Tuesday, November 14, 2006
This week's news article:
Pump, with drugs, can reverse heart failure
Nov 03 (Reuters) - A device that helps severely damaged hearts pump may be able to do what was once thought impossible -- reverse heart failure in people who are weeks away from death, British researchers reported on Wednesday.
The left ventricular assist device, or LVAD, can boost the heart's ability to function, allowing it to recover if used with the right drugs, the researchers said in a study.
Meanwhile, a second study found that statin drugs, already found to lower the risk of heart attack, stroke and other heart conditions, reduced the rate of death from heart failure by 24 percent.
The studies, published in this week's issues of the New England Journal of Medicine and the Journal of the American Medical Association, bring new hope for heart failure -- one of the most devastating chronic heart conditions.
The British team, led by heart surgeon Sir Magdi Yacoub of the Royal Brompton and Harefield Hospital and Dr. Emma Birks of Imperial College London, used the LVAD device and a combination of heart drugs in 15 patients with severe heart failure.
They said 11 of them recovered enough after about a year to have the artificial pump removed.
"I think it's going to surprise a lot of people because most of these patients had really, really severe heart failure," Birks said in a telephone interview.
"Most probably would have died in the next week or two if they hadn't had the device. So to turn that around to normal cardiac function is quite dramatic," she said.
Heart failure affects nearly 5 million Americans and another 550,000 new cases are diagnosed in the United States each year. The condition, which can be caused by high blood pressure, a virus or other factors, severely weakens the heart and causes it to swell.
More than half the people with severe heart failure are dead within two years. Usually, the only cure is a heart transplant.
TAKING ON THE STRESS
The pump -- a device made by Thoratec was used in this study -- is designed to relieve stress on the heart by vigorously pushing blood from the main pumping chamber into the body's main artery. Thoratec helped pay for the study.
The patients also were given a combination of commonly used heart drugs to shrink the heart and rebuild its muscle.
Not everyone survived implantation of the pump long enough to be helped by the drugs. Originally, 27 patients were enrolled in the study but some were excluded because too much of their heart muscle was already dead.
The researchers also excluded patients whose heart failure had been caused by a virus because there was a chance they would have improved on their own.
One of the 11 who had the artificial pump removed died immediately after surgery, a second died of cancer, and a third needed a transplant, possibly because of alcohol problems.
"Of the eight patients surviving without a heart transplant, four are working, two are retired and lead very active lives, one is a mother looking after two children, and one does not work despite a normal exercise capacity," Birks and her colleagues reported.
The therapy is risky and expensive. The chest must be opened up to implant the pump and the price tag for the surgery, including the device itself, is about $124,000.
In the Journal of the American Medical Association study, Alan Go of Kaiser Permanente of Northern California in Oakland and colleagues studied 24,598 adults, of whom half took statin drugs between January of 1996 and December of 2004.
The statins reduced the risk of death by 24 percent, they reported. Statins were designed to lower cholesterol but researchers are finding they have a range of effects on the blood vessels and possibly the heart.
