December 2019

New Cardio-oncology Service Launched

Patients with possible heart conditions are set to benefit from a new joint cardio-oncology service established by Liverpool Heart and Chest Hospital (LHCH) and Clatterbridge Cancer Centre.

The new service, sees close collaboration between oncologists and cardiologists from the two trusts to provide cardiac assessment and care for a wide-range of patients before, during and after their cancer treatment.

Dr Rebecca Dobson, Consultant Cardiologist at LHCH, is leading the service and said the benefits for patients and families will be significant.

“This new dedicated cardio-oncology service not only helps to identify patients at risk from cardiac illness earlier in the patient pathway and provides rapid access to specialist cardiovascular care and treatment, but also ensures a more holistic approach that will improve the patient’s experience.”

The service will be based initially at LHCH and will be supported by Dr Jay Wright, Consultant Cardiologist, two highly specialised cardiac physiologists and a wider multi-disciplinary team. It will look after patients who:  

  • need cancer treatment but need their heart function assessed before treatment starts
  • are currently receiving cancer treatment and have developed a cardiac complication
  • are clear of cancer but are now suffering from heart problems due to previous cancer treatments.

November 2019

BHF Clinical Lead Appointment

Professor Rod Stables, Chair of the ICMS Executive Committee, has been appointed to the role of Clinical Lead for the British Heart Foundation (BHF) Clinical Research Collaborative. This vital role will provide the essential clinical leadership to support the planning and delivery of world-class clinical research in all aspects of cardiovascular disease.

Prof Stables is consultant cardiologist and Director of the Cardiac Catheterisation Laboratories at Liverpool Heart and Chest Hospital. He was the Chair of the Academic and Research Committee at the British Cardiovascular Society and holds academic appointments at the University of Liverpool and Imperial College, London.

The newly established BHF Clinical Research Collaborative aims to unite and coordinate the current clinical research efforts of the existing professional societies and clinical research groups in heart and circulatory diseases.

Professor Sir Nilesh Samani, BHF Medical Director said: "I am delighted that Professor Rod Stables has been appointed as the Clinical Lead for the BHF-CRC. Professor Stables has a leading reputation for practice and research in cardiology, focused on the democratisation of clinical research, which will provide the perfect skill-set to lead this important initiative.”

Professor Simon Ray, President of the British Cardiovascular Society, said: "I am delighted that Prof Rod Stables has been appointed as the Clinical Lead of the BHF Clinical Research Collaborative. Rod has an international reputation as a clinical trialist and has done a great job as interim lead in bringing together a diverse range of specialist groups under the umbrella of the Collaborative."

His clinical interests include coronary intervention including emergency Primary Percutaneous Coronary Intervention (PPCI), TAVI, and non-surgical septal reduction in hypertrophic cardiomyopathy. He founded the Clinical Trials and Evaluation Unit at the Royal Brompton Hospital and led its initial flagship ventures.

His research interests are focused on the democratization of clinical research, seeking to simplify the design, conduct and reporting of clinical trials, and other forms of outcomes analysis. This is exemplified in the conduct of the HEAT-PPCI trial (the largest ever single-centre trial and the only study to recruit 100% of eligible patient presenting with the clinical syndrome of interest).

Prof Stables’ term as the BHF CRC Clinical Lead role will commence immediately until the end of May 2021.

October 2019

Newly published outcomes from the Stent or Surgery (SoS) Trial

First published in the Lancet in 2002, the SoS trial assessed the effect of stent-assisted percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) in the management of patients with multiple diseased vessels. The study found that the use of PCI reduced the need for repeat revascularisation when compared with previous studies, though the rate remained significantly higher than in patients who were managed with CABG.

A study published this month in the International Journal of Cardiology, used some of the data collected in the SoS trial. This study aimed to compare patient and clinician reporting of angina both before and after revascularisation. The authors of this study suggest that prior to the procedure, clinicians often declare a modest overstatement of angina when compared to patients. However, in the months following the procedure, clinicians report a greater proportion of patients to be angina-free. The study highlights the importance of including patient reported outcomes in evaluating the treatment of coronary artery disease.

Read the paper in full here.

