The British Heart Foundation (BHF) has awarded BHF Professor Gavin Murphy and his team at the University of Leicester a programme grant award of £1.4 million over the next five years to explore the ‘obesity paradox’ and what underlying biological processes may explain why overweight or obese patients have a higher likelihood of surviving cardiac surgery in comparison with equivalent patients who have a standard Body Mass Index (BMI).
More than 35,000 people in the UK have heart surgery each year. Despite decades of research to improve outcomes, kidney and heart failure resulting from cardiac surgery still affects many patients. Organ failure affecting the heart and kidneys are common and often life threatening complications of cardiac surgery. There are no effective treatments. Professor Murphy has shown in previous research that the frequency of organ failure is 30% lower in obese and 15% lower in overweight patients. This has been described as the ‘obesity paradox’.
The team now propose to investigate the biological processes that underlie this obesity paradox, and establish whether these may be harnessed to reduce organ damage in all cardiac surgery patients.
The research will take three stages. Firstly, in a series of clinical trials they will evaluate the effects of pre-surgery weight loss, weight gain, and a drug treatment that can potentially mimic the effects of obesity, on post cardiac surgery organ injury. Secondly, they will assess how these interventions alter molecular processes that influence susceptibility to organ failure. Finally, they will assess whether indicators of these processes in blood can identify those patients at greatest risk of developing organ failure.
BHF Professor Gavin Murphy of Cardiac Surgery at the University of Leicester, said: “In our previous studies we saw a 25% reduction in death by being overweight as opposed to being a standard weight. It fundamentally changed one of the most basic approaches behind surgery, which is that people need to lose weight before surgery. Obese patients have been generally considered unfit for surgery. This raises several questions which we are now investigating. The potential implications of this paradox extend beyond those who are overweight. If we are able to recreate the protective impact that being overweight offers through a new drug, this offers a new avenue for treatments for all cardiac surgery patients.”
Professor Jeremy Pearson, Associate Medical Director at the British Heart Foundation, explained:
“We always recommend a healthy waistline, which significantly reduces lifetime risk of heart disease and therefore a person’s risk of needing cardiac surgery. However we need to improve our understanding of the basic processes in overweight and obese bodies that previous studies have demonstrated offer protection when recovering from heart surgery. Organ failure blights the lives of 30% of heart surgery patients across the UK, and can cause serious problems. Providing optimal treatment with lower risks associated with surgery can help patients lead longer, healthier lives. Thanks to your donations. Professor Murphy hopes to change the way people are treated for the better by improving the lives of people who have to undergo heart surgery.