Scientists at the University of Oxford are set to test a new way of treating people with aortic stenosis.
A side view of a normal aortic valve and one with stenosis. MRI scans can be used to see the thickened valve.
Dr Masliza Mahmod has been awarded £290,000 by the British Heart Foundation (BHF) to carry out a pilot study in patients with the debilitating condition.
Aortic stenosis is a narrowing of the aortic valve. This limits the flow of blood through the valve into the aorta - the large artery that transports oxygen rich blood from the heart to the rest of the body. This forces the heart to work harder in order to pump blood around the body.
Typically, people with severe aortic stenosis experience shortness of breath and find it harder to exert themselves physically. If the valve becomes too narrowed, patients need surgery to replace the diseased valve.
Previous research has shown that people with the condition can have excessive fat deposits in their heart muscle – known as cardiac steatosis. This fat is toxic to the heart muscle and prevents it from pumping as powerfully as needed.
Targeting heart fat
To address this problem Dr Mahmod and her team will try to reduce excessive heart fat by targeting it with a fat-busting, fibrate drug which they hope will improve the heart’s function and exercise capacity. The six month long study will involve 60 people who will randomly be assigned to either be given the fibrate drug or a placebo so that the impact of treatment can be assessed.
Study participants will be recruited from hospitals in Oxford. They will have an MRI scan at the start and end of the trial to assess what impact the drug has on the cardiac steatosis and on the pumping action of the heart. Results from the study could suggest a way for doctors to help patients manage their condition.
Dr Masliza Mahmod, Head of Clinical Trials Group at the Oxford Centre for Clinical Magnetic Resonance Research, said: “Aortic stenosis is a common condition in older people and it can have a big impact on a person’s ability to do everyday tasks.
“Surgery to treat the condition is usually effective and well established, but sometimes the heart’s pumping function doesn’t return to normal after surgery. Also, as aortic stenosis is more common in elderly people, sometimes patients will not be fit to withstand surgery, and there is currently no effective medication.
“If we can show that these fat-busting drugs improve the heart ability to pump blood around the body in aortic stenosis, then it would give doctors a way to help people manage their condition with medication.”
Proving the concept
Dr Shannon Amoils, Senior Research Advisor at the BHF, said: “This study is a first step in examining whether a drug that is already used to treat high fat levels in people could potentially improve heart function in aortic stenosis.
“If the concept behind it is proven, then the potential is there to use fibrates as a new treatment for aortic stenosis after larger trials. Research to ‘repurpose’ medicines that are currently already used in patients for other conditions to treat cardiovascular disease is always exciting as positive results can lead to changes in clinical practice quite quickly.
“Research projects like this, which seek to improve the prevention and treatment of heart disease, are only possible thanks to generous donations from the public.”