Research in Progress 2009-10
Grant No. 1016
A tailored intervention to increase New Zealander’s fruit and vegetable consumption
Dr Caroline Horwath
An innovative computer program, 5+Your Way®, had been created to motivate and enable New Zealand adults to eat more fruit and vegetables. The programme attempted to mimic a personalised consultation with a dietitian trained in behavioural psychology. Each participant completed a questionnaire, which the computer ‘read’ and used to select appropriate text and graphic messages from the Message Library to appear in his/her individually tailored booklet. In Phase I approximately 150 New Zealanders were interviewed to improve these novel print materials. In Phase II, 1050 New Zealanders, aged 25 to 60 years, participated in a 12-month randomised controlled trial to test the effectiveness of tailored and generic communications.
RESULTS: It appears the 5+YourWay® tailored communications successfully increased fruit and vegetable consumption in a reasonably nationally representative sample of mainly low fruit consumers. Self-efficacy partially mediated the effectiveness of the intervention. The tailored group had higher mean fruit and vegetable intakes than the generic and control groups at each follow-up (3, 6 and 12 months), but many between group differences were not statistically significant when conservative intention-to-treat analyses were performed. Increased fruit and vegetable intakes in the no treatment control group were unexpected; completing the 5+Your Way® psycho-behavioural questionnaires may have acted as a brief intervention.
Grant closed.
Grant No. 1059
Research Fellowship
Dr Carlene Lawes
This fellowship comprised several projects that investigated modifiable risk factors for cardiovascular disease. Project work had reviewed evidence on different methods to manage obesity, analysed trends in strokes worldwide, and examined the long term impact of stroke. Ongoing research will determine whether high heart rate is an important risk factor for cardiovascular disease, and focus on smoking cessation as smoking is another important risk factor for cardiovascular disease.
Grant closed.
Grant No. 1088
Early prediction of brain damage after heart surgery in infants
Dr John Beca
This research project investigated whether advanced monitoring of the brain could detect damage as it occurred in infants having heart surgery. It also investigated whether advanced MRI scanning could predict subsequent developmental problems. All children have been recruited and the majority have had their development assessed at 2 years of age. Analysis of the results is currently under way.
Grant closed.
Grant No. 1092
Dual vent cardiopulmonary bypass to reduce ischemic brain injury in cardiac surgery
Dr Paget Milsom
A small number of people sustain brain injury as a complication of open heart surgery. A new heart bypass technique that aimed to reduce this brain injury has been developed. Magnetic resonance imaging (MRI) brain scans are being used to show if any brain injury has occurred. The amount of brain injury sustained in people with the new heart bypass technique is then being compared with those having conventional heart bypass. In the preliminary results, clear evidence of new brain lesions in almost half of the patients enrolled in the ReBICS study has been found. These lesions were due to cerebral ischemia (strokes). While most of the brain lesions were small, all of the patients with these new brain lesions had measurable memory decline. It was concluded that these lesions were due to showers of emboli made up of clotted blood and air bubbles that occurred as a result of the surgery. The ReBICS study aimed to see if these emboli could be prevented. Patients are still being recruited.
Grant No. 1094
Coenzyme Q10: Potential for improving cardiovascular risk
Professor Russell Scott
Coenzyme Q10 is an increasingly used complementary medicine for prevention of heart attack and stroke, and thus requires investigation. Statins are indicated for people with cholesterol disorders to reduce cardiovascular events. 14% of statin-treated subjects develop muscle-aches [myalgia], possibly due to depletion of coenzyme Q10 levels. No improvement in myalgia symptoms with coenzyme Q10 supplementation in subjects previously intolerant to statin therapy was found. Reductions in coenzyme Q10 in statin-treated subjects have been associated with improvements in vascular function. The investigators will examine whether coenzyme Q10 supplementation in statin-treated subjects further improves vascular function, giving additional benefit to CVD reduction.
Grant No. 1115
Clinical and neurohormonal predictors of outcome post-DC cardioversion for atrial fibrillation
Professor A Mark Richards
Atrial fibrillation is the most common cardiac arrhythmia. There are two different strategies when treating this condition: restoring normal rhythm or controlling the heart’s ventricular rate. Cardioversion, a procedure done to restore normal rhythm, has an initial success rate of 80-90%. Most of the patients with initial successful outcome will revert back to atrial fibrillation (only one third of those who had successful cardioversion initially will remain in normal sinus rhythm a year later). A combination of plasma hormone measurements together with clinical characteristics will help accurately identify those patients most likely to enjoy sustained return to normal rhythm after cardioversion.
Grant closed.
Grant No 1143
Effect of pulmonary valve replacement in tetralogy of Fallot
Dr Brett Cowan
A large number of New Zealand children are born with defects in their hearts. Magnetic resonance imaging (MRI) is now routinely used to make the correct diagnosis and plan surgery for those that require it. This project has enabled the successful development of new software to analyse the heart in much more detail than was previously possible. This software is being used at the Centre for Advanced MRI at the University of Auckland in clinical trials looking at new treatments for heart disease and as more experience develops, it will be used to help New Zealand children with heart problems.
