Mark Richards

Arthur Mark Richards (born 1 May 1955) is a New Zealand physician, academic and medical researcher. He is a professor of cardiology and director of the Cardiovascular Research Institute at the National University of Singapore, and a professor of medicine and founder of the Christchurch Heart Institute at the University of Otago, Christchurch, New Zealand, where he holds the National Heart Foundation (NZ) Chair of Cardiovascular Studies.

Richards has written over 850 peer-reviewed journal articles, and has over 25 patents in the field of cardiovascular biomarkers. His research revolves around integrated cardiovascular translational research incorporating clinical applied research, molecular biology, cardiovascular peptide biochemistry, genetics and preclinical physiology, with a particular focus upon discovery and application of biomarkers in cardiovascular disease.

Education Richards completed his MB ChB at the University of Otago in 1978. He was admitted as FRACP in Internal Medicine by the Royal Australasian College of Physicians in 1984. He graduated Doctor of Medicine (MD) with distinction in 1986, PhD in medicine in 1993 and Doctor of Science (DSc), with a thesis titled The cardiac natriuretic peptides – from bench to bedside, in 2000 from the University of Otago. The Royal College of Physicians admitted him as FRCP in 2008. In 2019, he graduated with a Bachelor of Arts degree in history from Massey University, New Zealand. and has also been an associate faculty member at the Genome Institute of Singapore since then.

Richards was awarded a personal chair in medicine by the University of Otago in 1995. He was deputy head of the Department of Medicine at the University of Otago, Christchurch, in 1998, and head of department from 2002 to 2003. From 1993 to 1997, he directed the FRACP Part 1 Registrar Training Programme (Christchurch) and was an examiner for FRACP clinical examinations. He was admitted to the fellowship of the Royal College of Physicians (FRCP) in 2008.

Richards was programme director of the New Zealand Health Research Council (HRC) programme grants for serial cardiovascular HRC research programmes continuously for 24 years from 1995 to 2019. In 1997, he was appointed to the National Heart Foundation chair of cardiovascular studies. He founded and assumed chairmanship of the Christchurch Cardioendocrine Research Group, University of Otago, Christchurch, which later became the Christchurch Heart Institute in 2012. All authoritative international guidelines on the diagnosis and management of heart failure globally now recommend measurement of plasma B type cardiac natriuretic peptides in aid of diagnosis and risk stratification in heart failure.

Richards leads ongoing research aimed at refining the clinical applications and beneficial actions of the natriuretic peptides. He has investigated the effect of atrial fibrillation on the diagnostic and prognostic performance of NT-proBNP in suspected heart failure. In the mid-1990s, Richards pioneered human clinical studies of neprilysin inhibition, important in metabolism of the NPs. His group has studied the integrated haemodynamic, endocrine and renal effects of human ANP analogues selected for exclusive vasodilatory or diuretic activities in experimental heart failure laying the path for possible precision peptide therapy in heart failure. His group has demonstrated the beneficial integrated hemodynamic, endocrine, and renal effects of phosphodiesterase-9 inhibition (PDE9-I; which specifically impedes breakdown of the 2nd messenger, cGMP generated by the natriuretic peptides) in experimental HF. Results support PDE9's role in HF pathophysiology and implies that its inhibition could possibly be a novel anti-heart failure therapy.

Richards has contributed to clinical research work establishing measurement of plasma cardiac troponin as an essential element in the diagnosis of acute myocardial infarction. He has also made numerous original contributions on the biology and biomarker potential of the urocortins and the adrenomedullins. Richards has also published influential data on the potential role of circulating microRNAs as biomarkers in heart failure.

