Category: Research

Your generosity empowers young researchers like Dr Penny to lead the way in transforming cardiovascular medicine. She began her journey with the Excellence in Scholarship, Enterprise and Leadership (EXSEL) programme.

Each year, Heart Research UK funds two of these scholarships at the University of Leeds, giving students the opportunity to conduct medical research with specialists in cardiovascular medicine.

Heart Research UK has funded the scheme since it was established, helping build future pioneers in the field. This experience allowed Dr Penny to train alongside world-renowned experts and develop the skills that now drive her career.

In this interview, Dr Penny Sucharitkul shares what inspires her to push the boundaries of patient care, striving to make a lasting difference in the lives of those who need it most.

What do you do now, and where did your journey with the EXSEL programme begin?

“I graduated as a doctor from the University of Leeds in 2023 and moved to Bristol for my first job. I’m currently an academic foundation doctor at Southmead Hospital, working on the foundation programme. I’m fortunate to be on the academic track, thanks to Heart Research UK. This path offers protected time for research and study, allowing me to attend conferences and focus on my academic interests.”

“I joined the EXSEL programme to pursue vascular research, particularly in relation to cardiovascular outcomes. For my first project, I studied patients with peripheral arterial disease, those who experience pain in their legs due to poor blood flow. I looked at their cardiovascular outcomes following surgery and had the opportunity to present my findings at a conference, where I won a national prize. Since then, I’ve continued attending the Vascular Society’s Annual Scientific meeting every year.”

How has the EXSEL programme impacted your career and research journey?

“Without the EXSEL programme, I think I would have been working as a healthcare assistant throughout medical school, with no time for extracurricular activities or research. Through EXSEL, I had the opportunity to integrate to a Master of Research, where I took a year out of medicine to study peripheral arterial disease in detail. It was an incredible year, allowing me to research deep into the cardiovascular outcomes related to statin medication, cholesterol, and other influencing factors.

“That first project really set things in motion. I began taking on more research projects, which led to more publications and presentations. My work has primarily focused on improving the overall health of vascular patients to reduce their risks and enhance treatment outcomes, which has been really interesting. It snowballed into an early academic career, and eventually, that’s how I secured my academic job here in Bristol, where I’m now supported by the vascular surgeons. It’s worked out really well.”

What was the highlight of your experience with the EXSEL programme?

“In my fourth year, I did a project that looked at how much vascular teaching medical students in the UK received. The results were concerning, many students had no vascular placement and were unaware that vascular disease is often undertreated. They didn’t know that vascular patients, who are commonly thought to only face amputations, are actually at a much higher risk of heart attacks. This gap in knowledge likely means that many GPs and other doctors aren’t prescribing the medical therapies that these patients need.

“The project was a great learning experience for me, and I had the opportunity to present it at the same conference I’ve been attending every year since EXSEL. This time, it was a bigger moment for me because it was my own project. EXSEL allowed me to develop the idea, write the protocol, and select my team of supervisors. It was my first lead author paper, and I was proud to win another national award for it. The paper was later accepted by the Royal College of Surgeons of England Annals, so now a lot of surgeons will read it and understand the gap in how vascular surgery is taught. This was a huge milestone in my career, and it wouldn’t have been possible without the skills and support I gained through EXSEL.”

Why is it important for charities like Heart Research UK to continue to fund EXSEL scholarships?

“I come from a disadvantaged background. My parents didn’t go to university, and I wasn’t raised in an academic family. I came into research with no real understanding of what was expected or what the standard was. EXSEL provided me with mentors who, in many ways, were like parental figures who encouraged me to set a higher standard for myself than I would’ve ever imagined. EXSEL kept pushing me to grow and put that emphasis on me that I could reach that ceiling if I wanted it. And then I just went for it and realised that it’s not as hard as it’s made out to be.

