Research spotlight

“It truly is an amazing time to be involved in PH research”

A presentation about heart rate and energetic function won Dr Chinthaka Samaranayake a PHA UK-sponsored prize at last year’s National PH Research Forum. Emphasis caught up with him to find out more about the findings of his study, and the implications of wider research in the field of pulmonary hypertension.

Can you tell us more about your study and what it involved?

The research study investigated what factors determine the way the right ventricle [one of the chambers of the heart] responds in terms of its energetic function. Specifically, we studied whether reducing the heart rate using a commonly used drug (beta-blockers) brings about a favourable response in the energy the heart uses during each heartbeat.

The patients who took part in the study were given a short infusion of a beta-blocker medication while exercising on bicycle pedals during a right heart catheter procedure, and we measured the changes in the heart function with a special catheter before and after the medication infusion.

What were the findings and how significant are they? How will your research influence diagnosis or management of PAH?

We showed that heart rate moderation during exercise improved right ventricle relaxation and therefore its function. This was a small study designed to test the concept, but hopefully the results will lead to better understanding of the heart function during exercise in patients with pulmonary hypertension. The results will ultimately help in the selection of patients who are likely to benefit most from treatments for pulmonary hypertension in the future, and lead to new therapies specifically targeting the right heart in pulmonary hypertension. This project allowed us to establish a very nice platform for doing

“Research in PH is moving forward on a lot of fronts, with multiple different treatment options being tested in clinical trials”

other similar studies, and the team at the Royal Brompton Hospital has been working on two other novel ideas, translating some of the laboratory-based research into clinical trials. I have been very lucky to be involved in some of this work.

How enthused are you by the research that’s taking place across the board in PH at the moment?

Research in PH is moving forward on a lot of fronts, with multiple different treatment options being tested in clinical trials.

Moving the focus away from pulmonary vasodilatation alone and focusing more on disease modifying therapies is very exciting.

The results from the early phase clinical trials of these treatments are extremely encouraging and hopefully will translate into a lot of treatment options for our patients in the near future. There is also a lot of amazing basic science research work in PH carried out both in the UK and overseas which will significantly advance our knowledge and understanding of this condition.

The recent advances in the procedural interventions and monitoring techniques have also been incredible. It truly is an amazing time to be involved in PH research.

Why is medical research in PH so important?

PH is a relatively ‘young’ disease, so most of the treatment options have only been available in the last 30 years. The major advances seen in PH in recent years is driven entirely by the incredible medical research that has been conducted over the last few decades.

There is so much more to understand about PH and the key to further developing our knowledge is through research. We need to think broadly in the clinic and in the laboratory to advance research in PH to continue to help our patients. The incredible collaborations established through the PH network and the PHA UK have meant that UK researchers have been world-leaders in driving research.

How did you feel to win the PHA UK prize at the research forum?

It was a huge honour to receive the PHA UK prize. It is a reflection of all the hard work the PH team at the Royal Brompton Hospital has done over the years to establish platforms for translational and clinical research in PH. I feel very privileged to have had an opportunity to make a small contribution.

I want to express my sincere thanks to the whole PH team at the Royal Brompton, and in particular Dr Colm McCabe, for providing guidance and support for my PhD research. I also want to acknowledge and thank all the patients who participated in the project – we couldn’t have done it without the amazing patients who are always willing and engaged to advance PH research.

Dr Samaranayake is a thoracic physician with special interests in pulmonary hypertension, pulmonary embolisms and pulmonary vascular physiology. He completed medical training in New Zealand and specialist respiratory physician training in Australia, and is now working as a Senior Clinical Fellow at the Royal Brompton Hospital’s pulmonary hypertension unit. He is completing several research projects towards a PhD in risk stratification and early interventions in pulmonary vascular disease.

The National PH Research Forum takes place annually at the Chelsea Physic Garden in London. It brings together physicians, scientists and academics from all over the country and the PHA UK has provided sponsorship since 2012. The annual forum is an opportunity for those involved in developing better treatment for people with PH to share research, experience and ideas. After a forced break due to the COVID-19 pandemic, the forum returned in November last year.

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