Cardiovascular

The Institute of Cardiovascular Science (ICS) and the Cardiometabolic domain at UCL encompasses some 450 research-active clinicians and scientists within cardiovascular medicine, while  UCLPartners brings together several major paediatric and adult partner hospitals affiliated to UCL.  Working with this powerful network, UCLPartners’  Cardiovascular Programme has targeted three key areas for translating  UCL’s world-class cardiovascular research into clinical practice.

Prevention

Successful treatment of dementia, Alzheimer’s disease and many cancers requires better understanding of disease pathogenesis.  In cardiovascular disease, by contrast, the determinants of atherosclerotic vascular disease and the cause of most strokes and heart attacks are sufficiently well understood to enable prevention – provided lifestyle change can be achieved, coupled where necessary with pharmacological therapy. This is a public health challenge, requiring better understanding of the determinants and motivators for behavioural change.  UCLPartners has established a Prevention and Outcomes Unit with the main mission of developing cost-effective strategies for disease prevention.  These include  novel, targeted screening and treatment strategies for high risk individuals with familial hypercholesterolaemia;  and population-based strategies focused on wellness and lifestyle change.

Heart Failure

Congestive heart failure (CHF) is the greatest single health care cost in most Western countries. In the UK, most heart failure patients are identified after acute hospital admission. Management algorithms involve education and patient surveillance to ensure treatment compliance (fluid intake, diet, drugs) and to assess response. It was recognised more than a decade ago that close monitoring by specialist nurses improves outcomes and quality of life and reduces hospital admissions.

The North Central London (NCL) sector has an estimated 1,200 new CHF cases a year, and a total of about 18,000 patients with CHF.  The UCL CHF network presents the potential for an integrated diagnostic and management programme across the sector.  The network’s Board has therefore scoped the patient pathway from presentation to death in relation to the standard of care and appropriate resources required to deliver quality outcomes, and is working to establish an integrated care programme focused on delivery within the community.  Novel patient-determined quality outputs are being developed and assessed across the network. These include patient- and family-reported outcomes; the cost efficacy of a 6 minute walk test; and implementation of Quality of Life questionnaires.

Congenital Heart Disease

An integrated paediatric and adult programme is well established at Great Ormond Street Hospital and The Heart Hospital for diagnosis and management of congenital heart disease.  Improved quality of care is linked to joint frontier research in imaging and percutaneous “surgical” treatments (such as valves, stents and hole closures) to avoid repeated surgery.

For more information, please contact Professor William McKenna, Programme Director for Cardiovascular at UCLPartners.