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

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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. …