Cardiovascular Health - Q3 2020 by Mediaplanet UK&IE

A PROMOTIONAL SUPPLEMENT DISTRIBUTED ON BEHALF OF MEDIAPLANET, WHICH TAKES SOLE RESPONSIBILITY FOR ITS CONTENTS

Q3 / 2020

Cardiovascular Health Full campaign on www.healthawareness.co.uk

Keeping the beat: getting to the heart of detection and management Over the last 40 years, there have been dramatic reductions in deaths from cardiovascular disease (CVD). A tremendous achievement in its own right, these reductions have also made a significant contribution to increases in life expectancy.

WRITTEN BY

Katherine Thompson Head of the Cardiovascular Disease Prevention Programme, Public Health England

hile this means that many of us will benefit from living longer, those extra years of life are likely to be spent in poor health. Unfortunately, CVD also has a role to play here, affecting the lives of nearly seven million people. CVD doesn’t affect everyone equally. People living in England’s most deprived areas are disproportionately affected. It is also more common among men, older people, people with a severe mental illness and among South Asian or African Caribbean communities. This not only bears a great cost to those affected, but health care costs are estimated at £7.4 billion and those to wider society at £15.8 billion per annum. National CVD ambitions Given that most CVD conditions are preventable, there is a considerable opportunity to make a difference. Bringing together over 40 health and social care partners, Public Health England has facilitated the development of national CVD ambitions. These focus on improving the detection and management of three common CVD conditions: atrial fibrillation, high blood pressure and high cholesterol. Optimal management of these conditions can be very effective at preventing heart attacks and strokes. However, late diagnosis, under treatment and unwarranted variation in care is common.

Read more at healthawareness.co.uk | 3

How a quick operation can correct heart valve disease

If you are experiencing any symptoms, do go and ask your GP for a stethoscope check. Find out more at newheartvalve.com/uk/

Aortic stenosis is a potentially fatal heart valve condition which used to require open heart surgery. Now patients’ lives can be saved with a non-invasive treatment called TAVI.

Why you should never dismiss signs and symptoms of HVD HVD has various causes, but is mainly due to general “wear and tear”, so predominantly affects those in later life. Symptoms can appear gradually and include breathlessness, chest pain, light headedness, or fatigue. If these occur, don’t dismiss them as ‘just what’s to be expected in old age’, warns Dr Blackman. In fact, it’s imperative to seek medical attention because any type of HVD can ultimately lead to heart failure. After the onset of symptoms, the average survival from aortic stenosis is just two years. Thankfully, if the problem is picked up in good time and treated properly, patients can do very well. “The only treatment for all forms of heart valve disease used to be open heart surgery, which is invasive and high-risk, especially for older people,” says Dr Blackman. “Patients could expect to

©DRAZEN ZIGIC

hen he turned 80, Roger Hammond decided to get an allotment. “I wanted to do something a bit different,” he laughs. It turned out to be a good decision – perhaps even a life-saving one, because it was then that he noticed the signs of a potentially serious heart condition. “As I was digging, I’d get breathless and have to stop what I was doing. I thought: ‘It’s my age.’” At first, West Yorkshire-based Roger, now 85, put off going to see his GP, but finally went to his local health centre for a check-up. He returned for his results, which seemed normal. “But as I was leaving, the doctor said: ‘Roger: I’ll just listen to your heart with my stethoscope.’ And I’m glad he did because he could hear a murmur. After further investigation, Roger was diagnosed with aortic stenosis (AS), a type of heart valve disease (HVD). “Heart valve disease is a malfunction of one of the four valves that connect the chambers in the heart and control the flow of blood,” explains Dr Dan Blackman, Interventional Cardiologist at Leeds Teaching Hospitals, NHS Trust. “Aortic stenosis is one of the most common types of HVD in adults, and occurs when the aortic valve fails to open properly.

spend eight days in hospital with a recovery period of up to six months.” But for the past 10 or 15 years, a noninvasive keyhole valve replacement – called transcatheter aortic valve implantation (TAVI) – has been available for aortic stenosis patients. Here, an artificial replacement valve is implanted into the heart using a catheter, usually inserted via the main artery in the groin.

