Innovations in Cardiovascular Science: ‘The more I learn, the more I learn how little I know’

Written by Dr. Sherbano Ali Khan (UCL Institute of Cardiovascular Science MSc student)

Despite significant medical and therapeutic advances in cardiology in recent years, cardiovascular disease remains the biggest killer in the UK and a major cause of mortality and morbidity worldwide.

On Monday 22 April 2013 the UCL Cardiometabolic Science Domain hosted the Innovations in Cardiovascular Science Symposium with the aim of encouraging new interdisciplinary links and collaborations to help tackle this pressing global health issue.

The symposium (which focused on hypertension, heart failure and therapeutic innovation) brought together more than 150 doctors, surgeons and scientists to showcase and discuss some of the cutting-edge research that is currently taking place across UCL, Queen Mary University of London (QMUL) and UCL’s partner hospitals.

After an introduction by Professor Sir John Tooke (UCL Vice-Provost (Health) a number of speakers presented their research before taking questions from the audience. There was also a heated interactive debate, a poster competition for early-career researchers and valuable opportunities for networking.

Professor Patricia Munroe kicked things off by presenting the results of genome wide association studies, and explaining that developing knowledge about the genetic architecture of hypertension (high blood pressure) is crucial because it is the leading cause of preventable death worldwide.

In addition to genes, the central autonomic nervous system also plays a crucial part in the regulation of blood pressure. Dr. Nephtali Marina-Gonzalez talked about ‘astrocytes’, the most abundant type of glial cells in the nervous system, and the significant impact they might have on the activity of the neuronal pathways that generate the central sympathetic drive in the human body.

There was also a very enlightening talk by Professor Bryan Williams about the stiffening of the ‘great artery’ (the aorta) and the causes. Aortic stiffening often becomes a problem from mid-life onwards and the movement of the blood through the aorta is extremely important in determining the cause of big and small vessel diseases like diabetes and ageing.

Hypertension is also a threat for pregnant women and can lead to pre-eclampsia, which can cause problems for both mother and baby. Dr. David Williams presented his research on pre-eclampsia, including the ongoing ‘StAmP’ randomised controlled trial (in collaboration with Birmingham University) which is exploring the effect of statins on early onset pre-eclampsia.

The symposium got even more exciting as Professor Alexander Seifalian showed everyone a sample of Polyhedral Oligomeric Silsesquioxane (POSS), a family of nanoparticle polymers that can be used as cardiovascular implants. The implants that are currently used can become calcified and induce thrombogenic reactions, leading to severe complications. However, anti-thrombogenic POSS is already being used for small conduits and bypass grafts, and the hope is that it will be used more widely in the future.

Before the symposium ended Dr. Pier Lambiase and Professor Anthony Mathur took to the stage and engaged everyone in a thought-provoking debate entitled ‘Are we ready for stem cell research trials?’ The argument against was presented by Dr. Lambiase who supported the idea that it is time to return to fundamental biological principles. he argued that stem cell research and its clinical efficacy need to be demonstrated through a more pragmatic approach for the good of the patients.

In opposition, Professor Mathur argued in favor of starting stem cell research trials and tried to persuade the audience that new research ideas often turn into realities (in terms of diagnosis and therapeutics) only after they go under extensive human trials.

He argued that clinical trials are therefore a perfect example of the type or research that should be funded, as translational research has hit an important milestone with ‘cell therapy’ for cardiovascular diseases. Doctors are currently often left with no alternative solutions for patients who have been given all available pharmacological and surgical therapy. In such cases, stem cell therapy might provide a solution for the patients – but without clinical trials nobody will ever know.

The field of cardiovascular medicine is like an iceberg – we have probably only hit the tip of it and there is much still left to discover. As Socrates said: ‘The more I learn, the more I learn how little I know’.

Nonetheless, this symposium proved to be an excellent opportunity for knowledge exchange and networking – one that I hope will be repeated next year.