Efficacy And Mechanisms Of Exercise Training In Diastolic Heart Failure
Funder
National Health and Medical Research Council
Funding Amount
$385,250.00
Summary
Heart failure is modern epidemic which presents a significant public health burden, due to a high mortality, frequent hospital admissions and impaired functional capacity. Although the typical heart failure patient presents with a reduced contractile function, many patients have typical heart failure symptoms but with normal contraction. The problem in these patients seems to relate to the heart's ability to fill with blood, and this entity is known as diastolic heart failure (DHF). This syndrom ....Heart failure is modern epidemic which presents a significant public health burden, due to a high mortality, frequent hospital admissions and impaired functional capacity. Although the typical heart failure patient presents with a reduced contractile function, many patients have typical heart failure symptoms but with normal contraction. The problem in these patients seems to relate to the heart's ability to fill with blood, and this entity is known as diastolic heart failure (DHF). This syndrome is most frequently due to ischemic or hypertensive heart disease, and most commonly occurs in the elderly. The optimal management of DHF is not well defined, although some drug trials are currently in progress. A number of studies have shown exercise training to improve functional capacity by 15-20% in typical heart failure. However, training has not so far been trialled in DHF. In this multicenter, multi-disciplinary study, we will study a training and control group to determine whether exercise capacity and DHF symptoms are responsive to exercise training. This work will teach us about the optimum exercise prescription, in terms of the duration and nature of training, as well as the safety and effectiveness of exercise training. By using a number of sensitive measurements of heart and vessel function (in which our group has special expertise), we will identify whether exercise training exerts its effect through improvement in vascular function and myocardial properties. If successful, the clinical implications of this study are that; 1. Exercise training will be adopted to improve functional capacity and symptoms of DHF 2. The merits of aerobic and strength training will be identified in DHF 3. Abnormal blood vessel function will be identified as a major and reversible contributor to DHFRead moreRead less
An abnormal blood pressure (BP) response to a clinical exercise stress test is a signal for increased cardiovascular disease risk. However, current clinical guidelines do not provide evidence based information surrounding values that may constitute this increased risk. The EXERcise stress Test collaboratION (EXERTION) aims to fill this knowledge gap via establishment of a large, national database of exercise stress test results, linked to acute and chronic cardiovascular disease outcomes.
Studies On The Effects Of Endogenous And Exogenous Opioids In Modulating Exercise-induced Dyspnoea In People With Moderate / Severe Chronic Obstructive Pulmonary Disease (COPD). Two Double-blind Randomised, Placebo Controlled Trials.
Funder
National Health and Medical Research Council
Funding Amount
$197,086.00
Summary
There is evidence that morphine-like chemicals made by the body itself help reduce breathlessness. It is not clear whether this response is because of the effects of these morphine-like chemicals on the brain, in the lung or both. This study will help understand where these chemicals act to reduce breathlessness in people with emphysema during exercise. Subsequently, it will also help to understand whether small, regular doses of morphine safely further reduce breathlessness during exercise.
Domiciliary Oxygen Therapy In Interstitial Lung Disease
Funder
National Health and Medical Research Council
Funding Amount
$124,608.00
Summary
Interstitial lung diseases (ILD) are chronic lung diseases with significant health impacts, but limited drug treatment options. Although home oxygen treatment (HOT) is commonly used in these patients, its clinical benefits are uncertain with potential risks and significant costs for both patients and the health care system. Very little published information is available on the use of HOT in these patients. These studies aim to improve our knowledge and management of HOT in patients with ILD.
NOVEL NON-INVASIVE METHODS FOR THE EARLY DETECTION OF PULMONARY VASCULAR DISEASE
Funder
National Health and Medical Research Council
Funding Amount
$320,463.00
Summary
Pulmonary arterial hypertension (PAH) is a severe, progressive disorder. Current non-invasive diagnostic modalities are insensitive for detecting early disease, thus preventing early intervention with therapy. We aim to develop novel and reproducible ways to assess the pulmonary circulation, which will ultimately allow for the early diagnosis of PAH and in turn facilitate early initiation of treatment and improved patient outcomes.