Roger was conscious throughout, didn’t find it painful and was discharged after an overnight stay. A life-saving procedure that reduces the burden on the NHS The TAVI procedure, carried out under local anaesthetic, has revolutionised life for AS patients because they are in hospital for an average of just three days, while post-op recovery usually takes a week. “This is important in the COVID-19 era when people want to minimise the amount of time they spend in hospital,” says Dr Blackman. “What’s more, because the procedure and recovery is so quick, it reduces the burden on NHS resources.”

Initially, Roger was due for his TAVI procedure at Leeds General Infirmary in March of this year; but coronavirus threw these plans into disarray. Because of lockdown the operation had to be cancelled and he was told to expect a long wait for a rescheduled appointment. “Unfortunately, my breathlessness and dizziness started to get a wee bit worse,” says Roger. “So I contacted the hospital to tell them and I was fast-tracked. Just weeks later I had the procedure.” Roger was conscious throughout, didn’t find it painful and was discharged after an overnight stay. Life is good now. Roger especially enjoys going out for walks with his wife, Joyce. “In fact, we’ve walked every day since lockdown began, apart from when I was in hospital, obviously. We’ve already done 3,500 steps today!” The couple are also looking forward to going on holiday to Scarborough, on the North Yorkshire coast. “Unfortunately, that’s been put on hold because of coronavirus,” he says. “But when we DO get there, our aim is to get out for a long walk around the sea front – every single day.” Written by: Tony Greenway

INTERVIEW WITH

Dr Dan Blackman Interventional Cardiologist, Leeds Teaching Hospitals, NHS Trust

INTERVIEW WITH

Mr Roger Hammond Patient

Paid for by Edwards Lifesciences

A promotional supplement distributed on behalf of Mediaplanet, which takes sole responsibility for its contents | MEDIAPLANET

4 | Read more at healthawareness.co.uk

Why remote monitoring has increased in the COVID-19 crisis Remote monitoring technology is the future for heart arrhythmia patients, because it can save unnecessary hospital appointments and free up the system for those who really need it.

Positive reaction from arrhythmia patients However, there has been one positive outcome from the last six months. The pandemic has meant that a growing number of arrhythmia patients have been using remote monitoring technology to manage their condition – and their reaction to it has been extremely gratifying. “We found that most people welcomed having a remote monitor at home that could monitor their device 24/7 without the need to visit the hospital. In fact, many wondered why they hadn’t been offered it before,” says Lobban. “For example, patients like video consultations because they do not have to leave the house, but can still make eye contact with their doctors. “Meanwhile, those who have a pacemaker or ICD implanted have been impressed with remote monitoring devices. This simple technology connects to their wi-fi and, while they are sleeping, sends information about the rhythm of their heart and device activity to their clinician.” If there are any problems, this shows up in the data and can be addressed by the clinic almost immediately. “I am a big believer that if you have a pacemaker or an ICD, you should automatically be given remote monitoring technology as part of your treatment plan,” says Lobban. Indeed, she believes that remote monitoring is the future for arrhythmia patients. “It saves people unnecessary visits to the hospital and it saves money on hospital transport or public transport,” says Lobban. “Plus, it frees up clinics for patients who really do need to be seen urgently by healthcare professionals. And, of course, it helps reduce the spread of COVID-19, because most patients get to stay at home, which is particularly important if they are living with other comorbidities. In the long-term this can save the NHS money because it is more expensive to care for someone with COVID-19 than to give a remote monitor to someone who has a device implanted.” WRITTEN BY

Trudie Lobban Founder & CEO, Arrhythmia Alliance

©IMAGE PROVIDED BY BRITISH HEART FOUNDATION

f you have heart arrhythmia – an abnormal heart rhythm that is either too fast, too slow or irregular – you may need a surgical procedure to treat or manage your condition. This could include a catheter ablation (a treatment for atrial fibrillation, the most common form of arrhythmia), or the implantation of a pacemaker or implantable cardioverter defibrillator (ICD).

Why the Government must prevent a research funding crisis The COVID-19 pandemic has left charity-funded medical research facing a catastrophic funding crisis. We anticipate that, without Government support, our BHF annual research budget will fall by half to £50m this year alone, jeopardising progress in how we tackle heart and circulatory diseases.

