Costanza Emanueli

Costanza Emanueli is the BHF Professor of Cardiovascular Medicine at the National Heart Lung Institute, Imperial College London.

Professor Costanza Emanueli and her team at the National Heart Lung Institute are focused on improving the lives of people with cardiovascular disease by finding new ways to encourage blood vessel growth to repair damaged hearts as well as by developing new approaches to predict and combat some of the complications caused by cardiac surgery. To supercharge that science and ensure it benefits patients as soon as possible, she is collaborating with researchers across the UK, from London to Edinburgh and Glasgow, and around the world.

Diabetes and heart disease

Professor Emanueli’s research programme centres on diabetes and coronary heart disease. Having diabetes increases a person’s risk of developing coronary heart disease and it makes the disease worse by damaging the small blood vessels of the heart. 

One treatment for coronary heart disease, where the large blood vessels supplying blood to heart become narrowed causing chest pain, is heart bypass surgery. In the UK, bypass surgery is performed very frequently and can be life-changing by reducing the stress on the heart caused by the narrowed arteries.

But bypass surgery is not perfect – it cannot fix the smaller blood vessel damage associated with diabetes and the operation can cause complications, including kidney damage, especially in people with diabetes. Professor Emanueli is working to find a treatment for the small blood vessels and find ways to better predict the outcome of surgery, so doctors can manage patients to reduce the risk of complications.  

Tiny molecules with huge potential

MicroRNAs are small molecules which help to control which proteins  are turned on and which are turned off within the cell.  MicroRNAs can travel between cells inside small containers called extracellular vesicles (exosomes and microparticles), which have been recently discovered to be natural delivery vehicles, transferring microRNAs from one cell to another. 

Professor Emanueli’s research has shown that microRNAs carried in extracellular vesicles are involved in controlling the health of blood vessels in diabetes. Her team also provided the first evidence that microRNAs can be manipulated to reverse the effects of diabetes on blood vessels. Her current research therefore aims to develop microRNAs delivered in vesicles as novel therapies for heart and blood vessel disease.

They are also studying whether measuring levels of certain microRNAs released by heart cells inside vesicles before and during cardiac surgery can predict whether a person is at greater risk of complications afterwards. This could lead to new tests to help surgeons ensure the best possible results from the bypass operation.