“I really believe EXSEL should continue to provide funding for opportunities like this. There are so many talented students and only a few places. We need more people coming into academia, advancing medicine for the benefit of patients. It’s also important to encourage people from disadvantaged backgrounds to get involved in research and medicine. Having that perspective matters. For example, I do think of the social challenges patients face, whether it’s how someone manages their medication or the financial pressures they face, like not being able to afford prescriptions. I think my background gives me insights that others may not have, and we need that diversity in medicine and research to make sure we’re addressing all aspects of patient care.”

By supporting initiatives like the EXSEL programme, you’re helping researchers like Dr. Penny break new ground in cardiovascular medicine. Your generosity is nurturing the next generation of researchers and equipping them with cutting-edge skills and resources.

By Ebba Ritzen

Aortic dissection is a rare but life-threatening condition where there is a tear in the inner wall of the aorta, the main artery in the body that carries blood from the heart to the rest of the body. A research project at the University of Dundee has now been awarded a £200,000 grant by Heart Research UK, to develop a faster test for better diagnosing the condition and hopefully save more lives.More people die in the UK of aortic dissection every year than in road accidents. The condition has a survival rate of less than 50%, often thought to be due to missed or delayed diagnosis when people arrive in hospital.

Dissection is often caused by an underlying aortic aneurysm, a swelling or bulging of the aorta. These often have no symptoms up to the point of dissection. This is why it is important that we improve the diagnosis of acute aortic dissection, as well as improve how we measure the risk of dissection for those with a known aortic aneurysm.

Dr Huang and the project he leads are trying to do just that. Previous research has discovered a substance called desmosine that, when present in the blood, indicates damage to the aorta. The levels of desmosine in the blood can also accurately predict the severity of an aortic aneurysm and the risk of it dissecting.

This has led to the possibility that desmosine can be used to diagnose and predict risk of dissection, but unfortunately the process for measuring the desmosine levels takes too long for it to be useful in an emergency.

Dr Huang’s project aims to shorten the analysis time so that desmosine can be used in emergency situations and hopefully improve the numbers of people who survive aortic dissection.

Dr Jeffrey Huang said:

“Quicker diagnoses of aortic dissection could change the game in emergency situations, which would be a turning point in improving survival and long-term outcomes for these patients. The discovery of desmosine also has significant potential in informing us about the risk of dissection in aortic aneurysms, which would help patients to make informed decisions about their own care.”

Kate Bratt-Farrar, Chief Executive at Heart Research UK, said:

“We’re pleased to be awarding one of our Novel and Emerging Technologies grants to Dr Huang and his team. The number of people dying from aortic dissection is devastating and a quicker and better way of diagnosing the condition would save lives.”

By Ebba Ritzen

Swelling or bulging of the body’s main blood vessel can lead to dissection or rupture, which is often fatal. New research at Imperial College London will use artificial intelligence (AI) to analyse which aneurysms are most likely to rupture, which could lead to better monitoring and save more lives. The research project has received a Novel and Emerging Technologies Grant of £220,000 from Heart Research UK. The aorta is the main blood vessel in the body and a thoracic aortic aneurysm (TAA) is a swelling or bulging of the aorta in the chest. Although a TAA can remain stable in the body for years, once it grows beyond a certain point there’s a risk of an aortic dissection or rupture. Both these events can be fatal.

Despite being a rare condition, aortic dissection kills more people in the UK each year than road traffic accidents. Around one third of cases of aortic dissection are misdiagnosed and 50% of people die before reaching a specialist centre. This is why it’s very important that patients with TAA are monitored closely.

If the aneurysm is small, surveillance through scans is recommended, but if it’s bigger than 5.4cm the patient is often offered surgery to replace that section of the aorta. But the decision to have surgery is difficult and involves deciding whether the benefits outweigh the risks. Also, 60% of aneurysms have been found to rupture below the size cut off point. As these acute conditions are life-threatening, improvements in surveillance are needed.

