The Pioneering Body Right to the Heart of Committed to Getting Biggest Killer in Wales; the UK's First Purpose-Built Heart Research Institute Celebrates Its 10th Anniversary Today. Health Editor Madeleine Brindley Spoke to Some of the Researchers at the Cutting Edge of This Complex Science
Byline: Madeleine Brindley
EVERY day 30 people in Wales die as a result of heart or circulatory disease and almost a quarter-of-a-million people are living with a heart condition.
Heart disease remains Wales' biggest killer, but the nation's only dedicated research institute is not simply looking for "the cure".
Unlike other diseases, there is no easy answer about what causes heart disease - in some cases it may be genetic, in others it may be caused by age or by a specific defect; it may be related to another underlying condition, it could be the result of general wear and tear or by the way we live our lives.
For the last 10 years the Sir Geraint Evans Wales Heart Research Institute at Cardiff University has, among other things, been going back to basics to gain a better understanding of the heart and the mechanisms that make it work.
Research at the institute currently focuses on three main areas - myocardial biology, understanding the basic mechanism of how cardiac muscles work; vascular biology - the control of blood vessels in health and disease - and clinical cardiovascular studies.
The emphasis is on translating basic and clinical science research findings into improved patient care, from diagnosis to outcomes.
Professor Julian Halcox, chair of clinical cardiology, said: "Heart failure and heart muscle disease are very common and devastating problems - arterial disease is the biggest killer.
"We still need to understand more about the basic workings of these common disease processes, for example how genes and proteins interact with environmental changes and look at how new findings can be translated into better treatment.
"By concentrating our expertise in these areas, we hope to make a bigger impact, rather than dissipating our focus across many other areas.
"The science policy for Wales emphasises that this is the right approach to take in our small, clever country." Dr Christopher George, a British Heart Foundation lecturer at the institute, said: "Heart failure is very common and there's a perception that it should be treatable. But while there are strategies and therapies that slow the progression, basically it is still a one-way ticket.
"The problem is that there are so many defects which can cause heart failure. The latest round of studies from the American Heart Association said that $5bn was spent on treating heart failure - that's treatment in its vaguest sense.
"The disorder is so complex and there are so many side-effects associated with treatments that are almost worse that the condition itself, that drug companies are not developing new drugs - a lot of investment in novel agents has not provided a great deal of benefit.
"We've come to the end of the road in one approach and we now need a radical redesign of how heart failure treatments are taken forward." Prof Halcox added: "Most heart failure is caused by heart attacks, high blood pressure and ageing. While we can't treat the latter, a lot is related to general wear and tear of the arteries and we can look at what goes wrong along the way.
"By understanding and treatment of heart and blood vessel disease processes earlier and more effectively, then we should be more likely to prevent heart failure." In the last decade the institute has earned an international reputation for its work and is now striving to ensure that discoveries in the laboratory can one day be applied to patients' treatment.
Current research projects include the idea that stem cells could be used to repair heart muscle damaged during a heart attack and how factors involved in the immune system can contribute to atherosclerosis.
Dr Alan Fraser, who leads echocardiography research at the institute, has helped to develop international guidelines for professional education and echocardiography in clinical practice..
His research is currently focusing on the early diagnosis of heart muscle disease, which has the potential to prevent clinical heart failure.
Other research areas include studies into pre-clinical arterial disease, which could also eventually help to prevent future heart attacks and strokes.
Dr George said: "If we are looking at transitional strategies, our goal would be to take what we know and come up with a treatment that is far better than what is currently available.
"Presently new treatments are regarded as better if they are safer - there has been no real drive towards developing more effective treatments or those that can prevent the problem.
"For me personally, the driver is new therapeutic regimes that work, rather than just not doing people any harm."
Prof Alan Williams, the British Heart Foundation Sir Thomas Lewis professor of cardiovascular science, added: "It is such an enormous task to come up with therapies, but what we can do is contribute to their worldwide development - we shouldn't lose sight of the fact that we are part of a much bigger picture.
"We communicate our findings worldwide but we also benefit from the research that goes on elsewhere." The institute will celebrate its 10th anniversary with a mini symposium today.
First Minister Rhodri Morgan said: "As the first purpose-built cardiovascular research institute in the UK, in its first 10 years it has become internationally renowned as a centre of excellence. It provides, under one roof, the facilities and equipment to stimulate strong interaction and collaboration between leaders in this research field, providing fresh ideas and initiatives.
"The population of Wales is particularly prone to cardiovascular disease. The causal determinants of this are largely unknown but congenital and lifestyle factors are obviously involved.
"I take a personal interest in heart disease because of my own experience of 2007 of getting heart disease and then receiving the benefits of all the wonders of modern technology and making as full a recovery as I could ever have hoped.
"I am proud that Wales has a flagship institute at the forefront of international research and the cutting edge of care for patients like me and thousands of others with cardiovascular disease."
BHF invested pounds 5m in institute The tenacity and enthusiasm of supporters and volunteers in Wales has allowed the British Heart Foundation to invest almost pounds 5m into the Wales Heart Research Institute and Cardiff University.
The charity committed pounds 500,000 in 1999, which was pivotal in convincing other funding agencies to contribute to what became the Wales Heart Research Institute.
Heart failure expert Professor Michael Frenneaux held a BHF Chair at the WHRI until 2004 and more recently the position has been filled by Prof Alan Williams.
BHF's investment of more than pounds 2m in 2007 allowed Prof Williams and a team of researchers to join Prof Tony Lai's group - this brought together two leading international teams to explore the causes of heart conditions that devastate families every year.
Prof Williams and Prof Lai's research investigates the working of a giant protein - the calcium-release channel - which controls cardiac muscle contraction and regulates the heartbeat.
"Defects in this protein have been recognised as an underlying cause of arrhythmia, irregular heart rhythms which can sometimes cause sudden death.
Prof Peter Weissberg, the BHF's medical director, said: "We are proud of our long tradition of funding worldclass research in Cardiff, particularly through BHF professors Henderson and Frenneaux and now Prof Williams."
CLOSE CHECK: Discovering how the heart really works VITAL RESEARCH: A scientist examines the effects of adding drugs to cells. The emphasis at the institute is on translating basic and c d clinical science research findings into improved patient care…
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Publication information: Article title: The Pioneering Body Right to the Heart of Committed to Getting Biggest Killer in Wales; the UK's First Purpose-Built Heart Research Institute Celebrates Its 10th Anniversary Today. Health Editor Madeleine Brindley Spoke to Some of the Researchers at the Cutting Edge of This Complex Science. Contributors: Not available. Newspaper title: Western Mail (Cardiff, Wales). Publication date: May 18, 2009. Page number: 24. © 2009 MGN Ltd. COPYRIGHT 2009 Gale Group.
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