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Mahmod group

Cardiovascular Clinical Research Facility Division of Cardiovascular Medicine Oxford Centre for Clinical Magnetic Resonance Research

Our expertise is in clinical trials, whereby we aim to discover novel treatments for improving the health of patients with cardiac diseases. We use cardiovascular magnetic resonance imaging (CMR) and spectroscopy techniques to improve our understanding of myocardial metabolism and function, and for early detection of cardiac abnormalities in cardiomyopathy, heart failure, valve disease and diabetes. We use cardiopulmonary exercise test to understand cardiovascular exercise physiology, by studying how oxygen and other nutrients are used by the heart during exercise. We work closely with multidisciplinary research teams including MR physicists, biomedical engineers and other cardiac imaging experts in the UK and elsewhere in the world.

Our main current studies are

the tempest trial

This is a multicentre, randomised double-blind, placebo-controlled, phase 2 evaluation of the efficacy and mechanism of trientine in patients with hypertrophic cardiomyopathy (HCM). Initial studies have been promising in demonstrating a trend towards regression of left ventricular hypertrophy in patients taking trientine, which is second line therapy for Wilson’s disease. The Oxford group is in charge of the substudy evaluating the role of myocardial energetics in trientine potentially reversing the HCM phenotype. The results of this trial could make trientine the first therapy in HCM that alters its natural history. The trial is funded by the National Institute of Health Research (NIHR), sponsored by Manchester University NHS trust and co-ordinated by the Liverpool Clinical Trials Centre. 

 

GO-DCM STUDY

This is the largest multi-centre study investigating dilated cardiomyopathy (DCM), funded by the British Heart Foundation (BHF). DCM is a disease of the heart muscle affecting both adults and children. It can be acquired or inherited, and represents a frequent cause for heart failure, a syndrome where the heart fails to provide adequate amounts of oxygen for the body. DCM leads to a weakened, thinned heart muscle which can result in symptoms of breathlessness and heart rhythm abnormalities. To investigate this further, this study aims to improve understanding of the underlying genes causing DCM whilst identifying blood markers doctors can use to individualise treatment, and potentially to improve symptoms. This study seeks to recruit 1200 participants across several research centres in the UK.

THE IMPROVE-HCM TRIAL

This is a multi-centre, phase 2 clinical trial investigating a novel drug designed to target myocardial metabolism, with the aim to improve the efficiency of energy generation in patients with non-obstructive hypertrophic cardiomyopathy (HCM). Patients with symptomatic non-obstructive HCM represent one of the most important unmet needs for this genetic heart disease and this clinical trial aims to evaluate this novel drug therapy aimed at improving the lives of this subgroup of HCM patients. This study will measure the change from baseline of peak oxygen consumption as measured by cardiopulmonary exercise testing (CPET), and myocardial energy metabolism measured by magnetic resonance technique, in patients with non-obstructive HCM treated with this drug over a 12-week period. Safety and tolerability of the drug will also be examined. This trial is sponsored by Imbria Pharmaceuticals, Boston, USA.

 

The EMPA-Vision trial

This multi-million pound, phase 3 clinical trial investigates a novel drug that could help failing hearts. This is the first trial to evaluate the effect of the diabetes medication empagliflozin on cardiac energy metabolism in patients with heart failure. The results of this trial combined with other ongoing multi-centre trials assessing clinical outcomes in patients with heart failure, could make empagliflozin a promising new treatment for patients with heart failure. Trial sponsored and funded by Boehringer Ingelheim

Ox-FAST study

This British Heart Foundation-funded pilot project is the first step in examining whether a drug that is already used to treat high fat levels in people could potentially improve heart function in aortic stenosis, one of the most common and serious heart valve diseases. In this study, we will try to reduce excessive heart fat by targeting it with a fat-busting, fibrate drug which we hope will improve the heart’s function and exercise capacity. If the concept behind it is proven, there is the potential to use fibrates as a new treatment for aortic stenosis, after larger trials.

Our team

Selected publications

collaborators (UK)

  • Dr Pablo Lamata, King’s College London, UK
  • Dr Sanjay Prasad, Royal Brompton and Harefield NHS Trust, UK
  • Prof Mary Sheppard, St George’s, University of London, UK
  • Prof Jules Griffin, University of Cambridge, UK
  • Prof Vicente Grau, University of Oxford, UK

collaborators (outside the UK)

  • Prof Alistair Young, University of Auckland, New Zealand
  • Dr James White, University of Calgary, Canada
  • Dr Ntobeko Ntusi, Groote Schuur Hospital, Capetown, South Africa
  • Dr Raymond Kwong, Havard Medical School, USA
  • Prof Jean-Luc Balligand, Université catholique de Louvain, Belgium
  • Dr Christopher Kramer, University of Virginia, USA

Related research themes

We aim to better understand, diagnose and treat heart and vascular disease through our extensive cutting edge research programmes. We have a particular focus on understanding disease mechanisms and on new approaches to stratifying patients. Our expertise encompasses genetic studies to identify causative and risk genes, cardiovascular physiology and cellular biology to understand health and disease, the development and application of advanced imaging, experimental medicine and clinical trials.
Cardiovascular Science
Our focus is on finding the causes of metabolic and endocrine disease and capitalising on these discoveries to yield new treatments. We are world leaders in both large-scale genetic studies and global clinical trials, taking an international approach to advance our understanding and treatment of type 1 and type 2 diabetes. From target discovery for type 2 diabetes and probing the biochemistry of fat, through to understanding islet physiology and transplantation, investigating liver disease and unravelling the mechanisms behind rare endocrine tumours, our research truly spans the bed to bedside journey.
Diabetes, Metabolism and Endocrinology
We have world-class clinical imaging facilities aimed at better understanding, diagnosing and treating disease. Our clinical studies feedback into molecular research, taking learnings from the clinical setting to ask further questions in model systems. We have particular strengths in cardiovascular imaging and our facilities integrate clinical care with the latest research.
Clinical Imaging
We are committed to translating our innovative research into clinical benefit. From new methods of diagnosing chronic conditions, to finding the latest treatments for diabetes, cancer, heart disease, stroke and rare diseases, our department is involved in hundreds of clinical studies every year.
Clinical Studies and Trials