New hope for broken hearts
December 10, 2015
Cardiovascular diseases are among the most frequent causes of death worldwide. The ability to repair a damaged heart is one of the grand visions of medical science. Cardiac regeneration is possible in fish and in newborn mice. But so far it has not been known whether human hearts can regenerate as well. Scientists at IMBA – Institute of Molecular Biotechnology of the Austrian Academy of Sciences in Vienna and the Innsbruck Medical University have described the first complete clinical and functional repair of a human heart following an acute heart attack in an infant. This astonishing discovery nourishes hope that cardiac repair in humans might be possible in the future.
The scientists report the case of a newborn that had suffered a massive heart attack in the first hours of life. It was caused by a blockage in a vital coronary vessel. “The baby's heart was severely damaged. Astonishingly, the baby recovered very quickly,” said Bernhard Haubner, a cardiologist and researcher, and his colleague, Johanna Schneider, in an article just published in the journal “Circulation Research”.
“One and one-half months after his severe illness, we were able to release the child. His heart is functioning normally. This observation proves for the first time that the human heart can fully recover after suffering massive damage,” said Jörg-Ingolf Stein, head of pediatric cardiology at the Innsbruck Medical University. “This discovery has enormous potential. After all, cardiovascular diseases are among the most frequent causes of death worldwide”.
Each year, 17 million people around the world die of cardiovascular diseases, 2 million of them in the EU alone (WHO). Even though medical care for cardiac patients has improved tremendously and the immediate fatality rate has dropped, most patients still face permanent damage leading to chronic heart failure. During a heart attack, cardiac muscle cells die and are replaced by scar tissue. But scar tissue cannot pump, which leads to limitations in cardiac function and a weakening of the heart muscle. So far, heart muscle cells lost in adults cannot be efficiently regenerated despite innovative approaches such as stem cell therapy.
Researchers already know from the animal research that lifelong regeneration of the heart is possible, for example in fish. “Along with a group from Texas, we were the first to describe complete cardiac regeneration following myocardial infarction in mice. But that only works if the mice are one week old or less,” explained Bernhard Haubner, a clinician scientist working with IMBA director Josef Penninger. “To translate findings in model organisms such as mice into future therapies in humans, two key issues remain: what are the mechanisms and can cardiac regeneration indeed occur in humans? The latter we now observed, namely complete cardiac repair in a newborn human.”
IMBA director Josef Penninger emphasizes the significance of this finding: “Every cardiologist dreams of being able to restore full function to a damaged heart, and now we have seen that this works in principle in humans. If we can figure out the key mechanisms that control cardiac repair in mice and other organisms, we might be also able to repair damaged heart muscle in humans in the future.”
Title of the original publication:
“Functional recovery of a human neonatal heart after severe myocardial infarction”. Haubner, B. et al. 2015. Circulation Research.
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Mag. Evelyn Devuyst, MAS
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