Professor O’Regan and his team will use AI technology to analyse CT scans of thoracic aortas and generate 3D images. Not only will this give more accurate measurement of aneurysms, but it will also allow clinicians to establish which section of the aorta is under the most stress. Additionally, using data from thousands of patients with TAAs, the team hopes that the AI technology will be able to predict which aneurysms are at the greatest risk of dissection or rupture.

Professor O’Regan said:

“We’re pleased to have received a grant from Heart Research UK for this research, which will have major benefits to both patients and healthcare professionals.

“For patients, it will reduce anxiety around aneurysms and allow them to make more informed decisions about surgery if the time comes. For healthcare services, it will enable more accurate and efficient analysis of scans that will greatly benefit the NHS screening and surveillance programmes, ultimately with the view to decrease the number of acute aortic events and save lives.”

Kate Bratt-Farrar, Chief Executive of Heart Research UK, said:

“This is a project that is highly deserving of one of our Novel and Emerging Technologies Grants. The project is using some of the latest and most innovative developments and ultimately aims to decrease the number of acute aortic events and save more lives.”

By Ebba Ritzen

A research project at the University of Leeds aiming to find an easier way to establish the optimum heart rate for heart failure patients with pacemakers, has received a £200,000 grant from Heart Research UK. This could reduce symptoms of heart failure and enable patients to be more physically active, which would improve their lives.Heart failure is a condition where the heart fails to pump enough blood around the body, and it’s a long-term condition that gradually gets worse over time. People with heart failure often suffer from breathlessness and fatigue, often to the point where something as simple as walking up the stairs can be an overwhelming task.

When healthy people exercise, their heart rates increase together with heart pumping power so that more blood is pumped to the muscles. In heart failure, this relationship is disrupted, meaning that above an optimal heart rate range, the heart’s pumping power actually decreases. Also, some of the medication prescribed to people with heart failure limit how fast the heart can beat, which can contribute to the breathlessness and fatigue experienced during physical activity.

Around 30% of people with heart failure will get a pacemaker implanted in the chest, which can increase the heart rate during physical activity. An ultrasound scan of the heart, called echocardiography, can be used to measure each person’s individual optimal heart rate and programme the pacemaker accordingly. However, echocardiography is a very time consuming and expensive process, and therefore it is often inaccessible.

The new research project, led by Dr John Gierula, will instead use a different monitoring device which uses blood pressure cuffs around the fingers, to establish this optimum heart rate. This procedure is very cheap compared to echocardiography and can be carried out in minutes. The researchers aim to find out if this method is a valid alternative to the original heart scan method. If it is shown to be as effective, it could be incorporated within routine practice in the NHS.Dr John Gierula

Dr John Gierula said:

‘We’re hoping this method will prove to be an accurate and cost-efficient alternative to echocardiography. Overall, the study represents a step closer to widespread personalised pacemaker programming, which has the potential to reduce symptoms and improve quality of life for patients with heart failure and pacemakers across the world.’

Kate Bratt-Farrar, Chief Executive at Heart Research UK, said:

‘We know that many patients with heart failure struggle to be physically active, even with a pacemaker implanted. That’s why we’re so pleased to give one of our Novel and Emerging Technologies Grants to Dr Gierula and his team. They are aiming to develop a new method for personalising pacemaker programming and improve these patients’ lives, which is ultimately what our research grants are all about.’

Professor Regent Lee and his team at the University of Oxford received one of our Novel and Emerging Technologies grants for their development of a method which uses artificial intelligence (AI) to generate ‘contrast enhanced’ CT scans without using contrast dye. The new technology would have a reduced risk of complications and may also have a positive impact on the sustainability of healthcare. Computerised Tomography (CT or CAT) scans are widely used in all fields of medicine and surgery. When doctors are considering treatment of a blood vessel, they need to get a detailed view of the inside of the vessel, so special dyes, called contrast agents, are injected to visualise the blood flow and find any abnormalities.

