Biopeer

Report discovers root of cardiac fibrosis

A report published in Nature Medicine by researchers at Beth Israel Deaconess Medical Center (BIDMC) helps explain the roots of cardiac fibrosis. The research further showed that the bone morphogenic molecule known as rhBMP7 might prove to be a therapy for cardiac fibrosis. The study used mice, in which endothelial cells had been marked genetically, to confirm the conversion of cells into fibroblasts during cardiac fibrosis. These cells were responsible for slowing down the proper function and electrical conduction of the heart. In the second part of the study, the investigators analyzed the rhBMP7 protein to determine its function in reducing the development of fibroblasts. “These findings provide compelling proof that the process of fibrosis can be reversed in the heart and offers the possibility of new therapies for patients who have developed cardiac fibrosis as the result of myocardial infarction, hypertension, valvular diseases or heart transplantation,” said senior author of the study, Dr. Raghu Kalluri.

Researchers from the University of Edinburgh found that heart disease might lead to a decline in cognitive function. The four-year study evaluated 452 elderly individuals who were suffering from at least one type of cardiovascular disease. The results showed that individuals who had suffered from multiple strokes during the trial period experienced a decline in verbal memory performance. But, researchers also found that atherosclerosis reduces the flow of blood required to feed the brain and hence gradually degrades the cognitive function of individuals. “Anything that leads to better cardiovascular health – more favorable levels of cardiovascular risk factors, blood pressure, cholesterol, not to smoke – these are all likely to impact the brain, the blood flow to the brain, arterial function, and eventually cognitive function,” said lead researcher, Dr. Snorri Bjorn Rafnsson.

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Processes in the brain could lead to heart disease

Through a research study, UK scientists attempted to explain how certain areas of the brain might exert stress on the heart. The researchers electrically examined the surface of the skulls of 10 patients with particular heart conditions while they carried out a mildly stressful activity. The region around the cerebral cortex showed similar levels of activity as the heart. A feedback loop was created which led the heart to pump more blood to these areas in order to enhance activity. This weakened the heart muscles and made them unstable. The procedure can possibly be utilized to predict which patients are more likely to suffer heart diseases.

A study conducted at the University of Montreal, Canada linked restless legs syndrome to heart disease. Ten patients with the syndrome were made to sleep in a laboratory, while researchers measured their blood pressure and leg movements. Usually, the leg movements, which are most severe at night, come every 20-40 seconds. At the time of each movement, the blood pressure rates of the patients rose drastically. These results imply that the neurological disorder adds to the risk of developing cardiovascular disease, particularly in severe cases and the elderly. Advanced studies will help explain in detail, the harmful implications of these findings.

Another interesting study revealed the benefits of cocoa in keeping blood pressure low. German scientists re-examined the results of earlier research studies, which analyzed the supposed effects of cocoa and tea on lowering blood pressure. They discovered that the consumption of cocoa-rich food considerably reduced blood pressure, but tea did not give the same effects. According to the researchers, the effects of cocoa can rival the effects of one-drug therapies like ACE inhibitors. However, the cocoa must be taken in moderation keeping in mind its harmful properties.

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Stem cell therapies show potential for heart patients

For the first time, UK researchers have used stem cells to develop a heart valve. Scientists at Harefield hospital positioned bone marrow stem cells into the scaffolds formed from collagen and developed them into heart valve tissues. They hope that testing these heart valves on animals in the future will see positive results. In addition, if the procedure were put to practice on humans, there would be no need to use drugs to prevent the patient’s body from rejecting the new cells. The researchers are optimistic that in 10 years time, stem cells can be used to grow a whole heart.

Meanwhile, scientists at Rush University Medical Center found that stem cell therapy restored damaged muscle in heart patients. The researchers conducted a placebo-controlled experiment. Over a period of 2 years, they examined 53 patients who were given either a placebo or Provacel, the intravenous adult stem cell therapy, 10 days after having a heart attack. Those who were given Provacel had a 75 per cent lower chance of suffering from arrhythmic adverse events. Within six months, the overall condition of the heart and lungs of these patients had been enhanced considerably. The scientists are delighted by the positive results of these Phase 1 trials.

Another research study has examined the effects of post-menopausal age on hormone therapy for heart patients. Findings from the secondary tests of the Women’s Health Initiative (WHI) imply that women who receive hormone therapy, not more than 10 years after menopause, have lower risks of coronary heart disease (CHD), than older women do. They rechecked the data collected earlier and studied three age categories of women between 50-79. Those who had symptoms like hot flashes and night sweats were more likely to have a higher risk of CHD. However, overall the hormone therapy did not significantly prevent the risk of CHD.

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Cardiovascular research makes significant advances

Scientists from UT Southwestern Medical Center discovered a tiny molecule responsible for stress-related heart disease. They mutated the genes of a group of mice in such a way that they could not generate a particular microRNA, known as miR-208. The mutant mice were exposed to certain circumstances such as hypothyroidism, injecting them with a protein that leads to heart failure and so on. The hearts of these mice were found to be healthier than those of the control group, which had normal levels of miR-208. The beta-myosin levels, which indicate heart damage, remained low in these mice. The findings can help develop a possible treatment for heart disease.

