Is Heart Failure a Thing of The Past?

Failure? What's that?

In the modern day some strokes and heart attacks are able to be treated with no lasting symptoms if treated withing 2-3 hours of the event, but there are still those events where treatment simply isn't enough to get people back on their feet. Whether you are put on a beta blocker, an Ace Inhibitor, or diuretics, the heart doesn't fully recover in some cases. This is where newly discovered gene therapy comes in. Researchers had previously found a gene that produces a protein called cardiac bridging integrator 1 (cBIN1) that is integral in allowing the heart to perform at full functionality. Hearts that are low on cBIN1 are found to have trouble contracting, and have a severe risk of heart problems. Recently tested on pigs was this protein embedded in a virus, being shot into the blood vessels of pigs with heart failure. These pigs, prior to the treatment, were expected to die withing the 6 month window of the period. In fact they were slated to die much sooner, within 2-3 months. All of the 4 pigs survived the research window and were found to have a 30% improvement in heart function. A far shout from the results of current treatments, which range from 5-10%. FDA approval is being applied for to obtain permission to test on humans, but it isn't expected to go through until 2025 at the earliest. 

I am excited for this to develop into later stages. As somebody who has a genetic heart condition, seeing that heart failure and it's aftereffects may become a thing of the past is greatly comforting. I can't wait to see where this research goes, and I will be personally following this subject. Once this protein is successfully implanted in humans, I'm hoping we can find an enzyme that helps control the gene expression and protein production, so we could possibly make a pill for people who are found to have cBIN1 deficiencies. 

Links

https://www.nature.com/articles/s41536-024-00380-0

https://www.nhs.uk/conditions/heart-failure/treatment/

When It Comes To Heart Attacks, Less Seems To Be More

In the United States alone, heart disease is the number one cause of death in both men and women. Although both a poor diet and not enough exercise are large contributing components to heart disease, scientists have begun to discover that genetics also plays a large role in decreasing a person’s chance of having a heart attack. Specifically, people who have a mutation on a gene called ANGPTL4 run a 50% lower risk of having a heart attack. They also had lower levels of triglycerides in the blood.

In the study conducted, researchers analyzed 13,000 genes from 200,000 patients, looking for correlations between ANGPTL4 mutations and coronary artery disease (CAD). Patients who had the mutation had not only a much lower incidence of heart attacks, but also had lower levels of triglycerides. It is relevant to note that ANGPTL4 inhibits the lipoprotein lipase (LPL) enzyme, which breaks down triglycerides. This lead the researchers to hypothesize that if ANGPTL4 is not working, then the LPL enzyme is not inhibited, thus lowering the triglycerides found in the blood. Over time this leads to less fat deposits in the arteries, significantly reducing a person’s heart disease risk.

These findings lead to two important conclusions that are very valuable to clinical medical practice. First is, it highlights the importance of healthcare professionals emphasizing lowering triglycerides, and not just cholesterol. Secondly, the discovery of this ANGPTL4 mutation could lead to a new target for medications. It also makes me want to run out and get my blood tested! It is really interesting overall what a big contribution genetic research can/is contributing to modern medicine. Hopefully in a decade or two, targeted medicines will be available for almost all the conditions that affect humans. However, the topic of is they will be affordable or not is a whole other discussion (#FeelTheBern!)

http://www.popsci.com/genetic-mutation-could-save-you-from-heart-attack 
http://www.nejm.org/doi/full/10.1056/NEJMoa1507652?query=featured_cardiology&