Grant closed.
Grant No. 1152
Overseas Training Fellowship
Dr Sujith Seneviratne
No final report received.
Grant No. 1156
Research Fellowship
Dr Natasha Rafter
Cardiovascular disease is our leading cause of hospitalisation and premature death. Guidelines recommend people at high risk (e.g. those who have had a heart attack or stroke) receive long-term treatment with aspirin and medication to lower blood pressure and cholesterol. Most New Zealanders do not continue to take these medicines long-term. The IMPACT trial will assess whether a combination pill improves uptake of these medicines compared to standard practice (multiple pills). The PILL pilot trial will show how much the combination pill lowers blood pressure and cholesterol and whether it is well tolerated.
Grant No. 1159
Systemic ventricular remodelling after cardiac surgery in early infancy: pilot study
Dr Tom Gentles
Babies who are born with a single ventricle and require complex surgery have a high risk of developing heart muscle problems after operation. These heart muscle problems are most likely the result of excessive pressure and volume strain on the heart muscle. Further analysis is required to find the exact cause of these problems but it is likely that medical treatment and refinements of operation can help to avoid these issues in the future.
Grant closed.
Grant No. 1203
Renal impairment in decompensated heart failure
Professor A Mark Richards
This project was undertaken by Professor Mark Richards and Dr Suetonia Palmer who investigated possible new tests to predict the onset of acute kidney problems in patients admitted to hospital with acute heart failure. This is a common combination and the presence of kidney disease in heart failure predicts far worse outcome. The need to protect kidneys during treatment of heart failure is obvious but has been limited by the absence of early markers of this evolving problem. In this study a number of candidate markers were tested in a pilot study of 32 patients admitted to hospital with severe heart failure. Investigators found that levels within urine of a new marker known as NGAL showed considerable promise with levels being far higher in the third of patients who were destined to suffer kidney problems in the course of their admission. This early test of kidney problems in heart failure will help the study of future treatment approaches to protect the kidney during treatment of heart failure.
Grant closed.
Grant No. 1204
Nicotine replacement therapy selection box trial
Dr Natalie Walker
Smoking is a major cause of death and disease. Nicotine replacement therapy (NRT) is an effective aid to stopping smoking, however only the patch and gum forms are subsidised. New ways are urgently needed to get more people to use NRT when quitting. This trial will find out whether 1,410 smokers are more likely to quit smoking if they are given more choice over which NRT they use, as opposed to being given no choice. Recruitment has finished for the trial, with results expected to be available publicly mid 2010.
Grant No. 1209
Overseas Training Fellowship
Dr Sandhir Prasad
Dr Prasad undertook a research fellowship at MonashHeart in Melbourne, Australia that examined several clinical issues in the diagnosis and treatment of acute myocardial infarction in the modern era. This work was carried out under the supervision of Professors Ian Meredith and James Cameron, for whose guidance and support Dr Prasad was much indebted. The work examined the prevalence and significance of normal coronary arteries in heart attack patients, the role of obesity and the Metabolic syndrome in heart attack patients, and also the use of novel technology such as drug-eluting stents in the treatment of heart attacks. The research has been presented widely at international meetings, as well as published in peer reviewed cardiology journals.
Grant closed.
Grant No. 1210
Research Fellowship
Dr Hannah Badland
There is increasing evidence that sustainable solutions to increasing habitual physical activity and reducing obesity at the population-level may be related to design aspects of the neighbourhood environment. This research is focussed on these associations through the Understanding the Relationship between Activity and Neighbourhoods (URBAN) study by exploring the associations between body size and physical activity engagement in adults and children with built environment variables. Body size and physical activity levels are measured over 48 neighbourhoods in four New Zealand cities using objective measures and self-report survey methods. Built environment characteristics of study neighbourhoods are assessed using Geographic Information Systems (GIS), audits, and self-report measures. Study outcomes will directly inform national urban design policy and interventions to improve health outcomes by supporting population physical activity engagement and reducing obesity. The research is part of an eight-country study.
Grant No.1211
Research Fellowship
Dr Ralph Maddison
Physical activity is important for the health and well-being of all New Zealanders. A comprehensive programme of research was conducted which involved two studies that focussed on improving our understanding of physical activity and measurement, and two focussed on improving physical activity levels and decreasing sedentary behaviours. The first two studies utilized novel technologies and approaches (e.g. GPS and GIS) to improve physical activity measurement, while the second two studies showed that it was possible to reduce sedentary behaviours such as video games and TV watching, which could help prevent weight gain. Novel technologies and approaches could be used to better understand physical activity and improve physical activity in New Zealanders.
Grant closed.
Grant No. 1213
Postgraduate Scholarship
Ms Katrina Poppe
Type 2 diabetes increases the risk of cardiovascular disease and can cause changes in the heart muscle itself which adversely affect the way the heart contracts and relaxes. The aim of this research is to develop equations specifically for diabetics that can be used to estimate their individual level of cardiovascular risk. Different equations will be developed for different situations depending on the level of information available. For instance, the information available to a GP is different to that which is available to a cardiologist after specialist tests. The earlier a person is identified at being of increased risk, the greater the chance that risk can be reduced.
