Cardiovascular Research Centre

Staff Profile

Dr Djordje Jakovljevic

Senior Lecturer (Research) in Cardiovascular Ageing and Heart Failure

Background

Introduction

I joined the Faculty of Medical Sciences of Newcastle University in 2009, having moved from London to Newcastle. I completed Doctoral training in Clinical Cardiovascular Physiology and Heart Failure at Buckinghamshire University and Harefield Hospital (London, UK) under the mentorship of Prof David Brodie and Prof Sir Magdi Yacoub. Prior to my doctoral training I also completed an MSc (Brunel University, London) and BSc (University of Belgrade, Serbia) as the best student of the year. Due to excellent academic achievements at undergraduate and postgraduate level I received several highly prestigious scholarships and awards, including those from the Serbian Royal Family, Government of Serbia, Brunel and Buckinghamshire Universities.

Currently I am leading research programmes in cardiovascular ageing and heart failure within the multidisciplinary team consisted of clinicians, allied health professionals, basic and behavioural scientists. My work is supported by the UK Medical Research Council grant to the Newcastle Centre for Ageing and Vitality.

Roles and Responsibilities

To lead and implement an independent research programme in cardiovascular ageing and heart failure.

To advise on non-invasive clinical physiological (cardiovascular and metabolic) measurements.

Contribute to postgraduate teaching, supervision of postgraduate (MRes and PhD) students, and development of specialist postgraduate modules.  

Qualifications

B.Sc. - University of Belgrade, Belgrade, Serbia (First-class honours)
M.Sc. - Brunel University, London, UK
Ph.D. - Buckinghamshire University/Harefield Hospital, Buckinghamshire, UK                                          A.C.S.M. - American College of Sports Medicine Certified

Memberships

2008 – present            European Society of Cardiology

2008 – present            Heart Failure Association of the European Society of Cardiology

2008 – present            European Association for Cardiovascular Prevention and Rehabilitation

2014 – present            Member of the ESC Working Group on Myocardial Function

Languages

English, German, Yugoslavian (Serbo-Croatian)

Research

Research Interests

The focus of my research is on Cardiovascular Ageing and Heart Failure.

(1) Cardiovascular Ageing:

The growing ageing population represents one of the greatest societal challenges of our times. Identifying strategies to improve cardiovascular function and risk stratification is a key determinant of successful ageing because the age-related cardiovascular dysfunction and associated heart disease is the leading cause of morbidity and mortality in older people. Physical activity, exercise and associated high level of the functional capacity of the cardiorespiratory system reduce all-cause and cardiovascular mortality across the lifespan but their effect on cardiovascular function and underpinning molecular and cellular mechanisms in later life is not well understood.

Our research aims to develop an intervention that will help people maintain and improve their cardiovascular function and quality of life in older age, while reducing mortality and morbidity. In short-term we will define physiological, molecular and cellular basis underpinning cardiovascular changes with ageing and lifestyle. We are particularly interested to investigate malleability of age-related changes in mitochondria function and inflammation with lifestyle interventions in cardiac and vascular tissues and how this impact on overall cardiovascular function. In long-term, in collaboration with our colleagues from basic, applied and clinical sciences we will develop a unique intervention combining both physiological and pharmacological therapies to improve cardiovascular function and extend healthy lifespan. We will be working with our study participants, general public, clinical and research teams to design clinical pathways and implement large scale interventions to improve cardiovascular function in older people. This research will provide evidence to delay the onset of age-related cardiovascular diseases and provide new therapeutic targets for improving cardiovascular and overall health of our ageing society.

(2) Heart Failure:  

Heart Failure is one of the most common forms of heart condition in older age and affects around 1 million people in the UK. The incidence and prevalence of heart failure have increased steeply as a result of improved prognosis of coronary artery disease, ageing of the population, and better treatments. Aside from the obvious individual burden, heart failure also accounts for 2% of all NHS inpatient bed-days and 5% of all emergency medical admissions to hospital. Hospital admissions because of heart failure are projected to rise by 50% over the next 25 years. There is a pressing need to explore effective ways to manage the individual and societal burden of heart failure with the ageing population of the UK.

