Innovative Research Gives Heart Patients Hope

Robots, gene-driven pacemakers and even a link to creme brulée served up at AHA meeting

THURSDAY, Nov. 17, 2005 (HealthDay News) -- Researchers presenting at the American Heart Association's annual meeting in Dallas this week report they are doing everything from harnessing food technology to using tiny robotic arms to help patients with heart problems.

First, the food-chemistry angle: Similar to making creme brulée, a chemical reaction between proteins and sugars in aging arteries can make them harden or caramelize, making the owners more vulnerable to heart disease.

"The same process that makes food tasty wrecks havoc in the body," explained geriatric cardiologist Dr. Susan Zieman, the study's lead investigator and an assistant professor of medicine at Johns Hopkins University School of Medicine in Baltimore. "Cross-linked sugar and protein stiffens the arteries and strains the heart."

A compound called alagebrium, similar to an ingredient used in anti-wrinkle creams, was able to stretch the arteries back out as well as restore endothelial function, essentially counteracting two of the essential processes of aging.

"It affects the process that leads to a lot of these changes," Zieman said.

Alagebrium is already being used in clinical trials for heart disease. but these results indicate that there's every reason to keep moving forward, she said.

Also at Johns Hopkins, researchers managed to create a "biological pacemaker" in guinea pigs by fusing connective tissue from the lungs with heart muscle.

Electronic pacemakers that guard against potentially fatal arrhythmias are effective for many, but come with a hefty price tag and a battery life of only five years.

"Every five years, you have to have open heart surgery to replace the battery and along with this come complications such as infections and inflammations," noted study author Hee Cheol Cho, a postdoctoral cardiology research fellow at Johns Hopkins University Institute of Molecular Cardiobiology.

The new pacemaker, Cho explained, would be a permanent implant requiring only one surgery.

In the guinea pigs, fibroblast cells, which are present throughout the body, were fused with regular (albeit deficient) heart muscle cells. The fibroblasts were genetically altered to give them the ability for electrical signaling.

This is how it would work in humans: A patient with arrhythmia would come to the clinic. A five-minute skin biopsy would yield the necessary fibroblasts which would then be expanded in the lab. In about two weeks, the new gene would be introduced, the fusion would be induced and the biological pacemaker born.

The researchers plan to test the technology next in pigs.

A third study at the meeting combined robotically assisted coronary artery bypass surgery (CABG) with stented angioplasty as a potential new treatment for extensive coronary artery disease.

For the robotically assisted portion of the equation, the surgeon's hand movements at a console were mimicked by miniature robotic arms inside the patient.

The study was small, involving only 27 patients, but was successful in opening blocked arteries in each case. The patients also had shorter hospital stays.

Finally, an experimental imaging technique appears able to tell the difference between different types of plaque. Some kinds of plaque, which can build up inside arteries, are more likely to rupture and cause problems than others.

Here, a laser pulse heated up plaque molecules. Researchers distinguished different types of plaque by how long their molecules maintained this "excited" state.

More information

Visit the American Heart Association for more on preventing and treating heart disease.

SOURCES: Hee Cheol Cho, Ph.D., postdoctoral cardiology research fellow, Johns Hopkins University Institute of Molecular Cardiobiology, Baltimore; Susan Zieman, M.D., Ph.D., assistant professor, medicine, Johns Hopkins University School of Medicine, Baltimore; Nov. 14-16, 2005, presentations, American Heart Association annual meeting, Dallas
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