NZ heart-failure study findings ‘pivotal’

Jamie Morton

A seven-year study has revealed how two forms of heart failure aren’t as similar as first thought — a finding that holds big implications for treatment here and around the globe.

The fresh insights, just published in the European Heart Journal, stem from Kiwi-led research involving 2000 patients from New Zealand and Singapore and leading heart-health experts from both countries.

Heart failure is common and serious, affecting about 80,000 Kiwis.

In many, the heart muscle is stretched and weakened and does not pump properly.

In other cases the heart may have near-normal pumping function, but the muscle is stiff and often thicker than usual and the heart cannot fill properly between beats.

These two types of heart failure were previously thought to be equal in occurrence and risk of death, said Professor Rob Doughty, the NZ Heart Foundation Chair of Heart Health at the University of Auckland.

“However, our new findings reveal that the stiff heart muscle is less common than originally thought, affecting about three out of every 10 heart failure patients, and there is less risk of dying from this type compared with heart failure where the heart is not pumping properly.” He said 2 per cent of Kiwis live with heart failure, and the study’s findings offer more accuracy about their risk of dying.

“Based on our new findings from this study, the global approach and treatment of patients with heart failure, based on measures of heart pump function, may need to be reviewed,” Doughty said.

“This information will influence clinical thought and health-care planning of heart failure around the world, and provide more precise treatment.”

Christchurch Heart Institute director Professor Mark Richards said the findings were “pivotal” to understanding occurrence, death rates and risk prediction within different classes of heart failure.

Richards supervised the study in Singapore. Sixteen heart doctors and researchers had been involved, including Professor Carolyn Lam of the National Heart Centre in Singapore and Professor Richard Troughton of the Christchurch Heart Institute.

The researchers had also shown that the world’s most successful cardiac biomarker — NT-proBNP, discovered and validated in the Christchurch Heart Institute — was a powerful indicator in both types of heart failure in Singapore and NZ. “Overall, this will exert major influence on clinical thinking and planning.” Raihania Tipoki, waka captain over the past 50 years — could mean, by 2050, the volume of plastic in oceans outweighs that of even fish.

The new effort, organised with ESR, Algalita South Pacific and research group The 5 Gyres Institute, aims to shed some much-needed light on how much ocean plastic is being contributed by New Zealand.

Waka captain Raihania Tipoki said the quantity of microplastics collected off Napier — about 15 pieces with each 20-minute trawl — had been alarming.

“We are not a big port and we don’t have any giant cities in Hawke’s Bay, yet there was a significant amount of microplastics in the water.”

The group are yet to trawl Wellington Harbour, but they expect to find a lot of floating waste, ranging from microplastics to bottles and caps. “We are quite concerned about what we might find.”

ESR scientist Olga Pantos, who has been involved in the project, said waka were ideal vessels to carry out slow-speed trawls.

Tipoki said it was immensely important to Maori, who felt an obligation through kaitiakitanga, or environmental guardianship, to ensure they weren’t taking advantage of nature. “We understand that we descend from the land and sea — and that the gods didn’t create us.

“A lot of New Zealanders think it’s not our problem or it’s not our fault, but there are things that we can be doing and if we really want to be environmental leaders we need to be actively promoting change.”

NZ has moved to ban microbeads, but the problem of microplastics couldn’t be tackled in the same way.

Current legislation encouraged product stewardship and environmental responsibility at the beginning of a product’s life cycle.

Tipoki, who is also marching in the Ban the Bag Hikoi in Wellington tomorrow, hopes the waka voyage will help toward a new strategy to reduce single-use plastics in NZ.

A 60,000-signature Greenpeaceorganised petition calling for their ban is expected to be presented to the Government tomorrow.