Grant No. 1214
Postgraduate Scholarship
Mr Christopher Booker
Obesity has become a major problem in our modern society, and is concerning from a health care perspective due to the greater risk of heart disease or diabetes that it brings. Inflammation is part of the body’s natural immune response, but in obesity, diabetes and heart disease this response is chronically overactive, and may be a link between these three diseases. This research examined the effect of a recommended diet on levels of inflammation in people with diabetes, and also examined the actions of one inflammatory factor on pathways in the brain governing appetite and body weight control. Current results are being prepared for presentation.
Grant closed.
Grant No. 1216
Postgraduate Scholarship
Ms Katrina Ellis
In addition to the much reported ‘lifestyle’ risk factors for heart disease, such as smoking and obesity, in some people up to half of their risk of developing heart disease is inherited. Genetic factors play an important role in the progression of coronary heart disease. This project studied gene variants from pathways involved in blood pressure and cholesterol regulation to identify those associated with outcome in coronary heart disease patients recruited from Christchurch and Auckland Hospitals. Identifying genes that influence disease susceptibility and the ability to recover after a coronary event may provide significant improvements in patient management and care.
Grant closed.
Grant No. 1217
Postgraduate Scholarship
Ms Shirin Foroughian
Overweight and obesity in childhood is a major and growing public health concern with short and long term physical and psychological consequences. Historically obesity was seen as a non-Asian phenomenon, hence this research focused on looking at issues of overweight and obesity in 12-18 year old Asians in New Zealand. Particular emphasis was given to investigating the nutritional and exercise behaviours of young New Zealand Asians, in order to suggest a health promotion approach to empower and improve the health of young people. The research was based on both quantitative (structured individual interviews and anthropometry measurements with 821 students) and qualitative approaches (semi-structured interviews with 12 focus groups comprising 46 students) of South Asian, East Asian and European ethnicity who lived and attended high schools in South Auckland.
RESULTS: The findings suggested that being overweight was a concern faced by Asian adolescents at the same level as European adolescents. The results showed no significant difference in mean Body Mass Index or mean waist to height ratio amongst the three ethnic groups; and no difference in fat mass between South Asian and European adolescents when using same cut-off points for all ethnicities. Additionally, there were a number of other risk factors affecting the weight status of Asian adolescents in New Zealand including: missing breakfast or lunch; consumption of junk food such as chips, biscuits, chocolates and pies while at school or at home before dinner; purchasing food from school canteens or dairies; discrimination of traditional foods at school; high consumption of sugary drinks, fried and fast foods; having access to more food and more variety than in their traditional cultures; lack of exercise and opportunities to be active; and hours spent watching television or playing computer or electronic games. There were also a number of factors that played a protective role for all children in maintaining a healthy weight including: having breakfast and lunch; bringing food from home; walking to school; and doing sports at school or being involved in an organised or team sport. Empowering and culturally appropriate ‘education and physical activity interventions’ for young people and their families was recommended; but to deal with the issue of obesity in Asian adolescents, family, school, community and government all have to play a role.
Grant closed.
Grant No. 1218
Postgraduate Scholarship
Mr Hamish Prosser
The enzyme ACE1 converts the inactive hormone Angiotensin I to active Angiotensin II (AngII). AngII elevates blood pressure to normal levels in healthy persons. Cardiac disease chronically elevates AngII, increasing blood pressure to unsafe levels. Pharmaceutical agents designed to combat this currently all target ACE1, reducing its activity, minimising AngII generation. It has been shown that a newly identified hormone ‘PA12’, with similar attributes to Angiotensin I can produce AngII independent of ACE1 activity, instead using an alternate enzyme called Chymase. This finding may provide alternate therapeutic targets in the battle to reduce blood pressure in those suffering high blood pressure.
Grant closed.
Grant No. 1248
A randomised trial to improve patient understanding of cardiac risk
Dr Elizabeth Broadbent
This trial investigated whether a nurse could help heart attack patients to understand their cardiac risk better by using the information generated by the Predict risk management programme. Patients were randomised to either receive the Predict information or not and were followed up immediately and at 3-months to assess understanding and health behaviours. Patients who received the Predict information felt that they understood their condition better, that they had more control over their illness and that exercise and dietary changes could help, however their estimation of their numerical risk was not improved. Final analyses of the follow-up data are underway.
Grant closed.
Grant No. 1249
Reaching advanced age: older hearts and health
Associate Professor Ngaire Kerse
This project aimed to determine inflammatory markers, body composition, lipid profile, physical activity, nutritional status, and cardiac function in elderly subjects; and to determine the association of these parameters to past cardiovascular events. The research began in 2007 and is now complete having enrolled 70 people aged 85 years and 33 people of 75-79 years (Maori) to undertake comprehensive cardiac assessments, including cardiac history, cardiac imaging, body composition and blood tests. Results showed that the associations between risk factors and CVD differed for those in advanced age compared with younger people.
Grant closed.
Grant No. 1250
Comparison of left and right ventricular volume measurements with real time 3D echo vs cardiac MRI in congenital heart disease
Dr Nee Khoo
No final report was received.
