From bench to bedside: 4 new heart tests and treatments

Preventing bypass grafts failing

Professor Andy Baker and his team at the University of Edinburgh are searching for ways to improve bypass grafting (CABG). This is a very common surgical procedure for a blocked coronary artery, to improve blood supply to the heart.

Surgeons use healthy blood vessels from another part of the body to create a new route for blood to flow around the blocked blood vessels. Doctors usually use veins from the patient’s leg, but veins often become damaged when having to adapt to the higher blood pressure in the heart. In nearly half of cases, the graft fails and people start to experience symptoms again.

Professor Baker has discovered that after bypass grafting, cells in the vein called vascular smooth muscle cells start to divide abnormally and this may contribute to the graft failing.

He has found a way, using a drug, to block a key gene which is involved in this happening. This stops the excess cell division. The research team are improving their technique and testing it to see if it can prevent grafts from failing.

Developing a way to stop bypass grafts failing will reduce the number of people needing further graft surgery and benefit those whose health gets worse because the graft is not working well.

Earlier detection of heart attacks

When someone has a heart attack, rapid treatment is vital to limit the damage caused to the heart muscle. Any delay to the tests carried out in hospital to diagnose a heart attack can delay crucial treatment.

One of the main tests to diagnose a heart attack is a blood test that measures levels of troponin, a protein released into the blood during a heart attack. Currently, this can only be done in hospital.

But Professor Corrigan and his team at the University of Strathclyde are developing a troponin test that is portable, easy to use, and provides a diagnosis outside of a hospital lab in less than 15 minutes. Using similar technology to Covid-19 and pregnancy tests, the kit would work by measuring the amount of troponin in a blood sample.

Taking the test out of hospital would provide faster diagnosis, potentially saving lives, especially in rural and remote areas.

Better blood flow mapping in coronary heart disease

Coronary heart disease is when the coronary arteries become narrowed by fatty deposits building up in their walls. These arteries supply the heart with oxygen-rich blood, which is vital to keep the heart healthy.

The images we currently take of blood vessels with scans in hospital show the narrowing, but not how it is affecting blood flow. Until recently, cardiologists had to make judgements about how much the narrowing affected blood flow and decide on treatment based on this.

Now, Professor Julian Gunn at the University of Sheffield has developed a computer model that takes the images of the blood vessels from a heart scan and models the blood flow within them. His previous BHF-funded research showed that in a fifth of cases the computer model changed the cardiologist’s mind about what treatment to give.

Professor Gunn will follow up the people in the earlier studies to see if the computer model he developed provides greater long-term health benefits than the traditional method.

If the results are positive, it could provide the evidence needed for this computer model to be adopted more widely, helping doctors make the best treatment decisions for each patient.

New drug to prevent blood clots with less risk of bleeding

Professor Helen Philippou and her team at the University of Leeds are looking for new ways to protect people with heart and circulatory diseases from developing more blood clots.

Currently these people receive an anti-platelet drug and an anti-clotting drug, which work in slightly different ways by targeting different groups of molecules in the blood.

But it can be difficult to balance the benefits of preventing further clots with the potentially dangerous side effects of these drugs, which include excessive bleeding.

Professor Philippou has founded LUNAC Therapeutics to develop a new type of anti-clotting drug to treat and prevent life-threatening blood clots that cause heart attacks and strokes, which does not have the same risk of bleeding as current drugs.

With fewer risks, this new medicine might mean more people could be treated, while those at high risk of blood clots may be able to have higher doses of the new treatment.

What to read next...