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Home / Latest News / British Heart Foundation looks at ways to treat damaged hearts
cholesterol and heart disease

British Heart Foundation looks at ways to treat damaged hearts

Deaths from heart disease in Wales have more than halved in just three decades, but the British Heart Foundation is warning that the news should not mask the devastating burden that heart failure can have on patients.

Looking at ways of repairing the heart and regenerative medicines are the main areas of heart research at the moment.

It is key reason why the heart charity launched a new campaign last month, called Mending Broken Hearts Appeal, with the aim of taking the fight to heart failure by funding regenerative medicine research that could cure the condition.

Figures show that about 4,300 people now die from coronary heart disease in Wales each year – 2,500 men and 1,800 women. In 1981, more than 9,600 people from Wales died of coronary heart disease – about 5,600 men and 4,000 women.

But even though heart attack deaths in Wales are decreasing, the BHF says there is little evidence that the same is true of heart failure. The most recent audit shows that as many as 70% of heart failure cases are caused by coronary heart disease and an estimated 44,000 people now live with heart failure in Wales.

Heart failure occurs when so much heart muscle is damaged by the heart attack that the heart can’t pump blood around the body as well as it should. Three quarters of people with severe heart failure will not live beyond five years.

Professor Peter Weissberg, medical director at the BHF, said: “We’re undergoing an unprecedented period of change when it comes to heart health in Wales.

“It is pleasing that decades of British Heart Foundation-funded research has contributed to the dramatic fall in heart attack deaths over recent years. But this means that more and more people are surviving heart attacks with damaged hearts and there is now an urgent need to find ways of reversing that damage.

“Our scientists are making great strides in this fight against heart failure, but success will require much more money and much more research to ensure that this momentum is not lost.”

The research programme is cutting edge and involves stem cell research and developmental biology to work out how to repair or replace damaged heart muscle. One of the main researchers in the project is Dr Nicola Smart, from Cardiff, who is working at the University of Oxford with Professor Paul Riley.

Dr Smart is working on a way to teach the heart to repair itself after a heart attack. At the moment this is impossible but recent discoveries from her team offer hope for a cure for heart failure.

The team have isolated a protein called thymosin beta-4 that can switch on a repair mechanism in the heart which usually becomes dormant shortly after birth. After successful studies in mice they are searching for even more effective molecules – including approved drugs – that might stimulate repair in people with heart failure.

Dr Smart said: “We were interested in how the heart develops originally in the embryo during pregnancy.

“We took a lot of interest in cells in the outer layer of the heart. These cells are very active during development of the heart.

“We started looking at what would happen if you could get these cells back as an adult and if they would do the same as they do in the embryo. There’s a small protein that these cells need in order to migrate. We added the cells to a heart in a dish and added in the protein. We were quite surprised to see that the cells started growing and migrating.

“We then wanted to see what would happen in a mouse and we found the cells performed a DIY repair. It’s a very exciting piece of research but at the moment it’s still very limited.

“The process is not efficient enough yet and there are more than one billion cells in a heart and at the moment we could replace about 1%, so there’s still a long way to go.

“People always want to know when it will be ready for patients, but we do not know when the next breakthrough will come along.

“The effects of heart damage are often quite underestimated but it’s one of the most debilitating conditions. It’s quite shocking really, one day someone can be able to run up the stairs and the next they can barely walk.

“At the moment the only cure for a damaged heart is a heart transplant, but there are problems with rejection and there are not enough hearts to go around. If this is the case, people are left with no cure or treatment.

“The heart does attempt to repair itself but its’ not like the liver which can regenerate, it can only do one or two cells.”

Another plus in Wales is a new testing service for an inherited condition called familial hypercholesterolaemia, which puts people at very high risk of heart disease.

The screening is part funded by the British Heart Foundation and the Welsh Assembly Government and is being used as the basis of a campaign to have it introduced in England.

Familial hypercholesterolaemia (FH) is caused by a genetic mutation – a slight variation in DNA that makes up Suzanne Sheppard’s genes.

BHF Professor Steve Humphries has studied FH for almost 30 years and has made a major contribution to our knowledge of the condition. He was one of the first to show a DNA test could be used to see whether relatives of someone with FH also have the condition.

“Since then we’ve put a lot of work into developing faster and faster, more accurate, and cheaper ways to test and find the genetic mutation in a person if he or she is suspected of having FH,” says Professor Humphries.

Now, if someone in Wales has an unusually high cholesterol level their DNA can be tested for FH genes. If one is found, then their immediate family can be contacted to see if they want to be tested.

Research helps diagnose genetic risk 

Research by the British Heart Foundation has helped the likes of 39-year-old paralegal Suzanne Sheppard, from Cardiff. Despite a healthy lifestyle, Suzanne is at higher risk of heart disease than most people because of her genes.

“I have a condition called familial hypercholesterolaemia or FH that causes me to have high cholesterol that if left untreated, could mean I get heart disease at a younger age,” explained Suzanne.

Suzanne Sheppard takes cholesterol lowering drugs
Suzanne Sheppard takes cholesterol lowering drugs

Her body can’t process cholesterol normally so it stays in the blood where it can begin to form fatty plaques on the walls of arteries.

Suzanne was suspected of having FH because her cholesterol levels were unusually high.

Doctors recommended checking her cholesterol because her father died of a heart attack aged just 41.

“I had a DNA test where scientists checked to see if I had a mutation that causes FH,” said Suzanne.

This test is now being used as part of a screening programme, part-funded by the BHF, in Wales.

Now, if someone in Wales has an unusually high cholesterol level their DNA can be tested for FH genes. If one is found, then their immediate family can be contacted to see if they want to be tested.

“My son will be tested to see if I’ve passed my FH gene onto him. Hopefully he won’t have it but if he does, thankfully we’ll know early so doctors can give him medication and advice to reduce its impact,” said Suzanne.

FH, once diagnosed, is a very manageable condition. Suzanne now takes cholesterol-lowering drugs and is careful to lead a healthy lifestyle to keep her cholesterol as low as possible.

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