Search Results for: heart disease

Exploring new frontiers in coronary heart disease research

Dr Rasha Al-Lamee

This festive period, Three Wise Women from the Faculty of Medicine will be giving us the gift of wisdom.

Dr Rasha Al-Lamee, Clinical Reader in the National Heart & Lung Institute and Clinical Academic Interventional Cardiology Consultant at Imperial College Healthcare NHS Trust, highlights the unique strengths of the UK’s life sciences research ecosystem, from the NHS to the invaluable contributions of patients. She reflects on her groundbreaking ORBITA trials, which challenged conventional wisdom about stenting for coronary artery disease. Dr Al-Lamee also shares how these experiences have shaped her career and passion for mentoring the next generation of cardiologists.

We are fortunate in the UK to have a well-developed infrastructure for research in life sciences. Our universal healthcare system within the NHS, world-leading academic institutions, and dedicated researchers provide a unique environment for innovation. Most importantly, it is our incredible patients—who not only understand the need for research but are willing to participate—that make groundbreaking studies possible. This unique combination allows us to lead the world in delivering research that tests novel treatments, evaluates existing practices, and paves the way for guideline-changing clinical practice.

As a clinical trialist, I have been privileged to work within this exceptional ecosystem. It has allowed me to carry out work that I do not believe could have been conducted in many other places in the world. My focus has been on treatments for ‘stable’ coronary artery disease, a condition that affects around 2.3 million people in the UK and causes chest pain, breathlessness, and sometimes pain throughout the body. Treatments often include medicines or angioplasty, a procedure where stents—wire mesh tubes—are placed into arteries to open blockages. However, since its introduction, there has been ongoing debate about whether the relief patients experience is due to the procedure itself or a placebo effect.

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Bringing patients together to tackle heart disease – the Heart Hive

Many researchers study a particular disease because they have a personal connection to someone who has been affected. For researcher Dr Nicky Whiffin, it happened in reverse.

I had been researching cardiomyopathies (diseases that affect the heart muscle) for a couple of years when my mum suddenly became very ill. Even walking up the stairs was a struggle, she had to pause halfway to catch her breath. Having just been through a very tough patch at work, it was put down to stress. I remember clearly what should have been an amazing trip to Paris in March 2016 to see England’s rugby team win the six nations grand slam – instead the trip was dominated by us all worrying about my mum’s illness. (more…)

Nurturing hope: Understanding Dilated Cardiomyopathy and transforming heart failure prospects

As the leading cause of heart failure in young individuals, dilated cardiomyopathy presents a unique set of challenges and implications. It is an intrinsic heart muscle disease that is the most common reason for needing a heart transplant. The origins of this condition are diverse, spanning genetic predispositions, external triggers that subject the heart to undue stress, or often, a combination of both. Dr Brian Halliday, a Clinical Senior Lecturer and British Heart Foundation Intermediate Fellow at the National Heart and Lung Institute sheds light on this disease and how medical advancements have enabled some patients to go into remission.

Heart failure can be a devastating diagnosis. The prognosis has been shown to be worse than many of the most common cancers. The words themselves often create a sense of doom for patients.

Dilated cardiomyopathy is the most common cause of heart failure in young people and the most common reason to need a heart transplant. It is an intrinsic heart muscle problem where the heart becomes baggy and weak. It may be due to genetic susceptibility, extrinsic acquired triggers that put the heart under stress, or a combination of the two. At the National Heart and Lung Institute, we have a particular interest in dilated cardiomyopathy.

The heart of a patient with dilated cardiomyopathy
The same patient’s heart after undergoing remission

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Getting to the Heart of the Matter: Sex Differences in Cardiomyopathy

Artwork by Mengmeng Tu, MSc Science Communication student

This festive period, Three Wise Women from the Faculty of Medicine will be giving us the gift of wisdom.

Could variation in the architecture of men and women’s hearts explain why their risk of cardiomyopathy differs? Dr Paz Tayal, Clinical Senior Lecturer in Cardiology at the National Heart and Lung Institute is investigating this with the aim of improving outcomes for patients affected by this disease of the heart muscle. Dr Tayal also discusses the ‘juggle struggle’ of balancing work and family life, and the importance of truth telling in academic medicine.

As winter sets in, I start to pack away the summer dresses and bring out the woolly jumpers and sturdy boots. When I do this, I will not be going into my husband’s closet to find things that fit me, nor indeed will I be wearing his shoes.

That seems obvious right, because we are different sizes.

We don’t think twice about that, yet in medicine, we are only just beginning to realise that male and female patients might need to have tailored ways to diagnose and treat disease.

Even in health, male and female hearts are not the same. At birth, the hearts of male and female babies are about the same size. However, at puberty, male hearts have a faster period of growth compared to female hearts. Whilst this eventually settles down, throughout adult life the mismatch persists, and the female heart remains smaller.

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HIV antiretroviral therapy: Getting to the heart of the matter

The HIV landscape has completely transformed since the start of the pandemic. A HIV diagnosis in the 1980s was considered fatal, as people usually progressed to AIDS due to the lack of available treatments. 42 years later, we have an array of different drug options and as a result, people diagnosed with HIV today can now expect to have near-normal life expectancies. Here, Dr Akif Khawaja from the National Heart & Lung Institute (NHLI), highlights the impact of HIV treatment over the last 42 years and how it influences cardiovascular research today.

