Dr Marc Dweck and the team at the University of Edinburgh, who have been awarded £1.36 million by the Sir Jules Thorn Charitable Trust to enable them to investigate myocardial fibrosis and left ventricular decompensation in patients with aortic stenosis.  

Aortic stenosis is the most common type of heart valve disease in the western world.  The condition is caused by progressive narrowing of the major outlet valve of the heart, the aortic valve. This puts the heart muscle under increased pressure as it attempts to pump blood out of the heart through an increasingly narrowed valve. Eventually this pressure causes the heart muscle cells to die and to be replaced by scar tissue which, in combination, reduces the capacity of the heart to pump properly. Patients then develop symptoms such as chest pain, fatigue after exertion, shortness of breath and heart palpitations.  These symptoms may be followed by heart failure and risk of sudden death.  Currently there is a lack of medications that can slow disease progression and the only treatment is replacement of the valve, often involving major surgery.  Decisions when patients should have their valve replaced are difficult: operate too early and patients are exposed to risks associated with surgery and having a prosthetic valve fitted; operate too late and the heart muscle becomes irreversibly damaged.  At present symptom development is used to guide the timing of surgery.  However, this is frequently hard to assess in elderly patients who are sedentary and often have many other conditions that may cause similar symptoms.

This 5-year project will test and validate novel markers of heart muscle cell death and scarring to identify more precisely when the heart is starting to fail. The team will then test whether these markers can better guide the timing of surgery and improve patient outcomes in a major clinical trial. 


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