T WRITTEN BY

Dr Charmaine Griffiths Chief Executive of the British Heart Foundation

he beginning of 2020 now feels like a distant and much more certain world. It was the start of a new decade and the British Heart Foundation (BHF) was embarking on an ambitious new ten-year strategy – with a core focus on investing in life-saving research. While our mission hasn’t changed, the ongoing COVID-19 pandemic has, as with the wider world, upended all our plans and created historic health and financial challenges for us to overcome. We’ve taken steps to meet this oncein-a-generation challenge by enabling our researchers to join the fight against COVID-19 and establishing a Coronavirus Hub to help heart and circulatory patients, who are at increased risk of complications from COVID-19. Calls to our Heart Helpline soared at the height of the pandemic and our online support page have been visited over two million times since March 2020. Devastating consequences The BHF has been at the forefront of research into heart and circulatory disease for nearly 60 years, funding around £100 million in life-saving research every year as the largest noncommercial funder of cardiovascular research in the UK. Sadly, the closure of our BHF shops, combined with the cancellation of fundraising events, has cut our research budget by half to £50 million. Such a dramatic funding drop will have a catastrophic impact on UK research

into heart and circulatory diseases, the careers of thousands of young scientists we urgently need, and ultimately advances in diagnostics, treatments and cures for people living with these diseases in the years to come. The solution requires collaboration To maintain the progress that’s been achieved through decades of investment, the BHF has joined with the Association of Medical Research Charities and its 151 members to call on the UK Government to establish the Life Sciences-Charity Partnership Fund to support the restoration of charity funded research over the next three years to protect hard-earned progress as we aim to beat heartbreak forever. Without help, we know that research progress will stall, and we will lose precious research and development research talent we urgently need to make life-saving discoveries. An international research and development hub The Prime Minister prides the UK on being an international hub for research and development. Now it is time for the Government to show true commitment to this claim and support the nation’s research charities so we can continue our trailblazing research. Patients are at the heart of all medical research. Unfortunately, unless the Government provides financial support, they are the ones who will pay the price if we’re not able to protect UK research.

Read more at healthawareness.co.uk | 5

Try Mornflake’s Pumpkin and Carrot Savoury Oats recipe at mornflake.com

Maintaining good heart health is important at any age and being aware of your cholesterol levels is an essential part of this. It’s tempting to think that high cholesterol-induced heart disease only affects people who are middle-aged or older but, according to experts, it’s never too early to adopt a varied and balanced diet and a healthy lifestyle to help look after your heart.

Lynne Garton Dietetic Advisor, HEART UK

WRITTEN BY

Tony Greenway

Improve your cholesterol levels by eating healthily While it’s true that you can’t change a number of factors that influence cholesterol levels – such as family history, age, ethnicity and gender – we can choose to eat better. That means cutting down on foods that are high in saturated fat such as fatty meat, meat products, pies, pastries, cakes and biscuits and instead eating plenty of fruit, vegetables, oily fish, healthy oils, pulses, nuts – and oats! Oats are a wonderfully versatile super grain, renowned for packing a nutritious punch - high in fibre and a good source of protein, and some vitamins and minerals. But did you know that oats are good for your heart, too? “The high concentration of beta glucan fibre in oats works by forming a gel, which binds cholesterol-rich bile acids in the intestines, preventing them from being reabsorbed back into the blood,” says Lynne.

©IMAGES PROVIDED BY MORNFLAKE

INTERVIEW WITH

ynne Garton, Dietetic Advisor at HEART UK, says: “Bad cholesterol builds up over time, and the longer it’s left untreated, the greater your risk of developing heart disease. “Cholesterol is misunderstood by many. It’s usually seen as a negative thing; but, actually, it’s vital for our good health in order to make cell membranes, various hormones, certain vitamins and bile salts, which help to digest the fat we eat. “The problems occur when we have too much so-called ‘bad’ cholesterol in our blood. This means any type of cholesterol other than high density lipoprotein (HDL) – aka ‘good’ cholesterol, which removes excess cholesterol from blood circulation. “Low density lipoprotein (LDL) is the main carrier of cholesterol in our blood and it’s often called ‘bad’ cholesterol because, over time, it can build up in the arteries, causing them to clog up, which can then lead to a number of diseases of the heart and blood vessels, such as heart disease and stroke.”

