Leading health charities Brain Canada and Heart & Stroke join forces in multidisciplinary research endeavour
A sudden cardiac arrest putting a young mother at risk of losing brain function; a transient ischemic attack (TIA), also called mini stroke, alerting a health researcher to the danger of cognitive decline: many people with heart health challenges experience consequences that affect their mental, psychological and emotional well-being.
Yet while the impacts of serious cardiac events on the brain are well documented, other important linkages remain less understood. Dr. Peter Liu, a cardiologist with the University of Ottawa Heart Institute, believes this knowledge gap is the result of heart and brain conditions being studied and treated in isolation. “Medicine has a long history of compartmentalization,” he explains. “Among specialists, there’s this attitude of ‘you mind your organs, and I mind mine.’”
Instead of this “siloed, one-disease model,” Dr. Liu advocates for a collaborative approach that “not only promises valuable new insights and better health outcomes but also enables a smarter use of resources.”
In Canada, one person dies from heart disease, stroke or vascular cognitive impairment every five minutes. With the premise that tackling the impact of heart and brain conditions requires a collective response, Brain Canada and Heart & Stroke teamed up to develop the Heart-Brain Connection IMPACT Award – a $6-million competition, awarded to two Canadian teams this month. The research endeavour not only brings together multidisciplinary teams of close to 100 leading researchers from institutions across the country – it also includes the requirement of meaningfully engaging people with lived experience as active collaborators.
For Dr. Liu, principal investigator of BHRIITE (Brain-Heart Research Integrative Innovation Team Endeavour), this represents a “paradigm shift, where we put the brains and hearts of talented and knowledgeable people together to work for the benefit of our fellow Canadians.”
Dr. Douglas Lee, Ted Rogers Centre for Heart Research at the Peter Munk Cardiac Centre, UHN, leads another pioneering project, UNEARTH CVD (Using Novel Approaches for the Early Recognition of TIA, Heart Failure and Connections with Vascular Dementia), with Dr. Gustavo Saposnik, a neurologist at St. Michael’s Hospital, a site of Unity Health Toronto.
Dr. Peter Liu
Cardiologist, University of Ottawa Heart Institute
“Significant scientific and technology advances enable a more thorough investigation of the heart-brain connection at this time,” says Dr. Lee. “However, no one person or one specialty can provide all the answers – this requires a big and diverse team effort, with experts from basic and clinical science, technology development, engineering, computer science and population health coming together to support one vision.”
Brain Canada, the national convenor of the brain research community, seeks out innovative partnerships such as this one to drive discovery and exploration, says Brain Canada president and CEO Dr. Viviane Poupon. “We’re proud of this collaboration with Heart & Stroke and congratulate Dr. Liu and Dr. Lee and their teams, including their patient participants, on these substantial awards. Having people with lived experience of the disease be part of the research team ensures the research and its outcomes are relevant because it aims to solve a real, pressing need; innovations informed by diverse stakeholder testing and feedback end up with the best possible design.”
Doug Roth, CEO of Heart & Stroke, expects tangible change coming from the two projects. “We’re confident that bringing together experts from across the country and from different disciplines to study questions that are often researched in silos will help to spark innovation and discovery,” he says. “Through our partnership with Brain Canada, we are leveraging our strengths and networks to drive change and tackle the most pressing issues facing people in Canada.”
Scientific and technology advances informing diagnosis and care
There is an urgency to tackle “the tsunami of heart and brain health challenges that affect individuals, the health-care system and society,” proposes Dr. Liu, who believes that many brain and heart conditions are diagnosed too late.
“Patients often get help when brain changes are locked in and the heart is weak,” he says. “By the time they experience severe symptoms, the chance of recovering full function is already diminished. Early detection – for which we already have tools in the testing stage – can provide a window for more successful interventions and for avoiding complications.”
Dr. Lee agrees that timely intervention can help to prevent adverse outcomes. One of his team’s research modules focuses on TIAs, where people experience brief periods of symptoms that resemble a stroke, he explains. “TIAs are often predecessors to a stroke, yet they can be difficult to diagnose, especially by care providers who are not neurologists or stroke experts.”
