Inter-university Cape Heart Research Unit

Current projects

The Hatter Institute for Cardiology Research
The two main focus areas include the study of ischaemic heart disease and the transition from cardiac hypertrophy to heart failure.

In the ischaemic heart disease division, researchers are investigating the way in which the heart itself can increase its resistance to damage from heart attacks. The ultimate aim of the group is to establish the mechanisms whereby the heart becomes tolerant to damage from heart attacks. Understanding this will enable researchers to design therapeutic agents which assist the heart to protect itself from heart attacks

The heart failure group is co-directed by Dr Faadiel Essop. Here a group of researchers is beginning to understand how the heart uses different fuels to function under normal conditions and in response to heart failure. It has been postulated that an inability to use fuels may contribute to the development of heart failure. Hence dissecting these mechanisms should allow Dr Essop and his team to establish definitively what role energy metabolism plays in the development of heart failure. If this is found to be central, new therapeutic strategies could be used in an attempt to diminish the devastating effects of heart failure.

The Cardiovascular Research Unit
A major focus of this group is to use tissue engineering to develop heart valves from tissue within the body. This approach, if successful will be of major benefit to patients with rheumatic heart disease that requires valve replacement and subsequently lifelong medical therapy. The major sponsor of this work is The Medtronic Company and a major goal of this research team will be to develop tissue engineering in order to insert heart valves that do not require intensive medical therapy and follow up subsequently.

The biology group within the cardiovascular research group is focusing on understanding wound healing. The emphases in this complex area are on:

• angiogenesis;
• the involvement of the matrix metalloproteinases; and
• the motility of the critical cell types on modified synthetic surfaces.

The aims are two-fold: achieving basic insights into this fundamental area and manipulating any findings to attain more rapid and complete healing of vascular grafts.

The Lipid Unit
This Unit has a large clinical component. The clinical consultation service attends to patients with severe dyslipidaemia by providing a clinical assessment to the patient. This information is later made available for research purposes and is relevant to both the Cape region and the country as a whole.

The Unit sees about 500 new patients per year, and does approximately 1500 follow-up consultations. There is also an inpatient service for acute problems.

The plasmapheresis for homozygous familial hypercholesterolaemia is supervised from our clinic, being the most experienced centre in Africa.

A major research interest at our clinic is prevalence and causes of type III dyslipidaemia. We have previously found that a large proportion of local patients have an unusual molecular defect for this disorder, especially black patients.

We have set up a low cost screening test (non-denaturing gradient gel electrophoresis) which seems to detect the disorder well and could make a contribution to the diagnosis of patients with cholesterol disturbances world-wide.

We are also attempting to study the prevalence of this unusual gene for type III hyperlipidaemia, as it is a disease placing patients at very high risk for heart disease.

The Human Genetics Unit
Research activities at the Division of Human Genetics are focused on investigating treatable genetic diseases that are relatively common in South Africa. These include familial
hypercholesterolaemia (FH) and hereditary haemochromatosis (HH), that significantly increase the risk of heart disease in South Africa.

Molecular-genetic studies are aimed at developing cost-effective DNA-based assays for accurate disease diagnosis, which is a prerequisite for optimal treatment.

Assays that have been developed for FH and HH are currently being used routinely to identify the causative mutations in index patients, and subsequently to trace the defective genes in affected families. This approach allows pre-symptomatic diagnosis and disease prevention in cases where preventative measures are implemented before the onset of clinical symptoms.