The future of heart research
The final word went to Cardiologists, Tian Zhao and Sharon Wilson, from Addenbrooke's Hospital. Chris Smith asked them what areas do they think are the most promising, or the most important, to surmount matters of the heart...
Tian - I think inflammation is the next frontier, right. These narrowings in the heart which cause heart attacks; they’re made of lipid or cholesterol or fat, we know that.
Chris - In the arteries that supply the heart muscle?
Tian - In the arteries, exactly. But it’s more complicated than that; it’s about how the body reacts to this lipid, and inflammation is a major part of that. And we’re here in Cambridge doing great work trying to treat that inflammation. We saw Professor Bennett talking about the senescent cells that are causing the inflammation and he’s doing great work trying to treat them. And I think that goes back to the very nature of human beings, of ageing.
Chris - Sharon?
Sharon - I’m more a clinical cardiologist, so I’m more interested in the new work that’s happening with biomarkers and actually getting the patient sorted out. So it’s very worthwhile to have lots of work within research in the basic science, but we also need to remember the person at the end of the equation is a patient.
Chris - Indeed. Now when you say biomarkers, what does that mean?
Sharon - So that’s looking at assays like troponin or what you’ve previously mentioned of the myosin C, of ways of detecting is a person in front of me having a heart attack or having damaged their heart at this exact point? How can I prevent them from having a major issue, and how we can treat them through the system efficiently and effectively?
Chris - Many people argue though that by the time you’ve got a person with a heart attack in front of you it’s a bit late, we should have intervened sooner. Are there any things on the horizon that enable us to make better predictions of the people who are at risk?
Sharon - So even using the biomarkers in a different way. So they’re using the biomarkers with myosin C primarily looking at diseases such as aortic stenosis, which is a valvular problem, rather than a heart attack. Then looking to see where is the point when intervene before the heart is actually sustaining damage? And that’s where I feel this is quite exciting. There’s also a lot of work with people who’ve had a heart transplant, looking at biomarkers there to see are we treating these patients effectively? How can we prevent them from rejecting their organs, and how can we made sure that the organs we have available are being utilised appropriately?
Chris - What about the role of genetics? We’ve got the Hundred Thousand Genome project in the NHS, for example. There’ve been enormous strides made in sequencing people’s genomes. Are we seeing strong associations between certain combinations or cocktails of genes and people who are at risk of certain types of heart outcome?
Sharon - We are. The Hundred Thousand Genome project is fantastic initiative, which the NHS is behind, and we have seen benefits even in our clinical practice to some of our patients who’ve had problems with a dilated aorta, or the big tube that come out of the heart. You’ve got particular association which you may not have a specific gene that’s been identified, but you can put their information in, get particular panels, get particular genes to identify new targets. You might have a person who’s in Swansea who has a problem, you might have a person in Cambridge who has a problem, and their clinical data you can try and get them to overlap to identify new targets. And I feel that that’s very important.
Chris - Yeah. The whole big data of being able to look at very large numbers of people, all at once across a population, that’s very valuable isn't it?
Sharon - Yeah. I think that’s where some of our greatest gains in cardiology is going to come from in the next couple of years.
Chris - Well I tell you what, we’re going to find out whether you’re right aren’t we? Because we’ll have to have you back in about five years time and see if actually your predictions have come true.
Sharon - That would be very interesting and I’ve a feeling I will probably win against Tian and his inflammation.
Chris - Well, I think the thing is you’re solution, Sharon, is slightly more attractable in terms of looking for markers and that can predict things. Whereas actually trying to intervene and change things is always going to be a bit more risky and that’s going to take a bit longer for you isn’t it?
Tian - We’re doing work already in Cambridge trying to get the next step, so we’re hopeful!