Working together to build a better heart

We are pleased to share that Professor Costanza Emanueli was re-awarded her position as British Heart Foundation (BHF) Chair of Cardiovascular Science

In normal times the BHF would visit the lab in person but given restrictions introduced due to the COVID-19 pandemic, a two-day virtual visit took place in October 2020 with members (both staff and PhD students) and collaborators of Professor Emanueli’s research group. The virtual visit also involved Imperial's Provost, the Dean of Medicine, and Dean for Research for the Faculty of Medicine, and senior departmental members of the National Heart and Lung Institute.

Professor Emanueli, who joined Imperial College London in April 2018, was initially awarded the post of Chair in 2015 when working at Bristol University. Prior to this, she was appointed as BHF Senior Fellow in 2005 and University Research Professor in 2010. She has been a visiting Professor with the College since 2013.

Professor Emanueli spoke to us about her role at the BHF, the importance of collaboration and her current research.

Working together to build a better heart

As BHF Chair, Professor Emanueli is responsible for applying for five-year Programme Grants – a detailed and complex process. Professor Emanueli tells me, “last year I was really lucky as we managed to secure the £1 million grant just two weeks before we went into lockdown. It was a big relief! We write a lot of grant applications - they take time to complete as you need to consider so many different things and gather a lot of pilot data, but once it’s done and approved, it’s a great feeling.”

There’s a great deal of collaboration between the BHF Chairs across UK Universities - “we work together to try to find solutions for patients suffering from heart attacks and other ischaemic diseases. We try to find new options for recreating a better heart.” 

“Research is based on collaboration”

“You need so many different skills and expertise, it’s so important that we collaborate – we do better research, we save money and we can be at the forefront of research in our field.” 

“Imperial is known for being quite a competitive place to be, but I find it very inclusive.”

Professor Emanueli focuses her research on different types of RNA molecules and their role in cell-to-cell communication leading to cardiovascular disease, but also as possible new therapies. She says that she is not daunted by new scientists joining her field. “Personally, I really like to be cooperative when working with other people, and to have fun with my colleagues. I’m not afraid of people “invading” the field I work in. In the past it used to be like that, but now it’s a lot more open minded and there is always enough work for everybody.” Within fundamental research everyone has different specialities. “Even people working solely on the human heart will all have different angles - which ultimately means that we can do better research.” For this reason, Professor Emanueli is contributing to national and international research networks, including the BHF Regenerative Medicine Centres and the European Cost Action in Cardiac RNA, which already include participants from 37 countries around the world.

She works closely with clinical staff - people who design and run clinical studies, and bioinformaticians who can analyse the vast amounts of data gathered. She has also worked with bioengineering colleagues, who obtain ideas and data from her team, and then use their expertise to build therapeutic prototypes based on this research.

Understanding what causes issues in blood vessels

Professor Emanueli’s area of research looks at blood vessels in ischaemic disease, a condition where insufficient blood reaches the heart or limbs with adverse consequences. We all have large blood vessels, arteries, and smaller blood vessels, microvascular capillaries, which distribute blood to the heart. Patients can have problems in one of these types of vessels, or sometimes both. Atherosclerosis is a block in the arteries, but you could also have Microangiopathy, a specific disease in the smaller blood vessels which can kill the vessels, stop them from functioning properly and make it more difficult to regenerate them. When you have ischaemia in the heart, it also affects cardiomyocytes, the beating cells which form the heart muscle, and that can lead to heart failure.

“The technology we have at our disposal today is incredibly better than when I was a PhD student!”

If defective blood vessel function can be repaired, specific therapies for the heart and the other cells in the heart can then be developed. This is Professor Emanueli’s aim – to better understand what causes problems in these two types of blood vessels. Clearly, diabetes is a major risk factor for the blood vessels and heart health in general. Professor Emanueli is therefore extremely committed in finding solution to meet the medical needs of diabetic people. She also advises Diabetes UK as part of their Science and Research Advisory Group.

COVID-19 effects on the heart

With the global impact of COVID-19, research communities across Europe have teamed up to help. Putting out a call for action in Spring 2020 in the European Journal of Cardiology, Professor Emanueli and some of her CardioRNA colleagues were set on helping as a group and so when the European Covid 'emergency' grants were announced, they submitted a successful application for 'A diagnostic test to improve surveillance and care of COVID-19 patients'.

The team are trying to understand if biomarkers can be found which predict the outcome from COVID-19, and if those changes in RNA are not only good as biomarkers, but also if they can explain some of the consequences of COVID-19 in the heart, and see if some specific approach can be designed to treat those patients with cardiovascular complications in the future. 

“I think unfortunately COVID-19 still has a lot of negative surprises in store for us. There are so many new variants emerging and in some countries the situation is desperate. It’s a new world and we don’t really know what to expect at this stage.” It is very important to develop global research and Imperial teams are leading in this context. In my team, we are working closely with the European partners, but also with Brazilian scientists who are confronting this drama on a daily basis.