The Heart: Heart disease and stroke news and discussions

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weatheriscool
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Research team delivers a new first in heart failure treatment using cell therapy
https://medicalxpress.com/news/2023-02- ... -cell.html
by Texas Heart Institute
Physician-scientists at The Texas Heart Institute announced today the results of the largest cell therapy trial to date in patients with chronic heart failure due to low ejection fraction. The therapy benefited patients by improving the heart's pumping ability, as measured by ejection fraction, and reducing the risk of heart attack or stroke, especially in patients who have high levels of inflammation. Also, a strong signal was found in the reduction of cardiovascular death in patients treated with cells. The findings are published in the Journal of the American College of Cardiology.

Investigators in this landmark clinical trial have shown that a special immunomodulatory cell-type called MPC (mesenchymal precursor cells) developed by Mesoblast Inc., has the potential for the first time to address a major contributor to heart failure—inflammation. Patients in the trial were on full guideline-recommended drug therapy for heart failure, suggesting that the effect of the cell therapy was synergistic with and additive to state-of-the-art heart failure medications.

More than 6 million Americans have chronic heart failure, a progressive disease that leads to a weakening of the heart muscle and a loss of its pumping function. Most heart failure drugs used today are aimed at addressing the detrimental changes that occur in the heart as a result of complex neurohormonal pathways that are activated during heart failure to compensate for poor heart function.

These activated pathways eventually contribute to the progression of heart failure and repeated hospitalizations. Despite advances in therapies targeting these pathways, mortality rates remain high. The unique mechanism of action of MPC appears to provide an alternative approach that has the potential to make a significant impact on the high mortality of this disease.
weatheriscool
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Strong signs for cell therapy in the fight against heart failure
By Bronwyn Thompson
February 27, 2023
https://newatlas.com/medical/cell-thera ... t-failure/

More than six million Americans suffer from chronic heart failure, a disease that progressively weakens the heart’s muscle and destroys its ability to pump enough oxygen and blood to other organs.

However, results from the largest clinical trial of its kind offer hope to those with the disease, who up until now have relied largely on drugs that work on the heart’s complex neuralhormonal pathways but have done little to lower the mortality rate in time.

Physician-scientists at The Texas Heart Institute have shown that a new approach to heart failure, using cell therapy to combat one of the disease’s lead culprits – inflammation – can have a dramatic impact on the outcomes of sufferers.

In the phase 3 DREAM-HF trial, performed across 51 sites and involving 565 patients on medication for chronic heart failure, non-placebo recipients received a single transendocardial administration of mesenchymal precursor cells (MPC), then had a baseline and 12-month echocardiography performed.

Patients receiving the MPC cells, which were obtained from the bone marrow of healthy donors and developed by Australian biotech company Mesoblast, showed a significant strengthening of the left ventricular muscle and its pumping ability during that first 12 months. Thirty months on from the initial treatment, MPC therapy reduced the rate of heart attack or stroke by 58%, with this figure rising to 75% for those with high levels of an inflammation blood marker.

“The results of DREAM-HF are an important step in understanding how cell therapy provides benefits in patients with chronic heart failure due to poor pump function,” said Dr Emerson C. Perin, Medical Director at The Texas Heart Institute and the lead author of the study. “The cells appear to work by reducing inflammation, increasing microvascular flow, and strengthening heart muscle.”
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Mitochondrial transplantation improves rat recovery from cardiac arrest
https://medicalxpress.com/news/2023-03- ... rdiac.html
by Justin Jackson , Medical Xpress
When a heart stops beating, blood stops flowing and delivering oxygen to the brain (hypoxia) and other vital organs (ischemia). There is a small window (about 4 minutes) before the lack of blood flow begins to damage the brain. After 10 minutes, severe brain damage is expected. The sooner the heart can be restarted, the less the chances of severe brain injury.

Researchers at the Feinstein Institutes for Medical Research have tested a novel approach to increase survival rates, mitigate damage and accelerate repair in the ischemic brains of rats via mitochondrial transplantation. In a paper, "Exogenous mitochondrial transplantation improves survival and neurological outcomes after resuscitation from cardiac arrest," published in the journal BMC Medicine, the researchers detail the steps they took from in vitro lab to in vivo rat models in achieving a 91% survival rate—a 36% improvement over the control.

According to the endosymbiotic theory, mitochondria originated as a bacteria that "got swallowed" and forged a symbiotic relationship with the host cell, evolving into the mitochondria within the eukaryotic cells of complex lifeforms. Still, mitochondria have kept some of their ancient bacterial characteristics. They have double membranes like gram-negative bacteria and the ability to generate ATP with aerobic respiration—which requires oxygen—which is why our cells need oxygen deliveries from blood.

