Preventing stroke and dementia: discover the research we’re funding
In the last three months we’ve funded 50 new projects – that’s nearly £19m of life-saving research. Here are five of the most exciting.
1. We want: to understand the causes of sudden cardiac death
We invested: £176,618 to Dr Elijah Behr at University of London
A cross-section of muscle fibres in the heart.
Sudden arrhythmic death syndrome (SADS) is a sudden and unexpected death where no cause can be identified at post-mortem. It is often caused by one of several rare heart conditions that may run in families.
One important cause of SADS is Brugada syndrome, an inherited heart rhythm disturbance caused by problems with the way electrical signals pass through the heart. It doesn’t cause noticeable changes in the structure of the heart that can be seen at a post-mortem examination.
However, recent research has shown that there might actually be subtle structural changes, and these are similar to those seen in a heart muscle disorder called Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC).
This research will compare microscopic differences between Brugada syndrome, ACM, and normal hearts, to identify markers that could be used to diagnose the cause of SADS at the time of post-mortem.
This study could improve understanding of how Brugada syndrome and ACM arise. It could help bereaved relatives by giving them answers about the cause of the death, and giving them more information about whether they need testing to avoid other deaths in the family.
2. We want: to prevent stroke and dementia by spotting silent rhythm disorders
We invested: £2,464,260 to Professor Barbara Casadei at University of Oxford
An MRI scanner
Atrial fibrillation (AF) is the most common irregular heart rhythm. Short episodes of AF are relatively common, particularly in the elderly, and tend to go unnoticed. But it’s possible that these “silent” episodes could cause damage to the brain and cause a decline in brain function, which could be prevented by drugs, if doctors were aware of it.
To find out whether these unnoticed episodes of AF do affect brain function, Professor Casadei is monitoring the heart rhythms of 20,000 people, using a skin patch recorder.
She’ll also use magnetic resonance imaging (MRI) scans to detect damage to blood vessels in the brain, alongside tests that measure people’s brain function.
Participants will be involved for life, and by studying this data over time, the team hope to link these medical measurements to future occurrences of stroke, heart attack, hospitalisation, dementia, and death.
By determining whether “silent” AF increases the risk of stroke, Professor Casadei aims to identify at-risk patients, who can then receive appropriate treatment, potentially preventing many occurrences of stroke and slowing people’s path towards dementia.
3. We want: to understand when and how to get children’s views about their own heart surgery, to minimise their stress, fear and misunderstanding
We invested: £112,707 to Dr Katy Sutcliffe at University College London
Having surgery can be stressful and worrying, but often if we find out more about it and know what to expect, some of those worries can be eased. But knowing how and when to inform and involve children in decisions about their planned heart surgery is tricky.
Dr Sutcliffe and colleagues will address this by interviewing 40 patients aged six to 15 before and after heart surgery, as well as their parents and 20 doctors and nurses. The current practices around informed consent will also be observed in two hospitals and the related legal, medical and ethical debates will be reviewed.
This project aims to inform policy on informed consent for children, to make things easier for them and their families. The findings will help healthcare professionals and parents understand when and how best to seek children’s views about their heart surgery.
4. We want: to stop heart problems before they develop, by understanding the role of calcium in the womb
We invested: £267,013 to Dr Richard Tyser at University of Oxford
The heart is the first organ that forms in the developing embryo, but exactly how it first starts to beat is not understood.
We know that calcium plays an essential part in the beating of the heart, which moves in and out of cells and triggers muscles of the heart to contract. But for the heart to pump blood properly, all the muscles need to contract at the same time, and this requires the coordinated movement of calcium.
Dr Tyser hopes to understand how calcium moves in and out of cells and how this becomes synchronised to generate the coordinated movement that triggers the first heartbeat. He also plans to determine when the movement of calcium first starts to change in individual cells.
This understanding is important for developmental biology and congenital heart disease. It could also provide insight into new treatments to help treat heart disease and heart rhythm disorders.
5. We want: protect your heart against high levels of stress hormones that cause heart disease
We invested: £675,929 to Dr Mark Nixon at University of Edinburgh
High levels of hormones that are released when a person is stressed, called glucocorticoids, are known to increase the risk of obesity, diabetes and heart and circulatory diseases. These stress hormones circulate in our blood.
Dr Nixon has been awarded BHF funding to study how another hormone, neutrophil elastase, affects this interaction between stress hormones and fat storage, and how this is linked to a healthy metabolism.
The results will help us to understand whether blocking neutrophil elastase could be used to treat obesity, and in this way help reduce the risk of heart and circulatory diseases.