Grant No. 1269
Inhibition of cardiac sympathetic nerve activity: novel therapies post-MI
Dr Chris Charles
Cardiovascular disease is a leading cause of death and significant burden on our health system. As existing drug treatments remain less than ideal, additional effective strategies for management of these patients is needed. Nerve activity going to the heart is of major importance in the control of heart function and is likely to be involved in the cause of heart failure and sudden death from heart attacks. Reducing nerve firing directed at the heart is crucial following heart attacks and in ongoing heart failure. The objectives of this project are to (1) assess changes in this nerve activity in response to commonly prescribed medications both before and following a heart attack; (2) to assess the therapeutic potential of agents which inhibit nerve activity immediately after a heart attack; and (3) to measure interaction of novel hormones with this nerve activity. These studies will identify candidate hormones or other drugs which may attenuate the severity of heart damage following a heart attack and may reduce the incidence of sudden death. As such, this project is likely to produce important and unique information likely to improve our understanding of this important aspect of heart function. Such insight has the potential to lead to new or improved treatments for these common, often devastating disorders.
Grant No. 1270
Effect of chronic Urocortin 2 treatment following experimental myocardial infarction
Dr Leigh Ellmers
Cardiovascular disease is a leading cause of death in New Zealanders. Despite advances in therapy, the prognosis remains poor for those effected, necessitating investigation of possible new treatments. The Urocortin family of hormones may have beneficial effects in heart disease. In this study the role of urocortin 2 as a possible therapeutic agent was investigated. This hormone was administered after heart attack in mice to assess its function in ameliorating the damage associated with this type of heart disease. The study has shown urocortin 2 is a cardioprotective hormone which reduces the damage to the heart after a heart attack and helps to maintain normal cardiac function.
Grant closed.
Grant No. 1271
Determinants of obesity and cardiovascular risk factors at 11 years of age
Professor Ed Mitchell
The Auckland Birthweight Collaborative study is investigating factors including diet and physical activity in childhood and how these factors are related to children becoming overweight and obese as they grow up. The investigators are also looking at how such factors affect the cardiovascular health of these children. Data has been collected on these children at birth, 1, 3.5, 7 and 11 years of age. Therefore the investigators are able to track how these factors and changes in lifestyle might affect children as they grow up both in terms of their physical size and body composition, and the risk of them developing disease as they grow older.
Grant No. 1273
The Maori Community Heart Study ? Non-Maori Cohort
Ms Suzanne Pitama
There is a major disparity in heart disease mortality between Maori and non-Maori, but how many Maori are living with cardiovascular disease in the community is not well documented. The investigators are documenting current levels of established heart disease, levels of previously undiagnosed diabetes, cardiovascular disease and risk factors in rural Maori community at Wairoa (Hawkes Bay), and urban Maori in Christchurch, as well as evaluating the implementation of treatment programmes, interventions, and outcomes for study participants. The current project documented cardiovascular disease and risk factors in a non-Maori comparator group, matched to the Christchurch Maori cohort.
Grant closed.
Grant No. 1274
Regional secretion and clearance of novel peptides in health and heart disease
Professor A Mark Richards
Professor Mark Richards and Dr Suetonia Palmer have investigated the relevance of some newly discovered circulating chemicals to heart health. 120 patients coming forward to cardiac catheter tests volunteered blood samples from a number of different positions within the circulation which allowed the investigators to determine where these circulatory and heart hormones were produced, where they were cleared, and how levels related to cardiac function, kidney function and other clinical features. In all, over five different circulating proteins have been investigated in this manner leading to a much improved understanding of the sites of production and clearance and their relationship to heart health.
Grant closed.
Grant No. 1275
Promoting healthy childhood nutrition through primary schools: a study of barriers, supports, and effective policy options
Dr Louise Signal
Primary schools are seen as key sites to promote healthy nutrition practices to students. This study looked at the influences on children’s diets within five case study primary schools, and discussed possible policy interventions to support schools to promote healthy nutrition with sixteen policymakers. Eleven interventions were identified to promote healthy childhood nutrition. Interventions ranged from food policies within schools; through to influencing the price of healthy food compared to unhealthy food; to improved nutrition labelling on food and providing free breakfasts or lunch at school. The interventions recognised that schools had a limited impact on children’s diets, with home and community based influences also being important.
Grant closed.
Grant No. 1277
Overseas Training & Research Fellowship
Dr Ruvin Gabriel
This overseas training fellowship was undertaken in multi-modality cardiac imaging over two years at the Cleveland Clinic, Cleveland, Ohio, USA. The heart can be imaged using different technologies, each with different strengths and weaknesses. Dr Gabriel obtained clinical expertise in recent advances in 3D ultrasound of the heart (echocardiography) and use of ultrasound contrast bubble agents in echocardiography during the first year of the fellowship. In the second year, he obtained clinical expertise in cardiac CT imaging of the coronary arteries and aorta, and in cardiac MRI. Research undertaken in all three imaging modalities, was performed and presented at international conferences and has been published in peer-reviewed cardiology journals. The clinical and research skills obtained will help manage patients at Middlemore Hospital, South Auckland.
