local cooling of the heart

[News Report | Author: Catharina Hospital]

For the first time in history, cardiologists successfully managed the local cooling of a human heart during a coronary infarction. Cooling part of the heart before and after percutaneous angioplasty can limit the damage caused by a coronary infarction and significantly improve the patient’s health, according to the cardiologists.

The innovative procedure, performed at Catharina Hospital, was developed together with scientists of Technische Universiteit Eindhoven (TU/e) and LifeTec Group in Eindhoven.

“We were able to demonstrate in 10 patients that it is technically feasible to cool the heart locally, and safely, during a coronary infarction,” says cardiologist/intensivist Luuk Otterspoor, who obtained his PhD on 11 January based on this study. The study was supervised by Nico Pijls MD, PhD, of Catharina Cardiovascular Centre. 

Collision on the sports field

Otterspoor explains: “Compare it to icing a knee after a collision on the sports field, for example. The knee will start to swell because there’s an immediate inflammatory reaction. So in order to prevent the swelling, the muscles are cooled as quickly as possible. We use this same principle for the heart muscle. By cooling the part of the heart that’s affected by a blocked or narrowed coronary artery, we limit the damage to the heart muscle once the artery is opened up again. We believe this can reduce the severity of the heart infarction and the damage to the heart muscle by 20 to 30%.”

Luuk Otterspoor
Tissue damage after percutaneous angioplasty

In patients suffering an acute myocardial infarction, part of the heart muscle tissue may die. For this reason the blockage of the coronary artery is opened up as quickly as possible with a percutaneous angioplasty procedure. But as soon as the blood starts to flow again, it causes extra damage to the heart muscle. The cells in the heart muscle swell up and the pressure closes off the capillaries, which causes irreversible damage. Otterspoor: “With our new method we try to limit that extra damage, the so-called reperfusion injury. International studies on animal hearts proved that cooling works, but so far it was not yet possible to try local cooling of a human heart.”

Cardiologists at Catharina Cardiovascular Centre lower the local temperature of the heart 4 to 5 degrees by injecting a fluid into the coronary artery just beyond the blockage. The affected part of the heart is then cooled for 10 minutes. Then the coronary artery is opened up with the use of a small balloon, allowing the blood to flow to the affected part of the heart again. Otterspoor: “We then cool the heart for another 10 minutes, and after that we place a stent in the narrowed section of the artery.” 

Heart failure

Ten patients received the new treatment and the method proved to be safe, technically feasible and practicable. In the new treatment, the blocked coronary artery is kept closed for ten minutes longer. “It means the patient feels pressure on the chest for an extra ten minutes, but this is compensated by the increased health benefits in the longer run.” The cardiologists expect the new method to increase the chances of survival for people suffering a heart attack. The method may also lead to fewer repeats of heart failure for cardiac patients, a complication that sometimes occurs after a first heart infarction. 

Cardiac Cooling Thermocam image | Source: LifeTec Group

European study

Catharina Cardiovascular Centre intends to start up a large-scale European follow-up to further test the effectiveness of the method and to more accurately establish the benefits to be gained by local cooling of the heart. The study will be done in six large European cardiovascular centres. Besides Catharina Cardiovascular Centre they are the heart centres in Aalst (Belgium), Glasgow (UK), Copenhagen (Denmark), Orebro (Sweden) and Budapest (Hungary).

A group of 100 patients will undergo the new treatment over the next few months. It will be a so-called randomized controlled trial in which the group is compared to 100 other patients who receive traditional percutaneous angioplasty treatments. Otterspoor: “We expect to have some hard figures on the health benefits of this new way of working in three years’ time.”

- End of news report - 

Members of the involved LifeTec Group R&D team:

Head of MedTech Innovation

Marco Stijnen

Senior Research Engineer

Sjoerd van Tuijl

Preclinical study:

PhysioHeart™, the 'beating heart platform', used for the preclinical study [link]

(PhysioHeart™ uses slaughterhouse materials. No animals were harmed for these experiments)

Relevant links and Background:

 

- PhysioHeart™: the 'beating heart platform', used for the preclinical study [link]

- LifeTec Group, Preclinical Contract Research (PCRO) [link]

- Link to published article (euroPCR) [link]

- Catharina Hospital [link]

- Eindhoven University of Technology [link]

- Volkskrant (Dutch national newspaper) [link]

- Eindhovens Dagblad (Eindhoven regional newspaper) [link]

Media Relations, Catharina Hospital

Roel Rambags +31 (0)40 239 84 92

mediarelaties@catharinaziekenhuis.nl

 

Media Relations, LifeTec Group

Toine Nagel +31 (0)40 298 93 93

info@lifetecgroup.com 

 

Media Relations, TU/e

Ivo Jongsma +31 (0)40 247 21 10

i.l.a.jongsma@tue.nl

 

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