Peter Liu, MD, was selected to receive the University of Ottawa Heart Institute (UOHI)’s 2020 Global Achievement Award. This prestigious award recognizes UOHI investigators who have made a global impact in their sphere of work.
Dr. Liu is the Chief Scientific Officer/VP Research and Director, Cardiac Function Laboratory at the UOHI. His research program is focused on advancing early detection and precision medicine for heart diseases and elucidating novel mechanisms of disease.
The Global Achievement Award recognizes Dr. Liu’s leadership in the emerging COVID-19 scientific and medical community. Based on his work in how viral myocarditis can lead to heart failure, his expertise and authority on the impact of COVID-19 on the heart were globally sought out.
Dr. Liu, together with his global collaborators, published several important papers, including a review in the journal Circulation outlining the impact of COVID-19 on the heart. In another state-of-the-art review published in Circulation Research, Dr. Liu and colleagues discussed the unique biological and clinical implications of COVID-19 on the cardiovascular system. The review outlined how cardiovascular disease, not only the number #1 killer in the world, is also the #1 killer in COVID-19 patients. Elderly patients with a previous heart attack or stroke, or hypertension or diabetes, have a high risk of getting infected and suffer a three- to five-fold increase in mortality compared to other COVID-19 patients. The review also discussed how renin-angiotensin system (RAS) inhibitors, including angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs), have been under considerable controversy. On the one hand, these RAS inhibitors are highly protective for our cardiovascular patients. On the other hand, they are suspected to increase the levels of ACE2 receptor (part of RAS) which the novel coronavirus uses to infect lung cells.
In a study co-led with researchers from the UCLA David Geffen School of Medicine in the US and Wuhan University in China and published in Hypertension, Dr. Liu redefined the threshold levels of cardiac biomarkers for predicting mortality of inpatients with COVID-19. In this multi-centre study of 3,200 patients with diagnosed COVID-19, Dr. Liu et al found that the cut-offs of cardiac markers for effective prognosis of 28-day mortality of COVID-19 were 49% lower than the currently recommended thresholds for regular heart disease. Patients with cardiac marker levels above these newly established thresholds were associated with a significantly increased risk of COVID-19 death. These are important findings, informing clinical management as well as definitive research trials.
Based on these observations, Dr. Liu mobilized a global network that includes centres in Canada, the US, Mexico and Brazil, to conduct a randomized controlled trial evaluating whether adding ACE inhibitors to COVID-19 treatment would improve outcomes for high-risk patients. This large-scale trial is funded by CIHR and the International Development Research Centre. The trial will have immediate impact on the management of COVID-19 patients.
Importantly, Dr. Liu’s expertise and authority on the impact of COVID-19 on the cardiovascular system has been globally sought out by prestigious scientific journals and prominent mainstream media alike. Dr. Liu was interviewed by the journal Science and discussed the potential of COVID-19 causing myocarditis, based on observations that after contracting COVID-19, previously healthy people exhibit signs of myocarditis-induced heart failure. He was also sought out by the journal Nature, for an article discussing blood clots as frequent complications of COVID-19 and the possibility of the novel coronavirus directly attacking blood vessel endothelial cells, which have the same ACE2 receptor that the virus uses to enter lung cells. In healthy individuals, the blood vessel is ‘a smoothly lined pipe’ and this endothelial lining actively stops clots from forming, whereas a viral infection can damage these cells, causing them to release proteins that trigger the clotting process.
Furthermore, Dr. Liu was interviewed for an article by The Guardian, a respected British newspaper. He was extensively quoted in this article, providing insights and expert opinion to the public on the impact of COVID-19 on the heart. He discussed that blood tests indicate one-third of COVID-19 patients show evidence of cardiac injuries, and that research trials are underway looking at whether ACE inhibitors and ARBs have cardioprotective effect in high-risk COVID patients.
In sum, Dr. Liu has made a global impact in his advancing our understanding of COVID-19 on the cardiovascular system. Congratulations to Dr. Peter Liu on receiving the UOHI 2020 Global Achievement Award!