CV-PEARL (Pacific Rim Education and Research Liaison)

Diseases of blood vessels, particularly atherosclerosis, lead to coronary heart disease, stroke and peripheral vascular disease. Heart disease is already the leading cause of death in Canada, and its prevalence is increasing rapidly in Hong Kong.

At the Universities of Hong Kong and British Columbia, there is complementary experience in "bench to bedside" programmes in cardiovascular diseases, which range from basic research in vascular biology to comprehensive clinical research and treatment programmes. These activities are organised locally by the Institute of Cardiovascular Science and Medicine (ICSM) in Hong Kong and the Vancouver Vascular Biology Research Center (VVBRC). In April 1997 the two centres of excellence joined forces to create CV-PEARL, the Pacific Rim Education and Research Liaison.

The initiative involves three major levels of collaboration.

• Risk identification and reduction provides a major opportunity for world class collaborative research and discovery.
  
• Clinical and basic research directed towards vascular pathophysiology can benefit from the combined expertise of biophysicists, physiologists, pharmacologists, biochemists, molecular biologists, pathologists and clinicians at both centres of excellence.
  
• Clinical and basic research can be directed towards new surgical and percutaneous techniques in the treatment of atherosclerotic arterial occlusive disease.
  
  

PROJECTS

1. Basic Science

Research is focused on normal function and abnormalities of blood vessels. The main themes are:

• Cell-cell signalling
  
• Endothelial regulation of vascular tone and endothelial dysfunction
  
• Pathology caused by oxidised lipids and its prevention by antioxidants
  
• Endogenous cardioprotective substances

Our approach aims to link cellular signals to tissue response in man, and to gauge the similarity of findings in the laboratory to human disease. Thus, studies at the cellular level will facilitate the development of novel strategies and technologies to tackle cardiovascular disease in patients.

2. Clinical Trials

The recent establishment of a Clinical Trials Centre in the Faculty of Medicine enables the University of Hong Kong to take a central role in multi-centre trials and complements the recognised expertise of the University of British Columbia in such clinical trials.

Studies on new antiplatelet agents and anticoagulation will be conducted with the objective of preventing strokes. Thrombotic tendency appears to be different in Chinese and Caucasians, and so a comparative study may reveal new therapeutic approaches for thromboembolic diseases.

3. Healthy Heart Programme

A Cardiac Rehabilitation and Prevention Programme was established in the University of Hong Kong in 1992 and will form the basis for a collaborative Atherosclerosis Reversal Programme between Hong Kong and Vancouver. The aim of the Healthy Heart Programme is a comprehensive strategy for the short and long term aggressive treatment of patients at high risk for the development of coronary disease, as well as for those with established coronary artery disease. This programme will provide initial assessment and education as well as long-term follow-up to reinforce lifestyle modification and medical treatment.

The establishment of a common database between atherosclerosis reversal clinics in Hong Kong and Vancouver will allow us to compare the pathophysiology of atherosclerotic disease in the Chinese populations of Hong Kong and Vancouver. Availability of data from first generation immigrants as well as second and third generation populations, will provide a valuable insight into the roles of intrinsic and environmental factors in the development of atherosclerotic disease.

4. Transcatheter Techniques

Comprehensive programmes exist in Hong Kong and Vancouver using balloons, stents and other devices to treat coronary and other arteries. The University of Hong Kong has developed a multidisciplinary clinical and research programme in non-surgical (percutaneous) treatment of diseased arteries supplying the heart, brain, kidneys and legs.

5. Surgery

Current studies are focused on the identification of the most suitable and long-lasting vessels to be used in coronary artery bypass surgery.

6. Arrhythmia

Disorders in cardiac rhythym (arrhythmias) are common in coronary heart disease, heart attack and heart failure. There is extensive experience in arrhythmia management in both Hong Kong and Vancouver. Principal foci of the joint research programme are the assessment of antiarrhythmic drugs and implantable devices for patients with complex arrhythmias and the long-term outcome of atrial fibrillation.

EDUCATIONAL OPPORTUNITIES

An important goal of the academic collaboration is the joint training of undergraduates and postgraduates, allowing such students to perform part of their research or be supervised in the sister institute.

OUTREACH AND PUBLIC IMPACT

We aim to help the public to understand how to reduce cardiovascular risk. The Healthy Heart Program is one example of a framework for public education and partnership. Health promotion involves imparting information directly to communities as well as the continuing education of healthcare professionals.