Grant closed.
Grant No. 1278
Overseas Training & Research Fellowship (White-Parsons)
Dr Judith MacCormick
This fellowship is based at the Children’s Hospital Boston, Massachusetts. The fellowship programme offers broad training in paediatric cardiology, with well-developed divisions of interventional cardiology, cardiac imaging, electrophysiology, intensive care cardiology, transplant cardiology and adult congenital heart disease. Dr MacCormick will complete her cardiology training and commence a further year of senior fellowship in paediatric cardiac imaging. This involves advanced training in echocardiography, fetal echocardiography and cardiac magnetic resonance imaging. Dr MacCormick is undertaking two research projects; the first examines cardiac structures in newborns with congenital diaphragmatic hernia, while the second investigates the clinical impact of diagnostic error in non-invasive imaging.
Grant No. 1279
Research Fellowship
Dr Jade Hollis-Moffatt
It is well established that high serum urate (hyperuricemia) is the primary cause of gout. Recently, hyperuricemia was also recognised as an independent risk factor of cardiovascular disease and hypertension. The outcomes of this research, in partnership with Ngati Porou Hauora, will advance knowledge on the underlying genetic cause(s) of hyperuricemia. Implementation of a genetic test to predict hyperuricemia and uric acid-lowering interventions (Allopurinol) will be trialled in susceptible Te Tairawhiti individuals, with the aim of reducing the impact of cardiovascular disease, hypertension and gout. The investigators have continued recruitment of a clinical cohort and identified genetic variants within candidate urate transport genes that contribute significantly to the development of gout in Maori and Pacific New Zealanders.
Grant No. 1280
Research Fellowship
Dr Melody Oliver
Almost a third of New Zealand children are overweight or obese. Physical activity is fundamental to obesity prevention and treatment in children, and may be strongly influenced by the physical and social environments that children are exposed to. Greater understanding of these environmental influences on activity behaviours and obesity is required to develop effective solutions to reverse obesity and insufficient PA levels in children. The focus of this research is thus to objectively assess physical activity in New Zealand children, and to identify factors within children’s built and social environmental contexts that are related to activity behaviours and body size.
Grant No. 1282
Research Fellowship
Dr Nicola Scott
The metabolic syndrome is a risk factor for developing diabetes and heart disease. The number of people being diagnosed with the metabolic syndrome every year is increasing and although it is a very common disorder, little is known about how it develops or why it increases the chance of developing other diseases. Through the development of an animal model of this disease the researchers are able to investigate the tissue changes which occur during establishment of the metabolic syndrome, furthering understanding of this disorder. The investigators are also proposing to study variants of two genes that are associated with insulin resistance and high cholesterol in New Zealanders with and without metabolic syndrome.
Grant No. 1284
Research Fellowship
Dr Shieak Tzeng
Impaired neural regulation of cardiac function and blood pressure is a major risk factor for sudden death from established cardiovascular disease. The current fellowship consists of several projects investigating the fundamental relationships between respiratory activity and cardiovascular control, with a special focus on determining whether interventions directed at reducing breathing rate enhances cardiovascular regulation. Results from these ongoing projects will guide the development of respiratory pattern training as a non-invasive adjunct in the management of cardiovascular disease.
Grant No. 1285
Postgraduate Scholarship
Ms Helen Eyles
Tailored nutrition education, which is designed to reach one specific person based on characteristics unique to that person, is becoming an increasingly popular dietary intervention method. Funding from the Heart Foundation was used to undertake three PhD-specific research objectives within the framework of a large supermarket intervention trial assessing the effects of tailored nutrition education and price discounts on supermarket food purchases (the SHOP trial): (1) A systematic literature review indicated that tailored nutrition education is a promising way of improving the diets of adults, including priority population groups; (2) a 50-person sub-study indicated that household supermarket sales data are a good surrogate measure of some individual nutrient intakes, particularly saturated and total fat, and; (3) a modified version of The Heart Foundation Tick programme, as used in the SHOP trial, was found to effectively distinguish between healthier and less healthy options, and to categorise foods similarly to the Food Standards Australia New Zealand Nutrient Profiling Calculator.
Grant No. 1286
Heart disease mortality after radiotherapy
Associate Professor Brian Cox
The objectives of this research are 1: to assess the risk of heart disease after radiotherapy to the chest for breast cancer by comparing the rates of heart disease in women with left-sided breast cancer with those with right-sided breast cancer; and 2: to assess the risk of lung cancer in women with breast cancer who have chest irradiation. Delays in combining the 48 worldwide data sets have occurred and two more years of data is being added. The New Zealand data is currently being analysed separately and the results being prepared for publication.
Grant No. 1287
Can an antioxidant targeted to mitochondria inhibit lesion development and proinflammatory signalling in a mouse model of atherosclerosis?