Structural And Functional Correlates In Adult Congenital Heart Disease
Funder
National Health and Medical Research Council
Funding Amount
$89,699.00
Summary
Survival in congenital heart disease patients has improved. Despite long-term sequelae, evidence is scarce. We aim to correlate structural cardiac features on MRI in adults with exercise capacity to determine predictors of poor outcome. Non-compaction cardiomyopathy ("spongy" heart) is a rare, unclassified form of heart failure. The incidence is much higher in patients with congenital heart disease. We aim to examine the causes, mechanical consequences and its effects on cardiac electrical condu ....Survival in congenital heart disease patients has improved. Despite long-term sequelae, evidence is scarce. We aim to correlate structural cardiac features on MRI in adults with exercise capacity to determine predictors of poor outcome. Non-compaction cardiomyopathy ("spongy" heart) is a rare, unclassified form of heart failure. The incidence is much higher in patients with congenital heart disease. We aim to examine the causes, mechanical consequences and its effects on cardiac electrical conduction to understand this undefined entity.Read moreRead less
Development Of Quantitative Tools For Assessment Of Regional Cardiac Function By Echocardiography
Funder
National Health and Medical Research Council
Funding Amount
$209,430.00
Summary
The application of ultrasound imaging to the assessment of cardiac function (echocardiography) is an invaluable tool for the assessment of patients with known or suspected cardiac problems. The assessment of contraction in each region of the heart is probably the most important of the reasons for doing this test, as regional function is disturbed in patients with coronary artery disease, which is one of the most common causes of death in Australia. The problem is that this analysis is currently ....The application of ultrasound imaging to the assessment of cardiac function (echocardiography) is an invaluable tool for the assessment of patients with known or suspected cardiac problems. The assessment of contraction in each region of the heart is probably the most important of the reasons for doing this test, as regional function is disturbed in patients with coronary artery disease, which is one of the most common causes of death in Australia. The problem is that this analysis is currently completely subjective, and the reliability of the tool is based upon the availability of an experienced observer. This is particularly a problem in rural Australia, as most specialists with expertise in this modality work in the capital cities, and especially a problem in Queensland, where fewer than half of the population live in the capital. The cardiac imaging group at the University of Queensland have been working in collaboration with GE-Vingmed Ultrasound to develop a quantitative technique for the assessment of regional cardiac function since 1997. This collaboration has been the source of a number of published papers and presentations at international meetings. Our group is considered to be a world leader in the field and our industry partner is clearly the most focused of its competitors in addressing this problem. This submission seeks to address several remaining problems. The data thus far addressed function during stress, when the condition of most patients is similar. Tissue velocities are more variable at rest, and a more sophisticated approach is required to accurately measure the lower velocities in the resting state. This research plan seeks support for the development of a new, high frame-rate acquisition that would facilitate the examination of velocities relative to each other, so that translational motion of the heart does not influence the reading. This new method would then be validated against other techniques for assessing function and disease.Read moreRead less
Central Blood Pressure: Physiology And Clinical Application
Funder
National Health and Medical Research Council
Funding Amount
$459,270.00
Summary
Current methods used by doctors to measure blood pressure (BP) have many limitations that could result in incorrect diagnosis and inappropriate treatment of high BP (hypertension). This research program will determine the clinical usefulness of new methods to diagnose and treat people with high BP. The underlying mechanisms contributing to high BP will also be examined. The findings will lead to improved ways to identify and more effectively manage people with high BP.
Importance Of The Transmural Distribution Of Viable Myocardium To Outcome Of Patients After Revascularization
Funder
National Health and Medical Research Council
Funding Amount
$268,800.00
Summary
After a heart attack, up to 50% of tissue showing reduced function can recover if blood supply is returned to normal with bypass surgery or balloon angioplasty. Because these procedures may be risky in cardiac patients, the investigators have used various imaging approaches including radionuclide and ultrasound techniques to predict regions where function will recover after intervention. The results of these tests may be discordant because they assess separate attributes of cardiac muscle, and s ....After a heart attack, up to 50% of tissue showing reduced function can recover if blood supply is returned to normal with bypass surgery or balloon angioplasty. Because these procedures may be risky in cardiac patients, the investigators have used various imaging approaches including radionuclide and ultrasound techniques to predict regions where function will recover after intervention. The results of these tests may be discordant because they assess separate attributes of cardiac muscle, and selection of patients for intervention on the basis of recovery of regional function ignores some other aspects that may be important. These include avoidance of heart enlargement, improvement of exercise capacity, and avoidance of heart rhythm disturbances and even other heart attacks. In this study, the investigators seek to define the importance of the proportion and site of live (viable) myocardium to the parameters listed above. A new magnetic resonance technique will be used to identify whether radionuclide and ultrasound techniques assess different parts of the heart wall. The relative importance of these sites will be identified by comparing the outcome of patients who have live tissue in the inner half, compared with the outer half of the heart wall. This study will involve 180 patients who will undergo testing with magnetic resonance and radionuclide imaging. A subgroup will undergo dobutamine echocardiography. Their responses over follow-up will be assessed by accurate evaluation of heart size, exercise response, heart rhythm abnormalities and clinical events.Read moreRead less
Insulin Resistance In Peripheral Artery Disease: Clinical Significance And Therapy
Funder
National Health and Medical Research Council
Funding Amount
$316,449.00
Summary
This project seeks to improve our understanding and treatment of peripheral artery disease – a condition caused by narrowing/blockages in arteries that supply the legs. Peripheral artery disease affects ~15% of adults >40 years and often causes severe, disabling leg pains during walking. Building on recent findings that peripheral artery disease shares some similar characteristics to type 2 diabetes (“insulin resistance”), a common anti-diabetes drug will be trialled as a potential new strate ....This project seeks to improve our understanding and treatment of peripheral artery disease – a condition caused by narrowing/blockages in arteries that supply the legs. Peripheral artery disease affects ~15% of adults >40 years and often causes severe, disabling leg pains during walking. Building on recent findings that peripheral artery disease shares some similar characteristics to type 2 diabetes (“insulin resistance”), a common anti-diabetes drug will be trialled as a potential new strategy to alleviate these leg pains.Read moreRead less