What is heart valve disease?
Your heart has four chambers. The left and right atria, at the top, receive blood, and the left and right ventricles, at the bottom, pump it around the body. The left and right atria have valves to make sure the blood flows in the right direction. The two large blood vessels that leave your heart also have valves, to make sure blood doesn’t go back into the heart once it’s been pumped out.
These valves play a crucial part in making sure your heart works properly. But they can be affected by age and disease. They might become stiff, or leaky, putting extra strain on the heart.
Find out more about the symptoms and causes of heart valve disease.
Early detection, targeted treatment
Heart valve disease can go unnoticed for some time. By the time tiredness, breathlessness or chest pain are felt, damage to the heart could already be be severe. We funded Dr Leong Ng and his team in Leicester to see if a blood test could predict the severity of a condition called aortic stenosis before symptoms appear. In aortic stenosis the aortic valve stiffens and restricts blood flow out of the heart. Some people never develop symptoms, but in others, aortic stenosis progresses to life-threatening disease. If Dr Ng’s blood test is eventually able to identify which people are at risk of developing severe disease, doctors will be able to target early treatment to those who need it most - and save those who don’t from undergoing unnecessary treatments.
The perfect replacement
Since heart valve replacement began in the 1960s, a range of different materials have been used for the valve prosthetic. Early mechanical metal valves have been surpassed by super-smooth carbon devices. But patients who receive a mechanical valve still have to take lifelong anticoagulant (also known as blood-thinning) medication to prevent blood clots forming around it. This carries an increased risk of severe bleeding.
We’re funding University of Cambridge chemical engineer Professor Geoffrey Moggridge to develop the next generation of mechanical valves. He’s using a synthetic material that’s both strong and flexible, like natural valve tissue. The material is long-lasting and due to his innovative design, it’s hoped the new valve replacements will avoid the the need for lifelong medication and risk of blood clots.
A whole new approach
Despite decades of advances, heart surgery and other invasive procedures are still the only effective treatments for heart valve disease. Alongside funding research to make procedures as safe and effective as possible, we also support scientists as they look for totally new approaches that could stop the disease in its tracks.
Research suggests that as the aortic valve stiffens when diseased, blood vessels grow into the valve tissue. This new blood supply brings white blood cells, which cause inflammation - making the situation even worse. We’re funding a project in Dr Graeme Nixon’s lab in Aberdeen to block a protein (called the S1P receptor) in the cells of the valve. This should combat the invasion of white blood cells. The team are testing their approach on human aortic valves donated by patients after valve replacement surgery. If successful, it could lead to a medicine that slows the progression of valve disease without the need for invasive surgery.
In another study, Dr Marc Dweck is testing whether two existing medicines could combat aortic valve disease. In a trial of 150 patients in Edinburgh, Dr Dweck is using a high-tech PET scanner to assess whether these drugs - normally used to treat osteoporosis - can reduce the dangerous build-up of calcium that can stiffen the valve and make the disease worse.
More about Dr Marc Dweck’s research.
The difference we've already made
One of the first ever BHF research grants was made to a pioneer in heart valve replacement surgery. In 1963 we funded Donald Ross in his efforts to improve the safety of an innovative operation to use preserved human heart valves - called homografts - as transplants to treat valve disease.
A change to the surgery cut postoperative death rates from 71%to 15%, and some of Ross’s techniques are still used in life-saving valve operations today.
The race is on to develop the perfect material for the next generation of heart valve replacements. Until then, doctors have to help patients make choices between replacement valves with different strengths and weaknesses. To help, they use the results of two large studies set up by BHF Professors David Wheatley and Ken Taylor in the 1970s and 1980s. Each reported the safety of mechanical and biological valve replacements over two decades in hundreds of patients, providing vital data to improve the long-term health of valve recipients.
Find out more about our successes in heart valve research