Researcher exercises change of heart

A State Government-funded research fellowship is helping a Royal Perth Hospital junior doctor investigate the value of a novel form of exercise for patients recovering from heart failure.

Thanks to a Registrar Research Fellowship (RRF), Ho-Wing Arthur Yau is part of a project that is comparing standard rehabilitation exercises for these patients, with a modified training program that consists of “eccentric” exercises – exercises in which muscles are elongated during contraction.

Eccentric exercises have less of a cardiovascular burden than conventional concentric exercises (in which the muscles shorten when contracted).

Dr Yau said that although exercise was known to be of considerable value to patients with advanced heart muscle disease, many patients were unable to train at the level of intensity needed to derive benefit due to constraints such as breathlessness and fatigue.

He and his co-researchers hypothesise that eccentric exercises will make it easier for these patients to work at a beneficial level of intensity.

Dr Yau will assess changes in the structure and function of participants’ hearts before they begin training and again at the end of the 16-week trial period.

Dr Yau’s project is part of a broader trial, the main focus of which will be on the effect of each training regime on patients’ VO² peak (the maximum amount of oxygen the body can use during intense exercise – and an excellent indicator of fitness).

The main study has been funded by the National Health and Medical Research Council and is a collaboration between researchers from Royal Perth and Fiona Stanley hospitals, the University of Western Australia, Edith Cowan University and Curtin University.

The trial is recruiting 100 patients with advanced heart muscle disease from Royal Perth and Fiona Stanley hospitals who will attend three training sessions a week. Dr Yau said confirmation of the anticipated benefits could reduce hospitalisation and enhance the quality of life for such patients. It could also improve understanding of how to maximise participation in – and optimise outcomes of – exercise therapy in general, with implications for other chronic health conditions.

Dr Yau is among nine junior doctors awarded a RRF in the third round of the program which is designed to enhance the research capability of the WA Health Registrar workforce. It enables doctors-in-training to pursue research alongside their clinical duties while under the supervision of senior clinician researchers.

Assistant Director General Clinical Excellence Division, Dr James Williamson, said Dr Yau’s project was an example of the valuable research being undertaken within Western Australia’s public health system.

The full recipient list is:

Dr Umar Ali, Cardiothoracic Surgery, Fiona Stanley Hospital

Dr Ali will join the Heart and Lung Research Institute of WA where he will be co-investigator in the Shear Wave Elastography At heart Transplantation (SWEAT) project which will investigate the potential to non-invasively demonstrate the extent of ischaemic injury in hearts prior to transplantation.

Dr Kirsten Biddle, Trauma, Royal Perth Hospital

Dr Biddle will be involved in collaborative research between the trauma service and the intensive care unit investigating traumatic brain injury, including a retrospective review of traumatic brain injury management and outcomes.

Dr Nick Lan, Medical, Fiona Stanley Hospital

Dr Lan will be one of the lead investigators in the Glucose and Lipid Lowering Optimisation in Diabetes and Health Failure (GALLOP-HF) project which aims to improve management of glycaemic and dyslipidaemia in patients with diabetes and stroke and/or coronary artery bypass surgery.

Dr Rachael Marpole, Respiratory Medicine, Perth Children’s Hospital

Dr Marpole will contribute to a Delphi study that will elucidate best-practice options for the prevention and management of respiratory illness in children with cerebral palsy.

Dr Annalise Martin, Haematology, Royal Perth Hospital

Dr Martin will contribute to a study aimed at improving the understanding of the pathophysiology of Acute Myeloid Leukaemia and why patients relapse early after intensive induction chemotherapy.

Dr Julia Murdoch, Rheumatology, Fiona Stanley Hospital

Dr Murdoch will be study coordinator on a project which aims to establish and assess a collaborative Fast Track clinic for patients with giant cell arteritis which is an autoimmune inflammatory condition of blood vessels which commonly affects the blood supply to the eyes.

Dr Dipen Sankhesara, Cardiology, Fiona Stanley Hospital

Dr Sankhesara will contribute to a study investigating the possibility that bariatric surgery for obesity reduces coronary atherosclerosis plaque burden which is associated with cardiovascular events.

Dr Rachel Sills, Emergency Medicine, Royal Perth Hospital

Dr Sills will contribute to the Western Australian Illicit Substance Evaluation (WISE) study which investigates the prevalence and clinical effects of stimulant, hallucinogenic and cannabinoid drugs.

Dr Ho-Wing (Arthur) Yau, Cardiology, Royal Perth Hospital

Dr Yau will lead an echocardiographic study which will investigate the effectiveness of eccentric exercise which has a lower cardiovascular burden and therefore the potential to enable more patients with heart failure to benefit from improvements to their fitness and quality of life.

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