Accepting PhD Students

PhD projects

Evaluating the prevalence of primary aldosteronism in patients with stroke and/or atrial fibrillation Project description: Primary aldosteronism (PA) is the most common, and a potentially curable, cause of hypertension, estimated to affect 5-10% of all hypertensive patients. It leads to greater cardiovascular injury than hypertension alone. In particular, PA confers a 3 – 4 fold increase in the risk of stroke and atrial fibrillation compared to blood pressure-matched essential hypertensives. However, PA screening is not actively recommended in stroke/AF management guidelines. Given the potential health impact of diagnosing a potentially curable form of hypertension, and reducing the risk of stroke and AF, we seek to evaluate the prevalence of PA in patients presenting to Monash Health with either acute stroke or transient ischemic attack. This project has the potential to change management guidelines for hypertension in stroke patients and optimise the timely diagnosis of PA. Evaluating the cost-effectiveness of screening for PA in all vs subgroups of hypertensive patients Project description: Primary aldosteronism (PA) is the most common, and a potentially curable, cause of hypertension, estimated to affect 5-10% of all hypertensive patients. It leads to greater cardiovascular injury than hypertension alone. Studies have demonstrated the cost-effectiveness of screening patients with resistant hypertension for PA, but there are no economic modelling studies of screening newly diagnosed hypertensive patients. An early diagnosis is likely to be less complicated than in a patient with longstanding disease and offer greater benefit in reducing cardiovascular risk. However, without a formal cost analysis, hypertension screening guidelines will remain locked in the past to the detriment of our community. In this project, you will use the cost-utility analysis (CUA) approach to estimates the incremental costs and effectiveness of using ARR to screen for PA in primary care versus no screening. The within-trial analysis will be extrapolated using a Markov model, consisting of health outcomes following screening procedures versus no screening, to capture the long-term cost. The quality of life and direct medical costs will be collected from a current trial. The estimates of effect on long-run health outcomes, QOL and costs (such as cost savings of cardiovascular events averted) will be estimated from a comprehensive literature review. Sensitivity analysis will be performed to evaluate the cost-effectiveness of ARR screening in all vs subgroups of hypertensive patients. The outcomes will directly influence policy. Identification of novel transcriptomic markers of PA Project description: Whilst dichotomous thresholds are currently used to diagnose PA, emerging data supports the concept of a continuum of aldosterone excess. A longitudinal cohort study showed that higher aldosterone in the setting of a suppressed renin (392 of 850 normotensive patients) was significantly associated with the development of hypertension. A robust cellular marker of aldosterone excess that correlates strongly with clinical outcomes following MR antagonist treatment or adrenalectomy will complement the ARR and confirmatory tests in the diagnostic algorithm for PA. As peripheral blood monocytes highly express the MR, they represent an accessible MR-responsive tissue to study aldosterone-induced changes in gene transcription. A number of genes identified by previous students will be characterised in vitro using RT-PCR and cell culture to confirm a change in their expression in response to MR activation or antagonism. These may then be validated in larger patient cohorts as robust biomarkers of aldosterone excess and inappropriate MR activation. Establish a national PA registry to enable comprehensive data collection and multidisciplinary website Project description: Clinical registries play an important role in measuring healthcare delivery, supporting quality improvement and evaluating clinical outcomes, particularly in the long term. There are no PA registries in Australia. This is in contrast to other countries which lead the research in PA, including China (CONPASS PA Study Group – 3 publications in leading endocrine journals in 2018), Japan (JPAS – 6), Taiwan (TAIPAI - 8) and Germany (German Conn’s Registry – 10). Based on our existing REDCap database, we will develop a multicenter registry to systematically collect comorbidities, diagnostic parameters and long-term outcomes of patients with PA, both in and outside of clinical trials.

20022021

Research output per year

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Research Output

2020

Subtyping of Primary Aldosteronism in the AVIS-2 Study: Assessment of Selectivity and Lateralization

Rossitto, G., Amar, L., Azizi, M., Riester, A., Reincke, M., Degenhart, C., Widimsky, J., Naruse, M., Deinum, J., Schultzekool, L., Kocjan, T., Negro, A., Rossi, E., Kline, G., Tanabe, A., Satoh, F., Christian Rump, L., Vonend, O., Willenberg, H. S., Fuller, P. & 16 others, Yang, J., Chee, N. Y. N., Magill, S. B., Shafigullina, Z., Quinkler, M., Oliveras, A., Chang, C-C., Wu, V. C., Somloova, Z., Maiolino, G., Barbiero, G., Battistel, M., Lenzini, L., Quaia, E., Pessina, A. C. & Rossi, G. P., Jun 2020, In : The Journal of Clinical Endocrinology and Metabolism. 105, 6, p. 1-11 11 p.

