Our research

Pipette injecting substance into tubesRoyal Brompton & Harefield NHS Foundation Trust is recognised throughout the world for its pioneering research into complex heart and lung conditions. 

Research into cardiovascular and respiratory medicine is central to the Trust’s mission and our starting point is the needs of the patients we treat every day. By investigating the causes of their conditions and testing new ways of diagnosing and treating them, we have been responsible for many significant medical advances that have been taken up across the NHS and beyond. 

The Trust’s portfolio of cardiovascular and respiratory research encompasses numerous active studies across the breadth of our clinical practice.

Over the years we have nurtured strong partnerships with institutions such as Imperial College London and the National Institute of Health Research (NIHR) to provide our clinical teams with the necessary academic and financial support to advance their research programmes. 

During 2015/16, over 4,400 patients took part in our research, either by participating in a research study, or by donating genetic tissue to our biobanks.

We work with other universities, including the University of Nottingham, and numerous NHS organisations, such as Liverpool Heart and Chest, and Chelsea and Westminster hospitals, so that we all benefit from access to larger clinical populations, data banks, and knowledge sharing.

Trust researchers also recognise the importance of working with industry partners to run clinical trials, to conduct sponsored research, and to offer patients opportunities to participate in cutting-edge research. We collaborate with a variety of companies – large and small pharmaceuticals, and medical device, diagnostic and biotechnology companies – on investigator-led, commercial research partnerships.

Our latest discoveries

Pioneering blood test for inherited cardiac conditions

A new comprehensive genetic test has been developed to diagnose the most prevalent inherited cardiac conditions (ICCs) following international work led by experts at Royal Brompton Hospital and Imperial College London.

The cutting-edge blood test looks for mutations in all of the genes that are currently known to cause ICCs, improving diagnosis for patients.

In one test, 174 faulty genes that are known to be associated with ICCs can be detected. These include heart rhythm problems (arrhythmias), cardiomyopathies (which affect the size and shape of the heart muscle), diseases affecting the aorta (aortopathies) and hyperlipidemias (when patients have a high level of fat in their blood).

ICCs are thought to affect over half a million people in the UK and can be life-threatening. When there is an ICC in a family, the most accurate way to determine which family members may actually develop the condition is through a genetic test. This means that steps can be taken to reduce the risk of sudden death, such as surgery, medication or lifestyle changes.

Research carried out at Royal Brompton Hospital demonstrated that the new test could reliably detect mutations in all known genes associated with ICCs. The findings were published in February 2016 in the Journal of Cardiovascular Translational Research.

Previous genetic tests for ICCs looked at a smaller number of genes and were only able to identify specific conditions, leading to greater costs and more work, meaning that patients faced a longer wait before a diagnosis could be made. The research found that the new test, which is available to all testing labs in the world, is quicker and more reliable, reducing costs and allowing patients to be diagnosed quickly and accurately.

Around 40 patients a month are now being tested in this way at Royal Brompton Hospital.

Dr James Ware
Dr James Ware

Dr James Ware, consultant cardiologist at the Trust and clinical senior lecturer in genomic medicine at Imperial College London, is one of the study’s lead researchers. 

He says: “Genetic tests are invaluable when managing inherited heart conditions. They can help to make the initial diagnosis, and to choose the best treatment for the affected person. But where they make the biggest impact is in looking after that person’s family.

“Without a genetic test, we often have to keep the whole family under regular surveillance for many years, because some of these conditions may not develop until later in life. This is costly both for those being monitored and the health service, and can cause a great deal of anxiety for family members.

“By contrast, when a genetic test reveals the precise genetic abnormality causing the condition in one member of the family, it becomes simple to test other family members. Those who do not carry the faulty gene can be reassured and spared countless hospital visits.

“This new comprehensive test is increasing the number of families who benefit from genetic testing.”

The genetic test is a result of international collaboration between researchers at the NIHR Royal Brompton/Imperial College London Cardiovascular Biomedical Research Unit (BRU), MRC Clinical Sciences Centre, National Medical Research Council of Singapore and Duke-NUS Institute of Precision Medicine (PRISM). It was funded by the British Heart Foundation and the Health Innovation Challenge Fund (HICF), which is a partnership between the Department of Health and the Wellcome Trust. 

Genes linked to rare heart failure in pregnant women

A study into heart failure in pregnant women used genetic data from the Trust’s cardiovascular biobank to make an important discovery.

During normal pregnancy, the cardiovascular system of pregnant women adapts to increases in heart rate and blood volume. For some women however, their hearts do not cope with these changes; their heart enlarges and doesn’t pump properly, leading to heart failure, which can be life threatening. Pregnancy-related heart failure, or peripartum cardiomyopathy (PPCM), affects up to 700 women a year in the UK, and the most common symptoms are breathlessness and palpitations. 

To find out whether there is a genetic cause, researchers from a number of centres around the world, including Royal Brompton Hospital, carried out a genetic study comparing patients with PPCM, dilated cardiomyopathy (DCM) and healthy volunteers. The genetic data for DCM came from patients recruited into the cardiovascular biobank at the Trust. 

The study findings published in the New England Journal of Medicine suggest that PPCM can have very similar genetic characteristics to DCM – with changes in the Titin (TTN) gene found to be the most commonly occurring in each disease.


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