The BHF’s research highlights of 2020 – British Heart Foundation

18 December 2020 Lisa Jones

Category: Blog

What a year it's been for our community of researchers. Not only have they continued their life-saving research into heart and circulatory diseases, but some redirected their expertise to join the fight against coronavirus. Lets take a moment to reflect on some of the BHFs research highlights this year.

We started 2020 off with a bang as BHF researchers at the University of Bath and University of Manchester developed a smart bionic pacemaker to slow the progression of heart failure.

Theres no cure for heart failure but pacemakers are used to control the heart rate and improve the pumping action of the heart. Pacemakers dont normally listen to signals from our bodies, but our heart rate changes with every breath. It speeds up when we inhale and slows down when we exhale.

The team of researchers have built a pacemaker that reads the bodys own breathing signals and is able to restore natural fluctuations in the heart rate, rather than working at a steady rate. In rats, they found that this new technology dramatically increased the efficiency of the heart to pump blood and has the potential to revolutionise the future design of pacemakers.

BHF-funded researchers from Barts Health NHS Trust and University College London used artificial intelligence to instantly and accurately measure blood flow to the heart muscle for the first time.

They used the AI technique to analyse more than 1,000 heart scans from heart disease patients. It was able to better predict chances of adverse health outcomes including death, heart attack and stroke, compared to traditional approaches.

This research could ultimately allow doctors to offer patients with heart disease more personalised and targeted therapy to prevent a future heart attack or stroke.

Coronary heart disease is the leading cause of death worldwide and manifests when fatty deposits build up in the blood vessels supplying blood to the heart. This reduces the blood flow to the heart and leads to several problems, including angina or a life-threatening heart attack.

When a patient goes to hospital with chest pain or suspected heart attack, they will have an angiogram an X-ray to visualise the blood vessels. However, the severity and location of the blockages is not always clear. The alternative is a blood pressure wire test but very few people receive this as theyre expensive and time-consuming.

Professor Julian Gunn and his team at the University of Sheffield are developing a computer model called virtual Fractional Flow Reserve (vFFR) that calculates the pressure measurements from angiogram pictures of the blood vessels without needing the wire. The software aims to enable doctors to instantly know whether a narrowed blood vessel needs treatment or not, making interventions more accurate and reducing the number of unnecessary procedures.

When we entered 2020, little did we know that a pandemic was going to turn this year on its head. Soon after the UK went into national lockdown, some of our researchers directed their efforts to better understand Covid-19.

In April, BHF Professor Sir Rory Collins announced that hes enhancing UK Biobank data for Covid-19 research. This valuable resource will act as a goldmine to help researchers around the world understand the virus and its effects. It will help to unlock clues as to why some individuals are hit harder than others and gather comprehensive information on the course of the virus over time.

Two research teams from our Glasgow Centre for Research Excellence joined the global effort to understand how Covid-19 affects people with heart and circulatory disease.

High blood pressure is one of the most common risk factors for Covid, and BHF Professor Rhian Touyz is examining whether people with the condition develop a more severe Covid-19 infection. Her team are also testing the safety of blood pressure drugs in people with the virus, which will help doctors to best treat and manage Covid-19 patients with high blood pressure.

Professor Colin Berry is studying 160 Covid-19 patients to understand whether people recovering from the virus have persisting problems in the heart and lungs, and who is most at risk of heart damage. His work will help to guide the management of people with these long-lasting effects.

Although Covid-19 is a respiratory disease, data from the Office of National Statistics has consistently shown that heart disease is one of the most common pre-existing health conditions among those who die from Covid-19. The BHF joined forces with the National Institute of Health research (NIHR) to launch six flagship research projects to better understand why people with heart and circulatory diseases are at higher risk and often suffer more severely with the virus.

Researchers from across the UK are combining data from hospitals, information about our health and lifestyle, genetic studies, and cutting-edge imaging and artificial intelligence techniques to better understand how the virus affects our hearts and blood vessels.

