Reviving Hope: Advances in Myocardial Recovery Therapies

Cardiovascular health has come a long way in the past decades. Heart failure (HF) and heart attacks used to be almost a death sentence for many patients. However, advances in myocardial recovery therapies and several other treatment options have paved a new “path of hope” for patients and their families.

What is Cardiac Regenerative Medicine?

Although cardiac regenerative medicine is still relatively new, it’s progressing fast due to health organizations and medical research institutions gaining insight into how much potential value there is to be had.

The field of cardiac regenerative medicine refers to the study of regenerating the cardiac system and its components, including the heart muscle. It involves looking at the heart as both an organ and a muscle and studying how it can use energy to heal following an injury or stress. There’s even new research that is looking at how stem cell therapies could enhance the cardiovascular system’s natural regenerative abilities.

What is Myocardial Recovery?

Heart failure (HF) is a condition that results from long-term, chronic damage to the heart muscle, which eventually leads to functional deterioration and increased mortality. Over the years, medical professionals have been working to better understand HF and how to promote recovery. The National Institutes of Health Working Group on Advancing the Science of Myocardial Recovery defines cardiac recovery as: “a reversal of the pathological state of the myocardium with significant improvement in cardiac structure and function sufficient to achieve a sustained remission from recurrent heart failure events.” Put simply, myocardial recovery refers to your heart getting significantly better after a heart attack or other damage that may occur.

Heart Regeneration

Heart attacks are the leading cause of HF and mortality in Americans. During and shortly after a heart attack occurs, millions of heart cells die which make it hard for the heart to contract and pump blood to the body. These cells are not replaced as part of the normal healing process, so there’s little help for heart attack patients beyond trying to make the most of the cells that they have left.

It was originally thought that people had all the heart cells they would need for their lives. However, scientists have discovered within the last decade that the heart muscle cells can be replaced, just like other cells in the body. As a result of this, there has been an uptick in research studies investigating how heart muscle cells can be regenerated. Many of these studies are looking at the use of stem cells as a potential solution since the heart appears to use it own stem cells for replacement, too.  

Reverse Remodeling

One of the biggest impacts on the potential for recovery is reverse remodeling. Reverse remodeling refers to a significant improvement in the heart’s function from a therapeutic intervention. The heart can work more effectively because certain procedures or treatments help to improve its pumping function.

What You Can Do

If you or someone you love is suffering from HF or cardiovascular disease, you need to know there is hope. You also need to find a cardiologist who follows the latest news and research so that you know you’re getting the best possible treatment options for your condition. It may also help if you do some research on cardiac recovery for yourself so that you know what to expect, as well as what to ask when working with a cardiac specialist.

Final Thoughts

Although there’s still a long way to go, there is a lot more hope than there used to be for cardiac patients who are diagnosed with heart failure or who have suffered major heart attacks. As studies progress and new discoveries are made, more opportunities for myocardial recovery will present themselves, allowing everyone a chance to get their life back and perhaps even extend it a little longer. Heart failure is a progressive disease that impacts the lives of millions, but with continued research, there’s hope that it can be stopped in its tracks and the heart can recover.

Cardiac Recovery Research at the CVRTI

Several different labs at the Nora Eccles Harrison Cardiovascular Research and Training Institute are very interested in studying myocardial recovery from HF.

Drakos Lab Research on Myocardial Recovery

First, the Drakos lab and clinical research team has identified molecular, cellular, and physiologic features that influence myocardial recovery after circulatory support with assist devices which has altered paradigms in the field and has generated new therapeutic approaches. Following a bedside to bench and back approach Dr. Drakos’ research team has been using myocardial tissue findings from cardiac recovery patients to guide their basic science investigations to inhibit or overactivate these specific targets using small and large animal models. With this specific approach Dr Drakos’ research identified novel therapeutic targets for myocardial recovery: (a) MCT4 inhibition, (b) VDAC2 activation and (c) AEBP1 inhibition.

Selzman Lab Research on Myocardial Recovery

Next, the Selzman lab is interested in developing “real-world” therapies to be able to help the heart recover following injury. They have very interesting data to suggest that the use of amniotic fluid (“Mother Nature’s Cocktail)” is beneficial to the heart muscle after injury. The Shaw lab has been working on defining the paradigm of Targeted Delivery which describes how the cytoskeleton delivers membrane proteins directly to their functional membrane subdomain and why there is less delivery in failing hearts. In the process, the Lab discovered and named a new protein: cBIN1. This protein has a fundamental role in organizing the internal architecture of heart muscle cells and has important translational implications in the treatment of chronic heart failure to achieve myocardial recovery (cBIN1).

Shaw & Hong Lab’s Research on Myocardial Recovery

The Shaw and Hong labs have together developed a gene therapy for cBIN1 that may prove extremely favorable to HF patients. Furthermore, in the clinical research arena Drs. Drakos, Selzman and others have led in the field of myocardial recovery several studies. They published structure-function studies characterizing in detail the impact of mechanical unloading on reverse cardiac remodeling. Furthermore, they identified practical clinical predictors, including left ventricular torsion, circulating TNFα and IFNγ and myocardial microstructural changes, that effectively guide heart failure patient selection prior to guide the most appropriate therapeutic interventions.

CVRTI & The UCAR Program

Altogether, this body of work led to the establishment of the award-winning Utah Cardiac Recovery Program (UCAR) which is currently considered one of the leading programs in the field nationally and internationally. The cutting-edge research that is conducted at the CVRTI surrounding myocardial recovery and cardiac regeneration will pave the way for future therapies to reduce mortality rates and improve the quality of life for the greater HF community.