When blood stops flowing and oxygen delivery stops, mitochondria can no longer produce energy, and soon the cell is in danger of dying. If the blood has stopped flowing everywhere in the body the danger is everywhere, but nowhere more so than in the brain.
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Mediterranean diet can cut heart disease risk in women by 24 percent, report says
Studies on the impact of a Mediterranean-type diet on heart disease have not often focused on women, the researchers say
By Ellen Francis
March 15, 2023 at 10:17 a.m. EDT
https://www.washingtonpost.com/wellness ... men-study/
A Mediterranean diet could lower the risk of heart disease in women by 24 percent, new research says.

It’s the first such analysis of the possible link between a Mediterranean-type diet and cardiovascular disease that focuses on women, the authors say.

Heart disease is the leading cause of death globally, according to the World Health Organization, and in the United States, it is the No. 1 killer of women, the Centers for Disease Control and Prevention says.
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Heart attack study could change the game in regenerative medicine
https://medicalxpress.com/news/2023-03- ... icine.html
by Sanford Burnham Prebys Medical Discovery Institute
Sanford Burnham Prebys researchers have identified a group of proteins that could be the secret to cellular reprogramming, an emerging approach in regenerative medicine in which scientists transform cells to repair damaged or injured body tissues. The researchers were able to reprogram damaged heart cells to repair heart injuries in mice following a heart attack. The findings, which appear in the journal Nature Communications, could one day transform the way we treat a variety of diseases, including cardiovascular disease, Parkinson's and neuromuscular diseases.

"Even if a person survives a heart attack, there could still be long-term damage to the heart that increases the risk of heart problems down the line," says lead author Alexandre Colas, Ph.D., an assistant professor in the Development, Aging and Regeneration Program at Sanford Burnham Prebys. "Helping the heart heal after injury is an important medical need in its own right, but these findings also pave the way for wider applications of cell reprogramming in medicine."

Even though each of our cells has the same number of genes—approximately 20,000—cells can select which genes to "turn on" and "turn off" to change what they look like and what they do. This is the foundation of cellular reprogramming.
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New drug offers “two-for-one” treatment of heart failure, sleep apnea
By Paul McClure
March 30, 2023
https://newatlas.com/medical/new-drug-t ... eep-apnea/

Heart failure is a global health problem commonly complicated by sleep apnea, a co-morbidity that further reduces a person’s lifespan. A promising new drug has been developed that could treat heart failure and sleep apnea by targeting the nervous activity that drives both.

For people with heart failure, the prognosis is poor and mortality high despite recent advances in treatment. According to the National Institutes of Health, heart failure affects more than 64 million people worldwide, making it a major global public health priority.

Heart failure occurs when the heart muscle weakens and doesn’t pump effectively. The brain responds to heart failure by activating the body’s sympathetic nervous system, the “fight or flight” response, to stimulate the heart to pump more effectively. However, long-term stimulation over the long term, combined with sleep apnea, leads to a reduced life expectancy. Most patients die within five years of a diagnosis of heart failure.

The part of the brain that sends impulses to the heart also controls breathing. Central sleep apnea (CSA) – where breathing repeatedly stops during sleep because the brain doesn’t send proper signals to the respiratory muscles – is common in people with heart failure. Sleep apnea is thought to be caused by increased sensitivity in the peripheral chemoreceptors found in the carotid arteries, which detect changes in arterial blood oxygen (hypoxia) and initiate reflexes to return oxygen levels to normal. One receptor in particular, P2X3, is known to affect this reflexive response.
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Treating a heart attack before it happens: It may not be a science fiction
Helen Sotiriadis/Stocksy

https://www.medicalnewstoday.com/articl ... ce-fiction
The effects of a heart attack are often permanent, as the heart tissue cannot regenerate, unlike some other tissues.
This means that despite somebody surviving a heart attack, the damage done could cause health problems or death in the years following the event.
Regenerating heart tissue to allow damaged heart tissue to be treated is a hot topic in research.
Now researchers have discovered a mechanism that allows them to treat heart tissue in mice, before a heart attack, in a way that provides protection months later.

Although most people survive a heart attackTrusted Source initially, the risk of death significantly increases over the following years.

In fact, 65% of peopleTrusted Source who have a heart attack over the age of 65 die within eight years of the initial incident. This is at least partly because while a person may survive an initial heart attack, the heart attack itself, which leads to the heart tissue being deprived of oxygen and then dying, does not regenerate in adult humans.

