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Study led by Dalhousie researcher may revolutionize how doctors and health professionals monitor and treat heart patients
(New Brunswick) – Game-changing research by Dr. Keith Brunt at Dalhousie Medicine New Brunswick (DMNB) and Dr. Jeremy Simpson with the University of Guelph will revolutionize how doctors and other health professionals monitor heart patient symptoms related to breathing.
“Translating our basic science to the clinic and clinical problems back to scientists is the only way to make healthcare better, the return on investing well in all areas of science is critical to teams like ours to find success and improve patients’ lives,” says Dr. Brunt.
The pioneering duo are both early career scientists. Together they have discovered that hormones from the heart and kidney travel to the brain to confuse those areas of the brain that regulate breathing, consequently forcing the muscles we use to breath to work harder. The consequence? Shortness of breath – a phenomena known as “air hunger,” and suffered mostly by patients with heart conditions.
“We’ve been pharmacologically managing heart failure and hypertension well for 30 years but did not know about the role the hormones have on the brain in creating breathlessness and what that would mean for heart patients,” explains Dr. Brunt. “We also didn’t realize the secondary effect of air-hunger actually occurs much sooner than the physical changes in the lungs.”
This new finding has been published in the internationally recognized and prestigious journal, Science Translational Medicine. This is the first publication in this preeminent international medical journal for the University of Guelph and the second for Dalhousie University and marks the first all-Canadian research team from both Universities. The research article titled, Central acting therapeutics alleviate respiratory weakness caused by heart-failure induced ventilatory overdrive, was published and is available online today, May 17.
The seven year study focusses on the first instance in which breathlessness could be identified in an experimental model. They examined what happens, when it happens, why it happens and what can be done to treat it using an experimental model of hypertensive heart failure.
The first two years of research was smooth. However, what they initially expected to be a physical explanation for breathlessness was disproven by their own findings. “Confirmatory experiments failed and we had to figure out why. This led us, eventually, towards the brain,” explains Dr. Simpson.
The kidneys send signals‑hormones (angiotensin and norepinephrine)‑throughout the body including the brain as the heart develops trouble pumping enough blood. The signals are to request more blood, making the heart pump harder and the respiratory muscles to work harder than they should. The problem occurs when the respiratory muscles don’t get a break. This leads to atrophy of the respiratory muscles, which results in inefficient productivity that in turn would make patients breathless.
Dr. Brunt & Dr. Simpson are continuing this research with cardiologists and respirologists at the New Brunswick Heart Centre to monitor patients with hypertension and heart failure in a clinical study that to better understand how to ensure the right patients, get the right drugs, at the right time.
“Fortunately, the drugs that stopped respiratory weakness are already on the market, which means they can start being used today,” Dr. Brunt adds. “We don’t have to wait for the development and testing of new drugs that could take years or decades to help patients – physicians can begin using this information in the art-of-medicine today.”
“Basically these findings could mean an improved quality of life for patients living with hypertension and developing heart failure. It’s not just heart patients we are interested in, but we are also looking at how similar mechanisms may be operating in other diseases (like sleep apnea and COPD),” says Dr. Simpson.
For more information on these findings, visit Dal News: Making breathing easier for heart patients.
Dalhousie Medicine New Brunswick
1 (506) 636-6279
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