Cardiovascular medicine has made great strides in recent decades. In the past ten years, for example, myocardial infarction mortality has decreased by almost 50 percent. This development can be attributed to better medications for treating elevated cholesterol levels and fewer smokers. And yet, cardiovascular diseases remain at the top of the disease statistics: According to the German Federal Statistical Office, coronary heart disease, acute myocardial infarction and heart failure were the three most frequent causes of death in Germany in 2011.
In efforts to make further advances, patient-oriented, interdisciplinary research based on large-scale studies, cohorts and biobanks is becoming increasingly important. The German Center for Cardiovascular Disease (DZHK) has created a space for research projects of this kind. It provides a framework that allows researchers to work together to translate their research ideas into clinical practice better and faster than before. The main objective of the DZHK is to make new research results available to all patients in Germany as quickly as possible and to advance not only treatments but also diagnosis and prevention of cardiovascular diseases.
On the initiative of the Federal Ministry of Education and Research (BMBF), Germany’s cardiovascular disease research landscape repositioned itself in 2011 with the founding of the DZHK. Twenty-eight institutions in seven locations throughout Germany have joined forces to develop a common research strategy.
The DHZK was formally established as an association whose mode of operation is governed by statutes.
Translational Research – Important for Heart Patients and the Health System
The DZHK focuses on translating new approaches in cardiovascular research into clinical practice as rapidly as possible in order to improve diagnosis, prevention and treatment of cardiovascular diseases. This mission is of utmost clinical and health economic importance because in the future, the incidence of cardiovascular disease will increase further as a result of the rising incidence of metabolic disorders (obesity, diabetes) and due to demographic change.
The research activities of the DHZK focus on three main topics which are particularly important for patients and for the health system:
- Prevention and treatment of myocardial infarction
- Prevention and individualised treatment of heart failure
- Prevention of sudden cardiac death
The DZHK is funded jointly by the federal government and ten state governments. The federal share amounting to 90 % of the total funding is financed by the Federal Ministry of Education and Research. Each DZHK partner institution receives the remaining 10 % from its respective state (Baden-Wuerttemberg, Bavaria, Berlin, Brandenburg, Hamburg, Hesse, Mecklenburg-Hither Pomerania, Lower Saxony, Rhineland-Palatinate, and Schleswig-Holstein).
The DZHK also takes an innovative approach to funding. Usually in an association, the entire funds for several years would be allocated to the respective partners in advance. Although these funds may be well invested, the association itself would only have limited strategic control over their use. The DZHK, by contrast, has reserved more than half of its funds for genuine common projects of the partners, so-called “Cooperative Initiatives”. The ideas for these projects are conceived in the DZHK – and the DZHK also decides which projects will be funded. Not every partner has to benefit from this in the same measure or according to a fixed scheme; good ideas and the ability to excel in cooperation prevail. This competitive procedure enables the DZHK to allocate funds flexibly, to promote the best scientific approaches and to implement a common strategy.
Seven Partner Sites under One (Virtual) Roof
In cardiovascular research, a centre with a nationwide reach provides many advantages. This field has seen enormous progress in recent years; for this reason further progress is expected to be incremental rather than paradigmatic. To continue to make progress, ever larger multi-centre clinical studies, patient registries and biobanks will be needed. This can be implemented much better in one nationwide centre than in many small single institutions. At the seven DZHK partner sites – Berlin, Göttingen, Greifswald, Hamburg/Kiel/Lübeck, Heidelberg/Mannheim, Munich and Rhine-Main – more than 140 recognized experts are working in concert.
Joint Research Programmes and Initiatives
The partner sites and the institutions of the DZHK cooperate in eight research programmes. The programmes are devoted to the following topics:
Hereditary and inflammatory cardiomyopathies
Heart failure (cardiac insufficiency)
At least four of the partner sites shall collaborate in each research project under the auspices of one of these programmes. In addition, there are overarching "cooperative research initiatives" in which all partner sites of the Centre work together and also provide financial means for collaboration with scientists outside the DZHK. This shall enable the initiation of large-scale cardiovascular clinical trials in Germany to evaluate new drugs or treatments.