Identifying microvascular dysfunction as a novel mechanism of poor health in heart failure patients

Dr Lewan Parker, Deakin University

2018 Postdoctoral Fellowship

Years funded: 2019-2023

Heart failure (HF) reflects the inability of the heart to provide sufficient blood flow to meet the needs of the body and affects at least 26 million people worldwide. HF with preserved ejection fraction (HFpEF) accounts for more than 50% of all HF cases and is 2 to 5 times more prevalent in people with type 2 diabetes (T2D).

Reduced ability to exercise (exercise intolerance) and poor blood sugar control greatly contribute to decreased quality of life and survival in T2D patients with HFpEF. However, current medications targeting the heart are largely ineffective, suggesting that peripheral (i.e. non-heart related) mechanisms likely play a larger role. Due to our poor understanding of this condition alternative effective treatments are lacking.

Using modern biochemical and ultrasound imaging techniques I will establish that peripheral skeletal muscle microvascular dysfunction (impaired blood flow through small blood vessels), rather than cardiac dysfunction, is the main mechanism behind exercise intolerance, poor blood sugar control, and reduced patient quality of life.

Exploring novel effective therapies, I will establish that exercise, both single session and long-term training, can improve patient health and quality of life largely through enhanced microvascular function. This research will radically change our understanding and treatment of this unique condition and will lay the foundation for future research investigating new effective microvascular related therapies.

This project is co-funded with NHMRC - National Health and Medical Research Council.