September 2019

Aorta: Structure to Rupture Meeting

This event was the 2nd Annual meeting of the Liverpool Aortic Biomechanics and Biochemistry (LABB) Research Group and was sponsored by the ICMS. It was an interdisciplinary day bringing together clinicians, engineers and life scientists to explore state-of-the-art in aortic pathology research.

The first keynote was by Prof. John Pepper OBE, a distinguished surgeon at the Royal Brompton and Harefield NHS Foundation Trust. The excellent talk covered inflammation, biomarkers, and the role of proteogycans in the dissecting aorta. Prof Pepper highlighted the need for emergency diagnostic tests.

The first imaging talk was by Dr Tim Fairbairn from Liverpool Heart and Chest NHS Foundation Trust. The talk provided excellent clinical insight into the utility of cardiovascular MRI for aortic imaging.

August 2019

New Head of R&I for Liverpool

Vicky Wilkinson took over as Head of Research & Innovation at Liverpool Heart and Chest hospital (LHCH) in August. She has come to LHCH from the Clinical Research Network North West Coast so we thought we’d have a chat about her new and her involvement and ambitions for the ICMS.

Firstly, tell us a bit about your new role.
I was appointed as Head of Research and Innovation at LHCH in mid-August 2019. I’m responsible for all aspects of NHS research and innovation throughout the Trust. My overall objective is to continue to have the Trust recognised as a centre of excellence for clinical research. It’s a busy and varied role and I definitely won’t be bored!

What excites you most about your new role and working within the ICMS?
I am excited to get to know and work with the research and innovation team and all of the clinicians and other staff that are directly involved with, or champion research and innovation throughout the Trust. I am looking forward to working within the ICMS as it brings together the expertise of our clinicians together with other leaders in the field of cardiovascular medicine to develop new and improved services for not just our patients, but those further afield.

What do you see as the upcoming priorities of the ICMS in 2019 and beyond?
I think to encourage the next generation of researchers and to keep driving cardiovascular research forward.

How can health professionals at your Trust get involved with the ICMS?
Coming to talk to us in the research and innovation department about their ideas and then we can link them to the ICMS partnership.

Away from research, how do you like to spend your time?
Vicky: I love spending time with my family and friends. I love reading and I enjoy keeping fit by running and doing circuit training. I really enjoy travelling and experiencing new places and cultures but one of my favourite weekend pastimes is closer to home and it’s taking the dog to our local beach.

July 2019

Royal Brompton Hospital Research Day 2019

The annual Royal Brompton and Harefield Hospitals (RB&HH) research day took place on 2nd July 2019. The day aims to highlight the world-class research that is carried out at the Trust.

Staff, patients, visitors and local students attended the eighth annual heart and lung research day, where staff from across both hospitals demonstrated their research using accessible and hands on activities. Visitors were given the opportunity to take part in a mock clinical trial, to try to “diagnose” lung disease by listening to recordings on a computer of healthy and unhealthy lungs, and to test out radial closure devices currently being used at Liverpool Heart and Chest Hospital (LHCH).

If you would like to find out about research at either RB&HH or LHCH please follow the links below:
LHCH Research Office
RB&HH Research Office

June 2019

The UK’s first international postgraduate course in heart failure

With heart failure being the end-stage of most forms of heart disease, and consequently a major cause of morbidity and mortality, the development and management of heart failure needs to be appropriately addressed by novel training programmes. This allows medical doctors to develop a professional profile, being competent in all aspects of care for patients with acute and/or chronic heart failure.

The London Postgraduate Course in Heart Failure Management, lead by Zurich Heart House, is a two-year programme consisting of 6 modules. The course has over 60 participants enrolled onto it from more than 30 different countries. Model 2 of the course took place from 20th-23rd June and covered the classification and different forms of heart failure.

Dr Ali Vazir from the Royal Brompton Hospital discussing sleep apnea.

Prof Stephan Rosenkranz from the University of Cologne discussing pulmonary hypertension. 

Dr Rob Cooper from Liverpool Heart & Chest Hospital discussing hypertrophic cardiomyopathy.

Prof Milton Packer from Baylor Health discussing obesity and heart failure. 