Our research programme in Heart Failure focuses on the following four areas:

i) Improving Diagnosis and Monitoring of Heart Failure (DIAGNOSE-HF). Whilst early diagnosis and management of heart failure lead to better patient outcomes and more cost effective care, there is evidence to suggest that heart failure can often be misdiagnosed or underdiagnosed. When based on presenting clinical features alone, there may remain considerable diagnostic uncertainty, particularly in the setting where more advanced diagnostic tests such as echocardiography are not readily available. Non-invasive assessment of cardiac function may have major clinical implications in heart failure as it can improve diagnosis, risk stratification and monitoring of heart failure. Our research aims to evaluate clinical (i.e. diagnostic and prognostic) and cost-effectiveness of non-invasive haemodynamic assessment in Heart Failure. This research has the potential to improve quality and length of life in those living with Heart Failure and Clinical Care Pathway. 

ii) Investigation of New Medication in Heart Failure. We lead Newcastle in the international RELAX-Cardio programme sponsored by Novartis Pharmaceuticals. A multicentre, randomized, double-blind, cross-over placebo-controlled phase II study will assess the effect of serelaxin on cardiac protection and high-sensitivity cardiac troponin release in response to exercise stress test in patients with chronic heart failure.

iii) Development and Implementation of Home-based Cardiac Rehabilitation in Heart Failure. Exercise-based cardiac rehabilitation programmes are safe and recommended to improve symptoms and outcomes in heart failure. However, national audit data show that only 2% of people participating in cardiac rehabilitation in the UK are referred because of heart failure, with the main reasons being lack of resources and absence of heart failure in local commissioning agreements. We are therefore developing home-based physical activity intervention programme that holds great potential to improve patient outcomes and clinical practice.

iv) Mechanical Circulatory Support. The use of Left Ventricular Assist Devices (LVADs) has been shown to be a successful therapy for patients with advanced heart failure as a bridge to transplantation, improving their functional capacity and quality of life. In some patients myocardial function can be recovered during LVAD support, allowing device to be explanted. In our research programmes we are identifying physiological markers that can predict recovery of patients with advanced heart failure, and improve decision making of clinical care teams about continuing with LVAD support or considering device explantation. 

Postgraduate Supervision 

Doctor of Philosophy (PhD)

Katherine Jones, PhD (completed 2010/10-2014/06). Project: The effect of interval training on clinical and physiological outcomes in patients with inclusion body myositis and mitochondial disorders (Joint-lead supervisor with Prof Doug Turnbull).

Sophie Cassidy, PhD (completed 2012/10 – 2015/12). Project: The effect of exercise on metabolic control, liver lipid and cardiac function in patients with type 2 diabetes (Joint-lead supervisor with Prof Mike Trenell).

Nduka Charles Okwose, PhD candidate (2014/10-expected completion 2017/09). Cardiovascular function and physical activity in patients with chronic heart failure (Lead supervisor).

Ghazaleh Alimohammadiha, PhD Candidate (2015/10 - 2018/09). Defining the molecular and physiological links between the ageing and cardiac disease and their malleability with exercise training (Joint-lead supervisor with Dr Greaves). 

Doctor of Medicine (MD)

Dr Sasiharan Sithamparanathan, MD candidate (2014/09–expected completion 2016/06). Project: Improving clinical and physiological outcomes using non-invasive haemodynamic assessment in patients with pulmonary hypertension. (Co-supervision with Profs Corris, Trenell, Gorman). 

Master of Research (MRes)

Dr Hugo Njemanze (MBBS, Mres 2015). Cardiac autonomic changes with ageing – the impact of physical activity.   

Dr Maria Nathania (MBBS, MRes 2016). The role of cardiac high energy metabolism on cardiac pumping capability and performance.

Dr Jose Syrianegara (MBBS, MRes 2016). The effect of high intensity interval training on cardiac performance in people with type 2 diabetes.

Dr Vivek Vaidya (MBBS, MRes 2017). The effect of high intensity interval training on cardiac autonomic regulation in patients with type 2 diabetes.

Jadine Scragg (MSci, 2017). Relationship between physical activity in cardiac function in heart failure. 

Internal PhD examiner at Newcastle University – Candidate David Burns. Thesis title “Ageing in the zebrafish heart” (September 2014).

Undergraduate Supervision

Jody McCoy (BSc thesis 2016). Pathophysiology of exercise intolerance in chronic diseases.

Ruth Perkins (BSc Faculty of Medical Sciences Summer Placement Scholarship 2016). Relationship between stroke volume estimates by magnetic resonance imaging and bioreactance.

Esther Apkan (BSc, School of Biomedical Sciences 2016). The effect of age on mechanisms of exercise intolerance.

Ellie Brown (BSc thesis 2017). The effect of age on cardiac and metabolic function.

Charlotte Jones (BSc thesis 2017). The effect of physical activity in cardiac and metabolic function.   

Research Funding

Medical Research Council Confidence in Concept (06/16-05/17). Sensitivity and specificity of non-invasive haemodynamic assessment to diagnose heart failure in primary care. Principal investigator £102,254. 

Novartis Pharmaceuticals (04/16-03/17). A multicentre, randomized, double-blind, cross-over placebo-controlled Phase II study to assess the effect of serelaxin versus placebo on high sensitivity cardiac troponin release in patients with chronic heart failure after exercise stress testing in addition to standard of care. Chief Investigator for Newcastle Site £74,000.

