Cardiometabolic Diseases: Tracking the '"Silent Killers"

Cardiovascular diseases (such as myocardial infarction) are among the most common causes of death in Austria, accounting for over 33,000 deaths a year.

University Heart Center; photo credit: KUK
University Heart Center; photo credit: KUK

Approximately half of these patients also suffer from the metabolic disease, diabetes mellitus. A new clinical research institute (CRI) at the JKU’s Faculty of Medicine will explore the interaction between the cardiovascular and metabolic systems.

Every second heart attack patient is diabetic. Given the fact that both diabeates mellitus (currently affecting approximately 800,000 Austrians) and hypertension (over 2.4 million Austrians suffer from high blood pressure) occur more frequently with age, based on demographic developments experts expect a significant increase of these " silent killers" over the coming years.

Together with the Kepler University Hospital and Brothers of Mercy Hospital Linz, the JKU continues its research focus on aging and health care research by creating a new clinical research institute for Cardiovascular and Metabolic Diseases. The institute will conduct multidisciplinary and cross-organizational research into the underlying mechanisms of interaction between cardiological, vascular, and metabolic diseases.

These four CRI founding members are renowned experts in their respective fields, pooling their expertise and research skills to create new approaches to early detection, prevention, diagnosing, and treating cardiovascular and metabolic diseases:

Univ. Prof. Dr. Andreas Zierer’s department, the Department of Cardiothoracic and Vascular Surgery at the JKU), performs an entire range of commonly found cardiac operations and procedures that are conducted worldwide, including over 1,000 open-heart surgeries using the heart-lung machine: "As a cardiac surgeon, I am mostly interested in surgical issues. Specific projects I would like to mention include the influence of using different blood vessels to support long-term results after bypass surgery in patients who have diabetes, or long-term heart valve replacement function, depending on the patient’s metabolic risk profile."

Prim. Priv.-Doz. Dr. Clemens Steinwender is head of the Kepler University Hospital’s Department of Cardiology and Internal Intensive Care Medicine. The clinic is equipped with 102 beds (including 12 cardiac ICU beds) and is one of German-speaking Europe’s largest cardiology clinics: "Interdisciplinary aspects, such as interface topics featuring basic and metabolic medicine or cardiac and vascular surgery, are important when it comes to my field. The same applies to issues regarding heart valve diseases and minimally invasive procedures. Last but not least, technological pacemaker aspects and defibrillator treatment along with advancements in terms of miniaturization."

With over 150 peer-reviewed publications, Prim. Prof. Dr. Martin Clodi, head of the Department of Internal Medicine at the Brothers of Mercy Hospital in Linz, and his team are proven metabolic experts: "The Brothers of Mercy have a large, acute internal medicine department focusing on diabetes and metabolic disease gastroenterology, intensive care, and emergency medicine. For me, these direct interactions between glucose metabolism, glucose toxicity, and the vascular system and, of course, direct damage to the myocardial structure are particularly important."

Univ. Prof. Dr. David Bernhard heads the Department of Pathophysiology of the Institute of Physiology and Pathophysiology at the JKU. His department focuses on conducting research on – including looking at the development of - age-related cardiovascular diseases: "A close partnership between the clinical institutes and pathology is important for my department, including cross-linking data and defining new biomarkers, especially in the area of early detection and disease progression as well as developing and testing new treatments, especially to identify new, previously unknown risk factors when it comes to cardio-vascular disease."

Research Projects and Expectations
Under the leadership of David Bernhard's Department of Pathophysiology and in partnership with CRI partners, an early detection marker for thoracic aortic aneurysms (bulges in the part of the aorta that passes through the chest cavity) is currently being developed which will be studied in patients and then tested for widespread use, including at family practices and in terms of care.

In addition, the best administration approach (the way a drug is administered) with respect to a new active ingredient to protects tissues in the event of any oxygen deficiency (heart attack, stroke, transplantation, etc.) will be looked at in more detail. This active ingredient and the way it is administered would reduce the time until initial treatment, such as in the event of a heart attack, thereby preventing or reducing some of the damage.

Clemens Steinwender expects: "… findings on widespread risk factors when it comes to vascular diseases (such as diabetes mellitus, elevated blood lipids)." Clarifying the following would be vital: When it comes to cardiovascular damage, what is the expected patient age or the risk factor intensity? How can damage be prevented or mitigated? Which group of patients requires special attention?

A key CRI project would be to create an Upper Austrian registry and database to collect corresponding patient information with regard to cardiometabolic diseases.

Andreas Zierer remarked: "The CRI’s partnerships will facilitate pooling data from the Upper Austrian healthcare system. In many areas, we need to have as much data as possible in order to obtain statistically significant results. More specifically, we aim to understand more about how underlying metabolic diseases, such as diabetes, influence the occurrence of cardiovascular diseases."

When will research outcomes be applied to patients? Martin Clodi stated: "In most cases, the findings in scientific publications cannot be immediately applied to patients, but the sum of the research outcomes from our institute - as well as from other institutes – will, like a jigsaw puzzle, become the whole picture that we can apply to patient care."

Initial research findings stemming from existing partnerships are already underway and will be published as early as the first half of 2023.

JKU Rector Meinhard Lukas added: "The new clinical research institute and its focus on cardiometabolic diseases is addressing an important issue that will become increasingly significant over the next few years. Our students and, above all, our patients will benefit from the CRI’s research findings. In order to strengthen research in Upper Austria, the JKU will create additional clinical research institutes. After all, cross-disciplinary and cross-institutional partnerships form the basis to support international and competitive research."

The JKU medTALK on Cardiometabolic Diseases
The third edition of the JKU medTALK is titled "Silent Killers - Cardiovascular and Metabolic Diseases". The medTALK will take place on November 23 at 3:30 PM at the JKU medLOFT. A panel including Marina Müller, MSc. (JKU Institute of Physiology and Pathophysiology, Department of Pathophysiology), Prim. Univ. Prof. Dr. Martin Clodi, (head of the Department of Internal Medicine, Krankenhaus der Barmherzigen Brüder), Assist. Dr. Jessica Gottsberger, (Department of Cardiovascular and Thoracic Surgery, Kepler University Hospital), and Prim. Priv. Doz. Dr. Clemens Steinwender (Department of Cardiology and Internal Intensive Care Medicine, Kepler University Hospital) will discuss the topic with journalist Christine Haiden.

Click here, opens an external URL in a new window to sign up to attend the JKU medTALK.