Ā mātou rangahau | Our Research

Cardiovascular Risk Prediction Model

Moving away from one-size-fits-all treatment and care

Using clinical data on over 400,000 patients, epidemiologists have developed an algorithm that predicts risk of experiencing a heart attack within the next five years. Further research is now needed to refine the model, so it can better predict the five-year risk for individual patients. With your support, researchers at Manaaki Manawa will use biomarkers, more precise diagnosis, physiological measurements and other prognostic indicators to improve the model’s accuracy, so its predictions can help guide and improve treatments.

Team includes: Professor Rod Jackson, Associate Professor Karina Poppe

Cardiovascular Risk Prediction Articles

New Cardiac Pacemaker

Trialling a device that could cure heart failure

Heart failure is a progressive disease, and it has no cure. Current treatments are only able to slow its development. But researchers at Manaaki Manawa have developed a new form of cardiac pacemaker, which is now ready for clinical trials. Your generous support can help us start testing this device on patients who need it and see if these lifesaving results can transform the way we treat heart failure globally.

Team includes: Professor Julian Paton,  Associate Professors Rohit Ramchandra and Nigel Lever, Drs Julia Shanks, Mridular Pachen and David Crossman and Ms Bindu George

Cardiac Pacemaker Articles

Cardiac Inherited Disease Register

Identifying people at risk of sudden cardiac death

Tragically, some genetic heart conditions only come to light when someone dies of a sudden cardiac arrest. To help identify families with inherited heart conditions and prevent sudden death, our researchers are working with the Cardiac Inherited Disease Registry NZ. We work together to identify potential genetic variants involved, and test family members for the same variants. Your support will help us to continue this genetic research, so therapies to prevent or treat these diseases can be developed.

Team includes: Professors Jon Skinner, Martin Stiles, and Drs Andrew Martin, Polona Le Quesne Stabej and Nikki Earle

Cardiac Inherited Disease Register Articles

Hypertension Research

A Growing Health Challenge

Hypertension is rising across New Zealand, impacting more than half of all adults worldwide. It contributes to heart disease and stroke but is often undiagnosed until it becomes severe. Even after diagnosis, fewer than 50% effectively manage their condition.

Research & Equity

Hypertension disproportionately affects Māori, Pacific communities, and those in high-deprivation areas, making it both a medical and equity issue. Manaaki Manawa is committed to advancing research and improving prevention, diagnosis, and treatment.

Community & Education

The pandemic has contributed to higher hypertension rates, even in children. Our Heart Health Education Programme teaches young people about lifestyle choices, stress management, and blood pressure through interactive learning. This initiative complements Breathe, Pause, Smile, emphasizing holistic well-being.

Advancing Clinical Care

Auckland previously lacked a dedicated hypertension clinic. Manaaki Manawa has now established a specialized clinic, uniting experts to drive innovation in hypertension research and treatment. By combining research, education, and specialised care, we aim to transform hypertension outcomes for all New Zealanders.

DNA Test

A DNA test to best determine most effective drugs for lowering blood pressure in individual patients, testing a new repurposed drug for controlling life-threatening blood pressure surges, a nutraceutical trial testing a vitamin and breathing training. 

Team includes Drs James Fisher, Fiona McBryde, Carolyn Barrett, Amanda Dixon-McIver, Audrys Pauza, Pratik Thakkar, Igor Felippe, Olivia Gold and Xin Shen and Professor Julian Paton

Hypertension Research Articles

Rheumatic Heart Disease Research

Rheumatic Heart Disease (RHD) affects 600-800 people annually in New Zealand, with 150-200 deaths. Young people, especially Māori and Pasifika, are most impacted. RHD starts as Rheumatic Fever (‘strep throat’), treatable with penicillin. Untreated, it can progress to RHD. Factors like limited healthcare access, poverty, poor housing, and overcrowding contribute to high rates. Manaaki Manawa is working on projects to address these issues.

3D Heart Valve Project

RHD damages heart valves, requiring multiple surgeries and leading to a shortened lifespan. Most patients need mechanical valve replacements, which can be rejected and don’t grow with the heart. Manaaki Manawa’s 3D modelling project, led by Dr. Olaf Diegel, uses hydrogel to print personalized heart valves. These valves would grow with the recipient and avoid rejection, reducing the need for repeated surgeries.

Needle-Free Injector

The University of Auckland’s needle-free jet injector delivers antibiotics and insulin without needles, increasing compliance and potentially being pain-free. This device could be used for penicillin in rheumatic fever patients, though penicillin requires deeper and larger volume injections.

