Understanding Heart Failure: Insights from Cardiologist Gustav Smith

Heart and vascular diseases continue to be the leading causes of death in Sweden, with heart failure standing out as a significant concern. Researcher and cardiologist Gustav Smith explains that heart failure represents the end stage of various heart diseases, resulting in the heart's incapacity to pump enough blood to meet the body's oxygen and nutrient demands. This debilitating condition often results in a reduced quality of life and frequent hospital visits. Common symptoms of heart failure include fatigue, shortness of breath during rest, and swelling in the legs. While the onset of heart failure can be gradual, it can also occur acutely, presenting severe shortness of breath and anxiety, which can be life-threatening. "The risk of developing heart failure increases with age," notes Smith, "with approximately one in ten individuals over the age of 80 living with the condition. The prognosis is alarming as it is often worse than that of many cancers." Although older patients are predominantly affected, younger individuals are not immune, with genetic factors playing a substantial role in the latter group. A study from Framingham indicates that about 25 percent of the population will experience heart failure at some point in their lives—making it a considerable public health issue. The pathophysiology of heart failure is multifactorial, with interconnected factors ultimately compromising the heart's ability to pump effectively throughout the body. Common risk factors identified on a population level include high blood pressure and coronary artery disease. However, given the complex interplay of various factors affecting heart muscle function, finding a definitive cure remains elusive. Treatment traditionally focuses on alleviating the symptoms of heart failure rather than addressing its root causes. "We have a wide array of treatments available that can relieve the heart's burden. Many patients are prescribed diuretics to eliminate excess fluid that can accumulate due to slow blood circulation," says Smith. While some individuals experience significant relief, most require lifelong treatment with no cure in sight. Smith's commitment to understanding heart failure has led to groundbreaking research that earned him the Prince Daniel's Grant from the Heart-Lung Foundation in 2016. His focus is on genetic methods aimed at uncovering the causes of heart failure. "Conducting research in this field can often feel like searching for a needle in a haystack. However, advances in technology now allow us to study the entire genome simultaneously, helping us identify signals that might indicate the causes of various diseases, including heart failure that manifests later in life. Genetics undeniably play a role and can point us toward new mechanisms and treatment targets." Looking ahead, Smith expresses hope for the potential to prevent heart failure entirely. His research group has conducted extensive studies through international collaborations, with promising results set to be published later this year. "We have identified specific inflammatory mediators in the heart that exacerbate inflammation and can hinder healing processes. We are carefully mapping these in the lab, having found a specific biomarker that shows great promise. There is already an approved medication targeting this marker, and I look forward to trials where we see if heart failure patients improve with it." The ultimate aim of Smith's research is to pinpoint individuals who possess heightened activity in certain genetic signaling pathways, putting them at imminent risk for heart failure. The identification of these individuals would allow for tailored preventive strategies, significantly altering the trajectory of heart diseases for many. However, the pursuit of this vital research is contingent upon financial backing. The Heart-Lung Foundation, predominantly reliant on private donations, has been essential for advancing Smith's work. "As researchers, we don’t have products to sell or a means to generate revenue. I am deeply grateful for the donations that have fueled our progress, without which much of our current research would not be possible," concludes Smith. Related Sources: • Source 1 • Source 2