BHF researcher Professor Marc Dweck at the University of Edinburgh led a study which analysed heart scans of 1,216 patients from 69 countries with Covid-19. In July he revealed his findings that over half of the Covid-19 patients who received an echocardiogram - a type of ultrasound scan used to look at the heart in real-time - in hospital showed abnormal changes to the way their heart was pumping. Around one in seven showed evidence of severe heart dysfunction likely to have a major impact on their survival and recovery from the disease.

One in three patients who received an echocardiogram had their treatment changed. The findings suggest that these scans could prove crucial for identifying patients who may benefit from additional treatments to improve their Covid-19 recovery and prevent potential long-term damage to their heart.

What do the BHF and Da Vinci have in common? Back in the 16th century Leonardo Da Vinci first drew strand-like structures in the heart, and now, BHF-funded researchers have discovered that they could hold the key to heart failure risk.

These columns of muscle fibres called trabeculae were originally thought to have no use beyond the hearts early development. However, Professor Declan O'Regan and his team discovered that they play a key role in the pumping and electrical activity of the heart and protect against heart failure.

Using AI to analyse MRI scans of the heart in over 18,000 people, they found that people with a more complex network of trabeculae had an increased ability to pump blood. This discovery could pave the way to the development of vital new treatments for heart failure, a condition which affects the lives of around 920,000 people in the UK.

A staggering 4.7 million people are living with diabetes in the UK. Adults with diabetes are two-to-three times more likely to develop heart and circulatory diseases due to the damage it causes to blood vessels.

Scientists we fund at Queen Mary University, Belfast, discovered a gene called QKI-7 - that increases the risk of blood vessel damage in people with diabetes.

Professor Andriana Margariti and her team found that the level of the gene was very high in people with heart and circulatory disease caused by diabetes. Developing a drug to switch off this gene could help people with diabetes live longer and healthier lives.

In October, we awarded 265,000 to scientists at the University of Sheffield and University of Manchester to investigate the links between vascular dementia and heart disease. The team led by Professor Sheila Francis are testing whether a drug currently used to treat arthritis could also be used as a treatment for vascular dementia by reducing inflammation in the brain.

Vascular dementia happens when theres a problem with the blood supply to an area of the brain and leads to difficulties with concentration and personality changes. At least 150,000 people are estimated to be affected by the condition, but theres sadly no cure. This research will hopefully bring us one step slower to finding a much needed treatment and provide hope for those living with vascular dementia.

Dr Gavin Richardson at Newcastle University revealed some spooky results at Halloween. His team discovered that senescent cells, also known as zombie cells, build up in the heart and prevent recovery after a heart attack. Zombie cells get their name because theyre not dead, but they dont work as they should and can stop neighbouring cells working properly.

They looked at the hearts of mice whose blood flow was restored after a heart attack. When the mice were given a drug known to kill zombie cells navitoclax they found that inflammation was reduced, scar tissue became smaller, there was an increase in the growth of blood vessels, and the hearts were able to pump blood around the body more effectively. They hope that zombie cell-killing drugs could be treating heart attack patients in the next five to ten years.

To round off the year, we awarded researchers at the University of Leicester nearly 150,000 to determine if giving dialysis to kidney failure patients overnight will reduce the damage to their heart and improve quality of life.

Dialysis - a procedure to remove waste products and excess fluid from the blood is a vital procedure for people living with heart failure. However, it can lead to scarring of the heart which can eventually lead to heart failure. Its thought that this damage is caused by needing to remove the water and waste products quickly during the standard four-hour treatment.

The NightLife trial involves 350 patients who will either have dialysis for six to eight hours whilst they sleep, three times a week, or have dialysis during the daytime as normal. The team will carry out MRI scans to determine if having dialysis for an extended period overnight reduces heart scarring.

The Covid-19 pandemic has devastated our income and the amount we have been able to invest in our vital research this year has been halved. To preserve the future of our life-saving discoveries we are standing with other medical research charities and asking the Government to protect charity-funded research at this difficult time. None of this research would be possible without your generosity. Hearts need help now more than ever and we urgently need your support.

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The BHF's research highlights of 2020 - British Heart Foundation