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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  

 

institutions.

 

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  

 

infections. 

 

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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