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
TARGETING ROS-INDUCED DAMAGE RESCUES THE DIABETIC HEART
Funder
National Health and Medical Research Council
Funding Amount
$487,669.00
Summary
Over 1 million Australians have diabetes. Many of these patients die from cardiovascular disease. We have identified free radicals as a major cause of decreased pumping function and impaired recovery from each heartbeat in the diabetic heart. Stronger antioxidant approaches and-or activation of protective protein pathways is a more effective treatment for reversing impaired function in the diabetic heart, preventing or delaying heart failure in patients with diabetes.
Heart failure (HF) describes where the heart cannot pump adequately to meet the bodyÍs needs. Mortality remains high; therefore, there is an urgent need for new treatment approaches. The present grant aims to: (1) evaluate treatments for patients at high-risk for future development of HF (2) examine the ability to safely withdraw unnecessary HF drugs (3) focus on the effect of HF on the kidney via novel treatment strategies (4) examine the emerging role of cancer drugs in development of HF.
ANNEXIN-A1 MIMETICS: A NOVEL THERAPEUTIC APPROACH FOR TARGETING THE CARDIAC COMPLICATIONS OF DIABETES
Funder
National Health and Medical Research Council
Funding Amount
$815,185.00
Summary
Diabetes affects almost 2 million Australians, creating an increasing heart failure burden. A/Prof Rebecca Ritchie’s team at Baker IDI are interested in the precise role of cardiac inflammation in the progression of cardiomyopathy resulting from diabetes. Using her exciting discovery that a naturally-occurring anti-inflammatory protein is a key regulator of cardiac muscle cell survival and function, A/Prof Ritchie’s team will develop therapies for diabetic cardiomyopathy based on this protein.
Research Fellowship: Protection Of Myocardial Function In Health And Disease
Funder
National Health and Medical Research Council
Funding Amount
$631,010.00
Summary
Heart failure (HF) is a major cause of death in Australia. A/Prof Rebecca Ritchie heads Heart Failure Pharmacology at Baker IDI. Her research focuses on new drug strategies to maintain heart function in response to diabetes & heart attack, common precursors of HF. Many of the treatments discovered from this work are naturally-occurring antioxidants; enhancing their activity will ultimately reduce progression to HF & death in the >3 million Australians affected by these disorders.
Substrate Mapping And Ablation Of Ventricular Tachycardia
Funder
National Health and Medical Research Council
Funding Amount
$444,129.00
Summary
Sudden death is a tragic occurrence and can afflict Australians of all ages, racial and ethnic backgrounds. This research will aim to understand abnormalities in the heart muscle that cause dangerous heart rhythm abnormalities, which is the most common cause of sudden death. We will study ways to improve the technology of keyhole cardiac procedures so that it can be used to prevent these arrhythmias from occurring in the first place, and in improving the chance of long-term successful cure.
NOVEL CGMP-BASED THERAPIES PREVENT LEFT VENTRICULAR REMODELLING
Funder
National Health and Medical Research Council
Funding Amount
$533,433.00
Summary
Over 300,000 Australians are affected by heart failure. Current drugs for cardiac remodelling (the decline in heart pumping function and changed structure that precede heart failure) slow but not reverse disease progression. We have identified a new, nitrovasodilator-based therapy superior to those currently available. We propose it represents a more effective treatment for reversing abnormalities in both structure and function in the remodelled heart, preventing or delaying heart failure.
Annexin-A1 Agonists Rescue Cardiac Contractile Function After Myocardial Infarction
Funder
National Health and Medical Research Council
Funding Amount
$621,419.00
Summary
Myocardial infarction (or heart attack, a result of reduced coronary blood flow) and subsequent heart failure are the major cause of death in Western societies; this is expanding to all corners of the globe. New treatments for heart attack are thus essential. We have discovered that the natural hormone annexin-A1 rescues heart muscle function over the short-term, and propose that drugs based on annexin-A1 will prevent cardiac dysfunction of heart muscle up to several weeks after heart attack.
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
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