Research at the Allan Lab and the Jersey Heart Team

The Allan Lab and the Jersey Heart Team run a live portfolio of clinical research in heart failure, atrial fibrillation and cardiovascular prevention. Nine studies are currently active. They share investigators, a common registry backbone and imaging infrastructure built on the island, and most run in collaboration with the University of Oxford.

The Jersey Heart Failure Registry

The backbone of the programme. A prospective registry of every new heart failure diagnosis made under the Jersey heart failure service, phenotyped at the point of diagnosis and capturing NT-proBNP, NYHA class, aetiology, baseline medication and key blood markers.

404 new diagnoses were captured in the first 18 months: HFpEF 49%, HFmrEF 19%, HFrEF 32%, with 18-month all-cause mortality of 5.2%. For a population of 103,000, that is a phenotyping density difficult to achieve at this scale in fragmented systems. The registry works as both a quality-of-care monitor and the screening backbone for the team’s interventional studies.

Cardiac MRI studies with Oxford

SLENDER-HF tests whether a very low energy diet drives reverse remodelling, improves exercise capacity and improves symptoms in overweight and obese patients with reduced ejection fraction. Sponsored by the University of Oxford, with Professor Oliver Rider as Chief Investigator and Dr Andrew Mitchell as local Principal Investigator. Local recruitment target met, with around 30 cardiac MRIs delivered. SLENDER-HF brought cardiac MRI capability to Jersey for the first time; the studies below scale on top of it.

OWL-HFpEF extends the same model into heart failure with preserved ejection fraction, the phenotype that accounts for roughly half of all cases and has very few proven disease-modifying therapies. Funded by the Jersey Community Foundation.

ISLE-HFpEF characterises iron status in a well-phenotyped local HFpEF cohort and links it to cardiac structure and function on MRI, building the substrate for a future iron-repletion trial in a group where iron deficiency is common and modifiable.

Population screening

FIND-HF LOOP is a cluster-randomised study across Jersey GP practices, screening patients prescribed loop diuretics who have no coded heart failure diagnosis. Around 1 to 2% of the population has heart failure, and roughly 80% of diagnoses are still made during emergency presentations after decompensation. Recent UK primary care evidence shows that loop diuretic users without a coded diagnosis have event rates and mortality comparable to those with diagnosed heart failure. Actively recruiting, in collaboration with Oxford, with the Jersey GP estate structurally suited to a design of this kind.

Service redesign

REBRAND-HF tests whether renaming the service from Heart Failure to Heart Function changes patient experience, engagement and outcomes. The label matters: surveys report fear in 53% and sadness in 15% of patients on first hearing the term. A clean before-and-after design that only a single-provider jurisdiction can run without cross-contamination. Patient-facing materials are available in English and Portuguese.

Device validation

Watches AF compares smartwatch pulse-wave detection of atrial fibrillation against a standard medical chest-patch monitor, worn simultaneously over 24 hours by patients with documented paroxysmal AF. Approved by the Jersey Research Ethics Committee and actively recruiting.

Prevention: the Lipoprotein(a) programme

Lipoprotein(a) is a genetically determined, independent cardiovascular risk factor present at significantly elevated levels in roughly one in five people worldwide. RNA-targeted therapies now in Phase III trials reduce it by 70 to 95%, with regulatory approval anticipated within the next few years. The Jersey programme is positioning the island’s population to be ready.

It runs in three parts: a prospective island-wide Lp(a) registry; a risk-stratified clinical action pathway aligned to European Society of Cardiology guidance, with structured action by tier and a family cascade strategy; and a study of whether point-of-care Lp(a) testing changes management decisions in the rapid access chest pain clinic. That last study would be the first prospective decisional-impact study of Lp(a) in any clinical setting.

Collaborators

University of Oxford, Centre for Clinical Magnetic Resonance Research. City St George’s, University of London, for sports cardiology and sudden cardiac death prevention. Cambridge Biobank. Data for Good, on privacy-preserving population data methods. The British Society for Heart Failure 25in25 programme, a 60-organisation collaboration targeting a 25% reduction in heart failure mortality over 25 years.

Enquiries about collaboration, or about running research in Jersey, are welcome: austin@theallanlab.com