National Institute for Health Research Biomedical Research Centre (01/15-04/16). Development and evaluation of a personalised home-based physical activity intervention in older adults with Heart Failure. Principal Investigator £72,684

Medical Research Council Centre for Ageing and Vitality  (06/14-03/19). Co-applicant and Co-investigator with ProfessorsTurnbull, Trenell, Mann, Mathers, and Dr Greaves £5,550,483  

Medical Research Council, Arthritis Research UK (01/13-05/14) Effects of dietary nitrate supplementation on cardiovascular function in older subjects. Co-applicant and Co-investigator with Dr Siervo £39,700   

British Heart Foundation, NIHR BRC and MRC CBAV (11/12). Ageing Heart Symposium. Lead applicant £12,500

Travel Grant Diabetes and Cardiovascular Diseases EASD Study Group (10/11) €1,200  

Esteem Indicators

Invited ad hoc reviewer for:

• Peer reviewed journals including: International Journal of Cardiology, BMJ Heart, European Journal of Heart Failure, American Journal of Cardiology, Future Cardiology, European Journal of Applied Physiology, Journal of Cardiac Failure, Journal of Clinical Monitoring and Computing, Circulation Heart Failure, PLoS One, BMJ Open

• Research Funding Bodies including: National Institute for Health Research, Medical Research Council, Heart Research UK, Austrian Science Fund.

Editorial board member for the new scientific journal Heart Health: Open Access (USA, Aperito)

For full list of publications follow the Pubmed link: http://www.ncbi.nlm.nih.gov/pubmed/?term=jakovljevic+dg  

For full citation and h-index follow the Google Scholar link: http://scholar.google.co.uk/citations?user=ifsD-rkAAAAJ&hl=en

For RG score follow the Research Gate link: https://www.researchgate.net/profile/Djordje_Jakovljevic  

Invited Presentations:

Physical activity and cardiovascular ageing. International Sports Medicine Conference, Newcastle University, UK, 31 August – 2 September 2016.

How to gas rebreathing and electrical signal processing technologies to assess cardiac function during stress testing? European Society of Cardioloy Association for Cardiovascular Prevention and Rehabilitation, EuroPrevent Annual Congress. Istanbul, Turkey 5-7 May 2016.

Clinical consequences of haemodynamic measurements under stress testing. Qatar Cardiovascular Research Centre and Hamad Heart Hospital, Doha, Qatar, 11-14 May 2014. 

Heart failure in diabetes: mollecular and metabolic mechanisms. 12th International Congress on Clinical Cardiology and Heart Failure. Belgrade, Serbia, 24-27 April 2014. 

The impact of age and physical activity on cardiac function and performance. A cross-council research programme: New Dynamics of Ageing Annual Meeting. Birmingham, 22 May 2013.

The role of advanced glycation end products in cardiovascular disease. Meet the expert of translational research: Molecular Basis of Heart Failure. 11th International Congress on Clinical Cardiology and Heart Failure, Belgrade, Serbia, 26-27 April 2013.

Physical activity and age-related changes in aerobic and cardiac function. MRC Centre for Integrated Research into Musculoskeletal Ageing. Liverpool, 27 February 2013.   

Current tendencies in cardiopulmonary exercise testing: non-invasive assessment of cardiac power output. Magdi Yacoub Heart Foundation, Aswan Heart Centre, Egypt, 13-14 October 2012.

Neurohumoral system activation blockade: basis for prevention and treatment of heart failure. European Society of Cardiology Heart Failure Congress, Belgrade, Serbia, 19-22 May 2012.

Congress Highlights - Basic Sciences. European Society of Cardiology Heart Failure Congress, Belgrade, Serbia, 19-22 May 2012.  

Left ventricular assist devices improve cardiac and physical function in patients with severe heart failure. Medical School, University of Novi Sad, Novi Sad, Serbia. 29 May 2011  

The effect of mechanical circulatory support on cardiac and exercise performance in patients with chronic heart failure. Coventry University – Best Applied Research Competition First Award Winner, 30 June 2010

Exercise intolerance and cardiac power output in chronic heart failure. Freeman Hospital, Newcastle upon Tyne, 16 March 2010.

Cardiopulmonary exercise testing in heart failure. Staff Symposium, Faculty of Society and Health, Buckinghamshire New University, Chalfont Campus, 09 January 2009.

Cardiac power output in patients with heart failure undergoing mechanical circulatory support. Thematic Meeting on Clinical Consequences of Hemodynamic Measurements under Exercise Testing, Copenhagen, Denmark, 24 – 25 September 2007.

 

 

Teaching

  

1. MRes Programme (MMB8037) Cardiovascular Science in Health and Disease, Newcastle University (since 2013)

2. MSc in Clinical Sciences, Newcastle University; Module CVR8007 Diagnostic Approaches and Current Treatment of Cardiovascular Disorders (since 2012)


Publications