2013: Adam Lewandowski

I was born and raised in Ottawa, Canada and completed my undergraduate degree in Biological Sciences at the University of Guelph. In the final year of my undergraduate, I was awarded a Commonwealth Scholarship to fund my doctoral studies in Cardiovascular Medicine at the University of Oxford. My curiosity for medical sciences had developed as a result of pursuing science courses and medically related extracurricular activities throughout high school and my undergraduate degree. This included volunteer work with vulnerable populations and in hospitals, as well as basic science research related to stroke and coronary artery disease. I realised how much I enjoyed the challenge of trying to fill knowledge gaps in medical science and developed an understanding of the importance of research to advance clinical practice. My specific interest in cardiovascular research was borne out of some of my own family members suffering from cardiovascular related diseases. Ultimately, this is what led me to pursue a Doctor of Philosophy degree in Cardiovascular Medicine under the supervision of Professor Paul Leeson.

My DPhil research focused on the long-term cardiovascular impact of being born preterm. Advancements in clinical care have led to a growing cohort of preterm-born individuals now entering adulthood. Before birth, such adults were often exposed to a suboptimal intrauterine environment, and after delivery, key developmental stages that would normally occur in utero during the third trimester of pregnancy had to take place under ex utero physiological conditions. Through detailed cardiovascular phenotyping, I investigated the cardiovascular changes in preterm-born young adults, utilising a cohort of individuals with data collection since recruitment at birth. The detailed perinatal information was first used to design nested case-control studies to investigate the effects of early lipid and glucocorticoid exposure on long-term cardiovascular physiology in individuals born preterm. It was demonstrated that intravenous lipid administration leads to an artificial elevation of total cholesterol levels in immediate postnatal life, which is associated with long-term changes in aortic and left ventricular function proportional to the degree of cholesterol elevation. Additionally, exposure to antenatal glucocorticoids relates to a regional increase in aortic arch stiffness in young adulthood, as well as changes in glucose metabolism. It was then shown that young adults born preterm have increased left ventricular mass, out of proportion to blood pressure, and a unique three-dimensional left ventricular geometry, with reduced systolic and diastolic function compared to term-born controls. Similarly, they also show distinct differences in the right ventricle, with increased right ventricular mass and a proportion having clinically impaired right ventricular systolic function. Finally, it was demonstrated that preterm-born individuals have increased circulating levels of antiangiogenic factors in young adulthood, which relate to capillary rarefaction and blood pressure elevation. These findings are of considerable public health relevance given that nearly 10% of births are now preterm.

My current postdoctoral research position in the Oxford Cardiovascular Clinical Research Facility (CCRF) will allow me to build on the findings from my DPhil. In particular, our group aims to further characterise pathways leading to cardiac changes in preterm-born individuals and to better understand physiological responses to stress in these individuals. This work will be funded by a recently awarded British Heart Foundation Project Grant (PI: Professor Paul Leeson; Co-applicants: Dr Adam Lewandowski, Professor Stefan Neubauer, Dr Kenny McCormick). Understanding whether modification of these variations in cardiovascular structure and function prevent the development of cardiovascular disease in this growing subgroup of the population will be of future interest.

Following the completion of my postdoctoral research training at Oxford, I plan to go to medical school. My focus is to pursue a career in medicine that would allow me to work clinically to help individuals on a daily basis while doing research to advance our clinical knowledge. I therefore aim to contribute to a variety of aspects in the prevention, diagnosis, and treatment of disease.

The incredibly stimulating academic environment, vibrant international student community and immense cultural diversity made it easy to fall in love with Oxford. In addition to the many skills I have developed throughout my clinical research training, I have made a number of life-long friends during my time at Oxford and was able to get very involved in student life and volunteer projects in the community. In addition, I had the opportunity to compete in three Oxford vs Cambridge Varsity Athletics matches for the 800m and earned a Full Blue. These have been some of the best years of my life, and I will always be thankful for being given the opportunity to study at Oxford.