Advertisement by Mornflake

Oats are good for your heart. “As a result, the liver has to take more LDL cholesterol out of the blood to make more bile, thus lowering blood cholesterol levels.” So, whether you’re regularly tucking into oats or oatbran, rest assured you’ll be eating beta-glucan. The important thing is to make sure you’re eating enough of it. Mornflake oats – the facts One 40g portion of Mornflake Superfast Oats provides 1.5g of beta glucans from oats, which is 50% of the suggested daily amount. Beta-glucan is found in even greater concentrations in oatbran - the nutrient-dense outer layer of the grain that is removed when oats are milled. At Mornflake we use 340 years of know-how to extract more oatbran from our grain. Oatbran not only contains more B vitamins and iron than regular oats but also packs a greater amount of dietary fibre – including 50% more beta glucans. The exceptionally high beta glucans content in oatbran (76% of the suggested daily amount in one 40g portion) helps maintain healthy cholesterol levels as well as actively lowering total LDL cholesterol – making it one of the most affordable and effective cholesterol-lowering foods available. It also happens to naturally be a nutritionally balanced food, that fits into the context of a healthy diet – low in saturated fat, no added sugar or salt and it is a source of protein. “To achieve a cholesterol-lowering effect you’ll need to eat three grams of beta-glucan a day, with a portion needing to provide at least one gram,” says Lynne. “But that should be easy because oatbran can be used in a variety of ways. For example, it can be added to smoothies, baked products and sprinkled onto cereals. Oats, meanwhile, can be used as a replacement for flour, as a topping for yoghurts, and in fruit puddings and crumbles. These are very flexible ingredients.” With over 340 years’ milling craft and expertise, Mornflake offers Superfast rolled porridge oats, Stoneground Oatmeal for savoury bites, and Mornflake Oatbran for wholesome bakes and healthy shakes. For inspiration on recipes with oats, visit www.mornflake.com or follow us on Instagram @mornflake.

A promotional supplement distributed on behalf of Mediaplanet, which takes sole responsibility for its contents | MEDIAPLANET

6 | Read more at healthawareness.co.uk

Forget the fancy stuff, let’s get down to what we know works

Don’t miss the warning signs “During this pandemic we have seen a reduction in the numbers of patients being admitted to hospital with heart related issues; perhaps preferring to isolate at home and hiding symptoms.”

ot all the answers are rooted in technology, and we don’t need any more data; let’s do what we know works. This approach would give patients gold standard treatment and care for their heart failure. Signs, symptoms history and test By checking a person’s signs, having an awareness of common symptoms, (breathlessness, fatigue and fluid swelling) and knowing the person’s medical history, we then have a simple blood test, NT-proBNP to use as a ruleout tool for heart failure. Put them together, and what do you get? An efficient and timely diagnosis.

It is very important to diagnose heart failure early to improve people’s length of life and quality of life. Get newly diagnosed people to the right team The evidence indicates that treatment by a heart failure specialist in a hospital, results in mortality rates of 8%, whereas, without access to this level of care, they jump to 12.6%. Every patient needs the right team to stabilise and optimally treat their heart failure. This team should include a cardiologist specialising in heart failure, a specialist heart failure nurse and an engaged GP when the patient is discharged from their specialist team. Focus on the human need We need to invest in what the patient wants and needs, not just decisions based around the length of life and the cost of hospital readmissions. At Pumping Marvellous, we know people with heart failure value quality of life generally over anything else. Let’s change the paradigm where the quality of life becomes a valued metric in the decision-making process around access to care and treatments in heart failure. It is vital to help people with heart failure achieve a better quality of life by assisting them to better manage their condition by recognising what do and when. Heart failure lives at home in the community, so let’s treat it there. WRITTEN BY

Nick Hartshorne-Evans Founder and CEO Pumping Marvellous Foundation

H WRITTEN BY:

Lynn Mackay-Thomas Chief Executive Officer, British Society for Heart Failure BSH BOARD OF TRUSTEES;

Dr Lisa Anderson Deputy Chair Ms Carys Barton Chair BSH Nurse Forum Ms Janine Beezer Councillor Professor Roy Gardner Chair Elect Professor Paul Kalra Past chair Dr Stephen Pettit Treasurer Dr Sue Piper Councillor Dr Carol Whelan, Councillor Dr Simon Williams Chair

