Translating our basic science research into real-life clinical benefit lies at the very core of Bristol CardioVascular. Here are some examples of how we are revolutionising cardiac care.
We are repairing damaged hearts using pioneering techniques in regenerative medicine.
A heart attack causes irreversible damage to heart muscle. Bristol CardioVascular researchers are meeting this medical challenge head-on by running a world-first clinical trial into the use of stem cells to aid heart repair, exciting research that is funded by the British Heart Foundation.
When Deborah Pearse got up on the morning of 5th November 2009 little did she know she would end the day in hospital after suffering from a heart attack and being rushed into hospital in Maidstone, Kent. She returned to Bristol five days later and was admitted to the BHI Hospital.
After learning she would need to have surgery, Professor Raimondo Ascione approached her to ask if she would take part in research.
Deborah’s first thought was to find out more about what the trial entailed and, once Professor Ascione had explained exactly what was involved, she was happy to take part.
Two and a half years after the procedure, Deborah has recovered, has returned to work, is back to doing the horse riding that she loves, and is free of symptoms - but does not yet know if she received the treatment or a placebo.
On being asked what she'd say to others about volunteering for research, Deborah said that she would encourage anyone to consider volunteering for clinical research trials.
Having been involved in managing a clinical trial prior to her heart attack she fully appreciates the need for volunteers to take part in this important research.
Due to the rigorous design of the trials Deborah does not know if she received the stem cells or not, but either way she knows that by taking part she is helping to improve the outcome for people like herself who suffer a heart attack and hopefully enable them to live a full and active life.
Cardiac surgeon Raimondo Ascione is Chief Investigator of this world first clinical trial into the use of stem cells to aid heart repair during bypass surgery. According to Professor Ascione, "Stem cell science might revolutionise modern medicine in years to come."
Patients suffering a major heart attack, and agreeing to be enrolled in the trial, are then injected with stem cells taken from their own bone marrow, or with a placebo. Injections are made directly into the damaged heart during routine coronary bypass surgery.
Being a double-blind study neither Professor Ascione nor any of the other cardiac surgeons carrying out operations are aware of which patient receives stem cells, and which the placebo.
The ongoing trial has not encountered any safety concerns to date. Bristol CardioVascular members are continuing studies to ascertain whether there is an improved outcome for patients receiving the stem cells.
More on Professor Ascione's research >>
Lead researcher Paolo Madeddu conducts outstanding research in order to understand the fundamental scientific principles of stem cell physiology that underpin this revolutionary medical technique.
Perhaps the best known example of stem cells being used to compensate for loss of function is the use of bone marrow stem cells to treat leukaemia.
Professor Madeddu researches the use of stem cells to promote the growth of new blood vessels, a process known as angiogenesis. He has discovered new type of stem cells in segments of vein leftover from bypass surgery that appear to have special regenerative potential. The hope is that transplantation of these cells into the heart, during surgery, will help the heart muscle to compensate for the tissue damage and loss of function that accompanies a heart attack.
Restoring cardiac function via therapeutic angiogenesis will give much better outcome for patients' long-term health and quality of life.
As Professor Madeddu says, "Heart attacks and cardiovascular disease affect millions of people each year and we hope with the groundbreaking research that is taking place within Bristol CardioVascular that one day it will become a thing of the past."
More on Professor Maddedu's research >>
High blood pressure (hypertension) is a condition that afflicts one billion people worldwide.
Left untreated it significantly increases the risk of stroke, heart failure and chronic kidney disease. But 10-20 per cent of patients with the condition do not respond well to treatment with drugs.
For this sub-set of patients a new approach that we are developing, renal denervation, may help.
Renal denervation stops nerve signals travelling from the kidneys to the brain. Normally, these signals help a specific type of brain cell (show in the mircrograph, right) maintain a normal blood pressure. In hypertension this system seems to have gone wrong.
By preventing signals reaching the brain, our research indicates we can counteract hypertension and lower blood pressure to normal levels. Results published in The Lancet show that renal denervation reduced blood pressure by around 20%, with levels continuing to fall even after two years.
This research is a great example of doctors and scientists across Bristol CardioVascular - and beyond - working together to make the benefits of cutting edge research and clinical technology available to people in the South West.
Renal denervation may be a revolutionary way to reduce blood pressure. With this new treatment, thousands of people could avoid stroke, heart failure, and other diseases, and live longer, healthier lives.
Read more about the key Bristol CardioVascular members behind this research, and their ongoing work in combating hypertension:
Coarctation of the aorta is a condition where babies are born with a narrowing of the main artery from the heart, the aorta. In the past, coarctation often led to chronic high blood pressure (hypertension), stroke, kidney failure and early death.
Nowadays babies can be identified in utero, and the abnormality corrected immediately after birth. However, while this improves health and survival for most cases, at least 30% still go on to develop hypertension before they reach ten years old.
Within Bristol CardioVascular we are addressing this issue through fundamental science research.
We are studying animal models to understand the mechanisms underpinning perinatally-programmed hypertension, and using this information to inform clinical practice for children as they grow up after coarctation repair.
We have also recruited over 80 coarctation patients in order to evaluate their health over time and identify the time course and origins of hypertension. These studies have to be performed with minimal interference or discomfort; we are therefore making use of advanced technology that allows complex measurements to be taken non-invasively, even at home (see photos).
By obtaining a comprehensive understanding of how coarctation is linked with later disease we will be able to administer pre-emptive treatment, thereby preventing long-term consequences such as hypertension and other life-threatening conditions.
Read more about the key Bristol CardioVascular members behind this research, and their ongoing work: