A major new national study is launching to transform care for people living with aortic stenosis, a serious heart valve condition that affects tens of thousands of people in the UK. The research will investigate whether two established heart failure medicines can improve recovery after aortic valve replacement, the standard treatment for severe aortic stenosis.
The RELIEF-AS study is funded by a UKRI Medical Research Council (MRC) and NIHR partnership, and supported by the NIHR-British Heart Foundation (BHF) Cardiovascular Partnership.
Aortic stenosis develops when the aortic valve becomes narrowed, forcing the heart to work harder to pump blood around the body. Over time, this strain causes the heart muscle to thicken and stiffen, and in many cases leads to scarring.
While aortic valve replacement (AVR) restores normal blood flow, it does not reverse the underlying damage that has built up over years. As a result, many patients continue to experience breathlessness, fatigue and reduced quality of life long after surgery.
The new study aims to address this unmet need by testing whether 2 medicines — dapagliflozin and spironolactone — can support the heart muscle as it heals after AVR. Both medicines are already widely used and proven to benefit people with other forms of heart failure. Researchers believe they may also help patients with aortic stenosis by reducing scarring, improving heart function and supporting long term recovery.
Participants undergoing AVR will be randomly assigned to receive one of the study medicines or continue with their usual care for 12 months. The research team will use detailed MRI scans to assess changes in heart structure and function before surgery and 1 year afterwards. The study will also track symptoms, walking ability and quality of life to understand whether the medicines lead to meaningful improvements in day to day wellbeing.
Study co-lead Professor Thomas Treibel, Professor of Clinical Cardiology at University College London and Clinical Lead of the CMR department at Barts Health, said: “A dedicated group of patients have been central to shaping the study from the outset, identifying recovery, wellbeing and the ability to return to everyday activities after surgery as top priorities. Their feedback ensured the study focuses on outcomes that matter most to those living with aortic stenosis.”
Professor Marc Dweck, Professor of Clinical Cardiology at the University of Edinburgh, British Heart Foundation Senior Clinical Research Fellow and RELIEF-AS co-lead, said: “The prevalence of aortic stenosis is estimated to treble by 2050, reducing life expectancy and quality of life of thousands. This trial has the potential to offer new life-changing treatments that if successful will impact large numbers of patients worldwide.”
The preliminary work leading to the funding for the RELIEF-AS study was supported by an NIHR-BHF Cardiovascular Partnership Pump-Priming award and a BHF Clinical Research Collaborative Research Development Fund award.
About the NIHR–BHF Cardiovascular Partnership
The NIHR-BHF Cardiovascular Partnership brings together national cardiovascular expertise and infrastructure funded by the NIHR, the BHF and the Chief Scientist Office (CSO) in Scotland, to accelerate research and improve outcomes for people affected by heart and circulatory diseases. The Cardiovascular Partnership also serves as the designated NIHR Translational Research Collaboration for cardiovascular research.