eart failure can develop as a consequence of the heart muscle damage, sometimes caused by a heart attack; what we are already seeing is increasing numbers of new patients with heart failure but what we cannot know is what future repercussions may result from reduced intervention during this period. We can, however, expect this pattern to continue. ” says Dr Simon Williams, Chair of the British Society for Heart Failure. Heart failure is a condition that patients need to live with for the remainder of their lives. Early detection and accurate diagnosis in primary care, prior to presenting at hospital, are essential. With the right support from people around them, it is possible for patients to live well with heart failure. There are incredible life gains to be had with new and emerging treatments and our specialists are here to guide and educate on heart failure management. COVID-19 catalysing innovative solutions The COVID-19 pandemic has exacerbated pre-existing problems in the system and, as such, is changing the way we practice medicine, catalysing new and innovative solutions. As the professional association representing heart failure specialists, we are very proud of how our teams have found ways to address some of the issues. Our health professionals have flexed and adapted to change, supporting the national effort at the front line while also striving to keep patients with heart failure safe and well at home. However, we can do much better for our heart failure patients and their families.

With the right support from people around them, it is possible for patients to live well with heart failure. We need strong leadership and clear guidance from our heart failure specialists For the delivery of improved care throughout the system, we need strong leadership and clear guidance from our heart failure specialists to support all health professionals across the patient pathway. Many patients have been too frightened of contracting COVID-19 to go to hospital; too frightened to tell anyone about their symptoms, or perhaps confused their symptoms with those of the virus or a consequence of the virus. We urge you not to miss the warning signs; please tell your GP practice if you have symptoms of breathlessness, fatigue or unusual swelling of limbs or abdomen. Your GP can order a simple diagnostic blood test called NTproBNP and, if concerned, refer you for specialist diagnosis and management plan. The earlier we see you, the better your outlook. One in five people will develop heart failure in their lifetime – we all need to be far more aware of heart failure and its symptoms by ensuring: • Early and accurate diagnosis; • Accountability throughout the patient journey; • Guidance from our experts. We can win the fight against heart failure.

Read more at healthawareness.co.uk | 7

An under-recognised killer: shining a spotlight on heart failure

George Godfrey Head of Medical – Cardiology, AstraZeneca

Lack of awareness of heart failure symptoms A common misconception is that heart failure only affects the elderly.6 Although heart failure prevalence does increase with age, it can occur in younger patients too.4 This lack of understanding can contribute to delayed diagnosis and treatment, with one study suggesting that patients can wait more than two and a half years between first symptoms and diagnosis.7 Part of the problem is that heart failure symptoms can often be attributed to other, less serious conditions, making it difficult for doctors to make a clinical assessment recognising these as being connected to heart failure.8,9 When you add the current awareness gap on understanding what heart failure is and how it can affect us, we are more likely to ignore symptoms and not seek medical advice. This vicious circle results in delayed diagnosis, treatment, and ultimately worse outcomes. Heart failure usually linked to other conditions So how do we address this gap? This question spans a multitude of institutions, industries, and ideas, but a starting point is understanding that heart failure is usually linked to other medical conditions, particularly cardiovascular disease, diabetes, and kidney disease. For example, if you already have conditions such as high blood pressure, chronic kidney disease, or diabetes, you have a higher chance of developing heart failure and other associated cardiovascular disorders too.10,11,12 Men and women with diabetes are estimated to have a two- and fivetimes increased risk of developing heart

©NANOSTOCKK

WRITTEN BY

ight now in the UK, almost one million people are living with heart failure, a condition where a person’s heart cannot pump enough blood to their organs – with heart failure mortality risk being worse than some of the most common cancers (prostate, breast, and bladder cancer).1,2,3 Globally, the number of people living with heart failure rises to 64 million people.4 Yet, despite its prevalence and the fact that around half of people with heart failure in the UK will die within five years of their diagnosis, the majority of people aren’t aware of what heart failure means, making it an often overlooked condition.4,5 New research conducted by the World Heart Federation, and commissioned by AstraZeneca, has thrown this awareness gap into the open; while the majority of people surveyed had heard of heart failure, only around a quarter were able to identify two of the main symptoms, such as shortness of breath when resting or being active, or swelling of the feet, ankles, legs, abdomen or in the small of the back.4

Despite its prevalence and the fact that around half of people with heart failure in the UK will die within five years of their diagnosis, the majority of people aren’t aware of what heart failure means, making it an often overlooked condition.

