|
January 17, 2001
|
|
PUBLIC
HEALTH
Mending the Heart
New research on treatments for cardiovascular disease is underway
By Martha Gore
hen
Amy Johnson's husband asked what she wanted for Valentine's Day,
Amy's response was, "A mended heart." Johnson is one of many patients
waiting for a medical breakthrough that will restore her to the
active lifestyle she enjoyed before cardiovascular disease took
over.
Fortunately for Johnson and other heart patients, a team of physicians
and scientists are working on it. The Sarver Heart Center at the
University of Arizona recently put 100 researchers from 26 different
medical institutions on the job. All are collaborating to find
prevention strategies for cardiovascular disease and to develop
innovative treatments, perhaps even a cure. These researchers
are working with a variety of different theories -- some brand-new
and unconventional, some old and in need of improvement.
What's old is new again
Some researchers are going back to simple questions to find the
key to a cure for cardiovascular disease. One important question
is, Why can't the heart heal itself when other parts of the body
can? Cynthia Adamson, Ph.D., holds a doctorate in physiology and
is trying to find a way to get the heart to repair itself, possibly
by reprogramming the genetic information inside the cells. According
to Adamson, "Muscle cells work the same way as heart cells --
so why do skeletal muscles regenerate and reenter the cell cycles
when heart cells don't?" If researchers can find a way to jump-start
this process, it would be the ultimate cure.
|
|
Why
can’t the heart heal itself, while other parts of the
body can? |
|
|
|
Dissolving stent tubes
Another researcher working to prevent cardiovascular disease,
Marvin Slepian, M.D., is working toward finding a new way to improve
an old technique. For years, heart surgeons have been using stents
-- wire mesh tubes -- to prop arteries open. Stents are implanted
into arteries after angioplasty, the surgical repair of a blood
vessel, to ensure blood flow to the heart. Unfortunately, in about
20 percent of cases, the arteries become clogged again. Dr. Slepian
would like to create a biodegradable wire-mesh tube to deliver
drugs to the artery, bathing the vessel in a substance that would
make it healthy again. While coating stents with drugs is common,
delivering drugs inside biodegradable stents may make the procedure
much more efficient.
Raise the roof with nitric oxide
Another Sarver Heart Center study takes on the classic theory
that arteries become clogged because inflammation causes the endothelial
cells that line the arteries to contract. The theory says this
contraction creates spaces between the cells, providing an entry
point for harmful substances in the blood, such as bad cholesterol,
which can attach themselves to the artery wall. According to a
spokesperson at Sarver, researcher Ann Baldwin, Ph.D., has evidence
that what actually happens is a collapse of the scaffolding that
keeps the endothelial cells rigid. Baldwin aims to prove that
nitric oxide can reconstruct the scaffolding -- a theory that
could lead to new therapies for heart and vascular disease.
Can antibiotics reduce the swelling?
Researchers are also interested in determining the effects of
antibiotics on the arteries. Scientists will determine whether
the antibiotic azithromycin can be used to prevent heart attacks.
The hypothesis is that arterial inflammation causes blockages
to rupture and that azithromycin might reduce the inflammation
in some patients. While the cause of the inflammation is not known,
some believe it could be due to the Chlamydia pneumoniae, a
bacteria that is the fourth most common cause of pneumonia in
the country. Individuals with proven coronary disease -- previous
heart attack, bypass surgery, angioplasty, or coronary angiogram
showing at least a 50 percent arterial block -- are participating
in Sarver's Azithromycin and Coronary Event Study, which will
test the antibiotic's effect.
DITPA treatment
Many aspects of treating cardiovascular disease are being examined,
but there is a special emphasis on congestive heart failure, says
Steven Goldman, M.D., chief of the section of cardiology at the
Southern Arizona Veterans Affairs Health Care System. "While death
rates for most forms of cardiovascular disease have been decreasing
due in part to the aggressive treatment of acute ischemia (inadequate
blood flow to the heart due to arteriosclerosis or other blood
vessel injury), the prevalence of heart failure is increasing,"
Dr. Goldman points out. One potential new treatment Sarver researchers
are studying for heart failure uses the thyroid hormone analogue
DITPA (3,5-diiodothyropropionic acid), which may improve heart
contractions. "If this work proves successful, the use of thyroid
analogues to treat heart failure may soon become a reality," says
Dr. Goldman.
These are just a few of the studies in process at Sarver Heart
Center that will go a long way toward discovering new treatments
for heart disease. For Amy Johnson and others still facing a life
limited by heart disease or malfunction, the wait is a long one
-- but researchers may one day be able to deliver the gift of
a healthy heart.