However, contrast dyes can cause complications, including allergy and kidney damage. Contrast dye injection also requires the insertion of a needle, longer scan time and additional radiation exposure.

The injection into the patient’s arm can be both uncomfortable and can result in the dye leaking out from the injection site to the tissues under the skin causing skin problems.

Reducing the use of contrast dye could have a positive impact on the environment and sustainability of healthcare. Radioactive contrast agents are a major component of pharmaceutical waste in hospital water systems. Although the long-term impact on health is yet to be defined, several European countries are actively seeking solutions to minimise wastewater contamination by radioactive contrast agents.

Professor Lee’s team has developed a method which uses AI to generate ‘contrast enhanced’ CT scans without using contrast dye. Although human eyes cannot tell the difference between blood flow and abnormalities such as blood clots, there are minute details in the scan that can be used to differentiate them. Professor Lee said:

“The use of artificial intelligence in generating CT scans without the need for contrast dyes would allow diagnosis and treatment of blood vessel conditions with a reduced risk of complications. Also, the reduced scanning time, radiation dose and lower cost would bring important benefits, not limited to the scanning of blood vessels. This method may be used for diagnosis and treatment planning for other medical conditions where contrast enhanced CT scans are required.”

Professor Derek Steele

University of Leeds

£132,190

The rhythmic beating of the heart is controlled by the co-ordinated opening and closing of ‘ion channels’ in the heart cells which allow electrically charged particles – ions – to move in and out of the cells. If this electrical activity is disrupted it can lead to abnormal rhythms, called arrhythmias, which may prevent the heart from pumping effectively and be life-threatening. The most common form of arrhythmia is ‘atrial fibrillation’ which is thought to affect more than 1.4 million people in the UK.

Cells of the body naturally produce gases including, surprisingly, carbon monoxide and hydrogen sulphide. These gases are very poisonous at high levels, but in fact have important roles in controlling normal functions of cells and organs, including the heart.

This research showed that when atrial fibrillation was induced in heart muscle cells in the lab, the amount of a particular key ion channel that controls the electrical activity of the heart was increased. Importantly, application of carbon monoxide or hydrogen sulphide was found to supress the activity of this ion channel and protect against changes in electrical activity that are linked with atrial fibrillation.

This raises the exciting possibility that atrial fibrillation could be treated by altering the levels of carbon monoxide and hydrogen sulphide within cells or using drugs which release these gases. These results are promising and further research is now needed to look at the most effective ways to control the release of the naturally produced biological gases within the body, to see whether this is an effective way to treat atrial fibrillation.

COVID-19 Research Grant

Prof Sandosh Padmanabhan, University of Glasgow

Amount: £250,000

Summary: Research has shown that people who have certain other medical problems, including high blood pressure, have a higher risk of developing severe COVID-19. This project will investigate the links between COVID-19 infection and high blood pressure which may help to improve the long-term outcomes for survivors of COVID-19.

The COVID-19 pandemic is the biggest medical challenge of recent years. COVID-19 is caused by a virus which mainly affects the lungs, but it can also affect other parts of the body including the heart and blood vessels. Research has shown that people who are older, obese, male or those who have other medical problems including high blood pressure, heart disease, diabetes, cancer, or chronic lung conditions, have a higher risk of developing severe COVID-19. High blood pressure is a major risk factor for cardiovascular disease and is very common with more than one quarter of adults in the UK affected.

The virus causing COVID-19 enters the body’s cells through a receptor called ACE2 which is found in the lungs, heart, blood vessels, kidneys, liver, and bowel. ACE2 is very important for maintaining many of the body’s important processes including blood pressure, inflammation, and wound healing. Some of the medicines used to treat high blood pressure and heart disease may change the level or function of ACE2 which could have good or bad effects during COVID-19 infection. Also, COVID-19 can cause damage to the walls of the blood vessels which makes the risk of blood clots higher and this has been seen more often in people with high blood pressure. The reasons for this are not yet known which is why we need to understand more about the links between COVID-19 and high blood pressure.