Ms Elizabeth Ledgerwood
Antioxidants are widely touted as being able to prevent heart disease, however clinical testing of antioxidants such as Vitamin E has had disappointing results. This may be because the antioxidant is not in the right place within cells. MitoE is a new version of Vitamin E that is ‘targeted’ to the major site of oxidant (free radical) production within cells. The investigators hypothesised that MitoE would effectively block steps necessary for the development of heart disease. However in the pilot study in mice no beneficial effect of the MitoE treatment on the development of heart disease was found.
Grant closed.
Grant No. 1298
Maori CV Research Fellowship
Ms Amy Norman
This project investigated the influence of maternal nutrition during pregnancy on the development of obesity in the offspring. A nutrient poor environment during development has been shown to make the offspring susceptible to obesity and metabolic disorders in adulthood. Metabolic flexibility describes the ability to match energy fuels to energy demands and the primary aim of this research was to investigate how this is established from birth. Tthe composition of skeletal muscle was assessed in order to understand the influence of developmental nutrition on exercise capacity later in life. In addition, measures of insulin sensitivity in these prenatally-induced obese offspring was investigated.
Grant closed.
Grant No. 1307
Markers of pulmonary artery hypertension
Dr Adrienne Edwards
Pulmonary arterial hypertension (abbreviated to PAH) is a rare condition caused by high blood pressure in the arteries running from the heart to the lungs. Increases in blood pressure puts strain on the heart, and eventually caused the right side to stop working. Although modern therapies improve symptoms and outcomes there is still no cure for PAH which is devastating in this young patient group. This study aims to identify protein markers in the blood of participants with PAH. This will lead to a better understanding of PAH which may lead to earlier diagnosis and curative treatments.
Grant No. 1309
CoQ10: Potential to reduce cardiovascular risk ? extension study
Ms Joanna Young
Coenzyme Q10 (CoQ10) is an increasingly used complementary medicine for prevention of heart attack and stroke. Statins are indicated for people with cholesterol disorders to reduce cardiovascular events. Reductions in CoQ10 in statin-treated subjects have been associated with improvements in vascular function. The investigators will examine if CoQ10 supplementation in statin-treated subjects further improves vascular function, giving additional benefit to CVD reduction. Fourteen percent of statin-treated subjects cannot tolerate an appropriate dose of statin therapy due to muscle aches. The investigators aim to examine genetic variations that may increase susceptibility to statin-related muscle aches, facilitating the selection of optimal drug therapy.
Grant No. 1319
Linking multiple national datasets to describe the prevalence and management of coronary heart disease in New Zealand
Dr Wing Cheuk Chan
Statin is a cholesterol lowering medicine that had been shown to prolong life, and reduce the number of heart attacks. This study described how frequently these drugs were used in the year after receiving hospital treatment for a heart disease event, in New Zealand in 2007. Importantly, just over one in two people received enough statin therapy to obtain maximum benefit from them. These findings suggest that statin could be more widely utilised, and the fact that these medicines need to be taken regularly long term to obtain the maximum benefit should be emphasised.
Grant No. 1320
Oxidised cholesterol and antioxidants as determinants of macrophage activity during atherosclerotic plaque development
Dr Steven Gieseg
The formation of advanced plaque within the artery is a serious clinical development. The process is driven in part by the formation of toxic levels of oxidised cholesterol. The study data has shown that oxidised cholesterol causes the rapid shutdown of white blood cells metabolism, by triggering the generation of free radicals within the cells. It appears the binding and uptake of oxidised cholesterol that causes the oxidant production requires the cell surface receptor CD36. It has been shown that cellular CD36 production is inhibited by the antioxidant dihydroneopterin which is made by white blood cells during inflammation. These exciting results suggest incomplete inflammation processes are a key factor in advanced plaque development.
Grant No. 1321
Using an old antibiotic to lower lipoprotein(a)
Dr Sally McCormick
Cardiovascular disease is the leading cause of death in New Zealand. A major risk factor for developing heart disease is high plasma levels of lipoprotein(a) [Lp(a)]. There is currently no effective therapy for lowering Lp(a) levels. A new strategy to lower Lp(a) levels is being tested based on preliminary research that has identified the antibiotic bacitracin as an inhibitor of Lp(a) assembly. The mechanism of inhibition is to be studied as well as its ability to lower Lp(a) levels in Lp(a) transgenic mice. This research project may ultimately lead to the development of a potential Lp(a)-lowering agent for clinical use.
Grant No. 1322
Coenzyme Q10 adjunctive therapy in high-risk hypertensive patients
Dr Sarah Molyneux
Hypertension is a significant modifiable risk factor for both cardiovascular and renal disease. In New Zealand, approximately half the people taking medication for high blood pressure still have high blood pressure. Coenzyme Q10 (CoQ10) is found in every cell in the body, is essential for cellular energy production and acts as an antioxidant. CoQ10 supplements are available over the counter. CoQ10 has been reported to lower blood pressure. Supplemental CoQ10 is being given to 30 patients with uncontrolled high blood pressure, despite medication, to determine whether CoQ10 can further lower their blood pressure, and reduce their risk of serious disease.