Related links:
Send feedback on this article.
|
By Martha Gore
January 17, 2001
hen
Amy Johnson's husband asked what she wanted for Valentine's Day, Amy's
response was, "A mended heart." Johnson is one of many patients waiting
for a medical breakthrough that will restore her to the active lifestyle
she enjoyed before cardiovascular disease took over.
Fortunately for Johnson and other heart patients, a team of physicians
and scientists are working on it. The Sarver Heart Center at the University
of Arizona recently put 100 researchers from 26 different medical
institutions on the job. All are collaborating to find prevention
strategies for cardiovascular disease and to develop innovative treatments,
perhaps even a cure. These researchers are working with a variety
of different theories -- some brand-new and unconventional, some old
and in need of improvement.
What's old is new again
Some researchers are going back to simple questions to find the key
to a cure for cardiovascular disease. One important question is, Why
can't the heart heal itself when other parts of the body can? Cynthia
Adamson, Ph.D., holds a doctorate in physiology and is trying to find
a way to get the heart to repair itself, possibly by reprogramming
the genetic information inside the cells. According to Adamson, "Muscle
cells work the same way as heart cells -- so why do skeletal muscles
regenerate and reenter the cell cycles when heart cells don't?" If
researchers can find a way to jump-start this process, it would be
the ultimate cure.
|
|
Why
can’t the heart heal itself, while other parts of the body
can? |
|
|
|
Dissolving stent tubes
Another researcher working to prevent cardiovascular disease, Marvin
Slepian, M.D., is working toward finding a new way to improve an old
technique. For years, heart surgeons have been using stents -- wire
mesh tubes -- to prop arteries open. Stents are implanted into arteries
after angioplasty, the surgical repair of a blood vessel, to ensure
blood flow to the heart. Unfortunately, in about 20 percent of cases,
the arteries become clogged again. Dr. Slepian would like to create
a biodegradable wire-mesh tube to deliver drugs to the artery, bathing
the vessel in a substance that would make it healthy again. While
coating stents with drugs is common, delivering drugs inside biodegradable
stents may make the procedure much more efficient.
Raise the roof with nitric oxide
Another Sarver Heart Center study takes on the classic theory that
arteries become clogged because inflammation causes the endothelial
cells that line the arteries to contract. The theory says this contraction
creates spaces between the cells, providing an entry point for harmful
substances in the blood, such as bad cholesterol, which can attach
themselves to the artery wall. According to a spokesperson at Sarver,
researcher Ann Baldwin, Ph.D., has evidence that what actually happens
is a collapse of the scaffolding that keeps the endothelial cells
rigid. Baldwin aims to prove that nitric oxide can reconstruct the
scaffolding -- a theory that could lead to new therapies for heart
and vascular disease.
Can antibiotics reduce the swelling?
Researchers are also interested in determining the effects of antibiotics
on the arteries. Scientists will determine whether the antibiotic
azithromycin can be used to prevent heart attacks. The hypothesis
is that arterial inflammation causes blockages to rupture and that
azithromycin might reduce the inflammation in some patients. While
the cause of the inflammation is not known, some believe it could
be due to the Chlamydia pneumoniae, a bacteria that is the
fourth most common cause of pneumonia in the country. Individuals
with proven coronary disease -- previous heart attack, bypass surgery,
angioplasty, or coronary angiogram showing at least a 50 percent arterial
block -- are participating in Sarver's Azithromycin and Coronary Event
Study, which will test the antibiotic's effect.
DITPA treatment
Many aspects of treating cardiovascular disease are being examined,
but there is a special emphasis on congestive heart failure, says
Steven Goldman, M.D., chief of the section of cardiology at the Southern
Arizona Veterans Affairs Health Care System. "While death rates for
most forms of cardiovascular disease have been decreasing due in part
to the aggressive treatment of acute ischemia (inadequate blood flow
to the heart due to arteriosclerosis or other blood vessel injury),
the prevalence of heart failure is increasing," Dr. Goldman points
out. One potential new treatment Sarver researchers are studying for
heart failure uses the thyroid hormone analogue DITPA (3,5-diiodothyropropionic
acid), which may improve heart contractions. "If this work proves
successful, the use of thyroid analogues to treat heart failure may
soon become a reality," says Dr. Goldman.
These are just a few of the studies in process at Sarver Heart Center
that will go a long way toward discovering new treatments for heart
disease. For Amy Johnson and others still facing a life limited by
heart disease or malfunction, the wait is a long one -- but researchers
may one day be able to deliver the gift of a healthy heart.
Related links:
Send feedback on this article.