failure respectively, when compared to non-diabetics.13 We are continuing to build up a more comprehensive understanding of the links between diabetes, kidney disease and cardiovascular diseases. Although there have been significant advances in treatment and prevention, mortality remains high and we are dedicating our efforts to bringing awareness of heart failure to the forefront and highlighting the importance of tackling heart failure.2 Understanding the interconnectedness between these conditions gives us an opportunity to find more holistic approaches, that may ultimately help prevent or alleviate symptoms and maintain quality of life in those already living with or at risk of heart failure. Lifestyle changes such as exercising regularly and having a balanced diet can improve symptoms.14 Better knowledge and understanding of heart failure will lead to improved management and prevention.15 By knowing the symptoms and risk factors for heart failure, people can visit their doctor earlier and ask the right questions, potentially cutting the time to diagnosis and care, and – when partnered with improvements in patients being treated – potentially improving their outcomes as well.16 Now is the time for change. By raising awareness of how it can make people feel, how it can shorten their lives if diagnoses are late and how other common medical conditions can cause it, we can shine a spotlight on heart

failure and make a difference to the lives of people living with or at risk of developing the condition.

Paid for by AstraZeneca

References 1. Sutherland, K., 2010. Bridging the quality gap: heart failure. Health Foundation. 2. Savarese G and Lund LH. 2017. Global public health burden of heart failure. Cardiac Failure Review 3(1): 7-11. 3. Mamas MA. 2017. Do patients have worse outcomes in heart failure than in cancer? A primary care-based cohort study with 10-year follow-up in Scotland. European Journal of Heart Failure 19(9): 1095-1104. 4. AstraZeneca, World Heart Federation. Accelerate change together: heart failure gap review. Available at: https://www.world-heart-federation. org/resources/accelerate-change-together-heart-failure-gap-review/ Last accessed September 2020. 5. Taylor CJ et al. 2019. Trends in survival after a diagnosis of heart failure in the United Kingdom 200-2017: population based cohort study. British Medical Journal 364:1223. 6. Pumping Marvellous. Debunking common heart failure myths. Available at: https://pumpingmarvellous.org/debunking-common-heart-failuremyths/ Last accessed September 2020. 7. Hayhoe B et al. 2019. Adherence to guidelines in management of symptoms suggestive of heart failure in primary care. Heart 105: 678–685. 8. NHS. Symptoms: Heart failure. Available at: https://www.nhs.uk/ conditions/heart-failure/symptoms/ Last accessed September 2020. 9. Fuat A et al. 2018. A Qualitative Study of Accurate Diagnosis and Effective Management of Heart Failure in Primary Care. American Journal of Cardiology and Cardiovascular Diseases. 1(1)01-05. 10. British Heart Foundation. High blood pressure. Available at: https:// www.bhf.org.uk/informationsupport/risk-factors/high-blood-pressure Last accessed September 2020. 11. House et al. 2019. Heart failure in chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney International 95:1305-1317. 12. Nichols GA et al. 2001. Congestive Heart Failure in Type 2 Diabetes. Prevalence, Incidence and Risk Factors. Diabetes Care 24:9. 13. Kenny et al. 2018. Heart Failure in Type 2 Diabetes Mellitus: Impact of Glucose-Lowering Agents, Heart Failure Therapies, and Novel Therapeutic Strategies. Circulation Research 124:121–141. 14. NHS. Living with heart failure. Available at: https://www.nhs.uk/ conditions/heart-failure/living-with/ Last accessed September 2020. 15. Wang J et al. 2015. Early Detection of Heart Failure with Varying Prediction Windows by Structured and Unstructured Data in Electronic Health Records. Conference proceedings - IEEE engineering in medicine and biology society 2015: 2530–2533. 16. Remme WJ et al. 2005. Public awareness of heart failure in Europe: first results from SHAPE. European Heart Journal 26:22.

GB-23776 September 2020

8 | Read more at healthawareness.co.uk

A promotional supplement distributed on behalf of Mediaplanet, which takes sole responsibility for its contents | MEDIAPLANET

DEMOCRATISING HEART FAILURE We believe everybody should have the opportunity to get involved with medical research that is going to improve treatment and care for future generations. Through innovation, research and experience we intelligently match trials and eligible patients. Our platform just happens to be simple, easy to use and improve visibility of trials to everyone.

Developed with patient insights, for people with heart failure and their families Help us make heart failure clearer for everyone hearts@pumpingmarvellous.org www.pumpingmarvellous.org Registered Charity No 1151848 â&#x20AC;˘ Company No 08370761

Developed with assistance from the University of Glasgow Robertson Centre for Biostatistics

Supported by Vifor Pharma