This study aims to answer whether: –

High blood pressure makes COVID-19 infection worse and if so, why.

COVID-19 infection makes high blood pressure worse and if so, why.

Monitoring and management of high blood pressure needs to be a greater priority during the pandemic.

The project will be divided into the following three parts: –

Part 1 will look at routinely collected health records for people in the West of Scotland who attended hospital or had a positive test for COVID-19 between April 2020 and April 2021. This will be compared to the records of patients who attended hospital during 2019, for another reason. The team will also extend this to look in detail at a group of people with high blood pressure who attend the Glasgow Blood Pressure Clinic.

Part 2 will study a group of people that have recovered from COVID-19 infection who will undergo blood pressure monitoring, and tests of heart and blood vessel health. These tests will be repeated after 12 and 18 months to see if there have been any changes. They will be compared to a group of people who have not had COVID-19.

Part 3 will look at markers in the blood (biomarkers) with the aim of identifying any which are linked with high blood pressure, cardiovascular disease, or death in COVID-19.

This study will give us a better understanding of the links between COVID-19 infection and high blood pressure, and help to improve the long-term outcomes for survivors of COVID-19. Also, the findings may lead to recommendations on the monitoring and management of blood pressure during the pandemic.

COVID-19 Research Grant

Prof Faisel Khan, University of Dundee

Amount: £133,693

Summary: Inflammation in the body caused by COVID-19 might be responsible for harmful effects on the blood vessels, and blood cells, called neutrophils, might be the link. This project will study whether increased activation of neutrophils contributes to development of long-term disease of the blood vessels in COVID-19 patients and whether reducing their activation with drug treatment has beneficial effects. Targeting neutrophils in this way could be a treatment option for reducing blood vessel and heart complications in patients with COVID-19.COVID-19, which is caused by the virus SARS-CoV-2, is having a devastating impact on health worldwide. The major cause of death in patients who have COVID-19 results from development of complications in the lungs. However, the harmful effect of COVID-19 is excessively high in people who have pre-existing diseases of the heart and blood vessels. Also, COVID-19 can cause ‘new’ damage to the heart and blood vessels in people who have no pre-existing disease. The lining of blood vessels, called endothelium, acts as a barrier and first point of contact for the virus that causes COVID-19. From recent research studies, there is evidence that the virus causes damage to the endothelium which in turn leads to disease of the heart and blood vessels, particularly the very small blood vessels, called microvessels.

It is thought that inflammation in the body caused by COVID-19 might be responsible for some of the harmful effects on the blood vessels. Inflammation is a protective mechanism activated by the body’s immune system to fight infection, remove harmful toxins and help in the healing process. However, inflammation can also have detrimental effects on the human body, especially when it does not resolve and becomes persistent, as in COVID-19.

Professor Khan and his team believe that abnormal activation of a type of white blood cell, called the neutrophil, that is important in the body’s immune response, might be the link between COVID-19 and damage to the blood vessels. Importantly, Professor James Chalmers and colleagues have recently shown that a new drug, called brensocatib, reduces the abnormal activation of neutrophils and improve the symptoms of patients who have bronchiectasis, a lung disease that is caused by inflammation.

The aims of the project are to explore whether: –

abnormally high activation of neutrophils, caused by inflammation, is responsible for long term damage to the endothelium and small blood vessels in COVID-19 patients.

reducing activation of neutrophils with the drug brensocatib reduces damage to the endothelium and improves the function of the blood vessels.

The team will assess the function of the small blood vessels over 12 months in 120 patients who have had COVID-19 to see if this is abnormal compared with healthy people who have not had COVID-19. They will apply small amounts of chemicals to the skin and use a laser machine, which measures blood flow in the microvessels, to assess how well the blood vessels are working. They will also take blood samples to measure the activation of neutrophils and see if high levels of activation are linked to blood vessel damage.