May 2018

International Clinical Trials Day 2019

International Clinical Trials Day is an annual event celebrated on 20 th May each year. May 20 th is believed to be the date when the first controlled clinical  trial was conducted by a physician called James Lind. Dr Lind (1716-1794), whilst working as a surgeon on a ship, was appalled by the high mortality of scurvy amongst the sailors. He planned a comparative trial of the most promising cure for scurvy. His vivid description of the trial covers the essential elements of a controlled trial.

International Clinical Trials Day raises awareness of clinical trials to encourage patients, carers and the public to get involved in research. We also celebrate both our Trusts achievements and take time to reflect on the improvements made to public health. Both Liverpool Heart and Chest Hospital and the Royal Brompton and Harefield Hospitals are research active. To find out more about the ICMS research click here , or to find out about research at both Trusts, please follow the links below:

Liverpool Heart and Chest Hospital Research Department

Royal Brompton and Harefield Research Department

April 2019

ICMS welcomes new Directors at both Trust

April saw changes for both Trusts. Dr Margarita Perez-Casal took over as Director of Research & Innovation at Liverpool Heart and Chest hospital (LHCH) and Lyndon Bridgewater taking over as Associate Director of Research and Development at the Royal Brompton at Harefield Hospitals (RB&HH) , so we thought we’d interviewed them about their new roles and their involvement and ambitions for the ICMS.

Firstly, tell us a bit about your new role

Marga: As Director of Research and Innovation (R&I) I seem to be involved in a lot of things! I have a varied portfolio, and although R&I is my main area, I also cover Risk Management, part of organisational learning and the library. All this certainly keeps me busy without any time to get bored. The R&I part focuses on research strategy locally at the Trust but also with our partners; ICMS is a major part of this and driving ICMS to succeed is one of my personal objectives.

Lyndon: My new role oversees all research activity at RB&HH. This includes ensuring appropriate governance is in place to ensure research is conducted in accordance with the relevant regulations. The R&D office also ensure that the research is financially viable and work with external organisations to develop research at the trust.

What excites you most about your new role and working within the ICMS?

Marga: I have always loved R&I; I used to be a ‘lab-rat’ in a previous life and really enjoy talking to researchers to develop new research ideas and helping to make them a reality. It is really exciting to see a new collaboration flourishing or helping new blood getting onto the research ladder. I think that one of my duties is to promote R&I at the Trust and externally, across our partnerships, and to work with the younger members of the clinical teams to support them and get the research bug in them. This applies at LHCH and across ICMS, where forming the generation of tomorrow researchers is in the plan.

Lyndon: ICMS is an opportunity to share knowledge and expertise across organisational boundaries. This provides a platform to support the development of research ideas collaboratively to the benefit of all involved

What do you see as the upcoming priorities of the ICMS in 2019 and beyond?

Marga: I have already mentioned the need to drive young researchers, fellows and post-graduate students to be part of the ICMS Academy and to continue the ethos of collaboration for the delivery of the best cardiovascular research and service in the UK. We are at a place where we can really grow; ICMS is ready to move to the next level, by expanding our collaborations and by establishing recurring training opportunities across all three sites. The ICMS Academy is our next step .

Lyndon: I see the priority for ICMS in 2019 and beyond is to continue to foster collaborative arrangements between its partners. The ICMS Academy will help to maximise the opportunities for research and education.

How can health professionals at your Trust get involved with the ICMS?

Marga: Talking to us, telling us about their ideas for research, education or service that can benefit from the collaboration across the partnership. We are an open door to all professions and roles.  ICMS should be used as the platform for exchanging knowledge and expertise across our two Trusts.

Lyndon: There are many ways to be involved with the ICMS. Firstly you can talk to us at the respective Trusts about your ideas whether they be research led or you want to try to improve your clinical service by learning from others. You can also attend one of the many courses we are affiliated with and our ICMS Annual Symposium.

Away from research, how do you like to spend your time?

Marga: I love to spend time with my family; it’s in my culture. I love cooking, baking and good food. Walking the calories off with my dog and enjoying nature. I really enjoy walking by the sea and traveling. There is so much to see in this world!

Lyndon: I enjoy travelling and try to visit new places as often as I can. Whilst at home I like to cook and give new recipes a go (with mixed results, sometimes to the horror of any guests). I enjoy most sports, nowadays this is a largely as a spectator rather than participant however I still play the odd game of cricket from time to time.

March 2019

Women In Cardiology

On 8 th March 2019 people all over the world celebrated International Women’s Day .

