Researchers: Diabetes drug helps for weakness of heart08/12/2018
Drug for the treatment of Diabetes, helps for weakness of heart
German researchers were the first to show that a particular Diabetes medication affects the human heart muscle and improves heart function. Now hope that the therapy of the heart was a weakness with preserved pumping function. Currently, there are for this disease, there is no treatment that addresses the causes.
Around two million Germans suffer from heart weakness
According to health experts, chronic heart failure (heart muscle weakness and heart is weakness) in the Western society due to their frequency, mortality, and hospital admission is an increasing challenge. It is associated with a long disease course, a high degree of suffering and poor prognosis for the patients. According to experts, nearly two million people are affected in Germany alone. As a result of this disease, the heart is no longer able to supply the body sufficiently with blood and oxygen. Researchers found that be Concerned might help a Diabetes drug.
What can help those Affected
In the past years, it was repeatedly reported about new approaches to the treatment of heart weakness.
So for example, researchers at the Hannover Medical school (MHH) found that some patients, could help more iron because it makes the heart stronger.
And scientists of the German center for cardiovascular research (DZHK) have shown that a Diabetes drug for those Affected can be of advantage.
The researchers ‘ findings were published in the “European Journal of Heart Failure”.
Drug reduced the death rate
As the DZKH in a communication writes, is approved for the active ingredient Empaglifozin in Germany for the treatment of Diabetes mellitus type II in adults.
In the EMPA-REG OUTCOME study now the effect of Empaglifozin in the case of Diabetes patients, which is also a cardiovascular disease was present.
Surprisingly, the drug is reduced in this study, the mortality rate overall, as well as the number of cardiovascular disease deaths caused by more than 30 percent.
In addition, the number of hospital decreased stays due to heart failure by 35 percent.
These positive effects were already evident after two months, and were for Professor Samuel Sossalla of the University of Göttingen and the University hospital Regensburg reason to assume that something happens directly on the heart muscle and this a closer look.
“Would Empagliflozin act indirectly and secondary risk factors affect the blood pressure or cholesterol values, it would take years to see an effect,” said DZHK-scientists Sossalla.
Researchers worked with explanted heart
According to the figures, Sossalla and his staff have worked with explanted human hearts, the heart failure patients were taken, if you received a donor heart.
More precisely strips which can be thought of as a striking piece of heart in the laboratory, said it prepared Muscle.
“If we treated these cardiac muscle strips with Empagliflozin, improved ability to Relax the heart muscle,” says Dr. Steffen Pabel, a Postdoc in the group of Sossalla.
“The power of the heart, to contract, therefore, its ability, remained the same.” The effect of Empagliflozin on the relaxation ability was independent of whether Diabetes was present or not.
Currently, no causal therapy is available
As the communication explains, is a weakness of the relaxation capacity of the heart in patients with a heart with preserved systolic function is impaired. Half of all heart failure patients suffer weakness, therefore, in this Form of the heart.
The left ventricle is thickened so stiff that it can no longer expand in the so-called diastolic Phase enough and fill with blood.
This oxygen-rich blood is not included in the subsequent contraction of the heart, the systolic Phase, a sufficient in the body.
For this heart weakness, there are currently no therapies that fight the causes of the disease. Drugs can only alleviate the discomfort of the patient.
Effects on the human heart muscle strips
Sossalla focuses his research group on translational projects, so Work that contribute to the results from the lab arrive in the patient.
“Here we have to do it now-in the opposite way,” said Sossalla. “Results from the clinic back to the laboratory in order to understand the observed effect at all.”
The advantage of the in vitro studies, in contrast to clinical studies with patients, for it is clear:
“On isolated heart muscle cells we can see whether the heart muscle is directly affected. Effects on the heart, observed in patients, could be indirect effects.“
The human heart muscle strips observed effect of Empagliflozin were able to confirm the scientists at the heart of mice with and without Diabetes.
Mechanism for the increased relaxation ability of the heart muscle
At the heart with preserved function of the proteins of the heart muscle are weakness to certain contractile significantly less phosphate groups attached, as in a healthy heart.
In their studies of the mechanism of action the researchers were able to show that directly after the administration of Empagliflozin, the phosphorylation exactly these contractile proteins increased significantly.
“This is the first proven effect of Empagliflozin explains why the relaxation ability of the heart muscle to grow again”, said Pabel.
Another possible mechanism for the increased ability to Relax, the change in the concentration of calcium ions in the heart muscle, were able to exclude the experts experimentally.
Because after the administration of Empagliflozin, this concentration in isolated human heart muscle cells did not change.
In so-called stem cells-heart muscle cells that can be cultured for months in the laboratory, wants to find out, the working group now more about the mechanism of action and also about how Empagliflozin works in the long term.
Because up to now you have only observed the acute effect longer than 48 hours isolated heart muscle cells do not survive in the laboratory. (ad)