The Cardiac Imaging and Inflammation research group started off by using various imaging techniques to understand the development of various inflammatory heart diseases and conditions that lead to cardiovascular complications. It is embedded within the CHI, the UCT Department of Medicine and the Cape Universities Body Imaging Centre (CUBIC). In 2017, it extended to using molecular biology and basic immunological tools to understand the pathogenesis of these inflammatory heart diseases. The Principal Investigator has collaborations across the University of Cape Town (UCT), extending from CHI to the department of Medicine, to the Institute of Infectious Diseases and Molecular Medicine (IDM) and Centers for Infectious Disease Research in Africa (CIDRI-Africa).
Recently, they have been fully involved in understanding the pathogenesis of COVID-19, whereby in addition to their cardiac imaging modalities, they have embarked on understanding baseline immune profiles of frontline health care workers to COVID-19, immune responses associated with exposure and infections with SARS-CoV-2 virus as immune modulation mechanisms of SARS-CoV-2 infection and the immune response to the single-dose Johnson & Johnson COVID-19 vaccine administered for the Sisonke trial in South Africa. They are also involved in establishing a bio-repository for COVID-19 samples that may lead to bigger collaborations with other groups across UCT and internationally.
Rheumatic heart disease remains a public health problem in Africa and many LMICs, mainly because living conditions allow for the continuous spread of GAS, but late diagnosis is also a problem due to the variable spectrum of disease presentation. Patient stratification is necessary to prioritize and redistribute scarce resources for patient management. Prof Ntusi uses Cardiovascular Magnetic Resonance (CMR) and other Imaging tools to characterise Inflammatory phenotypes, fibrosis, strain in RHD. They aim to simulate a patient-specific model for left ventricular hypertrophy for RHD using both imaging and tissue-specific markers. This project also uses Mass spectrometry to characterise various proteins and metabolite changes in heart tissues and blood of RHD patients with prospects of finding a pathogenetic link between specific protein and metabolites with RHD and possible biomarkers for RHD stratification or outcome monitoring. This project has sampled heart tissues and blood from patients with RHD undergoing heart valve replacement surgery at GSH and is in the process to start sampling “control” heart tissues from the Division of forensics and toxicology
Systemic Lupus erythematosus: Use of Magnetic resonance imaging, blood inflammatory markers and autoantibody profiles to characterise early cardiovascular involvement in and inflammatory changes associated with disease in systemic lupus erythematosus.
Resistant hypertension: The other projects range include understanding left ventricular remodelling in hypertension and immune profiles of patients with resistant controlled and resistant uncontrolled hypertension in South Africa.
Semaglutide cardiovascular outcomes trial in patients with type 2 diabetes (SOUL). This is a randomised, double-blind, parallel-group, placebo-controlled trial to test the effect of oral semaglutide ( in association with standard of care) at lowering the risk of major adverse cardiovascular events compared to placebo in patients with type 2 diabetes and at high risk of cardiovascular event.
Afri-Co-Rad, a phase I clinical trial to assess the feasibility and safety of low dose radiotherapy in treatment of hospitalized oxygen dependent Covid19 patients. The goal of this trail is to compare clinical outcomes in oxygen dependent COVID-19 patients over the age of 35 years, with poor prognostic factors, between best supportive care versus best supportive care plus low-dose, whole-lung radiation therapy.
Healthcare workers (HCWs) present a cohort with higher exposure to SARS-CoV-2 and probably seroconversion rates than the general population. They are a population more accessible to be followed up with potential for serial sampling and testing, enabling an insight into early disease and markers of risk for disease severity. Studies to understand baseline genetic and immune profiles of South Africans, variability in responses to SARS CoV-2 infection and response to COVID-19 J & J single dose vaccination can then be carried out in HCWs. A bioresource of serum and plasma from these HCWs sampled through various time points through three waves of COVID-19 infection in South Africa has been established.
WHF COVID-19 and Cardiovascular Disease Survey: This is a multi-national prospective cohort study including consecutive confirmed COVID-19 patients, with aim to describe cardiovascular outcomes among patients hospitalized with COVID-19. This study also seeks to identify cardiovascular risk factors associated with poor in-hospital prognosis among patients with COVID-19.
University of Cape Town Faculty of Health Sciences COVID-19 Biorepository: SARS-CoV-2 infected patients are a vulnerable population, and as such, there is to protect them through a coordinated approach to sampling and obtaining clinical and biological data for many proposed studies. For this reason, a biorepository has been created by the University with the goal of an organised sampling approach. This should encourage obtaining biological materials from this resource by many researchers through coordinated action by few sampling groups that can then be shared by all desiring researchers with minimal interference with patient care. An added advantage will be a reduction of research staff exposure to high-risk areas, encourage collaboration between various researchers with similar approaches and avoid duplication of studies. Specimen sharing will lead to better use of research resources and avoid wasting limited research resources.
The development of tests for epidemic-prone pathogens by academic and industry groups are often hindered by the lack of standardized and well-annotated clinical specimens needed for product development and validation. Foundation for innovative diagnostics (FIND), based in Geneva is establishing a FIND Integrated Biobank (FIB) network to address this need and drive more rigorous work towards the development of diagnostics for epidemic-prone pathogens, by providing clinical materials for use by academic and commercial test developers. The University of Cape Town will be the first member of this network in Africa and they are starting with the 2019 novel coronavirus (COVID-19).
Chris Barnard Building
UCT Faculty of Health Sciences
Cape Town, South Africa