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Heart Failure Cure ?

Pioneering new injection to cure heart failure without need for major surgery

The technique, which involves a simple injection, could aid the recovery of   hundreds of thousands of heart failure patients – and could even consign   heart transplants to history.


Researchers hope to increase levels of SERCA2a, a protein in heart muscle cells that plays an important role in heart muscle contraction Photo: Alamy


A pioneering new treatment that allows damaged hearts to recover without the  


need for major surgery is being trialled by one of Britain’s leading medical  




The technique, which involves a simple injection, could aid the recovery of  


hundreds of thousands of heart failure patients. Heart transplants could   even be


consigned to history thanks to a trial by Imperial College, London,   which aims to


show for the first time that gene therapy could repair failing   organs.


Almost 500,000 people in Britain suffer from heart failure, with hundreds of  


patients requiring new hearts. Around 200 transplants take place in Britain   each


year. But two out of 10 people will die awaiting an organ due to severe  


shortages of donors. 


The trial involves researchers introducing a gene, created in a laboratory,   into


heart failure patients to boost the production of a key protein, which   they believe


will allow the muscle to recover.


Researchers say the treatment could offer a “viable alternative” to  


transplantation. The British Heart Foundation, which is funding the trial,   said the


discovery “offers genuine hope of an effective treatment in the   near future”.


Dr Nick Banner, the consultant cardiologist at Harefield Hospital in north   London,


who carried out the first infusion of the new gene therapy, said:    “Advanced


heart failure is a progressive condition that results in a poor   quality of life and


shortened life expectancy.


“The best treatment currently available is a heart transplant but the shortage   of


donor organs in the UK means that many patients will die on the   transplant


waiting list. Mechanical pumps can keep some patients alive long   enough for a


donor heart to become available. 


“The rationale for this study is to investigate the effectiveness of a new   form of


therapy, which might in the future be a viable alternative to   transplantation. 


“This study will help us better understand whether the concept of repairing a  


heart with gene therapy might be possible, even in patients with advanced   heart


failure.” Heart failure usually occurs after damage or disease, and   causes the


heart to become progressively weaker at pumping blood as its   cells become


overstressed and begin to malfunction.


It can be brought on by high blood pressure; damage to arteries caused by  


alcohol or smoking; weak heart muscles caused by genetic defects; or  




In many cases heart failure is caused by damage after a heart attack, where  


heart muscle and other tissue dies because its blood supply is cut off.


Some patients with advanced heart failure are fitted with a Left Ventricular  


Assist Device (LVAD), a mechanical pump that supports the failing heart and  


aims to restore normal blood flow. 


The pump moves the blood from the left ventricle into the main artery (the  


aorta) so it can circulate the oxygen-rich blood to the rest of the body. 


Currently there are about 100 to 150 people in the UK living with a pump but  


they are heavy and cumbersome and patients struggle to bathe or sleep while  


wearing the battery packs.


The new therapy is designed to increase levels of SERCA2a, a protein in heart  


muscle cells that plays an important role in heart muscle contraction. 


In the new treatment, genes are pumped into the heart muscle cells to increase  


the level of SERCA2a using a harmless engineered virus that will spread in   the


organ and help repair the damaged muscle so it can pump on its own. 


Previous studies have shown that the technique works in animals and on hearts  


in a laboratory. Now human trials are to begin.


The team plans to take small biopsy samples of the heart muscle six months  


after treatment to measure if the gene is present, detectable and functional   in


the patients’ hearts. 


Of the 24 patients enrolled in the study, 16 will be treated with the gene   therapy


and eight will be treated with a placebo. 


“We will be using state-of-the art methods to gain detailed information on how  


and where the gene therapy takes effect, which will potentially help us   develop


and improve the therapy,” said Sian Harding, professor of cardiac   pharmacology


and head of the British Heart Foundation’s Centre of   Regenerative Medicine at


Imperial College London.


“It’s important to remember that the therapy is not correcting a gene defect,”   


Prof Harding added.


“We are working much more downstream, which means that no matter what the  


cause of the heart failure, the therapy should be equally beneficial for   patients


whether their heart problems stem from genes, lifestyle or the   environment or a


mixture of all of these.”


Prof Peter Weissberg, Medical Director at the BHF, said: “Heart failure  


devastates the lives of hundreds of thousands of people in the UK. Despite   major


advances in treating heart attacks, we’re still some way off a   treatment that


restores function in hearts damaged by one. This cutting-edge   trial offers


genuine hope of an effective treatment in the near future.” 


Þ A drug taken by hundreds of thousands of Britons suffering from heart  


arrhythmia may increase death rates, research has suggested. A study of more  


than 122,000 Americans with atrial fibrillation showed that those given   digoxin


were 20 per cent more likely to die than patients receiving   different treatments. 


About 800,000 people in Britain have AF, the most common type of arrhythmia  


and the NHS prescribes around 5 million doses of digoxin each year. 


The research, carried out by Stanford University Medical Center, was published  


in the Journal of the American College of Cardiology.

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