The national incidence of heart failure hasn’t changed for 30 years. About half of the people whose hearts fail, or become too weak to pump enough blood to support their organs, die within five years of diagnosis. To understand how heart failure arises as a result of uncontrolled high blood pressure, damage to the heart muscle and coronary artery disease, Doug Lewandowski, PhD, director of Cardiovascular Translational Research at Sanford Burnham Prebys Medical Discovery Institute (SBP), and senior principal investigator at the Translational Research Institute for Metabolism and Diabetes (TRI-MD), is leading a new collaboration with cardiologists and thoracic surgeons at Florida Hospital.
“Preclinical studies from our lab and others have outlined key steps in how increased demands on the heart ultimately lead to heart failure,” says Lewandowski. “We know that the failing heart is starved of energy—it becomes less and less efficient at converting fuels to ATP—but we don’t know the molecular details of how this happens in humans. To shed light on the matter, we’re collaborating with clinicians to analyze patient heart tissue. To advance this ongoing work, we’re also developing protocols to assess the metabolic health of heart failure patients to confirm potential therapeutic targets and develop metabolic interventions. “
Lewandowski’s team will analyze tissue samples—heart muscle, adjacent fat, and blood—from patients with heart failure. They will measure levels of metabolic enzymes and fat molecules in both heart muscle and fat tissue to get clarity on the interactions that might contribute to heart failure progression. The overall goal is to confirm that the pathological changes in cardiac metabolism that have been observed in experimental systems also take place in patients.
“Heart failure is seriously debilitating, difficult to manage, and a huge drain on health care resources because people whose hearts are failing end up in the hospital repeatedly,” Lewandowski adds. “Finding effective ways to keep the hearts of patients at risk from developing heart failure would be a major advance for public health.”