Myerson Group: Heart Valve Disease

Our research aims to advance the treatment of heart valve disease in three main areas:

• Determining how many people have heart valve disease, and how severe it is
• Identifying who is at risk from severe problems
• Developing treatments to improve outcomes

The OxValve study has examined >4,000 people in Oxfordshire with cardiac ultrasound (echocardiography) and identified just how common heart valve disease is – 50% of those over 65 have it! The study is now following-up participants to examine how often and how rapidly valve disease progresses – currently we are at the 5 year stage. This will allow us to determine who needs follow up and who can be reassured that their valve disease is unlikely to ever be a problem. We are also examining multiple blood and genetic markers to identify the causes of valve disease, and performing activity monitoring and questionnaires to determine the impact on everyday life.

Cardiac MRI 4D flow image showing abnormal spiral flow in the aorta (the main artery) in a patient with a bicuspid aortic valve.

Our advanced cardiac magnetic resonance imaging (MRI) studies have shown which patients with severe valve leaks are likely to require surgery in the next few years. This allows good planning, potentially facilitates early surgery, and reassures others who are unlikely to need surgery and can reduce the frequency of their clinic visits. We have also identified abnormal flow patterns in the aorta (the main artery out of the heart) in young patients with bicuspid aortic valves (which have two rather than three leaflets in the valve) – this may be the underlying cause of dilation of the aorta, which can be dangerous. Dr. Rigolli is currently examining the impact of lung disease on patients with aortic stenosis (narrowing of the main valve out of the heart) in her AMICA study.

Lastly, we are undertaking clinical trials of both drug treatments and early heart valve surgery to see if these can improve outcomes for patients with valve disease.