Research output: Contribution to journalArticleResearchpeer-review

2019

Adrenal venous sampling with or without adrenocorticotropic hormone stimulation: A meta-analysis

Laurent, I., Astère, M., Zheng, F., Chen, X., Yang, J., Cheng, Q. & Li, Q., 1 Apr 2019, In : The Journal of Clinical Endocrinology and Metabolism. 104, 4, p. 1060-1068 9 p.

Research output: Contribution to journalArticleResearchpeer-review

4 Citations (Scopus)

Clinical Outcomes of 1625 Patients With Primary Aldosteronism Subtyped With Adrenal Vein Sampling

Rossi, G. P., Rossitto, G., Amar, L., Azizi, M., Riester, A., Reincke, M., Degenhart, C., Widimsky, J., Naruse, M., Deinum, J., Schultze Kool, L., Kocjan, T., Negro, A., Rossi, E., Kline, G., Tanabe, A., Satoh, F., Christian Rump, L., Vonend, O., Willenberg, H. S. & 15 others, Fuller, P. J., Yang, J., Chee, N. Y. N., Magill, S. B., Shafigullina, Z., Quinkler, M., Oliveras, A., Dun Wu, K., Wu, V. C., Kratka, Z., Barbiero, G., Battistel, M., Chang, C. C., Vanderriele, P. E. & Pessina, A. C., 1 Oct 2019, In : Hypertension. 74, 4, p. 800-808 9 p.

Research output: Contribution to journalArticleResearchpeer-review

7 Citations (Scopus)

Confirmatory tests for the diagnosis of primary aldosteronism: A systematic review and meta-analysis

Wu, S., Yang, J., Hu, J., Song, Y., He, W., Yang, S., Luo, R. & Li, Q., May 2019, In : Clinical Endocrinology. 90, 5, p. 641-648 8 p.

Research output: Contribution to journalReview ArticleResearchpeer-review

4 Citations (Scopus)

Electrocardiographic criteria for the diagnosis of abnormal hypertensive cardiac phenotypes

Jiang, X., Quan, X., Yang, J., Zhou, X., Hu, A. & Zhang, Y., 1 Mar 2019, In : Journal of Clinical Hypertension. 21, 3, p. 372-378 7 p.

Research output: Contribution to journalArticleResearchpeer-review

5 Citations (Scopus)

H-score of 11β-hydroxylase and aldosterone synthase in the histopathological diagnosis of adrenocortical tumors

Yang, Y., Xiao, M., Song, Y., Tang, Y., Luo, T., Yang, S., He, W., Cheng, Q., Ma, L., Zhang, Y., He, Y., Cao, Y., Yang, J., Peng, B., Hu, J. & Li, Q., 1 Sep 2019, In : Endocrine. 65, 3, p. 683-691 9 p.

Research output: Contribution to journalArticleResearchpeer-review

Mechanisms of Mineralocorticoid Receptor Signaling

Fuller, P. J., Yang, J. & Young, M. J., 1 Jan 2019, Vitamins and Hormones. Litwack, G. (ed.). Academic Press, p. 37-68 32 p. (Vitamins and Hormones; vol. 109).

Research output: Chapter in Book/Report/Conference proceedingChapter (Book)Otherpeer-review

2018

Current pattern of primary aldosteronism diagnosis: Delayed and complicated

Lim, Y. Y., Shen, J., Fuller, P. J. & Yang, J., 1 Oct 2018, In : Australian Journal of General Practice. 47, 10, p. 712-718 7 p.

Research output: Contribution to journalArticleResearchpeer-review

Open Access

Saline suppression test parameters may predict bilateral subtypes of primary aldosteronism

Hashimura, H., Shen, J., Fuller, P. J., Chee, N. Y. N., Doery, J. C. G., Chong, W., Choy, K. W., Gwini, S. M. & Yang, J., 1 Sep 2018, In : Clinical Endocrinology. 89, 3, p. 308-313 6 p.

Research output: Contribution to journalArticleResearchpeer-review

4 Citations (Scopus)

Setting up a primary aldosteronism program: an Australian experience

Yang, J. & Funder, J. W., Jun 2018, In : Chinese Journal of Endocrinology and Metabolism. 34, 6, p. 451-459 9 p.

