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In the past 40 years, progress in the treatment of heart disease has been great, and many premature deaths due to heart disease have been prevented. However, heart disease has been “postponed” rather than cured, and different forms of heart disease appear as people age, leading to disability as much as death.
All research supported by Australian Heart Research utilises a translational “bench to bedside” approach, where we aim to produce benefits to patients as quickly as possible.
Researchers supported by Australian Heart Research are focused on improving and developing new therapies to tackle various conditions that affect the heart and blood vessels. Prevention and diagnosis of heart disease are also areas of interest for the research team.
Please read about some of the research projects being undertaken below.
One of the projects currently being undertaken at The Queen Elizabeth Hospital focuses on patients who have coronary heart disease. This is a disease where there is a problem in blood supply to the muscle of the heart and usually manifests as chest pain, otherwise known as angina. Cholesterol filled blockages in the coronary blood vessels are the most common cause of chest pain, however researchers have found some patients don’t have a cholesterol blockage but still suffer from chest pain.
In these patients, their chest pain is caused by spasm of the blood vessels thereby cutting off the blood supply to the heart.
Common treatments such as bypass surgery and balloon treatments are ineffective in these patients, so the team is looking at different treatment possibilities to eliminate the blood vessel spasms.
Through their investigations, researchers have discovered the importance of a type of drug called a Calcium T-channel blocker, which has been proven to be effective in treating patients whose chest pain is caused by microscopic blood vessel spasm.
The effectiveness of this drug gave researchers greater understanding and has highlighted the need to develop more of these types of drugs to effectively combat this condition. It has had a major impact on the way people around the world think in Cardiology and has shown a new way of looking at treating heart disease patients.
In another project, the Cardiology Unit at The Queen Elizabeth Hospital has identified that Nitric Oxide (NO) and structurally related compounds (nitroxyl, nitrite) play a role in protecting the heart and blood vessels. The effectiveness of NO in suppressing clot formation and thickening of the wall of the heart is diminished in many forms of heart disease. It has been found that both nitroxyl and nitrite partially circumvent this problem and might therefore be useful for the management of cardiac emergencies. Work in this area is ongoing.
The Queen Elizabeth Hospital in South Australia is internationally renowned for its research studies into the Coronary Slow Flow Phenomenon (CSFP). Patients with CSFP suffer painful recurrent chest pain, but for a long time CSFP wasn’t a formal condition and therefore patients continued suffering without diagnosis and treatment.
However, studies at TQEH demonstrated that these patients have problems with the microscopic blood vessels of the heart causing blood to flow slower through their major heart vessels, producing recurring chest pain. This characterisation meant research could advance further into investigating treatment options.
Over the past 15 years, TQEH researchers have been evaluating the effectiveness of a number of different drug therapies for CSFP. A drug called mifibradil was an outstanding therapeutic option for CSFP sufferers but unfortunately, it was withdrawn from the market because of potential adverse drug interactions; thus the search for an effective therapy continues.
In 2014 Australian Heart Research together with The Hospital Research Foundation awarded a $300,000 grant to investigate a new treatment option. The team is investigating exercise therapy as an effective treatment; an exciting new research direction in the field. Clinical trials are currently underway.
Stress (Tako-tsubo) cardiomyopathy was first described by Japanese investigators 20 years ago, but is actually a relatively common cause of chest pain in older women. Attacks are often misdiagnosed as heart attacks but are actually triggered by physical or emotional stress. Cardiology Unit researchers have found that patients who experience Tako-tsubo Cardiomyopathy have increased levels of peroxynitrite within the heart which leads to inflammation of the heart and associated impaired function. This work is ongoing.
Managing heart failure is a research interest of the Cardiology Unit at The Queen Elizabeth Hospital. When a person experiences heart failure, a hormone called B-type natriuretic peptide (BNP) is released from the heart. This hormone should theoretically restore balance to the circulation but research has found that patients with heart failure may be poorly responsive to BNP. This discovery will now allow further work in this area.
Researchers are also determining the potential for improved outcomes in heart failure by improving patients’ compliance with prescribed therapy.
Valvular heart disease affecting the aortic valve may also result in heart failure, and the research team is developing strategies for slowing progression of valvular heart disease and have provided the first human evidence that this might be possible.
Atrial Fibrillation is the most common type of arrhythmic disorder where the heart doesn’t beat normally.
In people with atrial fibrillation the upper chambers of the heart will randomly begin to contract in a chaotic and irregular rhythm. Along with causing palpitations, fainting and chest pain, patients with atrial fibrillation are at an increased risk of experiencing a life-threatening stroke. At the moment, current methods of identifying which people who suffer from atrial fibrillation are at a higher risk of stroke are based on patient symptoms rather than markers in the blood which can be tested. Research being undertaken in the Cardiology Unit at The Queen Elizabeth Hospital is looking to identify biochemical markers of stroke risk in atrial fibrillation patients and to understand how these markers contribute to stroke risk.