NIHR partnership creates UK-wide network to improve cardiovascular outcomes for patients

The partnership has recently established a new UK-wide network that merges experts in rheumatology and cardiology. It aims to improve outcomes for people with Immune-Mediated Inflammatory Diseases (IMIDs) and cardiovascular disease. 

People with IMIDs are at an increased risk of death from cardiovascular disease 

IMIDs are a group of rare diseases. They occur when the body’s immune system targets its own tissues instead of foreign organisms. This causes inflammation and organ damage. Different IMIDs affect different parts of the body. Studies show that people with IMIDs have a higher risk of mortality from cardiovascular disease. This is due to disruption to the immune system and excessive inflammation. 

It is important to diagnose cardiovascular disease early, to identify treatments and develop effective treatment strategies. There are methods to identify many people at higher risk from cardiovascular disease. However, these methods are not effective for people with IMIDs, who are often women and young adults. Improving early detection and diagnosis of cardiovascular disease in people with IMIDs is therefore an unmet need. 

In recent years there has been a greater focus on the use of sensitive cardiovascular imaging. This is used to help measure the severity and type of cardiovascular disease in people with IMIDs. Cardiac magnetic resonance imaging is a type of cardiovascular imaging tool. It is a non-invasive scan used to show detailed images of the heart and vessels. Most findings in people with IMIDs are from small, single centre, observational studies. As a result, our understanding of the mechanisms of cardiovascular disease in people with IMIDs is lacking. 

NIHR-BHF Cardiovascular Partnership enables national interdisciplinary collaboration 

Maya Buch, Professor of Rheumatology at the University of Manchester, Honorary Consultant Rheumatologist at Manchester University NHS Foundation Trust, and co-lead of the NIHR-BHF Cardiovascular partnership Inflammation workstream, highlights that multicentre collaboration is crucial.  

With the support of members of the NIHR-BHF Cardiovascular partnership, Professor Buch established an informal virtual network of rheumatologists and cardiologists. She achieved this by using the existing infrastructure within the NIHR's Biomedical Research Centres and British Heart Foundation Centres of Research Excellence. Her role as Chair of the UK Musculoskeletal TRC (Translational Research Collaboration) was vital in bringing rheumatologists into the collaboration. As a result, an exemplar NIHR cross-TRC network was formed. This required no additional funding. The aim was to lay the foundations for interdisciplinary groups to meet and conduct joint research. This will help to address the unmet needs of individuals with IMIDs and cardiovascular disease.

Professor Buch explains how the Cardio-IMID UK network formed organically. The structure and operational governance of the NIHR-BHF Cardiovascular partnership made this possible. It enables centres and members to work in a coherent, strategic and systematic way.

“The NIHR-BHF Cardiovascular partnership allowed me to gain access to this research community. As a rheumatologist, I used this platform for my voice to be heard to proactively generate interest in this area, and to bring cardiologists and rheumatologists together.” - Professor Buch

UK Cardio-IMID network becomes a sustainable platform for experimental and early phase research 

After establishing the UK Cardio-IMID network involving 29 centres from across the UK, Professor Buch was awarded a £1.6m partnership grant from the Medical Research Council (MRC). The award was co-funded by an extra £400,000 from the BHF. At this stage the network was expanded and the name changed to the UK Cardio-IMID partnership. This funding will help to expand our understanding of the mechanisms of cardiovascular disease in people with IMID. This will help to identify optimal treatments and management approaches. The key goals of the partnership are as follows:

• Establish an active cardio-rheumatology community. The community will share clinical and research findings, conduct webinars, develop projects, and assist early career researchers.  
• Standardise practice and capabilities across the UK. This includes ensuring consistency in the protocols used for assessing people with IMID. This will involve using tools such as cardiac magnetic resonance and other cardiovascular imaging. 
• Establish a cohort for a longitudinal, prospective, observational study. This would serve as a resource for many studies conducted by the artnership.
• Develop new methods to better understand the disease. This will also involve identifying biological pathways towards potential therapeutic targets.

The UK Cardio-IMID partnership is now the first formally resourced and supported national network of cardiovascular and rheumatology clinicians and researchers. The partnership will ensure there is a continued pipeline of experimental research studies to inform the management of people with IMIDs. It will also sustain the cardiovascular community. This will be achieved as it provides the foundation for continued learning for future generations of researchers.