Researchers at Nepean Hospital are improving the health outcomes of patients experiencing severe heart attacks, with a new treatment helping to salvage heart muscle and give survivors of heart attacks better heart function and recovery.
Heart attacks occur when a blocked heart artery prevents blood supply to the heart muscle. One of the most life-threatening forms of heart attack is a ST- elevation myocardial infarction - commonly known as STEMI - and has a greater risk of serious complications for a patient, requiring immediate treatment even in the middle of the night.
The Cardiology team at Nepean Hospital have been developing a novel technique using sonothrombolysis (STL) to restore circulation to the heart as part of a research trial. The technique uses ultrasound waves to open tiny blood vessels in the heart to improve blood flow and reduce heart damage for patients who have experienced a STEMI heart attack.
The trial investigated the effectiveness of STL on three patient groups. One group received ultrasound treatment before and after a standard heart procedure, another group received ultrasound treatment only after a heart procedure, and a control group received only standard treatment.
From 122 patients screened between September 2020 and June 2021, 51 patients' results were analysed. Impressively, results from the trial highlighted evidence that patients who received STL before and after a heart procedure had better health outcomes.
Findings showed this group of patients had a smaller heart damage percentage when compared to the control group, and also had a higher myocardial salvage index (MSI) which meant more heart tissue was saved. The MSI was 79% in patients who had ultrasound treatment before and after a heart procedure, this was significantly higher in comparison to the group who had STL only after a heart procedure (51%) and the control group (48%).
Results also revealed that at 6 months (following a heart attack event) patients had better blood flow if they received STL before and after their heart procedure.
Lead researcher of the trial, globally renowned cardiologist Professor Kazuaki Negishi says the findings offer a promising approach for how heart attacks can be treated in the future.
"The outcomes of the trial highlights the importance of continually seeking better ways to treat serious forms of heart attack. The use of ultrasound before and after a standard heart procedure has shown we can save more heart tissue, which leads to a better recovery, shorter hospital stay, and better overall health outcomes for our patients," explains Professor Negishi.
"Moving forward we are currently conducting a larger clinical trial to confirm the results and validate the effectiveness of the treatment in helping patients live healthier lives in three NSW Hospitals, including Nepean."
The application of sonothrombolysis is already being explored further, with researchers currently investigating whether its use can be applied before a patient reaches hospital.
"With more and more portable ultrasound systems available, STL could feasibly be delivered in a pre-hospital setting such as an ambulance enroute to hospital. While there may be some logistical challenges for this to occur, it is something that is being examined in pilot studies," adds Professor Negishi.
Professor Negishi is positive about the future of cardiology treatments for heart attack patients, as well as the efforts of the Nepean Hospital teams who contributed to trial and achieved such remarkable results.
"This hospital (Nepean) is built on the principles of fostering innovative research. From the nurses in the catheterisation lab, to the radiologists and the cardiac physiologists, everyone had an important role to play in defining this medical breakthrough," says Professor Negishi.
"Trials like this are crucial in advancing medical science and gives us the opportunity to explore new types of treatments to further improve the health outcomes of our patients."
Full findings from the research trial have been published in the Journal of the American Society of Echocardiography.
