February 15, 2013
Story by Greg Kennedy; Photo by Dale Macmillan
EDMONTON — Sharing and helping others is something Ali Shawwa learned to love as a Boy Scout growing up on the Gaza Strip in the 1940s.
Today, he keeps his Scout’s honour alive and well by contributing to heart research and the cardiac health of future Alberta generations.
This upbeat, 72-year-old heart failure patient has experienced it all: heart attack, cardiac arrest, bypass surgery, pacemaker surgery and, most recently, the implant of a state-of-the-art pacemaker/internal defibrillator that regulates and restarts his heart as needed.
Through it all, he credits the care of Alberta Health Services (AHS) for his quality of life — and is giving back as a valued member of the Alberta HEART research team that’s now making significant advances in recognizing and treating diastolic heart failure, the least understood and toughest-to-diagnose form of heart failure.
“I’m not losing anything by taking part in research,” says Shawwa. “I’m gaining information, knowledge and every day I discover something new about my heart. As well, I’ve been able to build an excellent relationship with all my medical team and hear all the latest news about heart failure. I believe in this.”
Diastolic heart failure occurs when the heart fails to fill with enough blood because the heart muscle has become stiff. About 40 per cent of heart failure patients – roughly 32,000 Albertans – have diastolic heart failure but it can only be confirmed through diagnostic imaging exams, such as echocardiography or magnetic resonance imaging (MRI) scans.
Its symptoms – including chest pain, fatigue, weakness and swelling – are similar to those caused by the more common type of heart failure, systolic, which occurs when the heart muscle becomes too weak to pump with enough force.
“There is no well-established diagnostic checklist that says, without a doubt, you have diastolic heart failure. We’re changing that,” says Dr. Jason Dyck, Co-Director of Alberta HEART and a professor in pediatrics at the University of Alberta.
Diastolic heart failure looks like systolic heart failure when you’re examining someone at the bedside, adds Dr. Jonathan Howlett, director of Heart Failure at the Libin Cardiovascular Institute of Alberta and clinical professor of Medicine at the University of Calgary.
“We’re trying to learn more about it so we can identify it earlier, prevent it from happening and treat it when we see it,” says Howlett.
Little previous research has been done on diastolic heart failure because there were no animal models — lab mice with the condition — upon which researchers could test new drugs.
Now Alberta HEART– comprised of 24 scientists and clinicians across the research and health-care spectrum – has succeeded in creating an animal model with diastolic heart dysfunction.
As well, the Alberta HEART team has examined hundreds of Albertans with heart failure, like Shawwa, to develop a comprehensive analysis of risk factors, which could be used to build effective strategies to prevent heart failure before it happens.
The team has also succeeded in isolating biomarkers — genetic and biological substances found in the body that uniquely indicate diastolic heart failure — the crucial first step towards creating a simple blood test to make diagnosis easy.
All of this promises to lead to personalized, more effective treatment plans for diastolic heart failure patients, with therapies that take into account the very different cause of their heart failure.
Researchers hope this work will pave the way for human drug trials in the near future.
“We’re pushing for personalized medicine,” says Dyck. “If we know an individual is at high risk for developing diastolic heart failure, their treatment may be very different than for a patient at high risk of developing systolic heart failure. That’s certainly the direction we’re moving.”
Partners in this five-year project, now entering its fourth year, include Alberta Health Services (AHS), the University of Alberta, the University of Calgary, the Mazankowski Alberta Heart Institute and the Libin Cardiovascular Institute of Alberta, with $5 million funding from Alberta Innovates - Health Solutions.
For his part, Shawwa often meets with research students and lab staff to make friends and to help them put a human face to heart failure, to inspire their efforts. Somewhere down life’s road, he’s also prepared his ultimate gift.
“I’ve donated my body, after I go, to research,” but he hastens to add with a smile, “but I’m in no rush to go, you understand.”
February is Heart Month – the Heart and Stroke Foundation’s key opportunity to reach millions of Canadians to alert them to the risks of heart disease and stroke. Heart disease and stroke take a life every seven minutes; 90 per cent of Canadians have at least one risk factor.
