New BHF-funded research could predict the growth of life-threatening aneurysms before it is too late

Research funded by the British Heart Foundation (BHF) at the University of Leicester could reduce the risk of death from a life-threatening aneurysm.

An abdominal aortic aneurysm (AAA) is a bulging of the major vessel that supplies blood to the body, which runs from the heart down to the chest and stomach. If an AAA becomes too large, it can burst, causing massive internal bleeding, which is usually fatal. Just one in 10 people survive a ruptured AAA and it is responsible for more than 3,000 deaths in the UK each year. Scientists currently do not understand how they form and which ones are likely to become dangerous, so patients are kept under surveillance with regular ultrasound scans.

Thanks to a previous BHF grant, researchers have already been able to collect samples of more than 4,000 patients living with an AAA and discover new genes linked to the condition. Now a new £587,000 programme grant from the BHF will enable researchers in Leicester to test these samples and investigate if there are any genetic or biological factors with links to slow or fast growing AAAs.

They will also be able to see if these genetic markers can be used to predict whether an individual’s AAA will grow to a dangerous size, which could allow for intervention at an earlier stage when surgery is safer.

The research is being led by Matt Bown, Professor of Vascular Surgery at the University of Leicester’s BHF Cardiovascular Research Centre and vascular surgeon at Leicester Hospitals. The research will take place at the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre.

Professor Bown said: “AAAs are relatively common and the only treatment for them is high-risk surgery. When aneurysms are small, the risk of them causing harm is extremely low and surgical repair is not justified. People with small aneurysms are regularly monitored to make sure their aneurysm hasn’t grown.

“Very little is known about what causes aneurysms to grow and why some grow quickly and some grow slowly. This gap in knowledge means that we are currently unable to develop and test clinical strategies and drug treatments. Also, we cannot tell people if their aneurysm is going to grow or not, or work out if there are people with aneurysms who would benefit from earlier surgery. If this research reveals new ways to predict the most high-risk aneurysms, this could ultimately lead to new treatments, which may prevent the thousands of needless deaths caused by AAAs each year.”

Among those to welcome the new funding is Dave Stansfield, from Loughborough in Leicestershire. The 67-year-old was diagnosed with a small AAA two years ago, but it suddenly grew before rupturing in July this year. Thanks to emergency surgery performed by Professor Bown, Dave survived and has now fully recovered.

He said: “I was suffering severe stomach pain and said to my wife I wasn’t feeling particularly great. My wife called an ambulance and she explained that I had an abdominal aortic aneurysm and they rushed me to the Leicester Royal Infirmary. There, they carried out an ultrasound which revealed that the aneurysm had burst. I was blue lighted to Glenfield Hospital in Leicester, where I was operated on by Dr Bown. When I woke up, it dawned on me how lucky I was, especially because it was the second time I had undergone emergency surgery for an aortic aneurysm.

“In 1994, I had to have surgery for an aortic aneurysm found further up in my chest. I was told that they had managed to operate on me just minutes before the aneurysm was about to rupture, which could have also killed me. I feel extremely lucky to be alive, but also quite unlucky that I have had two aortic aneurysms in my lifetime. There is no history of aneurysms in the family so the doctors don’t know why I’ve been affected. I would really like to know if it is caused by lifestyle, or if it’s just something you are born with. That’s why I’m all for the research that the BHF is funding as hopefully it will find better treatments for people who are diagnosed with an AAA.”

Dr Abigail Woodfin, Senior Research Advisor at the BHF, added: “Currently, we don’t exactly know what causes an AAA, although we do know that smoking, a family history of aneurysms and high cholesterol can increase its risk. We also know it is unusual at a young age and that men are six times more likely than women to have an AAA. How and why these aneurysms grow, however, remains a mystery, but this exciting new research could be the key to finding answers.

“Funding for this research has only been made possible by the fantastic generosity of the public. We rely on their support so that we can drive forward research programmes into heart and circulatory conditions, which are vital in our mission to beat heartbreak forever.”