General applied cardiology In more general applied cardiology research, Richards recently compared the safety and efficacy of allied health care practitioner-led remote intensive management (RIM) with cardiologist-led standard care (SC) after myocardial infarction and found the former practice used with low-risk patients is feasible and should be further studied in higher-risk acute myocardial infarction cohorts. He has also used large-scale human plasma proteomics and single-cell resolution unbiased cardiac transcriptomics to prioritize candidate protein candidate markers of post-myocardial infarction adverse left ventricular remodeling heart failure. He has contributed to recruitment and investigation of clinical heart failure cohorts in both New Zealand and Singapore. Examples include research on optimal drug doses for heart failure medications. At a population level, he has contributed data towards large-scale whole-genome sequencing in Singapore with discovery of 52 million novel gene variants and improved understanding of the population structure and evolutionary history of Asians.

Awards and honours 1995 – R. T. Hall Prize for Cardiovascular Research, The Cardiac Society of Australia and New Zealand 2001 – Fellow, Royal Society of New Zealand 2021 – Inaugural Life Time Achievement in Research Award, Canterbury Medical Research Foundation

Selected publications Davis, M., Espiner, E. A., Yandle, T., Richards, G., Town, I., Neill, A.... & Billings, J. (1994). Plasma brain natriuretic peptide in assessment of acute dyspnoea. The Lancet, 343(8895), 440–444. Richards, A. M., Nicholls, M. G., Yandle, T. G., Frampton, C., Espiner, E. A., Turner, J. G.... & Smyth, D. W. (1998). Plasma N-terminal pro–brain natriuretic peptide and adrenomedullin: new neurohormonal predictors of left ventricular function and prognosis after myocardial infarction. Circulation, 97(19), 1921–1929. Troughton, R. W., Frampton, C. M., Yandle, T. G., Espine, E. A., Nicholls, M. G., & Richards, A. M. (2000). Treatment of heart failure guided by plasma aminoterminal brain natriuretic peptide (N-BNP) concentrations. The Lancet, 355(9210), 1126–1130. Richards, A. M., Nicholls, M. G., Espiner, E. A., Lainchbury, J. G., Troughton, R. W., Elliott, J.... & Yandle, T. G. (2003). B-type natriuretic peptides and ejection fraction for prognosis after myocardial infarction. Circulation, 107(22), 2786–2792. Januzzi, J. L., van Kimmenade, R., Lainchbury, J., Bayes-Genis, A., Ordonez-Llanos, J., Santalo-Bel, M.... & Richards, M. (2006). NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients: the International Collaborative of NT-proBNP Study. European heart journal, 27(3), 330–337. Hildebrandt, P., Collinson, P. O., Doughty, R. N., Fuat, A., Gaze, D. C., Gustafsson, F.... & Richards, M. (2010). Age-dependent values of N-terminal pro-B-type natriuretic peptide are superior to a single cut-point for ruling out suspected systolic dysfunction in primary care. European heart journal, 31(15), 1881–1889. Than, M., Cullen, L., Reid, C. M., Lim, S. H., Aldous, S., Ardagh, M. W.... & Richards, A. M. (2011). A 2-h diagnostic protocol to assess patients with chest pain symptoms in the Asia-Pacific region (ASPECT): a prospective observational validation study. The Lancet, 377(9771), 1077–1084. Lam, C. S., Teng, T. H. K., Tay, W. T., Anand, I., Zhang, S., Shimizu, W.... & Richards, A. M. (2016). Regional and ethnic differences among patients with heart failure in Asia: the Asian sudden cardiac death in heart failure registry. European heart journal, 37(41), 3141–3153. Lam, C. S., Gamble, G. D., Ling, L. H., Sim, D., Leong, K. T. G., Yeo, P. S. D.... & Doughty, R. N. (2018). Mortality associated with heart failure with preserved vs. reduced ejection fraction in a prospective international multi-ethnic cohort study. European heart journal, 39(20), 1770–1780. Chan, M. Y., Efthymios, M., Tan, S. H., Pickering, J. W., Troughton, R., Pemberton, C.... & Richards, A. M. (2020). Prioritizing candidates of post–myocardial infarction heart failure using plasma proteomics and single-cell transcriptomics. Circulation, 142(15), 1408–1421.