(a) Pathogenesis Of Aortic Stenosis : Relationship To Valvular Endothelial Function.
Funder
National Health and Medical Research Council
Funding Amount
$254,995.00
Summary
In the 21st century, heart disease will continue to be a major cause of disability and death in Western society. However, the relative decline in the frequency of premature death due to coronary disease (such as heart attacks) combined with increases in longevity, will see the emergence of new disease states. Aortic stenosis (AS) is likely to be one of the most important of these: progressive aortic valvular narrowing, culminating in the development of heart failure, and cardiac death. To date, ....In the 21st century, heart disease will continue to be a major cause of disability and death in Western society. However, the relative decline in the frequency of premature death due to coronary disease (such as heart attacks) combined with increases in longevity, will see the emergence of new disease states. Aortic stenosis (AS) is likely to be one of the most important of these: progressive aortic valvular narrowing, culminating in the development of heart failure, and cardiac death. To date, the only established treatment for severe AS is valve replacement. The incidence of AS increases with age: approximately 40% of individuals over the age of 80 have some AS, while 4% have severe AS. Studies to date have revealed that AS is more likely to occur (and to progress rapidly) in patients with impaired kidney function, and that some coronary risk factors (high cholesterol levels and diabetes, for example) also predispose to AS. The planned research will examine the potential role of the (endothelial) cells lining the aortic valve in protecting against the development of AS. In particular, we will try to identify which chemicals interfere with endothelial function, and how this leads to thickening of the valve. The ulitmate objective of this research is to delineate the chemical factors causing AS, in order to help in the development of preventative strategies for this disease.Read moreRead less
The Influence Of Transcatheter Aortic Valve Implantation On Myocardial Structure And Function
Funder
National Health and Medical Research Council
Funding Amount
$110,218.00
Summary
Transcatheter aortic valve implantation has given options to elderly patients who were previously faced with an open-heart operation. Our research utilises CT scans to determine the anatomical and physiological effects this new technology has on the heart. This research will help to guide the ongoing development and refinement of this technology. The research has the potential to revolutionise how aortic stenosis is assessed and timing of intervention is determined.
Effectiveness Of Imaging Pathways For CVD Epidemics Of The Elderly
Funder
National Health and Medical Research Council
Funding Amount
$713,453.00
Summary
Cardiac imaging is widely used to guide cardiology treatments, especially in the cardiovascular disease epidemics of the elderly (atrial fibrillation, aortic stenosis and heart failure). However, despite the expenditure of ~$1 billion/year on cardiac imaging in Australia, there is little evidence of value. This Partnership seeks to link researchers with providers and imaging industry to provide data regarding appropriate use, quality control and integration of decision-making with imaging.
Clinical, Pathological And Genetic Basis Of Familial Valvular Heart Disease
Funder
National Health and Medical Research Council
Funding Amount
$133,351.00
Summary
Mitral valve prolapse and bicuspid aortic valve are two common valve syndromes that are characterized by remarkable clinical diversity, ranging from no symptoms to potentially life threatening complications, heart failure and sudden death. Both disorders seem to run in families in a significant proportion of patients and thus are likely to have genetic causes, which remains unknown to date. This project aims to identify the underlying genetic basis of these common familial valve syndromes.
Congenital aortic stenosis is a life-long condition caused by a narrowing of the aortic valve. It accounts for 2-6% of congenital heart disease, and if left untreated, results in heart failure and death. While several surgical and non-surgical interventions are available, the ideal treatment for this condition is unclear. My research aims to evaluate outcomes of aortic valve repair and compare it to other techniques.
Determinants Of Occurrence And Progression Of Aortic Stenosis In Bicuspid And Tricuspid Valves.
Funder
National Health and Medical Research Council
Funding Amount
$546,394.00
Summary
Aortic stenosis (AS) is a major cause of cardiac failure and mortality in ageing Australians. AS occurs both in bicuspid aortic valves (BAV;0.5-1% of the population) and in anatomically tricuspid valves. There is an associated incremental risk of myocardial infarction. The research will investigate patients with BAV and with early AS in tricuspid valves, in order to examine the potential roles of loss of nitric oxide effect and of oxidant stress as predictors of AS development.
Regulatory Pathways Of Compensatory Left Ventricular Hypertrophy
Funder
National Health and Medical Research Council
Funding Amount
$309,536.00
Summary
An increase in muscle bulk (hypertrophy) of the major pumping chamber of the heart, the left ventricle, occurs as a compensatory mechanism to maintain cardiac function in a wide variety of common cardiovascular diseases, such as hypertension. Nevertheless, this compensatory mechanism appears to be strongly associated with an increased risk of death from cardiovascular disease. Consequently, the prevention or reversal of left ventricular hypertrophy is one of the major goals of the treatment of p ....An increase in muscle bulk (hypertrophy) of the major pumping chamber of the heart, the left ventricle, occurs as a compensatory mechanism to maintain cardiac function in a wide variety of common cardiovascular diseases, such as hypertension. Nevertheless, this compensatory mechanism appears to be strongly associated with an increased risk of death from cardiovascular disease. Consequently, the prevention or reversal of left ventricular hypertrophy is one of the major goals of the treatment of patients with cardiovascular disease. This project aims to improve our understanding of the complex chemical messengers in the heart muscle that control the development of hypertrophy to provide a basis for more specific drug treatments to control this process, with the aim of reducing the morbidity and mortality associated with hypertrophy.Read moreRead less
SUcceSS: SUrgery For Spinal Stenosis - A Randomised Placebo-controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$2,303,245.00
Summary
This will be the first placebo-controlled randomised trial of surgery for lumbar spinal stenosis and aims to determine the efficacy and safety of this intervention in decreasing pain and improving disability in this population. The cost-effectiveness of surgery for lumbar spinal stenosis will also be determined.
Interaction Of Angiotensin II And PPARg In Aortic Aneurysm Formation
Funder
National Health and Medical Research Council
Funding Amount
$427,398.00
Summary
Between 5% to 10% of men and 1% of women over the age of 60 years develop weakening of their main abdominal artery leading to slow dilation of the vessel. If this process continues long term the artery can burst resulting in sudden death. At present the only treatment available for this problem is surgery, either open or minimally invasive. Both these forms of treatment are associated with significant complications and unsuitable for some patients. Thus the development of a drug treatment which ....Between 5% to 10% of men and 1% of women over the age of 60 years develop weakening of their main abdominal artery leading to slow dilation of the vessel. If this process continues long term the artery can burst resulting in sudden death. At present the only treatment available for this problem is surgery, either open or minimally invasive. Both these forms of treatment are associated with significant complications and unsuitable for some patients. Thus the development of a drug treatment which can slow or halt the weakening and dilation of the aorta would have great patient benefits. We have identified an important role for a newly discovered protein in weakening of the abdominal aorta. In this study we investigate the role of a pathway which appears to be fundamental in generating this protein. In particular we will assess the role of drug treatment in blocking this pathway as a basis for medical treatment for artery weakening.Read moreRead less