It has been observed annually since the early 1900s and is a chance to celebrate the achievements of women as well as promoting equality between men and women.

Historically, science-based subjects have been a male-dominated environment. However, science advancing at a rapid pace and if potential talent is underutilised or inadequately cultivated due to gender inequality, this poses a major challenge not only to women, but to science in general. There has been progress in reducing the gender disparities in medicine over recent years however, there remains an under-representation of women within some sectors such as cardiology. As such, we have interviewed several women who work within the cardiology sector.

Who, within your sector has been your most influential female role model?

Registrar: “It’s difficult to pick just one! I have the privilege of working with several highly talented and dedicated female cardiologists but if I have to single someone out, Dr Clare Appleby , Consultant Interventionalist has taught me, not just clinically, but has demonstrated on a daily basis, that’s it’s possible to achieve whatever you want to, through hard work and perseverance.”

Research Nurse: “There are several Advanced Nurse Practitioners who I find influential within the Trust – they do a fantastic job!”

What, if any, are the current challenges for women in cardiology?

Registrar: “Generally speaking, women tend to organise family life/school life and juggling that with a demanding career, though not insurmountable, is difficult. Sadly there is still a minority who think that if you choose to take time out of work to have children or work less than full time, then you’re less committed to the specialty. Overcoming this misconception is difficult and many women have to work harder than their male counterparts to bridge this ignorant gap.”

Research Fellow: “The main challenge is the perception amongst trainees of both genders that a career in cardiology is not compatible with a good home life. Certainly, there is the potential to work as much as you like within this diverse specialty, but trainees should be made aware that there are also plenty of opportunities for flexible working."

How do you think cardiology, and science in general, will change over the next 5-10 years?

Research Fellow: “Now we are seeing more women entering medical school, I hope senior positions in medicine will see more women rising to the top. This could be helped by mentoring schemes and recruitment initiatives that promote and encourage women to take up senior roles within a medical specialty.”

Registrar: “I am hopeful that the new laws surrounding organ donation will increase the numbers of donor hearts available so that patients with end-stage heart failure will have a more realistic chance of a transplant.”

Research Nurse: “I think more women will be taking up influential posts within this field and think this will be achievable, but it may be closer to the 10-year point.”

Consultant: “Personalised medicine is now a real possibility - we are all unique and should have a tailor-made approach to our health care. In the coming years this will be routine rather than exceptional.”

What advice would you give a woman looking into a career in cardiology?

Research Fellow: “My advice to potential trainees would be don’t be put off by the current perception that a career in cardiology is not compatible with a fulfilling home life. This is simply not the case and we should be careful not to perpetuate this view.”

Research Nurse: “If it is your goal, don’t give up!”

Registrar: “Go for it! Cardiology is a fantastic specialty and if you’re prepared to work hard for what you love then you will go far. If I had my time again, I would still choose cardiology, but I would be more organised, plan further in advance and reach out to other women in the same position who are juggling work/home/children etc.”

February 2019

Sharing best practice through the ICMS.

At the start of 2019, three nurses from Liverpool Heart and Chest Hospital  visited Harefield Hospital to learn more about their Photo at Discharge programme alongside discussing surveillance processes, surgical site infections and quality improvement initiatives. Photo at Discharge was developed by health professionals and provides patients and carers with a practical, simple tool for use between acute and community care. Furthermore, it provides an unambiguous baseline as to whether the surgical wound is improving or deteriorating and a legible, documented full assessment of the surgical wound.

Melissa Rochon, Quality & Safety Lead for Surveillance at Harefield Hospital, helped develop the Photo at Discharge programme said “ It was terrific to have Julie, Nichola and Sam visit Harefield – getting together was a great opportunity to share practices and innovation, as well as lay plans for collaborating on research and quality improvement projects”.

Service development is a key theme within the ICMS. The ICMS enables staff to share best practice and learn from each other both within and between Trusts. Julie Tyrer, Tissue Viability Nurse at Liverpool Heart and Chest Hospital said “visiting other Hospitals and looking at other systems and processes can be a valuable learning opportunity”. She continued, “I am always inspired to come back and review local practice, trying to think innovatively of ways to develop practice and improve patient outcomes. It can highlight areas where improvements could be made locally and a chance to share each other’s areas of best practice”.

