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Tuesday, 6 March, 2001, 00:00 GMT
Heart failure damage reversed
Catheter
The gene therapy can be delivered using a catheter
Researchers have used gene therapy to reverse the damage caused by heart failure.

Until now, heart failure has proved very difficult to treat. All doctors can do is try to minimise the effect of the symptoms.

But a team from Duke University Medical Center in the US has already used gene therapy to prevent heart damage in rabbits with congestive heart failure.

Now they have gone one step further and actually reversed the damage already done to the rabbits' heart tissue.

The study raises the prospect of a similar technique being used on human patients.

One of its great advantages is that it does not require major surgery.

Knock out

The researchers were able knock out the action of a chemical which plays a central role in causing heart failure.


We anticipate being able to possibly test this approach in a certain group of patients within three years

Walter Koch, Duke University Medical Center
They did this by modifying the common cold virus to carry a copy of a gene which stops the chemical from working.

The virus was fed into the bloodstream of rabbits with heart failure using a catheter.

One week after the therapy, the cells that had been damaged by damaged by heart failure had started to resume their normal function.

Lead researcher Professor Walter Koch said: "If our work continues to progress as it has, we anticipate being able to possibly test this approach in a certain group of patients within three years.

"We would likely try it first on severe heart failure patients in the hospital awaiting a heart transplant to see if we could reverse the dysfunctioning part of the heart."

In patients with heart failure the cardiac muscle fails to stretch and contract properly.

This means oxygen-rich blood is not delivered around the body in sufficient quantity.

The disease, which is debilitating and ultimately fatal, is caused by coronary artery disease or a heart attack.

Fatigue

Patients experience fatigue, weakness, and often cannot conduct everyday activities.

As a natural response to a diseased heart, the body releases the hormone noradrenaline directly into the heart, causing it to beat up to five times faster than normal.

While in the short-term, this improves the heart's pumping action, in the long run it leads to heart failure.

The Duke researchers targeted a chemical which stimulates this longer-term damage.

The fact that the gene therapy can be delivered through a catheter could be very significant.

Currently, other gene therapy techniques being tested involve the patient undergoing open heart surgery.

Professor Koch said: "In the case of patients with heart failure, most are too sick to be able to withstand the rigours of major surgery.

"We already know that even very sick patients can safely undergo catheter-based procedures, so it would be an effective and safe way to deliver the therapy."

A spokeswoman for the British Heart Foundation: "Gene therapy has huge potential to improve the outlook for patients with coronary heart disease or heart failure.

"Much of the research done to date however has been on cells in a lab and very few clinical trials on people have taken place.

"This latest research offers real promise for future heart failure patients - a condition which already affects over half a million people in the UK and which is increasing.

"Although the benefits of this particular research are some way off, there are many other ways that heart failure can be treated that can improve patients' quality of life considerably."

The research is published in the journal Circulation.

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See also:

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