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Researchers at the Victor Chang Cardiac Research Institute (USA) have identified a new mechanism that causes thickening of the heart muscle, which increases the risk of irregular heart rhythms and heart failure
The discovery could open the way to a new treatment for the heart disorder known as cardiac hypertrophy.
“Cardiac hypertrophy is a key risk factor for premature cardiac death and a leading cause of heart failure,” said Professor Martinac, lead author of the paper.
Martinac considers that the results published in “Nature Cardiovascular Research” represent a great advance in understanding one of the main factors of heart disease.
“We have finally been able to find one of the key reasons why the heart muscle wall thickens and we have identified the molecules and pathways that cause this process.”
Cardiac hypertrophy, which affects one in 500 people, is caused by many common conditions, such as abnormally high blood pressure and narrowing of one of the heart valves (aortic stenosis).
Aortic stenosis is a disease that causes thickening of the wall of the main pumping chamber (left ventricle). Over time, this thickening can cause abnormal heart rhythms and lead to heart failure. Once heart failure develops, 5-year survival is less than 50%.
The new research identified the exact molecules in the heart muscle cells responsible and, importantly, discovered how they communicated with each other in a mouse model. They discovered that a molecule called Piezo1 triggered a signaling process, with another associated molecule, in cardiac muscle cells.
The discovery paves the way for developing a peptide that prevents these molecules from ‘talking’ to each other. This could prevent the heart muscle from thickening in the first place or stop any further thickening in those already affected.
Nowadays there are few therapeutic options for severe hypertrophy. Traditional approaches include lowering patients’ blood pressure or replacing a stenotic aortic valve, neither of which can reverse the damage caused by hypertrophy. “We hope that, in the long term, as soon as we see signs of thickening of the heart muscle given a treatment, perhaps a small peptide, that prevents the process from progressing in the heart. It could even be given to people with severe hypertension to prevent them from developing cardiac hypertrophy in the first place,” says study author Jane Yu.
“This preventive treatment could go a long way in reducing the number of people affected by heart disease in Australia and save many lives in the future.”
The same Institute team is also studying how this discovery could help heart attack victims recover.
“When someone has a heart attack, many of their muscle cells die and the heart loses its ability to pump as efficiently, so it compensates by thickening its muscle wall,” says Martinac.
“A therapy that stops this process could be very revealing for people who have a heart attack and prevent long-term deaths after the attack,” he adds.
“Although we are still in the early days of our research, there are similar treatments that show promise for stroke victims, so we are incredibly excited about the potential of our discovery.”
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