Funding “Mother Nature’s Bypass”

A new $435,371 award from the National Heart, Lung and Blood Institute of the National Institutes of Health will fuel the next stage of investigation as researchers on two continents seek a way to help prevent heart attacks in people with ischemic heart disease—without performing bypass surgery.

For years, William Chilian, Ph.D., Chair of Integrative Medical Science and professor of physiology at Northeast Ohio Medical University, has collaborated with the University of Amsterdam. A few years ago, this partnership evolved with Dr. Chilian providing support (as a collaborating investigator) to develop a new technology that not only enables three-dimensional reconstruction of the heart, but simultaneously tracks the locations of certain types of cells. This innovative technology, called a 3D Cryomicrotome, was developed by Maria Siebes, Ph.D., an associate professor at the University of Amsterdam.

Ischemic heart disease occurs when a patient has insufficient blood flow to the heart, due to a blockage in a large artery.  Often a preventive surgery known as bypass surgery is recommended to alleviate the blockage, but Dr. Chilian is looking for another solution. A process called coronary collateral growth can provide what Dr. Chilian calls “Mother Nature’s bypass,” by allowing blood flow to the area from a different source–thus mitigating the need for bypass surgery.

“When a patient has well-developed collateral circulation, their risk of sudden death or size of heart attack decreases,” says Dr. Chilian.

He will collaborate with Liya Yin, M.D., Ph.D., associate professor of integrative medicine, on the grant-funded project “What Mechanisms Underlie Coronary Collateral Growth?” Vahagn Ohanyan, M.D., Ph.D., assistant professor of integrative medical science; and Feng Dong Ph.D., associate professor of integrative medical science, are members of the research team.

New Equipment Opens Research Doors

The University of Amsterdam is a key partner in the project, as the only institution in the world with a three-dimensional fluorescence cryomicro-tomograph (known as a 3D Cryomicrotome). The equipment allows a researcher to take images of thin slices of the heart and build them into a 3D model that tracks the bone marrow cells. These cells are a potent weapon, since they can potentially improve circulation to the extent that a person with ischemic heart disease could avoid the operating room.

The researchers are studying how bone marrow cells become a part of the heart (such as the blood vessel or muscle) and how the heart lets the body know it is ischemic. This latter process is critical for the homing of the bone marrow stem cells to the site of injury in the heart.

“By better understanding the mechanism, we hope to amplify it and determine exactly what types of stem cells are needed to stimulate coronary collateral growth,” says Dr. Chilian.  “Most studies just re-inject the bone marrow cells into the body, but by knowing which cell to focus on, we can be far more effective in preventing heart attacks in the future.”