HIV Treatment: from AZT to U=U

At the start of the pandemic, there were no available treatments. Patients would progress to AIDS and were only offered palliative care. It wasn’t until 1987 that the first antiretroviral drug, zidovudine (AZT), was licenced for the treatment of HIV. A major challenge with HIV treatment soon became apparent, as the virus can rapidly mutate and change its genetic code to become resistant to the drug supressing its replication. This challenge was quickly seen by clinicians as their patients would start to rebound from antiretroviral monotherapy (one drug regimens) as HIV became drug resistant and was able to replicate again. The introduction of combination antiretroviral therapy in 1996 has been monumental to HIV management. A change in treatment guidelines meant that patients who would have previously been given one drug, were now given three drug combinations, each targeting different parts of the HIV life cycle. This approach meant that patients could suppress HIV replication and achieve a sustained undetectable viral load, meaning that the level of virus in their blood is so low, it can no longer be detected by diagnostic tests.

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Change of heart: will advanced therapeutics replace heart transplants?

To mark the 50th anniversary of the first UK heart transplant, Professor Sian Harding looks at the future of transplantation in this post. 

Fifty years ago, history was made at the National Heart Hospital in London with the first heart transplant performed in the UK. Half a century later, transplantation continues to the be the gold standard treatment for a failing heart. However, the growing number of people on the waiting list for a new heart, coupled with the risky and complex nature of the procedure is resulting in scientists exploring alternatives to transplantation. One of these alternatives is gene therapy. (more…)

Rare diseases: the hidden priority of scientific research

For Rare Disease Day, Professors Uta Griesenbach and Eric Alton tell us why rare diseases are the hidden priority of scientific research.

A rare disease, also known as an orphan disease, affects by definition less than five in 10,000 (or 0.05%) of the general population.

Hence the question arises: why a disease as rare as 0.05% of the population presents a good investment of research funding? We think the answer is simple and importantly the math adds up. Here are some facts, based on raredisease.org.uk: (more…)

Big hearts and giant genes: What lies at the end of the yellow brick road?

Upasana Tayal was shortlisted for the MRC Max Perutz Science Writing Competition 2017 for the following article on her research into a heartbreaking disease called dilated cardiomyopathy.

“Hearts will never be practical until they can be made unbreakable”, said the Wizard of Oz. “But I still want one”, replied the Tin Woodsman.

Your heart makes you human, makes you love, and keeps you alive. In just one year, it will beat 40 million times, without rest or time off for good behaviour. A pretty impressive piece of machinery you might agree, no wonder the Tin Man wanted one so much.

And like many things in life, he may have wished for a big heart at the end of the yellow brick road. (more…)

World Heart Day: Building new hearts at the BHF Regenerative Medicine Centre

Regenerative Medicine

On World Heart Day, Sian Harding Head of the BHF Centre of Regenerative Medicine looks at how the Centre’s cutting-edge science is working towards building new heart muscle. 

We are excited by the news that our BHF Regenerative Medicine Centre has been renewed for another four-year term from 1 October 2017! At Imperial we have been concentrating on the big challenge of producing new muscle for the damaged heart, along with our partners in the Universities of Nottingham, Glasgow, Hamburg and Westminster.

The heart has a very limited capacity to repair itself after a heart attack, or during the more insidious damage from high blood pressure, diabetes or chemotherapy. We have been looking at various kinds of stem cells to explore their power to become new cardiac muscle cells – one of the big successes of the current Centre. Pluripotent stem cells – those which have the capability of turning into any cell type in the body – can now be turned very efficiently into beating heart muscle in the laboratory dish, and made into strips of engineered heart tissue. Our partner, Professor Chris Denning, at the University of Nottingham has automated the process of making the cells and Professor Thomas Eschenhagen in Hamburg has contributed his technology for converting this into muscle. (more…)

Know your numbers – How home monitoring is redefining hypertension care

Dr Amit KauraDr Amit Kaura, Honorary Clinical Lecturer in the National Heart and Lung Institute, discusses the future of blood pressure monitoring in this blog post for ‘Know your Numbers!’ week – a campaign encouraging people to check their blood pressure.

Hypertension, or high blood pressure, is a major global health issue, affecting over 1.3 billion people. Yet, despite its prevalence, many people don’t fully understand what hypertension is, how it impacts health, and how they can manage it effectively.

Hypertension occurs when the force of blood against the walls of your arteries is consistently too high. This force, known as blood pressure, is measured in two numbers: systolic pressure, the pressure in your arteries when your heart beats, and diastolic pressure, the pressure when your heart is resting between beats. A normal blood pressure reading is considered to be around 120/80 mmHg, while readings consistently at 140/90 mmHg or higher indicate high blood pressure.

Often called the ‘silent killer,’ hypertension typically presents no symptoms until significant damage has occurred. Left unchecked, uncontrolled hypertension can lead to serious health issues, including heart disease, stroke, and kidney failure.

My journey into hypertension research is rooted in my background in data analytics in cardiovascular sciences. Hypertension, with its inherently numerical nature, fascinated me from the start. It is not just a static measurement; it is dynamic, with fluctuations that occur throughout the day and in response to various stimuli. This complexity piqued my interest and led me to explore the deeper intricacies of how we define and diagnose hypertension.

The traditional approach of diagnosing hypertension based on a single cut-off value – usually 140/90 mmHg – seemed overly simplistic to me. Through my research, I began to question whether this binary threshold truly captures the nuanced reality of hypertension. There is a wealth of data on the fluctuations and patterns of blood pressure that could offer more insight into cardiovascular risk than a one-time measurement.

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