Study identifies a root cause of chronic heart failure after a heart attack

Study identifies a root cause of chronic heart failure after a heart attack

A multi-institutional study led by Dr. Rohan Dharmakumar of the Indiana University School of Medicine has found that iron drives the formation of fatty tissue in the heart and leads to chronic heart failure in about fifty percent of heart attack survivors. The discovery, recently published in Nature Communications, paves the way for treatments that have the potential to prevent heart failure in nearly half a million people per year in the United States and many millions more worldwide.

For the first time, we have identified a root cause of chronic heart failure after a heart attack.”

Rohan Dharmakumar, PhD, Indiana University School of Medicine

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Dharmakumar is executive director of IU's Krannert Cardiovascular Research Center and associate director for research at the Cardiovascular Institute, a joint venture between the IU School of Medicine and IU Health.

“While advances across all populations have made heart attack survival possible for most, too many survivors suffer long-term complications such as heart failure,” said Subha Raman, MD, medical director of the Cardiovascular Institute. "Dr. Dharmakumar's groundbreaking science reveals who is at risk and why, and provides an effective way to prevent these complications."

The multimillion-dollar study, which involved staff from institutions in the United States and Canada, followed large animal models for six months. It turns out that in heart attacks that cause bleeding in the heart muscle - which accounts for about half of them - scar tissue is slowly replaced by fat. Fatty tissue cannot effectively push blood out of the heart, and this leads to heart failure and eventual death in many hemorrhagic heart attack survivors, Dharmakumar said.

“Using noninvasive imaging, histology and molecular biology techniques, as well as various other technologies, we have shown that iron from red blood cells drives this process,” he explained. "When we removed the iron, we reduced the amount of fat in the heart muscle. This finding opens an avenue for clinical investigation to resolve or mitigate iron-related effects in patients with hemorrhagic myocardial infarction."

Dharmakumar's team is currently testing iron chelation therapy in a just-launched clinical trial to do just that.

“Thanks to an ongoing clinical trial led by his team at Indiana University, I am pleased to see this treatment improving the lives of millions of heart attack survivors worldwide,” said Raman.

Source:

Indiana University School of Medicine

Reference:

Cokic, I., et al. (2022) Intramyocardial hemorrhage drives fatty degeneration of the infarcted myocardium. Nature communication. doi.org/10.1038/s41467-022-33776-x.

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