Research output: Contribution to journalArticleResearchpeer-review

2017

Coregulators as mediators of mineralocorticoid receptor signalling diversity

Fuller, P. J., Yang, J. & Young, M. J., 1 Jul 2017, In : Journal of Endocrinology. 234, 1, p. T23-T34 12 p.

Research output: Contribution to journalReview ArticleResearchpeer-review

17 Citations (Scopus)

Diagnosing endocrine hypertension: a practical approach

Yang, J., Shen, J. & Fuller, P. J., 1 Sep 2017, In : Nephrology. 22, 9, p. 663-677 15 p.

Research output: Contribution to journalReview ArticleOtherpeer-review

3 Citations (Scopus)
2016

Mineralocorticoid receptor antagonists - pharmacodynamics and pharmacokinetic differences

Yang, J. & Young, M. J., 1 Apr 2016, In : Current Opinion in Pharmacology. 27, p. 78-85 8 p.

Research output: Contribution to journalReview ArticleResearchpeer-review

11 Citations (Scopus)
2015

Clinical management of hyperaldosteronism

Wang, J. & Fuller, P. J., 1 Jan 2015, Adrenal Glands: From Pathophysiology to Clinical Evidence: From Pathophysiology to Clinical Evidence. Santulli, G. (ed.). New York NY USA: Nova Science Publishers, p. 115-142 28 p.

Research output: Chapter in Book/Report/Conference proceedingChapter (Book)Other

Corticosterpoid receptors

Fuller, P. J., Yang, J. & Young, M. J., 2015, Nuclear Receptors : From Structure to the Clinic. McEwan, I. J. & Kumar, R. (eds.). 1st ed. Cham Switzerland: Springer, p. 17-39 23 p.

Research output: Chapter in Book/Report/Conference proceedingChapter (Book)Otherpeer-review

GEMIN4 functions as a coregulator of the mineralocorticoid receptor

Yang, J., Fuller, P. J., Morgan, J., Shibata, H., Clyne, C. & Young, M. J., 2015, In : Journal of Molecular Endocrinology. 54, 2, p. 149 - 160 12 p.

Research output: Contribution to journalArticleResearchpeer-review

7 Citations (Scopus)

Role of adrenal vein sampling in primary aldosteronism: the Monash Health experience

Teng, J., Hutchinson, M. E., Doery, J. C. G., Choy, K-W., Chong, W., Fuller, P. J. & Yang, J., 2015, In : Internal Medicine Journal. 45, 11, p. 1141 - 1146 6 p.

Research output: Contribution to journalArticleResearchpeer-review

6 Citations (Scopus)
2014

Use of phage display to identify novel mineralocorticoid receptor-interacting proteins

Yang, J., Fuller, P. J., Morgan, J., Shibata, H., McDonnell, D. P., Clyne, C. & Young, M. J., 2014, In : Molecular Endocrinology. 28, 9, p. 1571 - 1584 14 p.

Research output: Contribution to journalArticleResearchpeer-review

15 Citations (Scopus)
2012

Interactions of the mineralocorticoid receptor--within and without

Yang, J. & Fuller, P. J., 2012, In : Molecular and Cellular Endocrinology. 350, 2, p. 196 - 205 10 p.

Research output: Contribution to journalArticleResearchpeer-review

34 Citations (Scopus)

Mechanisms of ligand specificity of the mineralocorticoid receptor

Fuller, P. J., Yao, Y-Z., Yang, J. & Young, M. J., 2012, In : Journal of Endocrinology. 213, 1, p. 15 - 24 10 p.

Research output: Contribution to journalArticleResearchpeer-review

46 Citations (Scopus)
2011

Identification of ligand-selective peptide antagonists of the mineralocorticoid receptor using phage display

Yang, J., Chang, C., Safi, R., Morgan, J., McDonnell, D., Fuller, P., Clyne, C. & Young, M., 2011, In : Molecular Endocrinology. 25, 1, p. 32 - 43 12 p.

Research output: Contribution to journalArticleResearchpeer-review

34 Citations (Scopus)
2009

The mineralocorticoid receptor and its coregulators

Yang, J. & Young, M. J., 2009, In : Journal of Molecular Endocrinology. 43, 2, p. 53-64 12 p.

Research output: Contribution to journalReview ArticleResearchpeer-review

66 Citations (Scopus)
2002

Pain Control in Outpatient Hysteroscopy

Yang, J. & Vollenhoven, B. J., 2002, In : Obstetrical and Gynecological Survey. 57, 10, p. 693 - 701 9 p.

Research output: Contribution to journalArticleResearchpeer-review

54 Citations (Scopus)