In a recent animal study, researchers identified a mechanism that allowed them to treat heart tissue and make healthy mice’s hearts more resilient before a heart attack.

The study’s results appear in Nature Cardiovascular Research.
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Scientists Have Overcome the “Biggest Roadblock” to Regenerating the Human Heart
https://scitechdaily.com/scientists-hav ... man-heart/

By University of Washington School of Medicine/UW Medicine April 9, 2023
Human Heart Anatomy

Researchers at the University of Washington School of Medicine have successfully engineered stem cells that do not cause dangerous arrhythmias, a major complication previously hindering stem-cell therapies for injured hearts. By using CRISPR-based genome editing to modify ion channels in the stem cells, the team created a new line of cells called “MEDUSA,” which engraft in the heart, mature, and integrate into heart muscle without generating dangerous heart rates.
Engineered stem cells do not provoke dangerous heart rhythms, a challenge that has prevented the progress of stem cell transplants for damaged hearts.

Researchers at the University of Washington School of Medicine in Seattle have successfully created stem cells that do not cause dangerous arrhythmias, a complication that has to date thwarted efforts to develop stem-cell therapies for injured hearts.

“We have found what we have to tackle to make these cells safe,” said Silvia Marchiano, a postdoctoral fellow in the laboratory of Chuck Murry at the UW Medicine Institute for Stem Cell and Regenerative Medicine. Marchiano is the lead author of a paper describing the findings published Thursday, April 6, in the journal Cell Stem Cell. The work was done in collaboration with the Seattle company Sana Biotechnology.

In earlier research, Murry’s team employed heart muscle cells derived from stem cells to mend heart tissue injuries resulting from myocardial infarction. This form of heart attack takes place when the blood supply to the cardiac muscle is obstructed, leading to the death of heart cells. Since cardiac cells do not regenerate, the damaged tissue is substituted by scar tissue. This compromises the heart’s strength and hinders its blood-pumping function. Extensive harm can culminate in heart failure and even death.
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New wrist sensor could save heart attack patients critical time in ER
By Bronwyn Thompson
April 12, 2023
https://newatlas.com/medical/wrist-sens ... tients-er/
A new device designed to accurately and quickly sense whether a cardiac arrest patient also has a heart valve blockage that needs urgent treatment is now undergoing trials in Seattle.

Cardiologists and emergency physicians at Harborview Medical Center in Seattle are testing the Tropsensor, which has been designed to detect telltale troponin levels within 3-5 minutes of being fitted on the patient’s wrist.

Troponin, a protein found in the heart muscle, appears in the bloodstream when heart damage has occurred and an artery has been blocked, signifying a heart attack. Detecting this as early as possible in patients that have arrived at the ER allowed medical staff to treat this serious condition as quickly as possible.

Right now, triaging this condition involves an electrocardiogram (ECG), which can lack accuracy for those who have had a cardiac arrest, or a troponin blood test, which can cost an ill patient precious time waiting for pathology results.

“Early recognition of acute coronary occlusion could allow us to rapidly restore blood flow to the heart, which improves the short- and long-term outcomes for patients who have unrecognized heart attacks,” said Dr. Graham Nichol, an emergency physician at the University of Washington School of Medicine and director of Harborview’s Center for Prehospital Emergency Care.
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Implantable graphene e-tattoo uses light to monitor, correct arrhythmias
By Paul McClure
April 18, 2023
https://newatlas.com/medical/new-implan ... rhythmias/
A team of researchers led by Northwestern University and the University of Texas at Austin (UT) have developed a novel graphene heart implant that’s about the thickness of a strand of hair and monitors and corrects abnormal heart rhythms using light.

Heart rhythm disorders – cardiac arrhythmias – are caused by faulty electrical signaling in the heart, causing it to beat too quickly or too slowly. In some cases, this can lead to heart failure, stroke, and even sudden death.

Cardiac arrhythmias are commonly treated with implantable pacemakers and defibrillators, which monitor and correct abnormal rhythms. But these devices are inflexible and can constrain the heart, causing tissue injury and discomfort and increasing the risk of complications such as swelling, perforation, blood clots, and infection.

The new pacemaker is the first made from strong, lightweight, biocompatible ‘super material’ graphene and the thinnest to date. Unlike existing implantable pacemakers and defibrillators, this one molds itself to the heart tissue while being strong enough to withstand the rigors of a beating heart.
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