November 2018

ICMS Annual Symposium 2018

Thank you to all those who attended the recent ICMS Annual Symposium at the Royal College of Physicians , London.

The day consisted of talks from clinicians and nurses from Liverpool Heart and Chest Hospital, Royal Brompton Hospital and Harefield Hospital discussing. Topics covered were wide ranging and included subjects such as skills training in cardiac pacing to electrophysiology research update, cardiomyopathy, and cardio-oncology to name a few. The guest lecture of the day was from Dr Ed Conley, Chief Scientific Officer at  AIMES , Liverpool gave an insightful talk on the use of health informatics research within the UK. The day was rounded off by Professor Greg Lip and Professor Tom Luscher providing their developments and aspirations both at Liverpool Heart and Chest NHS Foundation Trust and the Royal Brompton and Harefield NHS Foundation Trust. 

The day was a great success and we look forward to welcoming you to the ICMS Annual Symposium 2019!

October 2018

Dr Babu-Narayan of the Royal Brompton Hospital appointed Associate Medical Director for British Heart Foundation.

Dr Sonya Babu-Narayan,  a consultant cardiologist at the Royal Brompton and Harefield NHS Foundation Trust and clinical senior lecturer at Imperial College London, has been appointed the Associate Medical Director for the British Heart Foundation

Dr Babu-Narayan is internationally recognised for her research to improve the care and quality of life of adults who were born with congenital heart disease. In Dr Babu-Narayan’s new role as Associate Medical Director she will provide leadership and strategic direction to the mission of the Britsih Heart Foundation. She will work together with the existing Associate Medical Directors, Professor Jeremy Pearson and Professor Metin Avkiran whilst continuing both her clinical and research activity at Royal Brompton Hospital and Imperial College London.

September 2018

The ICMS features in the Cardiovascular Reseach 2018 Handbook published by The British Journal of Cardiology.

Professor John Pepper OBE,  cardiothoracic surgeon of the Royal Brompton Hospital, has written an article summarising the work of the ICMS in the Cardiovascular Research 2018 Handbook .

The handbook is for current and future medical researchers and seeks to introduce the research landscape in the UK. The handbook discusses research within academic institutions, healthcare organisations, charities and industry and the collaborations and partnerships that exist between different sectors, including the sharing of big data.

August 2018

HEAT PPCI: an NIHR research highlight of the last 70 years

The HEAT PPCI study was published by The Lancet in 2015 and is the largest trial of its kind in cardiovascular medicine. The study investigated the routine use of heparin rather than bivalirudin and concluded that heparin could improve outcomes for heart attack patients, while at the same time significantly reducing costs for healthcare organisations globally. The National Institue for Health Research (NIHR) has named the HEAT PPCI study as one of the most important research discoveries of the past 70 years.

To tie in with the NHS’s 70th birthday, the NIHR's I Am Research campaign is celebrating how research has improved health and care over the past 70 years and how NIHR research is helping to shape the future. The NIHR is showcasing 70 discoveries that have transformed the way the NHS works and outcomes for patients, drawn from the suggestions of experts from across the NIHR.

July 2018

Dr Fairbairn accepted onto the first cohort of the NWC CRN Research Scholars Programme

Dr Timothy Fairbairn , Consultant Cardiologist at Liverpool Heart and Chest Hospital, has been accepted onto the initial cohort of the NIHR Research Scholars Programme. The Research Scholars Programme is designed to develop 'research-interested' individuals in the early phase of their clinical research careers. The aim of the programme is to provide successful applicants with remunerated time to enable recruitment into National Institute for Health Research Portfolio studies and establish themselves as Principal Investigators and future Chief Investigators.

Currently, Dr Fairbairn is a Consultant Cardiologist sub-specialising in cardiovascular imaging at Liverpool Heart and Chest Hospital. He practices in advanced echocardiography, cardiac MRI and cardiac CT. His clinical and research interests include aortic valve disease, TAVI, inherited cardiac conditions and coronary artery disease and is also part of the ICMS flagship CASA-AF NIHR funded trial. The Research Scholars Programme will provide protected time to support the generation of research outputs including trial delivery and the development of research collaborations / future NIHR grant submissions.

To find out more about NIHR training and education click here  .

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