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Heart Disease
Researchers at the OHRI are looking into this very serious condition from several fronts.
OHRI scientists are exploring the signaling pathways or chemical reactions that control the determination, proliferation and differentiation of stem cells during embryonic development and tissue regeneration. Dr. Lynn Megeney (Molecular Medicine Program) in collaboration with Dr. Rudnicki were the first in the world to identify a population of cells in cardiac tissue that appear to have stem-cell like activity. This research holds out new hope for patients with chronic heart disease or for those who have suffered a heart attack.
Researchers in the Clinical Epidemiology Program have also determined that bystander CPR and rapid defibrillation programs are crucial interventions that have a significant impact on survival. They have concluded the largest multi-centre controlled trial ever conducted in a pre-hospital setting. The study is published in the August 12, 2004 edition of the New England Journal of Medicine. The lead author, Dr. Ian Stiell, is an emergency room physician, researcher and teacher affiliated with The Ottawa Hospital, the Ottawa Health Research Institute and the University of Ottawa.
Sudden death due to cardiac arrest remains an important public health concern. Every year, approximately half a million American lives are lost due to cardiac arrest, with almost one in two occurring outside of a hospital. The issue is equally as serious in Canada. In May of this year, a study in the journal Health Affairs showed that Canada has the worst record for cardiac arrest survival compared to four other major industrialized countries.
Dr. Stiell and his team concluded that the best chance of surviving a cardiac arrest is if someone actually witnesses the event and intervenes immediately. The study also showed that cardiac arrest survival improved significantly if a citizen or first responder (a police officer or firefighter, for example) performs CPR, and if rapid defibrillation is applied within 8 minutes. Researchers could not, however, demonstrate a change in survival rates associated with having ALS trained personnel attend to the cardiac arrest victim, mainly because immediate intervention is key. According to the researchers, "cardiac arrest witnessed by a bystander, CPR by a bystander and use of a defibrillator in eight minutes or less were strongly associated with improved survival."
Given these findings, the researchers raise concerns about the low rates of citizen-initiated CPR and suggest that investing more in training and awareness programs for the general public may have a greater impact on cardiac arrest survival rates than expanding the number of ALS-trained personnel at this time.
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