Top 10 Advances in 2004

Posted: Feb. 1, 2005

The first implantable artificial heart and a drug that dramatically improves survival in African American heart failure patients are among the top 10 research advances in heart disease and stroke in 2004, according to the American Heart Association. Here is the complete list.

1. First implantable artificial heart approved. The United States Food and Drug Administration (FDA) approved the first implantable artificial heart, which keeps heart failure patients alive until they can receive a transplant.
The CardioWest Total Artificial Heart takes over a patient’s failing ventricles, the heart’s lower two pumping chambers and all cardiac valves.

2. Nitric oxide-boosting drug improves heart failure survival among African Americans. Adding the experimental drug BiDil to standard therapy dramatically improved survival, according to the first major trial to test a drug only in Africans Americans.

3. One-two punch opens blocked brain vessels faster. By itself, tissue plasminogen activator (tPA) effectively dissolves clots that can cause an acute ischemic stroke. But using ultrasonography via continuous transcranial Doppler, in combination with tPA, improves the drug’s clot-busting abilities.

4. Less invasive technique as effective as surgery for stroke prevention. Patients at high risk of stroke due to fatty blockages in the arteries leading to the brain can benefit from a refined angioplasty procedure.

Stents can jab against the walls of the blood vessels, causing fatty debris to break off and enter the bloodstream. If the debris travels to and lodges in a blood vessel to the brain, the result can be a stroke.

The new technique circumvents that problem by using a small filter that catches loose bits of plaque before they have a chance to migrate to the brain.

5. Artificial blood vessels work like the real thing. Researchers reported that this year they were able to create long-lasting functional blood vessels by implanting two types of cells into a collagen gel, and then implanting them into mice.

The blood vessels created by this technique had greater stability and formed long, branching tubes that connected with the mice’s own blood vessels.

6. Public defibrillators a lifesaver for cardiac arrest victims. Training volunteers to use defibrillators distributed in shopping malls, sports venues and other public places can double the survival rate of cardiac arrest victims, researchers reported in 2004.

The results are so encouraging that they are expected to jumpstart efforts to get more defibrillators in public spaces and additional volunteers trained.

7. Preventing birth defects — in the womb. Researchers reported that they can identify infants at high risk of a serious heart defect and then correct the problem — while the fetus is still in the womb.

The researchers studied 24 babies at risk of hypoplastic left heart syndrome (HLHS) due to the narrowing of the aortic valve that makes it hard for the heart to pump blood to the rest of the body.

While the researchers must wait and see if the procedure results in normal heart function and anatomy at birth, the opportunity to save babies identified in utero as being at high risk of heart defects will be one of the most exciting fields in congenital heart disease in the coming years, specialists said.

8. Genetic screening for heart disease a step closer to reality. Last year, researchers uncovered three new mutations in MEF2A, the same gene they directly linked to heart attacks in 2003.

The MEF2A gene plays a role in protecting artery walls from building up plaque that can impede blood flow and lead to heart attacks.

The results suggest that nearly 2 percent of people with coronary artery disease — the equivalent of hundreds of thousands of Americans — may carry a MEF2A mutation.

9. Human heart, repair thyself. In 2002, the field of heart medicine received a shock when researchers reported that the human heart can generate new muscle cells. Last year, scientists took the work a step further, reporting that the human heart contains stem cells that can generate muscle cells and other cells — moreover; these cardiac stem cells can regenerate heart tissue after a heart attack.

10. One drug tackles two harmful habits. Researchers reported that rimonabant, the diet drug, packs a double whammy against obesity and smoking.

In one study of 787 smokers who failed in previous attempts to quit smoking, 28 percent kicked the habit for at least a month, compared with 16 percent on placebo.

The pill, which will be sold under the brand name Acomplia, attacks addictive behavior by blocking a pleasure center in the brain. Manufacturer Sanofi-Aventis hopes to apply for Food and Drug Administration approval in 2005.

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