Grant No. 1323
The role of prorenin and its receptor in cardiovascular disease
Associate Professor Miriam Rademaker
Prorenin and its recently identified receptor may be involved in blood pressure regulation and cardiovascular tissue damage. The aim of this project is to examine the role of prorenin and the (pro)renin receptor in the pathophysiology of heart disease by investigating the physiological, tissue and molecular effects of (pro)renin receptor-blockade in experimental models of heart attack and heart failure. Work to date suggests that antagonism of the prorenin system has beneficial effects in both settings, and thus may have potential therapeutic importance in clinical heart disease.
Grant No. 1324
Vasodilators for aortic regurgitation
Dr Ralph Stewart
Vasodilators may benefit patients with chronic aortic regurgitation by decreasing the regurgitant volume and/or decreasing LV after-load and therefore myocardial work. However current treatment guidelines do not recommend vasodilator treatment in these patients because of lack of evidence. This study will compare the effects of open label treatment with perendopril-amlodipine with usual care for one year using a randomised cross-over design in 25 patients with moderate-severe asymptomatic aortic regurgitation. This study was delayed due to staffing issues, which are now resolved, and recruitment is planned over the next 12 months.
Grant No. 1325
Individual patient meta-analysis of the mortality associated with heart failure with preserved versus impaired systolic function
Dr Gillian Whalley & Associate Professor Rob Doughty
Heart failure is an important health problem in New Zealand, with high rates of death and hospitalisation. Heart failure is typically regarded as ‘pump failure’ but many patients with the syndrome of heart failure have preserved heart pump function, so-called ‘heart failure with preserved ejection fraction’. This condition more commonly affects older women, with a prior history of high blood pressure, and less likely a history of heart attack. This meta-analysis, involving more than 46,000 patients has shown that this group of patients has a lower chance of dying than the patients with pump failure. These results will help to understand how to manage such patients who are commonly seen in everyday clinical practice.
Grant closed.
Grant No. 1330
Research Fellowship
Dr Samuel Lucas
Grant No. 1331
Research Fellowship
Dr Tania Riddell
PREDICT is a web-based decision support programme for doctors and nurses caring for people who have, or who are at risk of developing, cardiovascular disease or diabetes. This programme makes cardiovascular risk prediction easy and accessible and provides health practitioners with evidence-based patient-specific risk assessment and management support. At the same time, risk profile data is securely and anonymously collected and analysed by PREDICT researchers at the University of Auckland. The aim of this fellowship is to specifically address inequalities and promote equity in cardiovascular health care for Maori in New Zealand. The fellow plans to lead Maori research within the PREDICT programme; look at equitable models of care for Maori; and develop a strong base for epidemiological cardiovascular research as a tool for Maori advocacy and influence.
Grant No. 1334
Cardiovascular disease and HDL-cholesterol function
Dr Jinny Willis
HDL is often referred to as ‘good’ cholesterol because it is involved in removing cholesterol from artery walls. In general, high levels of HDL are associated with lower rates of heart disease. However, not everyone with high HDL remains free of heart disease, suggesting that some HDL particles are protective, while others accelerate the disease process. This research aims to characterise HDL function in people with high HDL levels, who either have heart disease, or who have no evidence of heart disease. People with type 2 diabetes have high rates of heart disease. In a separate part of the study HDL function will be compared in people with diabetes and healthy controls. Understanding the type of HDL, as well as the amount, may give to better estimate of individual disease risk.
Grant No. 1336
To support research in the area of prevention and management of overweight and obesity
Dr Andrew Jull
This grant helped fund the applicant to complete the development of the New Zealand guidelines for weight management in adults, children and young people. The grant also helped fund time to be involved with research looking at supporting people trying to lose weight. However, the research did not lead to any substantial weight loss in most people.
Grant closed.
Grant No. 1347
Do large deletions and/or duplications in LQTS genes cause sudden death in young New Zealanders?
Ms Carey-Anne Eddy
Long QT syndrome (LQTS) is the leading cause of unexpected death in young people. There are medications and treatments available which can save lives immediately, but a genetic diagnosis is crucial to detect the condition and allow for the best choice of treatment. A relatively new technique, MLPA, has been used to detect large deletions or duplications in LQTS genes in sudden death victims. None of forty eight sudden deaths were found to have carried such a mutation. It is likely that these mutations are just very rare yet still contribute to the sudden death of young New Zealanders.
Grant closed.
Grant No. 1349
Development of MRI ‘DENSE’ protocol and corresponding analysis software to detect heart failure in rats
Dr Jun Lu
The aim of this project was to implement a new MRI scanning protocol (DENSE) that would enable the study of regional myocardial function in small animal models with much higher resolution than using traditional tagging method. The DENSE protocol has been successfully implemented with the help of a collaborator from the University of Pennsylvania. The collaborator is constructing a suitable coil for such study. Good data sets have been acquired and three conference abstracts have been published.
Grant closed.
