Cardiorespiratory Research Group

The Cardiorespiratory Research Group is formed by researchers in the Department of Biological and Medical Sciences and the Department of Applied Health and Professional Development, and is headed by Dr Shakeeb Moosavi and Dr Helen Walthall. Our work is aimed at understanding cardiorespiratory mechanisms and sensations, both in clinical populations and in healthy individuals. Particular areas of interest include dyspnoea, fatigue, subjective symptom experience and assessment of care. We use both qualitative and quantitative research, including neuroimaging to assess brain mechanisms associated with symptom perception and cardiorespiratory modulation. Our research spans several clinical populations, such as stroke, glioma and chronic heart failure patients.

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(Students interested in working with the group towards a degree or for short-term projects are encouraged to contact us: This e-mail address is being protected from spambots. You need JavaScript enabled to view it )

Areas of Interest

Dyspnoea

Clinical dyspnoea is the cardinal symptom of cardiopulmonary disease but is also a feature of other conditions, accounting for ≈50% of the symptom burden among hospitalized patients. Half of patients with advanced cancer experience intense dyspnoea and patients with psychiatric morbidity (e.g. panic disorder) suffer ‘exaggerated’ dyspnoea. The symptom can be unyielding, even when the underlying disease is optimally managed, thus degrading the patient’s quality of life, undermining their will to live and making them frightened to engage in even basic daily activity. Despite its prevalence and clinical impact, we do not have effective and safe options to relieve dyspnoea when the underlying disease can’t be cured.

Since the late 1980s, progress has been made in (i) understanding the neuro-physiological mechanisms of dyspnoea, (ii) improving reliability, specificity and sensitivity of dyspnoea measurement tools and (iii) developing and validating experimental models of clinical dyspnoea that can be used to systematically induce specific forms of dyspnoea in healthy volunteers. Given this progress we are better equipped to design hypothesis-driven experiments in healthy volunteers with the aim of identifying new pharmacological targets for relief of intractable dyspnoea, paving the way to translational phase II and III clinical trials.

Chronic Heart Failure

Chronic heart failure is becoming more prevalent within the population. Many people are living with this complex syndrome for longer, primarily due to an increased evidence base in the medical management of the syndrome. However, many symptoms are subjective and not easily measured by health professionals, which can lead to the patients having a heavy burden of symptomology with no relief. The two main symptoms experienced by patients with chronic heart failure are fatigue and breathlessness. The pathophysiology of either of these symptoms is not fully understood, yet interventions are aimed at improving the burden these symptoms place on the patient. A key element to this is to understand the symptoms from a patient’s perspective and to understand how any intervention impacts on the symptoms for the person experiencing them.

More recently, it has become apparent that most of the evidence base and so focus of research is on the patient group who have been diagnosed with left ventricular dysfunction (HF-rEF). However, as much as 50% of patient group diagnosed with heart failure have a preserved let ventricle and are diagnosed with HF-pEF. Research on this group is essential to understand the progression of the disease. Furthermore, the disease trajectory of chronic heart failure is end of life. Yet evidence suggests that patients with chronic heart failure do not experience the desired pathway of care at this end of the disease pathway and collaborative working of relevant clinical specialities is required to ensure the patient’s wishes are both known and followed through.

 

Group members

Dr Shakeeb Moosavi - Joint Research Group Leader

Dr Helen Walthall - Joint Research Group Leader

Dr Mari Herigstad - Early Career Research Fellow

Mr. David Garner – Research Associate (Biodynamical systems)

Mr Emmanuel Debrah - PhD Student

Mrs Sue Schutz – Senior Lecturer; research interests: nursing and end of life care

Dr. Joanna Grogono – Clinical Research Fellow

 

Current projects

Chronic Heart Failure

  • Development of a Patient Reported Outcome Measure for Fatigue and Breathlessness for patients with Chronic Heart Failure.
  • Evaluation of a cardiac rehabilitation programme in a hospice for patients at the end of life with chronic heart failure
  • An exploration of the influences on Heart Failure specialist nurses in raising end of life care concerns with Chronic Heart failure patients

 

Clinical and experimental dyspnoea

  • Dyspnoea perception in stroke and glioma patients
  • Local field potentials recorded from implanted brain electrodes in patients during induced breathlessness
  • Effect of deep brain stimulation on breathlessness perception
  • Inhaled frusemide for dyspnoea relief in advanced heart failure
  • Does the unpleasantness of breathlessness perception involve a ‘Peak-end’ bias?
  • Air hunger perception in a man with loss of large fibre sensory afferent input from the chest wall

 

Biodynamical Systems

  • Measuring and locating zones of chaos and irregularity in biological signals
  • Detection of diabetes mellitus by relation of chaotic globals to heart rate variability
  • Chaotic global parameters correlation with heart rate variability in obese children

 

Brain imaging studies

  • The effect of low-level carbon monoxide on brain function
  • Testing baroreflex function within the MRI environment

 

Selected publications

Binks AP, Evans KC, Reed JD, Moosavi SH, Banzett RB "The time-course of cortico-limbic neural responses to air hunger." Respir Physiol Neurobiol 2014, 204: 78-85.