Meanwhile, another study looked into the dangers that clogged arteries pose even to those who appear to be perfectly healthy. Researchers examined information over a one-year period about 68,236 patients from across the globe, who either suffered from heart disease or had three factors such as obesity, diabetes or high blood pressure that predict clogged arteries. One-in-seven patients with the established disease were likely to have a fatal heart attack or stroke, or be hospitalized due to heart disease within one year. There were higher risks for these patients than those with the risk factors but no detected heart disease. This study is the first to put a definite measure on the risks of clogged arteries.

Researchers at the University of Wisconsin got positive results for phase one of the clinical trials to test stem cell therapies for heart disease. Even in the beginning of these trials, the subjects noticed a decrease in chest pain and an improvement in their exercise capacity. The scientists believe that infusing stem cells from the person’s blood into a damaged heart could possibly restore the cumulated decay. Through further success in their trials, they hope to develop a flawless cure for heart diseases.

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Getting to the heart of cardiovascular diseases

A research study conducted in the Netherlands has linked hypertension during pregnancy to heart disease. Contradicting earlier assumptions, these researchers feel that if women have high blood pressure while they are pregnant, chances of them suffering from heart disease in the future are higher. The researchers conducted a study on 491 women with the average age of 67 years. Through questionnaires, they found out that 31 per cent of these women had suffered from hypertension during pregnancy. Then the researchers measured the calcium build-up in the women’s coronary arteries as it determines their risk of heart disease. The women suffering from hypertension were 57 per cent more likely to have a calcium build-up. The researchers feel that this could be a means of predicting heart disease in women and will help in the management of their health.

Meanwhile, researchers have further explored the connection between heart disorders and the treatment of Hodgkin’s disease. Scientists from the Institute of Cancer Research, Sutton, UK, studied the records of 7,033 Hodgkin disease patients, who had received treatment between 1967 and 2000 in Britain. It was found that the chances of suffering a fatal heart attack increased in those who had received radiation above the diaphragm or consumed chemotherapy drugs known as anthracyclines and those who had been given the drug vincristine. The scientists now hope to work out a way to reduce the harm done by the treatments and find a new therapy, which will not have side effects.

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Research on heart attacks intensifies in India, Germany and NZ

In a study, researchers at the Government Medical College in Nagpur, India, have determined why South Asians suffer heart attacks at a younger age compared to the Western population. They analyzed the records of heart-attack patients and healthy people from five South Asian countries against those from Western countries. While the average age for suffering the first heart attack was 58.8 years in the Western countries, it was 53 years in the South Asian countries. The researchers claim that this is because the chances of performing activities that prevent heart attack were less for South Asians. Also, they had an increasing proportion of factors, like stress, that cause heart attack. The researchers believe that their findings add weight to the theory that changes in lifestyle habits, if implemented early enough in life, could reduce the chances of heart attacks.

In a debatable study, German researchers from the Center for Clinical Studies at GWI-TU found that taking a combination of the diabetes drug pioglitazone and the cholesterol-lowering drug simvastatin, brings down C-reactive protein, a marker of heart attack. They arrived at this after conducting a 12-week trial on 125 non-diabetic participants with heart disease. However, the clinical significance of the findings is under criticism from other scientists.

Meanwhile, researchers from Otago University’s Christchurch School of Medicine and Health Sciences, New Zealand, have found a connection between a protein and decreased ability of a heart to recover after an attack. The protein resistin comes from fatty tissue around the body. The study found that when the levels of resistin in the blood are high during a heart attack, the heart is able to recover only 68 per cent of its ability instead of the normal 90 per cent. The researchers are hopeful that the negative effects of resistin can be overcome with the development of drugs that will block it.

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Heart-related research gets a boost with new discoveries

Researchers have found a new marker NT-proBNP for heart attack. The researchers from the University of California concluded this after conducting a study on nearly 1,000 participants who had received treatment previously and had been undergoing a blood test for the protein NT-proBNP. During the years they were being observed, it was found that high levels of NT-proBNP resulted in cardiovascular events like heart attack, stroke or heart failure. In fact, the chances of dying increased eight-fold for those with the highest levels when compared to those with the lowest levels of the protein. However, the researchers agree that more studies are necessary to find an effective treatment for those whom the test identifies as being at risk.

Giving further credence to the ‘obesity paradox’, researchers at the University of California Los Angeles have observed that a higher body mass index (BMI) reduces an acute heart failure patient’s chances of death while hospitalized. Though obesity is risk factor for heart failure, the chances of death fell by 10 per cent for every 5-unit increase in body mass. The researchers are of the opinion that this maybe because such patients have a greater metabolic reserve they can fall back upon at the time of an acute heart failure episode.

