Heart disease doyen wins Alan Pifer Award

Renowned for her career-long dedication to addressing heart-health challenges common in Africa, especially among pregnant women, Professor Karen Sliwa’s legacy of research excellence, impact and innovation has won her the University of Cape Town’s (UCT) prestigious 2021 Alan Pifer Award.

The award, shared this year between Sliwa and fellow UCT heart-health pioneer Professor Liesl Zühlke, is the Vice-Chancellor’s annual prize that rewards outstanding welfare-related research. It also highlights UCT’s strategic goal of promoting socially responsive research, while honouring those who have helped advance the welfare of disadvantaged South Africans.

This year’s winners were recognised at both the UCT Staff Annual Awards 2022 dinner, to honour exceptional UCT staff for their dedication and excellence in research, teaching and service, and at the UCT Research Excellence for Change annual research celebration.

“This award is particularly special to me as it recognises the unique medical conditions we have in South Africa and Africa, and how well-planned studies can improve patient care,” says Sliwa.

Socially responsive research

Sliwa is hailed for her consistent success in drawing attention to the impact of heart failure on younger and middle-aged people in low- and middle-income countries – as opposed to the elderly in more affluent countries. She is also lauded for a discovery that changed the face of treatment and outcomes for patients with a specific form of pregnancy-associated heart failure common among African women.

A past president of the World Heart Federation and chair of the Neglected Cardiovascular Disease group, Sliwa’s scholarship has informed the development of a plethora of national and global policy and guidelines for heart disease, while significantly impacting research-capacity generation through the training of postgraduate students from South Africa and further north in Africa.

“The reach of her scholarship has been profound.”

UCT’s Professor Ntobeko Ntusi, head of the Department of Medicine, describes her impact as follows: “…aside from the societal benefits, the reach of her scholarship has been profound, influencing national guidelines in many countries, as well as international and WHO guidelines for the management of cardiovascular disease.”

Sliwa’s considerable experience in setting up simple, cost-effective registries and web-based data-entry platforms had a major impact on the planning of several groundbreaking research projects and facilitated the training of physicians from South Africa and many other African countries, including Cameroon, Mozambique, Nigeria, Tanzania and Uganda.

Ntusi stresses that these combined impacts – while more difficult to measure – will undeniably be seen in the upliftment of the lives of the hundreds of thousands of patients for whom she has cared during a clinical career spanning more than 30 years.

An “extraordinary introduction” to South Africa

Sliwa, director of the Cape Heart Institute based at UCT’s Faculty of Health Sciences, describes herself as a clinician-scientist. Born in Germany, she trained as an internal medicine specialist and cardiologist, obtaining a Diploma in Tropical Medicine and Hygiene, and a PhD related to immune activation in heart failure from the University of the Witwatersrand.

She moved to South Africa in 1992 to take up a position in internal medicine and general surgery at Soweto’s Chris Hani Baragwanath Hospital in 1992, a period she has been quoted as remembering as an “extraordinary introduction” to the country. “It was an incredible training ground for a young doctor as we learned about the great injustice, the diseases of poverty, and to work as a team,” she told The Lancet in a 2014 article.

After working for 18 years in Soweto, she moved to UCT in 2010. Here, she has led research into priority heart-health areas including cardiomyopathies, rheumatic heart disease, the effect of HIV on the heart, pulmonary hypertension, hypertensive heart disease and, more recently, COVID-19.

Her endeavours as a clinical cardiologist for pregnant women with heart disease at Groote Schuur Hospital prompted her seminal breakthrough in the field of peripartum cardiomyopathy. She researched the area for nearly three decades in a bid to identify the underlying mechanism detrimentally impacting the heart muscles of many pregnant African women – and practical interventions to address death rates as high as 15%.

“With this award, I hope I can encourage many more young researchers to work in areas relevant to South Africa and Africa.”

Questioned about the high point of her career, Sliwa says that she is extremely proud to have worked with her collaborators to discover the factors driving peripartum cardiomyopathy, and to advance its treatment.

Her interest was sparked, she says, when she noticed her daughter’s caregiver become increasingly short of breath after recently giving birth. When she took her to hospital, local physicians introduced Sliwa to the common condition that is peripartum cardiomyopathy.

This, in turn, led to the later expansion of her research interests to other cardiac conditions associated with pregnancy. Subsequently, she and the head of obstetric services at Groote Schuur Hospital, Dr Ayesha Osman, established a weekly clinic treating women with cardiac diseases that occur during pregnancy.

Training future national and global leaders

Sliwa has, to date, authored more than 400 publications and trained more than 30 postgraduate students, including 16 PhD students who comprised five women and nine black Africans. Some of these students are now national and global leaders in their fields.

“It is a true joy to see my former postgraduate students go on to have very successful careers while contributing in a very meaningful way to improving health care on the African continent,” she says.

“With this award, I hope I can encourage many more young researchers to work in areas relevant to South Africa and Africa, and can’t wait to witness their great discoveries and contributions to society.”

Sliwa adds this new award to a long list, which includes the German Cardiac Society Paul Morawitz Award for Exceptional Cardiovascular Research (2013); an honorary doctorate from the University Diderot-Sorbonne, Paris, France (2017); the European Cardiac Society Geoffrey Rose Award for Population Sciences (2019); and the South African Medical Research Council Gold award (2021).