Early Career Researchers

Melanie McGinlay is a Heart Failure Nurse at Leeds Teaching Hospitals and National Institute for Health and Care Research Predoctoral Fellow.

Melanie McGinlay, Heart Failure Nurse at Leeds Teaching Hospitals and National Institute for Health and Care Research Predoctoral Fellow.

In her clinical role, Melanie reviews medications and develops treatment plans for patients in hospital with heart failure, as well as optimising medications for outpatients, to help improve symptoms and overall prognosis.

She’s also supporting a research project, funded by Leeds Hospitals Charity, exploring the link between infections and heart failure.

“The questions around heart failure are vast. Patients want to know if it will shorten their life. If they’re the family provider, will it impact on their responsibilities? It can have a huge impact on families, financially, socially, and personally, particularly if patients are hospitalised and have had an infection and they’ve had an exacerbation of heart failure which can prolong hospital stay and delay recovery.”

Patients admitted to hospital with an infection can translate to a diagnosis of heart failure, as infection can mask symptoms. Heart failure can also trigger infections, as fluid retention goes onto the lungs or legs, becoming a breeding ground for bacteria.

“The goal now with this research is to recognise those at greatest risk of hospitalisation and develop strategies to help avoid an admission and treat symptoms of heart failure syndrome earlier.

“An acute infection can at times lead to a diagnosis of heart failure. One question the research asks is if some patients are just more susceptible, due to their immunology, biochemistry, or genetic make-up which is an emerging area of research.”

Clinicians and researchers are recognising a progressive rise in the number of patients who have heart failure and patients who dismissed symptoms such as breathlessness and fatigue, attributing them to other things, such as an infection, getting older or not being active enough. With such patients’ diagnosis often comes late when symptoms significantly impact quality of life.

“Heart failure is forecast to rise over the next decade, there is great concern that there are many people undiagnosed in the community who will receive their diagnosis following a hospital admission with acute heart failure despite potentially weeks to months prior with chronic symptoms.”

Melanie says: “I think it is crucial that we have as many answers for patients as we can clinically. We’re quite well informed with previous research, but there are still many questions surrounding heart failure disease trajectory we don’t have answers to.”

Both the LTHT heart failure team and research teams are seeing more younger people developing heart disease. “With that comes different kinds of understanding. For older patients, we anticipate an ageing heart muscle, but for those who have not lived long enough to develop comorbidities, the question is, what is driving their condition? Research can help inform best treatment options and improve outcomes for patients and their families.”

The funding offers the opportunity to find more answers, “Research can be ever emerging, in answering one question, it often opens the door to many more.”

She adds: “The charity funding is vital because the status quo can often be improved. We always want better for patients as there are still so many whose outcome and experience are not as good as it could be. Research here is key to help us recognise their vulnerabilities especially to infection and develop strategies to promote earlier diagnosis, access to treatment and minimise hospitalisation.”

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