Image of  Award winners Professor Andrew Taberner and Dr James Mckeage

Team includes Professors Jillian Cornish Olaf Diegel, Andrew Taberner, Associate Professor Rohit Ramchandra, Drs Nigel Wilson, Tyson Fricke, Massimo Caputo, James Mckeage, Marcus Ground, Alex Dixon and Ms Mirabella Uphof.

Rheumatic Heart Disease Research Articles

Multi-Ethnic New Zealand Study of Acute Coronary Syndrome (MENZACS)

Discovering how ethnicity impacts heart attacks

We currently don’t know why some groups, such as our Māori and Pacific Peoples, have a higher risk of developing and dying of cardiovascular disease. Treatments are also largely based on research on European males. MENZACS will help change this by studying the genetics of our diverse population and looking at why some people are more prone to heart attacks than others. Eventually, this will help inform appropriate treatment strategies.

Team includes Professor Rob Doughty, Associate Professor Katrina Poppe, Drs Nikki Earle, Anna Rolleston

Atrial Fibrillation and Womens Heart Health

Atrial fibrillation (AF) is the most common abnormal heart rhythm, and it significantly raises the risk of stroke, heart failure, and dementia. You are more likely to have AF as you age, and/or if you have high blood pressure. Its effect on quality of life is substantial. We need to better understand the causes of AF to develop more effective and long-lasting treatments. At Manaaki Manawa we are conducting unique research spanning from human heart cells to people with AF, to answer questions such as:

• How does the nervous system trigger and sustain AF?
• Does AF differ in males and females, and why could this be?
• Why does the risk of AF in women increase significantly after menopause?
• In our communities, what are peoples experiences from AF symptom onset to diagnosis and beyond?

Team includes Professor Johanna Montgomery, Professor Martin Stiles, Associate Professor Katrina Poppe, Dr Greg Sands, Professor Bruce Smaill

Dysfunctional Autonomic Nervous System

Can Computational Modelling Help Take Back Control from a Dysfunctional Autonomic Nervous System?

Dysfunction of the autonomic nervous system contributes to a wide range of cardiovascular system diseases, including heart failure, arrhythmia, and hypertension. However, its complex dynamics are difficult to characterise and understand through experiments alone.  Our team leverages computational modelling to bridge this gap, integrating data across scales to uncover insights that individual experiments cannot reveal. By combining physics-based models with multi-scale experimental data, we aim to generate actionable hypotheses for potential drug targets and optimise implantable nerve stimulation protocols.  

Our goals:

• Enhance experimental insights through advanced computational modelling, enabling deeper understanding of autonomic regulation and dysfunction.
• Test hypotheses for potential drug treatments in-silico, ensuring predictions are inclusive, accounting for risks and benefits for all.
• Optimise implantable nerve stimulation protocols using offline computational testbeds, then using online adaptive control algorithms that respond to individual patient measurements.

Team includes Drs Finbar Argus, Gonzalo Maso Talou,  Beatrice Ghitti,  Harvey Davis, Gregory Sands, and Daniel McCormick, Associate Professors James Fisher, and Rohit Ramchandra, Professors Julian Paton, and David J Paterson

Transforming Aortic Care: From Prediction to Prevention

​Aortic disease, particularly aortic dissection, is one of the most devastating conditions in cardiovascular medicine. Our research program at Manaaki Manawa, University of Auckland brings together clinicians, scientists, and engineers to answer a critical question: How do we predict, prevent, and better treat aortic catastrophes?

Our work spans four key areas:

• Risk Prediction Score: Developing advanced risk models using large national health datasets to identify patients at risk before symptoms occur.
• Understanding Pathophysiology: Investigating how blood pressure dynamics and novel therapies can prevent life-threatening complications.
• Advancing Early Detection: Applying cutting-edge imaging and radiomic technologies for accurate risk prediction and timely intervention.
• Why Does Aortic Dissection Occur? Exploring the role of the vessel lining (endothelium) and the coagulation cascade in disease initiation.

This multidisciplinary approach aims to shift care from reactive surgery to proactive prevention—saving lives and improving long-term outcomes.

