DZHK—which stands for Deutsches Zentrum für Herz-Kreislauf-Forschung—is an institution that does things differently. It is a multi-site network of basic and clinical researchers with a management office in Berlin and 31 partner institutions at seven sites. Members of DZHK cover the entire spectrum of cardiovascular research. Amongst the partner institutions are 14 university clinics and universities all focusing on cardiovascular research. DZHK brings together 1400 scientists and researchers around Germany. The centre was established in 2012 on the initiative of the Federal Ministry of Education and Research. In addition to DZHK, there are five more German centres for health research that are dedicated to investigating widespread diseases. Stefanie Dimmeler, PhD, Director of the Institute of Cardiovascular Regeneration at Goethe University, Frankfurt is the DZHK Chair and spokesperson (Figure 1).

Stefanie Dimmeler, PhD, Director of the Institute of Cardiovascular Regeneration at Goethe University, Frankfurt is the DZHK Chair and spokesperson.
Figure 1

Stefanie Dimmeler, PhD, Director of the Institute of Cardiovascular Regeneration at Goethe University, Frankfurt is the DZHK Chair and spokesperson.

What is your mission/aim?

The DZHK’s mission is to develop new therapies and diagnostic procedures that impact the lives of people with cardiovascular diseases. The centre aims to achieve this through rapid translation of results from basic research into clinical practice. Cardiovascular diseases continue to increase and are still the number one cause of death in Germany. They burden the health system far more than cancers and they are often chronic, depriving people of healthy years of life compared with other diseases. As more and more people live for a long time with heart failure, heart valve diseases or heart rhythm abnormalities our healthcare system and research must respond to this growing problem and ageing population. Research at DZHK is intended to help reduce the number of people dying from cardiovascular diseases and improve the quality of life of those affected. Our research focuses on heart diseases that are very common in the general population. These include heart failure, heart attack, atrial fibrillation, and sudden cardiac death.

What is the main focus of your work?

In the laboratories of our basic science researchers, we make important discoveries about what happens at the molecular level during the development of cardiovascular diseases. The process of translation and turning these findings into therapy involves many other steps. These are often very time-consuming and expensive, and the science can seem less ‘ground breaking’ as a tested idea is finessed. Nevertheless, these steps are very important and there are no new therapies without them. DZHK aims to accelerate the process of translation by investing in the actual process based on a co-ordinated research strategy. The centre has agreed to focus the central funds on specific steps of the translation process that are considered to be very challenging and are rarely dealt with:

  • Late preclinical studies

  • Early clinical trials

  • Guideline-relevant studies

We want to prevent heart attacks and key to this is the plaque that forms in the blood vessel walls of the heart muscle arteries and ruptures thereby blocking the vessels. If these two processes can be stopped, heart attacks would not occur in the first place. Even when someone survives a heart attack, this often results in heart failure, and although doctors can sometimes stop or delay the progression of heart failure, they cannot make a weak heart strong again. DZHK researchers are therefore looking for ways to regenerate the heart by:

  • Replacing the diseased heart tissue with heart cells grown in the laboratory.

  • Understanding the underlying processes of congenital heart defects and heart failure—the most frequent causes of sudden cardiac death—and how sudden cardiac death can be prevented.

  • Looking to improve diagnostics and treatment options for patients with abnormal heart rhythms that can significantly affect a person’s quality of life and, in the case of atrial fibrillation, can be fatal if they cause blood clots that lead to a stroke.

  • Investigating how people can protect themselves against cardiovascular diseases or prevent their progression. DZHK researchers, including psychologists, sports scientists, and nutrition experts, are jointly planning extensive studies on the prevention of cardiovascular diseases.

What are the advantages and strengths of the DZHK approach?

This was a big move for Germany. We now have a common biobank for the whole of the country, and this means we can be more uniform, and our efforts are more combined. We also have a programme for sharing technology across the country, which means that specialist equipment, such as that used in electrophysiology, isn’t needed at every site. Expensive equipment can now be shared, and we can use funds towards other budgets for research. The beauty of having this sort of network allows us to share knowledge. The central steering committee means we can decide to join forces for specific topics. We also have a collection of small networks that can co-ordinate their work and combine funds. The network allows for translational flexibility and also means we can use shared large animal resources and don’t need to build up our own facilities.

How do you feel about your role in the DZHK?

Overall, it’s a great joy for me. For Germany, it offers a really unique opportunity which we have developed and built up over the past few years. This approach is also an opportunity for the whole scientific landscape, offering many advantages for funding and outside participation. Although organizing a structure with so many institutions and individuals, it can sometimes be demanding and time-consuming to keep everyone on board; over the years, we have grown together like a family. We also have a good common spirit and a very good collaborative effort. There are sometimes different opinions, but this is a contribution, not a challenge. We are, of course, proud of our scientific output, but we also have to demonstrate how we have changed patients’ lives and made patient management and treatment better to our government funders. Clinical research is expensive, and in the end, we need to help patients and develop new therapies. Translational research is difficult and demanding, and it wasn’t always understood in the past how important many aspects of the process were. To make this easier and in order to be more efficient, we now have training programmes to try to get young researchers and junior investigators aware of the framework involved in the translational process.

Declarations

Disclosure of Interest

All authors declare no conflict of interest for this contribution.

Author notes

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