Boskabady MH, Neamati A, Hazrati SM, Khakzad MR, Moosavi SH, Gholamnezhad, Z. “The preventive effect of natural adjuvants, G2 and G2F on tracheal responsiveness, serum IL4 and IFNγ (Th1/Th2 balance) of sensitized guinea-pigs”. CLINICS 2014;69(7):491-496

Pickering EE, Semple SJ, Nazir MS, Murphy K, Snow TM, Cummin AR, Moosavi SH, Guz A, Holdcroft A. “Cannabinoid effects on ventilation and breathlessness: A Pilot study of efficacy and safety” Chronic Respiratory Disease 2011, 8:109-118

Yorke J, Moosavi SH, Shuldham C, Jones PW “Quantification of dyspnoea using descriptors: Dyspnoea-12” Thorax 2010 65:21-26

Booth S, Bausewein C, Higginson I, Moosavi SH Pharmacological treatment of refractory breathlessness Exp Rev of Respir Med 2009 3:21-36

Booth S, Moosavi SH, Higginson IJ. The etiology and management of intractable breathlessness in patients with advanced cancer: a systematic review of pharmacological therapy Nature Clinical Practice Oncology, 2008 5:90-100

Moosavi SH, Binks AP, Lansing RW, Topulos GP, Banzett RB, Schwartzstein RM. Effect of inhaled furosemide on air hunger induced in healthy individuals. . Respir Physiol Neurobiol 2007, 156:1-8

Moosavi SH, Banzett RB, Butler JP. Time course of air hunger mirrors the biphasic ventilatory response to hypoxia. J Appl Physiol 2004, 97:2098-103

Moosavi SH, Golestanian E, Binks AP, Lansing RW, Brown R, Banzett RB. Hypoxic and hypercapnic drives to breathe generate equivalent levels of air hunger in humans. J Appl Physiol 2003; 94:141.

Lansing RW, Moosavi SH, Banzett RB. Measurement of dyspnea: word labeled visual analog scale vs. verbal ordinal scale. Respir Physiol Neurobiol 2003; 134:77-83.

Moosavi SH, Guz A, Adams L. Repeated exercise paired with "imperceptible" dead space loading does not alter VE of subsequent exercise in humans. J Appl Physiol 2002; 92:1159-68.

Binks AP, Moosavi SH, Banzett RB, Schwartzstein RM. "Tightness" sensation of asthma does not arise from the work of breathing. Am J Respir Crit Care Med 2002; 165:78-82.

Banzett R.B. and S.H. Moosavi. Dyspnea and pain: similarities and contrasts between two very unpleasant sensations American Pain Society Bulletin 2001, 11(2); 1

Moosavi SH, Topulos GP, Hafer A, et al. Acute partial paralysis alters perceptions of air hunger, work and effort at constant P(CO(2)) and V(E). Respir Physiol 2000; 122:45-60.

Banzett RB, Garcia RT, Moosavi SH. Simple contrivance "clamps" end-tidal PCO(2) and PO(2) despite rapid changes in ventilation. J Appl Physiol 2000; 88:1597-600.

Morrell MJ, Heywood P, Moosavi SH, Guz A, Stevens J. Unilateral focal lesions in the rostrolateral medulla influence chemosensitivity and breathing measured during wakefulness, sleep, and exercise. J Neurol Neurosurg Psychiat. 1999. 67:637-45.

Moosavi SH, Ellaway PH, Catley M, Stokes MJ, Haque N. Corticospinal function in severe brain injury assessed using magnetic stimulation of the motor cortex in man. J Neurol Sci 1999; 164:179-86.

Wuyam B, Moosavi SH, Decety J, Adams L, Lansing RW, Guz A. Imagination of dynamic exercise produced ventilatory responses which were more apparent in competitive sportsmen. J Physiol 1995; 482:713-24

CONTACT US

Cardiorespiratory Research Group
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
@cardresp

Dr Helen Walthall
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+44 (0)1865 482603

Dr Shakeeb Moosavi
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+44 (0)1865 483257

A part of the Department of Biological and Medical Sciences and the Department of Applied Health and Professional Development