Injection to treat heart failure could spell end to transplants

A PIONEERING new treatment that allows damaged hearts to recover without the need for major surgery is being trialled.

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 that gene therapy could repair failing organs.

Thousands of people in Ireland suffer from heart failure, with many requiring new hearts - and some dying before one becomes available from a donor.

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: "The best treatment currently available is a heart transplant but the shortage of donor organs 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.

"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."

Damage

Heart failure usually occurs after damage or disease, and causes the heart to become weaker at pumping blood. 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.

In the new treatment, genes are pumped into the heart muscle cells to increase the level of the protein SERCA2a using a harmless engineered virus that will spread in the organ and help repair the damaged muscle so it can pump blood 
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.

Of the 24 patients enrolled in the study, 16 will be treated with the gene therapy and eight will be treated with a placebo.

Prof Sian Harding, head of the British Heart Foundation's Centre of Regenerative Medicine at Imperial College London, said: "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."