Meanwhile, in Germany, scientists from University of Berlin's Charité Hospital have found that tea with milk is not very good for health. They studied healthy women who drank half a liter of black tea with and without milk. Before and after drinking, the women underwent an ultrasound wherein the scientists could gauge the dilation of an artery in their arm. They observed that milk thwarts tea’s antioxidant properties and its ability to dilate blood vessels, the very two features that make tea so beneficial for the heart.

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Mixed news on Parkinson's disease

Research into the treatment of Parkinson’s disease has both lowered and raised hopes.

In a big blow to Parkinson’s disease treatment, it has been found that two commonly prescribed anti-Parkinson’s drugs are unsafe for heart valves. The drugs pergolide and cabergoline belong to the ergot-derived dopamine receptor agonists class. These drugs cause damage when they interact with a receptor as this interaction compels the valve to grow beyond its normal size, resulting in it becoming floppy and leaky. In one study involving 11,000 people, Berlin researchers found that nearly 30 per cent of participants on either of the drugs were more likely to develop newly diagnosed cardiac-valve regurgitation. In a second study conducted on 245 participants, the Italian researchers found that 23 per cent of those on pergolide and 29 per cent of those on cabergoline had heart valve problems. On the other hand, those on non-ergot-derived dopamine agonists did not suffer from any such problem. Researchers hope that the US Food and Drug Administration (US FDA) will henceforth not permit doctors to prescribe these drugs.

On the other hand, researchers have also come up with an innovative skin patch to treat Parkinson’s disease. A six-month study on 277 participants throughout Canada and the United States concluded that the patch does alleviate symptoms in those with early stage Parkinson’s disease. The patch delivers the drug rotigotine directly through the skin. One of its main advantages over the pill is that it facilitates the steady and uniform delivery of the drug to the brain over a period of 24 hours. The German firm Schwarz Pharma markets the patch under the brand name Neupro. It is currently sold in Germany, Britain and Austria. The firm is expecting US FDA approval by June 2007.

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Some riddles of the heart explained

In the last week, scientists have made important discoveries regarding cardiovascular problems.

While it had been widely accepted that certain Cox-2 inhibitors prescribed for arthritis increase the chances of heart attack, for the first time a study has shown the reason behind this. In a collaborative effort, researchers from different universities in London have found that these inhibitors block the enzyme Cox-1. Due to this, it is unable to produce prostacyclin, the agent that thins the blood. As a result, blood clots are formed and increase the likelihood of heart attacks and strokes. The researchers are hopeful that their findings will assist the development of Cox-2 drugs without these side effects.

In an attempt to put to rest the doubts about the benefits of folic acid for heart disease, Dr David Wald and his team conducted a study where they found that homocysteine concentrations do contribute to heart attacks and as folic acid lowered these concentrations, increasing its intake would reduce the chances of one suffering from a heart attack. However, they agree that the scope of the study was very small and clinical trials will be better able to justify their findings.

Across the channel, in the USA, researchers have found that people at moderate risk of heart attack would be extremely benefitted if they take statins to reduce their cholesterol, even if they do not suffer from any cardiovascular disease. Dr Niteesh K Choudhry, from the Brigham and Women's Hospital, Boston, examined studies of 48,000 patients and found that statins reduced the occurence of major cardiovascular problems like heart attack by 29 per cent when compared to a placebo. With the price of statins falling, the researchers are of the opinion that the benefits far outweigh the cost.

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Heart research makes promising inroads

Swiss researchers at the University Hospital of Zurich have made a possible breakthrough in the treatment of congenital heart defects. They have successfully developed a heart valve from stem cells. They obtained these stem cells from amniotic fluid. First, the researchers planted the stem cells onto biodegradable scaffolds and then grew them in a controlled environment. The valve functioned properly and was able to open and close accordingly. Since the cells come from the infant, the valves are not likely to be rejected by the child’s body after implantation. The researchers hope to help babies with congenital heart defects through this method.

Meanwhile, researchers from the University of British Columbia conducted a study on mice that established that heart disease or stroke could set off Alzheimer’s disease. They found that heart disease and strokes encourage the growth of the clumps of the protein beta amyloid that cause Alzheimer’s disease. The researchers believe that increasing oxygen supply to the brain is a promising way to treat Alzheimer’s disease.

Also, studies have found that a person’s chances of developing heart disease increase if he or she suffers from either sleep apnea or psoriasis. Researchers from the Saint Louis University studied 134 patients and found that 40 per cent of those with ventricular premature contraction had undiagnosed severe sleep apnea. Sleep apnea can worsen ventricular premature contraction causing death during sleep. In a separate study, researchers from the Mayo Clinic compared 622 adults with psoriasis with an equal number of people without the disease. They found that the adults with psoriasis suffered heart attacks twice as often as those without the disease. With the findings suggesting that psoriasis is a systemic inflammatory disease rather than just a skin disorder, the researchers hope the findings will lead to a better understanding of the processes behind cardiovascular disease.

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