Understanding heart failure and developing innovative therapies

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Approximately 60 million patients worldwide suffer from chronic heart failure – a disease which in its advanced stages is associated with a rather limited life expectancy that is actually shorter than with many types of cancer. Chronic heart failure is a clinical syndrome involving not only the heart, but numerous other organ systems, especially the lung. In its recently published position paper, the European Society of Cardiology (ESC) gives an overview of interactions between the heart and other organ systems, clinical findings and underlying mechanisms and calls for more experimental research and the development of appropriate disease models to help understand the individual molecular mechanisms underlying heart failure. Through research based on models of cardiopulmonary diseases, researchers at the Fraunhofer Institute for Toxicology and Experimental Medicine ITEM want to contribute to the development of new therapies.

© Fraunhofer ITEM, Ralf Mohr
Living slices from human tissue samples are particularly useful to address translational research questions.

Chronic heart failure is a condition in which the heart is no longer able to supply the organism with sufficient blood and thus with the oxygen that is essential for life. This leads to typical symptoms such as breathlessness during physical activity, abnormal sleepiness with reduced exercise tolerance, and peripheral edema, for example, severely swollen legs. The broad range of symptoms suggests that this disease is a syndrome involving multiple organ systems. Lung diseases in particular, such as chronic obstructive pulmonary disease (COPD), are closely linked to heart failure. There is also a strong relationship between respiratory exposure to cigarette smoke, airborne particulate pollutants or pathogens and cardiovascular morbidity and mortality. The pathological interplay between the heart and lungs is complex, both organs influence each other and there are no targeted therapies available at present.

“To get a better understanding of the interplay between the two organ systems heart and lungs and to detect new treatment options, we use human disease models for our research at Fraunhofer ITEM,” says Prof. Thomas Thum, Director of Fraunhofer ITEM. He is chairman of the ESC Working Group Myocardial Function and main author of the position paper. In his research, Thum has used human cardiac tissue for several years. In ex-vivo tissue sections, he studies for example the function and intercellular interactions of cardiomyocytes and other cell types. According to Thum, however, further research is needed to also investigate interorgan interactions. “At Fraunhofer ITEM, we successfully use an ex-vivo model of the lung – human precision-cut lung slices – for preclinical investigations, among other things to test new candidate drugs for safety and efficacy,” says Thum. In his opinion, this is an important key to understanding mutual relationships between organs.

Click here to read the ESC position paper: https://academic.oup.com/cardiovascres/article/117/12/2416/6105178?login=true