The researchers are looking to develop blood tests that can identify biomarkers pointing to TIAs or heart attacks, he says. Other diagnostic tools under investigation include sensors measuring cerebral blood flow to identify those at risk for cognitive impairment before their symptoms become severe. And speech pattern analysis powered by artificial intelligence could help to detect subtle changes in speech to provide clues on which patients are at risk of developing dementia.
“Using such new technologies and scientific insights can improve the outlook for people with many heart and brain conditions,” says Dr. Lee, who notes that cognitive impairment in people with heart failure has a big impact on their ability to care for themselves.
Dr. Douglas Lee
Ted Rogers Centre for Heart Research at the Peter Munk Cardiac Centre
“We know that self-monitoring, such as taking their medication and watching what they eat or how much they drink, is critical for people with heart conditions,” he says. “We are discovering more and more about how heart conditions impact the brain – and how brain conditions impact the heart.”
Engaging patients and communities
A key inspiration, for Dr. Liu, comes from “seeing patients fall through the gaps that are created when heart and brain diseases are treated and researched separately.” From talking to his patients, he has learned that mental health and cognitive function are among their top concerns.
“They are worried about depression and anxiety, about their memory being affected,” he says. “While we do a good job helping them with heart-related symptoms, such as shortness of breath or blood pressure control, the brain aspect is often neglected.”
However, there are a number of “cardiovascular tools, including prevention and treatment methods, that can also be useful for conditions affecting cognition. For example, we need to intensify our focus on preventative strategies such as exercise, healthy eating and social connections,” says Dr. Liu, who regards this synergy as “living example of how closely the heart and brain are connected.”
Beyond considering the risk factors for individuals, the projects will “use big data and artificial intelligence to identify clusters of people with higher risks – and encourage them to become active participants in determining their health outcomes,” he says. Engaging at-risk populations, including Indigenous people, ethnic communities and Canadians living in certain geographic areas, can help to bring tools and incentives – including education, screening and intervention programs – to those who need them most.
Dr. Lee sees such efforts as crucial steps for advancing health equity. “Studies have shown that people from marginalized communities do not have the same access to health care the average Canadian has,” he says. “We want our health-care system to provide quality care to everyone, irrespective of geography, ethnicity or socio-economic status.”
A brighter future for individuals and society
“We want to encourage everyone – from patients, advocacy groups, researchers and health-care providers to private-sector partners and funders – to recognize that we all have a stake in working together to improve the system,” says Dr. Lee.
As teams are committed to sharing updates from their research along the way, Roth envisions them to “accelerate a much-needed shift around how we explore heart disease and brain disorders, and ultimately help address the profound impact these diseases have on people’s lives and the health system.”
Dr. Poupon associates this kind of knowledge exchange and co-operation with building long-term capacity in research and care. “The implications for heart and brain vascular health will extend beyond Canada to the global stage,” she says. “When we improve our understanding of the heart-brain connection, this will benefit us all.”
Funding support for the Heart-Brain Connection IMPACT Award comes from Heart & Stroke and Brain Canada, through the Canada Brain Research Fund (CBRF), Brain Canada’s innovative partnership with the Government of Canada through Health Canada.
is a national non-profit organization that enables and supports excellent, innovative, paradigm-changing brain research in Canada. Connecting people, labs and platforms across the country – as well as institutions, organizations and sectors – helps to drive innovation and foster an interconnected brain research system, enabling Canada to excel and make even greater contributions to the global quest to understand the brain.
HEART & STROKE
has been leading the fight to beat heart disease and stroke for 70 years – and this work has saved thousands of lives and improved the lives of millions of others. The organization’s goal is to work together to prevent disease, save lives and promote recovery through research, health promotion and public policy.
Advertising feature produced by Randall Anthony Communications with Brain Canada and Heart & Stroke. The Globe’s editorial department was not involved.