Grant No. 1350
Young peoples’ response to graphic warning labels and plain packaging as a potential smoking prevention tool
Dr Judith McCool
Graphic warning labels (GWLs) were introduced into New Zealand in 2008. This study assessed how adolescents appraised these images and how they impacted on smoking uptake or behaviours. Results of focus group interviews with Year 7 students from Auckland schools indicated that adolescents were acutely aware of the graphic warning labels and were able to accurately recall the details of the images. The ‘potency’ of the GWLs as a smoking deterrent was determined by current state of smoking experimentation; credibility of the images was based on perceived believability of the health effect depicted on the cigarette package. The GWLs also operated to ‘taint’ or confuse the original cigarette branding.
Grant closed.
Grant No. 1351
A novel marker of acute coronary syndromes
Dr Christopher Pemberton
It has been discovered that a peptide fragment common to all secreted proteins, (known as a signal peptide), and previously thought to be degraded within cells, is in fact present in the human circulation. A sensitive assay has been developed to measure the signal peptide of the cardiac hormone BNP (BNPsp) and has been used to show that blood concentrations of BNPsp have the potential to act as a clinical biomarker used for the diagnosis of heart attacks and unstable angina. Current work focusing on improving the sensitivity and speed of assay of BNPsp will lay the platform for ongoing studies focusing on the areas of best clinical utility for this novel biomarker.
Grant No. 1352
Partial funding for the purchase of an ultrasound machine equipped with cardiac calculation package suitable for use on rodents
Dr Gerard Devlin
This project was aimed at investigating if the absence of a growth factor known as myostatin could limit the loss of cardiac muscle following a heart attack. Heart attack was induced in 2 groups of rodent models (wild type and genetically modified mice with the absence of myostatin). Heart function was assessed using cardiac ultrasound before and after the heart attack. It was found that mice without myostatin have a better recovery of function after a heart attack compared to the wild type animal. This finding suggests a potential agent which inhibits myostatin can potentially be developed and administered at the time of a heart attack to improve the clinical outcome.
Grant closed.
Grant No. 1353
Visit to the Cardiovascular Center and Cardiac Arrhythmia Service at Massachusetts General Hospital, USA, to learn new technique, 1-31 March 2009
Dr Ivone Leong
Long QT syndrome (LQTS) is an inherited disease that affects 1:1000 to 1:500 people worldwide. It is a serious disease that can cause uncontrolled arrhythmias, which can lead to sudden death. The use of zebrafish to model LQTS is still relatively new and the analysis of zebrafish hearts using electrocardiogram (ECG) and optical mapping technologies is highly specialised. The visit to the Cardiovascular Research Centre at Massachusetts General Hospital provided the necessary training to set up ECG and optical mapping for zebrafish in the School of Biological Sciences, University of Auckland.
Grant closed.
Grant No. 1359
Physical activity measurement in New Zealand children
Ms Louise Foley
This research aims to develop a self-report physical activity questionnaire for New Zealand children and young people, which could become the instrument of choice for national surveillance and for research. Overweight and obesity in New Zealand children is approaching epidemic proportions and lack of physical activity is a major contributor. Therefore, having accurate physical activity measurement is paramount in determining the effectiveness of programmes to increase physical activity as well as for population monitoring. Fifty children will be recruited from the Auckland region to take part in this innovative research project, and currently 15 have completed all study procedures.
Grant No. 1361
Establishing echocardiographic reference ranges that include people over 40 years of age
Ms Katrina Poppe
Echocardiography is widely applied in both clinical and research practice to identify abnormalities in individuals. Diagnosis of pathology or deleterious changes associated with cardiovascular disease requires comparison to a ‘normal range’. Existing echocardiographic reference ranges have been generated mostly among North American populations and are based on limited numbers of individuals. The small project grant from the Heart Foundation has enabled the recruitment of a group of older subjects free of cardiovascular disease to add to the series of younger normal subjects. From this, age appropriate reference ranges of echocardiographic parameters that are suitable to the contemporary New Zealand population will be created, allowing more accurate analysis and modelling of factors affecting the development of cardiovascular disease.
Grant No. 1362
Rheumatic fever/Rheumatic heart disease workshop: Towards abolition of inequalities
Professor Diana Lennon
Rheumatic fever causes long term heart damage. It occurs following a strep throat in school-aged children. If the strep throat is treated appropriately rheumatic fever is prevented. Lack of progress to date in New Zealand was summarised in a recent National Heart Foundation-sponsored workshop. Ways forward were identified:
- Sore throat clinics in schools in all high risk areas should be implemented. These are already in place in Kaeo, Kaitaia and Opotiki but these areas account for less than 5% of all RF cases.
- Echocardiographic screening to detect missed cases should be researched in detail.
- Improved community and professional knowledge should be addressed urgently.
Grant closed.
Grant No. 1386
How would plain packaging affect young adult smokers?
Professor Janet Hoek
Although regulations have curtailed the influence of tobacco marketing, this continues through branding, particularly packaging. A Best-worst experiment was used to estimate the effects of reduced branding and increased graphic health warning (GHW) size on young adult smokers. Four different branding levels (full, colour, brand name only and product category) and three GHW sizes (30%; 50% and 70%) were tested. As branding elements were reduced and GHWs increased in size, pack attractiveness decreased markedly and the likelihood the respondent would make a quit attempt, seek quit help, or reduce the number of cigarettes smoked all increased significantly.
Grant Closed.