Also, they will use these methods in 100 patients who have been hospitalised with COVID-19, to compare the effects of the drug brensocatib against a dummy drug (placebo) on the activation of neutrophils and function of the blood vessels. These measurements will be carried out before and after 28 days of treatment.

The study will show whether increased activation of neutrophils contributes to development of long-term disease of the blood vessels in COVID-19 patients and whether reducing their activation with drug treatment has beneficial effects. Targeting neutrophils in this way could be an important treatment option for reducing blood vessel and heart complications in people who have COVID-19.

Professor Paolo Madeddu

Bristol Heart Institute

£76,054

In the UK, at least 1 in 150 babies is born with congenital heart disease which means a heart defect that develops in the womb, before a baby is born. So that these babies can survive, cardiac surgeons often have to perform complex surgery to replace and correctly position defective arteries and valves. The grafts currently used to repair hearts are made of non-living materials. This means that as the baby’s heart grows rapidly during the first years of life, the grafts do not grow and the child will need further surgery to replace the grafts.

This project developed techniques for isolating special cells from the baby’s umbilical cord, called pericytes, and growing them in the lab. Importantly, when the cells were tested, they had the properties needed to form functioning blood vessels. Also, they found that these properties were better than for other types of stem cells more often used in regenerative medicine. After isolation from the umbilical cord, the researchers were able to seed the pericytes onto grafts and found that the cells not only grew and integrated well but also produced important proteins that support the formation of small blood vessels. This is a very important result because the success of graft integration into the baby’s heart depends on a good supply of oxygen and nutrients.

These promising findings show that pericytes have the potential to be used to grow bioengineered grafts that behave like an artery and will grow with the child’s heart. The ultimate aim is for these grafts to be used by cardiac surgeons to correct heart defects in babies and reduce the need for multiple traumatic operations. The research is ongoing and the team is working on a more ambitious plan to create a synthetic blood vessel where layers of gels are seeded with pericytes and other cells from the umbilical cord. This would be a definitive solution for the correction of blood vessel defects in babies and adults.

Professor Nicolette Bishop

Loughborough University and University Hospitals of Leicester NHS Trust

£147,805

A kidney transplant can transform the life of someone with kidney failure, but these patients have a high risk of heart disease. Regular exercise is an important part of a healthy lifestyle for everyone and can lower the risk of heart disease, however, there are no exercise guidelines designed specifically for kidney transplant patients. This is because there is no research evidence about what is safe and effective, and exercise guidelines for the general population may not be appropriate.

Before the effects of exercise on heart disease risk in kidney transplant patients can be assessed, the suitability of different exercise programmes needed to be determined. This was a feasibility study that looked at the willingness of patients to take part in three different exercise programmes, and whether they successfully followed and completed the programmes.

All three exercise programmes were performed three times each week for eight weeks. Two involved different durations of alternating short bursts of high and low intensity exercise (known as High Intensity Intermittent Training, or HIIT) and the third consisted of continuous moderate intensity exercise.

This is the first study to report the feasibility of HIIT in kidney transplant patients and all 20 participants who completed the exercise programmes increased their aerobic fitness. Also, there were promising reductions in blood pressure, a leading risk factor for cardiovascular disease.

Specific criteria considered key for progressing to a larger trial were co-produced by researchers, clinicians and patients. This is very important as it provides vital information about how to maximise participation in future, larger exercise studies, thereby increasing their success so that they can provide robust, impactful data.

This takes us a step closer to having the evidence-based exercise guidance that patients and healthcare teams want and need. Also, importantly, there were no adverse events or safety issues which should reassure patients and their healthcare teams.

Professor David Firmin and Dr Andrew Scott, Royal Brompton Hospital and Imperial College London

£106,043

During a heart attack some of muscle cells of the heart may die or be damaged. This often leads to this part of the heart wall becoming thin and not contracting as well as the rest of the heart.

