Uncovering mysteries of the heart
Right-side heart research hopes to cut heart transplants, extend lives
Story and Photo by Greg Kennedy
March 6, 2012, EDMONTON — Over the years the left ventricle has hogged all the limelight in the scientific community — but that’s all changing with the realization that the right ventricle really calls the shots when it comes to preserving lifelong heart health.
Research into the right ventricle — which can thrust a patient into a life-or-death heart transplant scenario if it fails — is now underway at the Mazankowski Alberta Heart Institute, thanks to a $300,000 grant from the University Hospital Foundation.
To date, almost all of the global research effort on heart disease has focused on the heart’s left ventricle, or chamber, which pumps blood throughout the body, and almost none on the right ventricle, which pumps blood to the lungs. This is expected to change as researchers learn more about how common diseases and conditions – such as pulmonary hypertension, or high blood pressure in the lungs – can cause the right ventricle to fail. When this happens, a heart transplant becomes necessary for survival.
A new Alberta Health Services (AHS) multidisciplinary research team — comprised of cardiologists, scientists, clinicians, a biomedical engineer and medical imaging experts — will spend two years studying right ventricular diseases in animals and humans.
“As we start to appreciate the disease process and how it can potentially be used to predict patient survival, we’re gaining a better appreciation for right ventricular disease and how to protect against it,” says cardiothoracic surgeon Dr. Jayan Nagendran. “Our study will be the first to use cutting-edge magnetic resonance imaging (MRI) technology in combination with blood tests to determine if there are substances in the bloodstream that can be used to predict patients at risk of developing weak right ventricles, so we can intervene early and prevent the deterioration.”
Typically, a ventricle can thicken in response to heart disease. Researchers suspect one of the reasons the right ventricle fails more easily than the left is that, as it thickens in response to disease, it cannot generate enough new blood vessels to supply the growing heart muscle.
“A thickened left ventricle can function for decades; a thickened right ventricle for just a few years,” says cardiologist Dr. Evangelos Michelakis, Vice Chair – Research, Department of Medicine, University of Alberta. “This is what it comes down to; when the right ventricle fails, it fails quickly.”
The Mazankowski research team — of which Dr. Nagendran and Dr. Michelakis are members — has twice garnered global attention for their scientific accomplishments: for showing that Viagra is a useful therapy for pulmonary hypertension (2002), and for showing that Viagra can help the right ventricle (2007).
“Dr. Nagendran’s work in showing Viagra is beneficial to the right ventricle is currently the only therapy in the world that can have preferential effects on the right ventricle,” says Dr. Michelakis. “However, its effects are mild. So it helps but it doesn’t solve the problem.”
Other members of the current research team include: Dr. Harald Becher, Dr. Ian Paterson, Dr. Sean McMurtry and biomedical engineer Dr. Richard Thompson.
Gaining greater knowledge about the right ventricle is expected to lead to new therapies that could extend lives, improve quality of life and ultimately reduce the number of patients who require a heart or lung transplant to survive, he adds.
Funding for the Innovative Team Research Grant Competition comes from donors to the University Hospital Foundation. This year, the University Hospital Foundation, in partnership with the Allard Foundation, is providing a total of $1.2 million to fund four interdisciplinary teams through the Innovative Team Research program.
“We are deeply grateful for the tremendous community support that makes this research possible,” says Joyce Mallman Law, President of the University Hospital Foundation. “We are able to fund new and emerging research fields; allowing our physicians to answer questions that have not been asked. This research in particular is a tremendous example of the power of philanthropy to change and save lives by focusing directly on patient outcomes, with a unique perspective.”
The Mazankowski Alberta Heart Institute/University Hospital Foundation Innovative Team Research Grant Competition promotes new research in priority areas. Through a partnership with the University of Alberta’s Faculty of Medicine & Dentistry, proposals are reviewed by leading scientists from Canada and around the world before local grant committee evaluation.
“The University Hospital Foundation should be proud of their investment in research, as their support has helped to put the Mazankowski Alberta Heart Institute on the map. We are proud to partner with them,” says Dr. Verna Yiu, interim Dean, Faculty of Medicine & Dentistry at the University of Alberta.
More than 35,000 patients are treated every year at the Mazankowski Alberta Heart Institute. More than 1,200 open heart surgeries are performed annually.