What do CRY Research Fellows do?
Within their role at cardiac screening events they:
- carry out consultations with every person CRY tests
- manage all the abnormal screening results
Within their role at hospitals they work with Professor Sharma at the CRY Inherited Cardiovascular Conditions clinics St George’s Hospital, London and at Lewisham University Hospital. Prior to 2010 they were based at Kings College Hospital. At these fast track clinics families can be seen within a few weeks of referral after the sudden death of a young family member.
Within their role as an academic they:
- publish abstracts and posters of CRY’s research
- publish articles in peer-reviewed journals
- present their research at international conferences
How does CRY fund medical research into young sudden cardiac death?
CRY funds medical research through research grants. These grants cover a broad spectrum from fast track screening to pathology after a death. The grants also help to provide specialist knowledge of sports cardiology. The field-gathered data in CRY’s screening programme is analysed and reported in peer-reviewed journals, providing essential information on the understanding of these conditions.
Background information on Professor Sanjay Sharma;
Professor Sharma qualified in the UK in 1989 and was appointed Consultant Cardiologist and Physician at University Hospital Lewisham and Honorary Senior Lecturer in cardiology at Kings College Hospital London in 2001. In 2006 he took up the post of Director of Heart Muscle Diseases at Kings College London and became Professor of Cardiology at St George’s University of London in 2009. He is medical director for Virgin London Marathon, Consultant cardiologist for the CRY sports cardiology clinic at St George’s Hospital, cardiologist for the English Institute of Sport, British Rugby League and the British Lawn Tennis association.
Professor Sharma’s interests include cardiovascular adaptation in athletes, sudden cardiac death in the young and heart muscle diseases for which he has an international reputation and has published over 120 scientific articles including original papers in highly rated peer reviewed journals. Professor Sharma was awarded the status of Fellow of the European Society of Cardiology and elected as a nucleus member of the Sport Cardiology section of the European Association of Cardiovascular Disease Prevention and Rehabilitation in the 2008.
Professor Sharma was an expert committee member of the National Service Framework chapter entitled sudden death and arrhythmias and is the cardiology representative on the RCP Sports and Exercise Medicine Committee. Professor Sharma leads the CRY screening programme, which is the largest of its kind in the UK. He has an active interest in medical education and is the lead tutor for the International teaching faculty for the Royal College of physicians. He has 16 years of experience in teaching for the MRCP exam and has published several educational books in medicine and cardiology including the Self assessment colour review of cardiology and Rapid review of clinical medicine for the MRCP part 2.
CRY’s Clinical Cardiology Research Programme – Elite Athletes
CRY was first to identify the upper limits of wall thickness and cavity size in British athletes. CRY are the first organisation in the world to characterise cardiac dimensions in adolescent athletes – knowing how to differentiate pathology (disease) from physiology (normal because of exercise) is vital for diagnosis – and the first organisation to characterise ECG changes in athletes in a document that is now the blueprint for the European Society of Sport Cardiology.
Apart from diagnostics and these physiological goals, CRY has also been pivotal in identifying the prevalence of conditions such as hypertrophic cardiomyopathy (HCM) in athletes. This includes recently identifying conditions such as long QT syndrome as more common than HCM. CRY is also the first organisation to look at cardiac adaptation for Caribbean athletes, as they differ from Caucasian athletes in the way they adapt to exercise.
CRY’s findings are published in reputable, peer-reviewed journals and CRY’s guidelines are now nationally and internationally recognised. Articles in 2008 included a paper published in the British Medical Journal, entitled ‘Preparticipation screening for cardiovascular abnormalities in young competitive athletes’. This paper highlights the proportion of young athletes with unsuspected heart disease who are at increased risk from exercise-related sudden death.
Being part of the CRY screening programme is not only about identifying those at risk through employing the highest level of cardiac expertise. It is about taking part in a national research programme that endeavours to eliminate young sudden cardiac death from sport and the lives of young people in general.
CRY’s Clinical Cardiology Research Programme – General Population
CRY’s research team has taken the lead in the UK in identifying the prevalence of cardiac conditions in young people in the general population. Our findings are that screening young, apparently healthy, individuals will identify minor cardiac abnormalities in 1% of people and potentially serious disorders in 0.3% – i.e. about 1 in 300 young people. The false positive rate for CRY’s screening programme is just over 3% – the lowest in any screening programme.
One of the most important papers in recent years in determining true incidence of young sudden cardiac death is this article:
Papadakis, M., Sharma, S., Cox, S., Sheppard, M.N., Panoulas, V.F. and Behr, E.R.
“The magnitude of sudden cardiac death in the young: a death certificate-based review in England and Wales.”
Europace 2009 Vol.11, No.10, p1353-1358 [Abstract]
For the first time CRY does not have to say “Evidence suggests…. ” when talking about the scale of young sudden cardiac death. Now, when the incidence of young sudden deaths is discussed, it is informed by peer-reviewed evidence rather than ‘expert opinions’ or ‘anecdotal evidence’. It is known that these statistics are still conservative, but this paper has at least established an important baseline from which further research can be conducted.
This research was initiated by the Loveday family and developed by CRY Research Fellows, Professor Sharma, Dr Mary Sheppard and Dr Elijah Behr.
CRY’s Clinical Cardiology Research Programme – The Future
CRY will continue to progress research both in elite athletes and the general population. Amongst CRY’s future aims is the identification and precise prevalence of cardiac disorders capable of causing sudden death in asymptomatic and apparently healthy individuals; as well as accurately assessing the cost implications of such a programme if it were implemented at national level.
Where do Research Fellows go after working with CRY?
One of CRY’s aims is to improve the quality of cardiology care of those affected by young sudden cardiac death and this will be achieved by increasing the number of specialists in the NHS with an understanding of how to best support families after the impact of these tragedies. The purpose of training Research Fellows in this specialist area is that they will take these skills to other NHS hospitals throughout the UK.