Doctors can look at the heart using several different scanning methods to measure the damage caused by a heart attack but one new method shows the changes in much greater detail. The new method, called diffusion tensor cardiovascular magnetic resonance (DT-CMR), could give doctors important new information on what happens to the heart after a heart attack, helping them decide on the best treatment for each patient. Without DT-CMR, this information about the heart muscle on a microscopic level is only available in a lab from pieces of muscle cut out of the heart. However, the pictures from DT-CMR have not been detailed or sharp enough so far to show the thin heart wall damaged by a heart attack.

This PhD project developed a DT-CMR method that collects data and builds up the picture over several heart beats to provide greater detail and sharpness. They made these improvements by recording pictures along spiral paths rather than the more traditional MRI way that collects pictures along a snake-like path from bottom-left to top-right. There are several down-sides to these spiral methods but Professor Firmin’s team successfully developed new ways to overcome these issues.

The team carried out studies in healthy volunteers and patients who had suffered a heart attack in the past to compare the new spiral DT-CMR method they had developed with existing ones. They showed that the new spiral method produced greater detail and sharpness, and that it revealed differences between the regions of the hearts damaged by a heart attack and other regions of the hearts.

The extra detail and sharpness that the new method gives is important as it means that researchers and doctors can study the hearts of patients with thin heart muscle, which is a feature of many heart diseases. The method may provide earlier diagnosis, new information on how diseases affect the heart and novel insights into treatments.

Professor Firmin’s team continues with their cutting-edge work on spiral DT-CMR methods and expects them to be used in the future to help doctors decide on the best treatment for each patient.

Professor Ioakim Spyridopoulos, Newcastle University

£29,980

The coronary arteries supply the heart muscle with oxygen-rich blood and a heart attack is usually caused by the blockage of a coronary artery. This starves the heart muscle of oxygen and the heart may be permanently damaged.

The death rate from heart attacks has significantly fallen over the last decade and more people are surviving heart attacks. This is partly due to advances in treatment, including coronary angioplasty and stent implantation to re-open the blocked coronary artery. However, 20 per cent of patients who undergo this procedure have a higher risk of developing heart failure in the future.

The aim of this project was to develop a blood test to identify high-risk patients using a new technology called ‘droplet digital PCR’. The technology was used to investigate whether tiny molecules, called microRNAs, may be useful as ‘biomarkers’ to predict which patients are at future high risk. Some of these microRNAs are released into the blood stream from damaged heart muscle soon after patients have undergone stent treatment to re-open a blocked coronary artery.

The research team measured blood levels of more than 2,000 microRNAs during the first three hours following stent implantation to treat a heart attack. They found two microRNAs which could predict a bad outcome following a heart attack and which therefore have the potential to act as biomarkers.

Further research in larger number of patients is now needed to assess whether these markers can predict risk and recovery after a heart attack. If successful, this may lead to a blood test to help doctors identify which patients are at higher risk of developing heart failure so that they can be closely monitored and given further treatments.

Dr Daniel Bailey, University of Bedford

£86,434

Prolonged periods of time spent being inactive and sitting (sedentary) increases the risk of heart disease even if the person is active at other times. Heart disease is one of the leading causes of death in people with spinal cord injury which may be because they are highly sedentary.

This research looked at whether breaking up prolonged periods of sedentary time with short regular bouts of activity can lower heart disease risk in people with spinal cord injury. The study measured heart disease risk markers over the course of a single day with participants either remaining sedentary or breaking up their sedentary time with two minute bouts of arm cycling exercise every 20 minutes.

The study found that breaking up sedentary time led to a reduction in blood sugar levels compared to uninterrupted sedentary time. High blood sugar levels increase the risk of heart disease so these findings suggest that this exercise regime may help reduce the risk of heart disease in people with spinal cord injury.

