports contain all analysis measurements from each echocardiogram in addition to details of the patient history, referral reason, and conclusions following each scan. The dataset currently holds over 140,000 clinical reports and has been linked to patient comorbidity data, hospital admission details, and laboratory tests. The dataset is continuously expanding within Oxford as well as external hospitals. This work is a key area of focus within the NIHR Oxford BRC Imaging Theme.

EVAREST

The EVAREST study was conducted from 2015-2023 and recruited over 18,000 patients who underwent a stress echocardiogram to identify coronary artery disease and other cardiac conditions. The dataset contains patient demographics, comorbidities, and in-depth details of each stress echocardiogram procedure. Stress echocardiogram images are available for around 6,000 patients. Additionally, for a subset of patients, there is long-term follow up data available which has been extracted from NHS England (formerly NHS Digital).