Novel drug offers hope for heart failure patients

A novel drug is showing promise for alleviating heart failure, a common condition associated with sleep apnoea and a reduced lifespan.

The drug, known as AF-130, was tested in an animal model at Waipapa Taumata Rau, the University of Auckland where researchers found it improved the heart’s ability to pump, but, equally important, prevented sleep apnoea, which itself reduces lifespan (see Nature Communications). “This drug does offer benefit for heart failure, but it’s two for the price of one, in that it’s also relieving the apnoea for which there is currently no drug, only CPAP (a breathing device), which is poorly tolerated,” says Professor Julian Paton, director of the University’s Manaaki Manawa, Centre for Heart Research.

When a person has a heart attack and subsequent heart failure, the brain responds by activating the sympathetic system, the ‘fight or flight’ response, as a way to stimulate the heart to pump blood. However, the brain persists with this activation of the nervous system, even when it is no longer required, and this together with the consequent sleep apnoea, contributes to the patient’s reduced life expectancy. Most patients die within five years of a heart failure diagnosis.

“This study has revealed the first drug to temper the nervous activity from the brain to the heart thereby reversing the heart’s progressive decline in heart failure,” says Professor Paton.

The part of the brain that sends nervous impulses to the heart is also controlling respiration, so this drug has a dual function, reducing the ‘fight or flight’ response while also stimulating breathing to stop the sleep apnoea. “These findings have real potential for improving the wellness and life expectancy of almost 200,000 people living with heart disease in Aotearoa New Zealand,” says Professor Paton.

Another exciting factor for the scientists, who are from the University of Auckland and the University of São Paulo, Brazil, is that the drug is soon to be FDA approved, albeit for a different health issue, paving the way for human trials in the next year or two, Professor Paton says.

“Over recent decades there have been several classes of drugs that have improved the prognosis of heart failure,” says cardiology consultant and Associate Professor, Martin Stiles. "However, none of these drugs work in the way that this new agent does. So it is exciting to see a novel method that potentially reverses some features of heart failure."