A large proportion of people with a spinal cord injury don’t take part in enough moderate-to-vigorous intensity exercise to benefit their health. Breaking up sedentary time may therefore be an important addition to the traditional structured exercise guidelines as it may be more achievable for people.

In the long term, these findings will help to develop new physical activity and clinical care guidelines that health professionals can use to help people with spinal cord injury lower their risk of heart disease.

Professor Manuel Mayr, King’s College London

£98,808

It is well-known that risk factors such as obesity, smoking, lack of exercise, high blood pressure, high cholesterol levels and diabetes can increase the risk of cardiovascular disease (CVD). However, assessment of these traditional risk factors fails to predict CVD in certain patients.

People tend to have a lipid blood test to help calculate their risk of developing CVD which relies on measurements of just four classes of lipid and in some CVD patients levels can be within the recommended range.

The aim of this project was to develop a ‘lipid profiling’ test that can measure a wider range of different fats and ‘lipoproteins’ in the blood to better identify people at increased risk of CVD.

The team’s work first measured more than 100 different lipid species in nearly 700 individuals and associated these measurements with CVD outcomes over a 10-year observation period. This research complemented this lipid profiling work by analysing the protein component of ‘lipoproteins’ that bind lipids and help to transport them in the blood. The findings provide evidence that the advanced techniques used by the team can reliably detect and quantify a wider range of lipids and lipoproteins, and that some of these may be promising new ‘biomarkers’ for assessing CVD risk.

Professor Mayr’s team now plans to develop the lipoprotein profiling test further. A more comprehensive test for CVD prediction than the traditional measurements of lipid classes currently used, could help with early diagnosis and prevention through lifestyle changes or medication.

Professor Ken Suzuki, William Harvey Research Institute

£88,489

Despite recent medical progress, heart attack and resulting heart failure are still major causes of death and disability in the UK. Research has shown that the heart contains cells called ‘macrophages’; these cells are usually involved in our immune system but also have an important role in repair and regeneration of the heart after a heart attack.

Using a laboratory model which mimics heart attack in humans, this project investigated the effects of a naturally-occurring messenger chemical, called Interleukin-4 (IL-4), on macrophages and the heart.

The findings show that IL-4 stimulated macrophages and was an effective treatment for heart attack. Also, the study optimised the dose and timing of the treatment, showing that IL-4 was effective when given in the early stages following heart attack and that the benefits lasted for a long while, with no side-effects being seen.

These promising results show that IL-4 has potential as a safe and effective new biological drug for the treatment of heart attack. Prof Suzuki is now planning further studies to help progress the drug towards clinical trials in the future.

Mr Steven Tsui, Royal Papworth Hospital

£249,612

Heart transplantation is by far the best treatment for people with advanced heart failure but there is a lack of suitable donor hearts. In the UK, the number of patients on the waiting list for a heart transplant has more than doubled in the last ten years.

Hearts are generally donated by people who have died from strokes or massive brain injury. However, the effects of brain death together with conventional ways of managing the donor and of retrieving the heart often result in injury to the heart. As a result, less than 30 per cent of donated hearts are accepted by doctors for transplantation.

The aim of this project was to develop techniques to limit injury to donor hearts after brain death, so that a greater proportion can be used for transplantation. The research team put together special apparatus that could be used to rest the donor heart before retrieval by supporting the circulation of the donor, as well as keeping the donor heart beating outside of the body after retrieval. Also, they showed that a new surgical technique could be safely carried out to retrieve donor hearts without having to interrupt the flow of blood and oxygen to the heart.

They then compared donor hearts managed in the conventional way with donor hearts managed with the special apparatus and new surgical technique. This showed that donor hearts appeared to beat more strongly with the new apparatus and surgical technique suggesting that there was less injury to the donor heart.

This exciting research may lead to better use of valuable donor hearts, fulfilling the wishes of more donors and their families who have generously offered organs for transplantation. Above all, it would give more patients who are dying from severe heart failure the chance of a life-saving heart transplant.