Medicine and Healthcare
For the Heart to Work Well
New Study Investigates Drug Treatment for Heart Failure
Scientific name of the study
Drug treatment for heart failure in systemic right ventricles: A retrospective analysis from the National Register for Congenital Heart Defects
Which drugs are used to treat heart failure in patients whose right heart chamber has to take over the function of the left heart chamber in Germany? We will investigate this in a large study that is based on the nationwide data collection of the National Register.
There is sound evidence for drug treatment for heart failure in patients with a limited function of the left heart chamber. However, there is no sufficient evidence for this kind of treatment in patients whose right heart chamber has to take over the function of the left heart chamber. With our study we aim to close this research gap in order to treat patients with TGA after atrial switch surgery and patients with congenitally corrected TGA with an individual-based approach. In doing so, we strive to achieve optimal medical care for these patients.
When the Right Heart Chamber Becomes the Systemic Chamber
Our blood circulation consists of the pulmonary circulation and the systemic circulation. In the pulmonary circulation, deoxygenated blood is pumped from the right heart chamber into the lung with relatively low pressure for oxygenation. By means of the heavily muscled left heart chamber, also referred to as systemic chamber, the oxygenated blood is then transported into the systemic circulation with high pressure. However, in the case of TGA after atrial switch surgery, as well as the so-called congenitally corrected TGA, the right heart chamber has to take over the function of the chamber that is usually the main chamber in the systemic circulation. Medical experts refer to such cases as a “systemic right ventricle”.
Are the Research Findings Transferable?
Other than in the left heart chamber, the muscles of the right heart chamber are not designed to pump that much. Accordingly, the unfamiliar stress ends up having an impact on the pump function. This leads to heart failure. Large-scale studies showed that drug treatment for heart failure is highly effective in cases where the function of the left heart chamber acting as systemic heart chamber is limited. The data of many patients were examined and analyzed at random. Can, however, the findings be transferred to the drug treatment in weakened right heart chambers that act as systemic chambers?
More Specific Prevention
We are finally able to investigate this question thoroughly. Thanks to the National Register, we have sufficient donated data by now to accurately determine the course of the primary disease in individual patients over a longer time period and depending on the treatment strategy used. We will compare the results within the scope of a cross-sectional analysis. In this way, we can also identify single factors that are associated with a later occurrence of heart failure. In a next step, this allows exact predictions regarding the long-term outcome of the heart health of patients with systemic right ventricle in connection with different treatment strategies. This will help us to identify the most suitable measure for each patient. In addition it allows an even more specific prevention.
In charge of the project:
Corinna Lebherz is a cardiologist with an additional qualification in ACHD and a senior physician at the Klinik für Kardiologie, Angiologie und Internistische Intensivmedizin (Med. Klinik I) at Uniklinik RWTH Aachen. More
Corinna Lebherz studied human medicine at the Hannover Medical School (MHH). She completed her residency training in internal medicine and cardiology at Klinikum Großhadern at Ludwig-Maximilians-Universität München (LMU Munich). As a postdoctoral fellow at the University of Pennsylvania School of Medicine (Philadelphia) over a period of three years, she acquired extensive knowledge in the basic sciences. As a certified ACHD cardiologist, she acts as a senior physician at the Department of Cardiology at the university hospital of Aachen. Corinna Lebherz has an additional qualification in subject-specific genetic counseling. Her clinical focus is on the treatment of patients with congenital heart disease.