The Enigma of Heart Health - Who are the “Some” that Heart Disease affects?

Why is it that some people die from heart disease while others don’t?

More to the point, why is it that some people who smoke cigarettes, are diabetic, and have high cholesterol are free from one of the biggest killers in the world – and others who stay fit and eat healthily die from heart attacks?

That’s the question that Dr. Einat Shaked, a senior cardiologist at Samson Assuta Ashdod Hospital, and a team of researchers sought to answer.

Their research paper, “Identification of protective biologic factors in patients with high cardiovascular risk, but normal coronary arteries,” published in the journal Coronary Artery Disease, zeroed in on one possible difference between the two populations.

Stem cells called endothelial progenitor cells (EPC) function better in individuals who, despite numerous risk factors, do not develop cardiovascular disease. EPCs circulate in the blood and have an important role in renewing and repairing the damaged walls of blood vessels.

Dr. Shaked, along with a team led by Dr. (and Professor) Eli Lev, the head of the cardiology department at Assuta Ashdod, also found that EPCs in these individuals had longer telomeres, a measure of a cell’s health and lifespan.

“We found that EPCs are a potential protective mechanism in this population, a factor that could protect them from the development of heart disease,” Dr. Shaked said. “Our research contributes to a deeper understanding of atherosclerosis and will allow us to both treat the condition and ultimately, prevent heart disease.”

Small cohort, limited conclusions

To target this population with higher functioning EPCs, Dr. Shaked reviewed CT scans of patients who had visited the hospital with symptoms of heart disease but who nonetheless had healthy arteries.

These patients also possessed one of a number of risk factors, including high cholesterol, diabetes, obesity, and tobacco use. But, to the surprise of the researchers, blood tests found that their chance of developing heart disease was lower than that of a person with lower-functioning EPCs.

A total of 24 people were studied, a small cohort that prevents the researchers from drawing definitive conclusions about the role of EPCs and heart health. Dr. Shaked was indeed encouraged by the results and is planning to further pursue this research.

“We can’t draw major conclusions, but it’s an interesting finding,” Dr. Shaked said. “We need to study a larger population to make a stronger hypothesis and possibly develop remedies that will help prevent and treat heart disease.”