Right now, there are more than 3,000 people in the US hoping for a life-saving heart transplant. With long waiting lists, there is great emphasis on finding more transplant donors and creating artificial hearts to keep up with the demands of those in need of a heart procedure.
But what if there was another option for heart patients besides a transplant or an artificial heart? What if drugs were available to help the heart repair itself so patients didn’t need to look for donors or seek permanent artificial hearts?
Thousands of lives could be dramatically changed, said Stavros Drakos, MD, PhD, a cardiologist and assistant professor of internal medicine at the University of Utah, who researches how drugs can help to treat heart conditions.
This month, Drakos received a $486,000 grant from the Doris Duke Charitable Foundation to further advance his work and move closer to developing a framework for drugs that could change the need for transplant donors and artificial hearts in the future.
Drakos is studying heart failure patients who have mechanical assist devices implanted in their hearts while waiting for heart transplants. The devices are designed to work as small artificial hearts and perfuse the patient’s body until a donor heart becomes available. At the same time, these devices unload, or de-stress, the failing heart and a small number of patients with the devices actually recover their heart function and no longer require a heart transplant.
These observations directly challenge the classic view that the human heart has limited ability to recover and restore itself. Drakos studies the unique biology of these humans with remarkable recovery capacities to understand the human heart’s potential to recover.
"If we find out about the mechanisms driving this phenomenon, then we can aid in recovery by giving drugs to help activate them," Drakos said. "But first we need to uncover the secrets of cardiac recovery, and that’s what we’re doing here."
Drakos started his career in cardiovascular medicine while he was a fifth-year medical student at the University of Athens, Greece and continued his studies while performing his post-doctoral studies at the University of Utah and Utah Transplantation Affiliated Hospitals Cardiac Transplant Program from 2001 until 2003. He became faculty at the University of Utah in 2009 and is now the medical director of the Cardiac Mechanical Support Program.
The University of Utah and the University of Athens have developed a working relationship and have been partnering on research and training since the 1960s, Drakos said. The University of Utah has been a pioneer in cardiovascular research for more than four decades, particularly in developing artificial heart technologies.
"Heart failure is an epidemic and it affects 2 to 3 percent of Americans and Europeans. And with an aging population, it’s increasing in prevalence," he said. "It breaks the bank right now in every hospital in the world. The US spends more than $32 billion each year on heart failure-related care."
Drakos said he was drawn to the University of Utah because it emphasizes both the clinical and research aspects of cardiovascular medicine.
"We need to have a conversation between the bench, or the lab, and the clinic, and that’s the central premise of this work," Drakos said. "Utah is the place to do this research. We have the strength clinically – the program here is huge – and we have the strength on the lab side. The level of collaboration here in Utah is what makes this all possible. You cannot find this in other places." Drakos said the research is being performed through a unique collaboration between University of Utah Health, Intermountain Healthcare and Veterans Affairs Medical Center. Without the collaboration of colleagues Josef Stehlik and Craig Selzman, from University of Utah Health and Veterans Affairs Medical Center, Abdallah Kfoury and Dale Renlund, from Intermountain Healthcare, and Jared Rutter, Dale Abel and Dean Li, from University of Utah Basic Sciences Services, the research and grant would not be possible, Drakos noted.
The Doris Duke Foundation received 292 eligible proposals, which were reviewed by a panel of experts and narrowed down to the strongest 16 candidates for funding. These grants are not specific to cardiovascular disease, but this year Drakos was the only award recipient studying heart disease.
This is the second consecutive year a University of Utah faculty member has been awarded the Clinical Scientist Development Award from the Doris Duke Charitable Foundation. Last year, Cammon Arrington, MD, PhD, was awarded a similar grant to study congenital heart disease. Arrington is a pediatric cardiologist and science researcher.