Team includes Associate Professors Nishith Patel, Arier Lee, Katrina Poppe, James Fisher, and Vinod Suresh, Drs Yattheesh Thanalingam, Ryan Sixtus, Ayah El Sayed, Professors Julian Paton and Martyn Nash, Kelly Henderson (RN), Qihao Zhang (PhD Student)

Novel Treatments for Heart Failure in Diabetes

People with diabetes often experience unique changes in how their hearts function, compared to those without the condition. Our research aims to understand these differences by focusing on two key areas:

1. How heart cells process glucose – We’re exploring new molecular pathways that affect how sugar is used in the heart muscle cells of people with diabetes.
2. The role of fructose in the heart – We’re investigating how fructose metabolism becomes disrupted in diabetes, and how this may lead to damage in heart tissue.

To do this, we study heart function both at the level of the whole organ and at the level of individual heart cells. We connect these functional changes to the underlying molecular signals and use advanced genetic tools to test how these processes work and how they might be improved with new treatments.

Team includes Associate Professor Kim Mellor, Drs Marco Annandale and Randall D’Souza, Samuel James, Gerald (Jay) Naepi, Jayd Dayaram, Lucas Pei

Type 2 Diabetes and Heart Health

Type 2 diabetes (T2D) affects over 7% of New Zealanders and significantly increases the risk of heart disease, even in those without other risk factors. Our research aims to uncover new ways to protect and improve heart function in people living with T2D.

We study heart tissue from consenting patients undergoing routine cardiac surgery to better understand how diabetes impacts the heart. So far, we’ve found that diabetic heart muscle contracts less effectively, is more vulnerable to arrhythmias, and struggles to generate energy.

Key Research Areas:

• Fueling the Heart: We’re testing whether the right mix of fuels (glucose, fats, and ketones) can restore heart muscle strength, potentially leading to new dietary strategies.
• Coenzyme Q10: This vital molecule supports energy production in the heart. We’re investigating how diabetes and statin use affect its levels, and whether supplementation can help.
• Calcium Cycling: In diabetic hearts, calcium can leak between beats, impairing relaxation and blood filling. We’re working to identify the cause of this “diastolic leak” and develop treatments to restore healthy calcium flow.

Team includes Drs Marie-Louise Ward and Amelia Power, PhD students Amanda Groenewald and Liam Zhang

Exploring Vagal Control of the Heart to Develop New Heart Failure Treatments

Heart failure affects around 40,000 people in Aotearoa and has a major impact on the lives of individuals and their whānau. People living with heart failure often experience reduced quality of life and can tire easily during everyday activities. New treatments are needed that not only improve heart function but also enhance quality of life.

The vagus nerve, the main nerve of the parasympathetic nervous system, is a promising new target for heart failure treatment. At Manaaki Manawa, we are conducting research from the cellular level to bioengineering and integrative physiology. This includes studying the action of neuropeptides and recording conscious vagal nerve activity in healthy and aged heart failure models that mimic the human condition.

We aim to answer key questions such as:

• How does vagal nerve activity affect heart function? And how is this altered in heart failure?
• What neurotransmitters are involved, and could they be new treatment targets?
• Could stimulating the cardiac vagal branch be a potential therapy for heart failure?

Team includes Drs Julia Shanks, Mridula Pachen, Daniel McCormick and Associate Professors Rohit Ramchandra and Nigel Lever

Personalised Care in Atrial Fibrillation: Early Detection and Targeted Treatment

The Cardiac Electrophysiology Group, led by Associate Professor Jichao Zhao at the Auckland Bioengineering Institute, is pioneering a transformative research programme aimed at improving the early diagnosis, precision treatment, and long-term management of cardiac arrhythmias, particularly atrial fibrillation (AF). AF is the most common sustained arrhythmia, and current treatment success rates are often suboptimal. This research focuses on three main objectives:

1. Early Detection: Developing an automated wearable ECG system for reliable early detection of AF, enabling timely and effective interventions to prevent severe complications.
2. Personalised Treatment: Employing digital twins, super-resolution imaging, and contrast-enhanced MRIs to characterise key atrial biomarkers and evaluate novel drug and ablation strategies to increase the success rate of AF therapy.
3. Patient Stratification: Advancing cardiac CT analysis to provide a cost-effective method for identifying patients most likely to benefit from catheter ablation.

This programme is supported by major national and international collaborations, extensive clinical datasets, and partnerships with healthcare leaders to ensure equitable impact. By aligning technical innovation with clinical and community needs, the team aims to enable faster, more accurate, and more accessible arrhythmia care across New Zealand.

Team includes Associate Professor Jichao Zhao, Professors Martin Stiles, Bruce Smaill and  Vadim Fedorov, Drs Mark Trew, Gregory Sands, David Baddeley, and David Crossman,