Discipline of Cardiology

Research

Cardiology has an established research interest in the following areas:  chronic diseases of lifestyle; cardiac failure in Black subjects; genetics aspects of coronary heart disease; cardiac disease in pregnancy; structural and functional aspects of hyper-tension; undergraduate education in cardiology.

The research productivity of the department is slowly, but steadily, improving.  Postgraduate students are required to submit a research protocol to the Head of Department in their final year of postgraduate training, after they have completed the Certification examination in cardiology.  In addition the department has a structured teaching programme including Journal Club, annual Cardiology Updates, outreach workshops and guest lectures, all of which are designed to encourage research within the discipline.  The research output of the department in the last 5 years includes two whole journal issues in FORUM, three chapters in books, two postgraduate theses and over 25 peer-reviewed articles, 25 critical reviews and 12 presentations at national meetings.

The department has also embarked on a strategy of actively promoting research amongst the young members of staff through an incentive-based approach.  All staff are encouraged to attend congresses to see what their peers are accomplishing with resources far less than ours.  This has enabled the registration of six masters and five PhD projects.

Department  Initiated Research

RESEARCH PROJECT and its Goals

Outcome

1)   Cardiac failure in valvular heart disease :

Early detection of ventricular decompensation will indicate the timing of surgery

Masters thesis: R Prakaschandra

2)   Genetics aspects of coronary heart disease:

The contribution of genetic factors and telomere function to coronary diseases

DP Naidoo ; N Ranjith ; S Khan

3)   Cardiac disease in pregnancy:

Markers of maternal disease will help reduce the unacceptable morbidity and mortality in pregnancy

Publications

4)   Structural and functional aspects of hypertension in pregnancy

  • Identifying changes that will enable better treatment of hypertension
  • Role of BNP in pregnancy – …. hypertension
  • Mitral stenosis in pregnancy

PhD Thesis : DK Desai completed and published

Masters Thesis: S Fayurs

Publication

5)   Undergraduate education in medicine

Improved learning methods at the bedside would foster deeper learning with retention and transference

Masters  Thesis: D P Naidoo

6)   Chronic Diseases of lifestyle

  • WHO funded Community project designed to establish the role of risk factors in the pathogenesis of the chronic diseases and introduce a community based intervention
  • Microalbuminuria and endothelial dysfunction

PhD Thesis: R Prakaschandra

M.Med: Y Duki

Publication

7)   Infective endocarditis and HIV

  • Disease pattern in HIV infected persons

Masters Thesis: S Nel

8)   Acute coronary syndrome

  • Acute coronary syndrome in black subjects
  • Echocardiography vs BNP as risk markers
  • Prevalence of Metabolic syndrome

M. Med: S Dela

Publication

Publication

9)   Clinical trials

  • Role of placebo in clinical trials
  • Contract research

Publication

Funding for academic research

10)               Technology projects

  • Role of Exercise testing
  • Cardiac disease in the elderly
  • Haemodynamic changes in Balloon mitral valvuloplasty
  • Echocardiography vs BNP in acute coronary syndrome
  • Electrocardiography  as a marker of ventricular function
  • Echocardiographic study in hypertension
  • Hypertension in the elderly

Seven B Tech theses

  

The main focus of the department research has been in coronary heart disease, the pathogenesis of with a focus on genetics and on telomere function.

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Researcher: Dr Tanya Maistry Designation: Committee Member at BREC Study: Genetic Contribution to the Risk for Metabolic Syndrome: An Investigation of Candidate Gene Polymorphisms related to Lipid and Carbohydrate Metabolism Summary: The study shows that Indian people living in Durban’s Phoenix area have a high risk of suffering from metabolic syndrome (MS). The metabolic syndrome is a group of risk factors – including abdominal obesity, elevated triglycerides, reduced high density lipoproteins cholesterol [HDL-C], elevated blood pressure, elevated blood glucose serum levels, insulin resistance and obesity – which increases the risk for heart disease and other health problems, such as diabetes and strokes. The term ‘metabolic’ refers to the biochemical processes involved in the body’s normal functioning. Risk factors are traits, conditions, or habits that increase ‘the chance of developing a disease’. MS risk could lie in its components rather than in MS as an entity. ‘Data obtained in this study may allow for the implementation and development of medical interventions that could counteract susceptibility to the MS, thereby reducing the risk for cardiovascular disease.’ The main objective of the study was to determine genetic patterns that may be associated with the MS. The data obtained resulted in two findings related to epidemiology and genetics.   In epidemiology, results demonstrated that South African Indians from the Phoenix community present with an increased risk for the MS. Age, gender and clustering of the metabolic components influenced the results. IR was also observed to be the driving factor for MS pathogenesis with age, gender, clustering patterns and physical activity serving as key contributing factors. In genetics, results demonstrated the adiponectin 45T>G and the human paraoxonase 1 192Arg/Gln polymorphisms to be genetic markers that may assist in identifying participants who are susceptible to hypocholesterolemia (in males with the MS and with IR) and hypertension (in males with the MS), respectively. The lipoprotein lipase HinfI and human paraoxonase 1 192Arg/Gln polymorphisms associated with IR may also serve as genetic markers that may assist in identifying males with MS who are susceptible to hypertension. Gene-environmental associations exerted a degree of protection against the risk for the MS and IR.’