Thinking outside the box

Heart failure is a serious diagnosis that impacts more than 600,000 Canadians and costs the health care system $600 million annually. 

One in five Canadians will be diagnosed with the condition in their lifetime, and as a result, will have numerous symptoms, such as extreme fatigue, weakness, shortness of breath, swelling and a reduced ability to exercise. Half of all heart failure patients will die within five years of their diagnosis.

And the burden of heart failure is growing, with costs due to heart failure projected to double by 2030.

But researchers are working to improve the quality of life for these patients and decrease the impact of the condition on the health care system.

  
Dr. Jonathan Howlett, a physician-researcher who focuses on heart failure, is the Canadian lead for an international study that discovered a new use for an existing drug. 

The study involved more than 4,700 heart failure patients in more than 100 centres around the world and was published in the New England Journal of Medicine – the top medical journal in the world—in September 2019.

Researchers found that Dapagliflozin, a drug approved for the treatment of diabetes, helps heart failure patients with reduced ejection fraction (HFrEF) by prolonging life, improving quality of life and reducing the length and number of hospital stays.

In these patients, the left side of the heart doesn’t pump blood out of the heart efficiently, often due to damage caused by a heart attack. 

As a result, the volume of blood that is pumped out of the heart with each beat is less than is needed for the body to function properly.  

 
Howlett is pleased that the prestigious journal recognized the importance of the international study. 
He is optimistic about the new use for the old drug. 

“It is very gratifying and also reflects the importance of this work,” says Howlett, a physician-researcher within the Libin Cardiovascular Institute. He added he is now using the drug to treat patients who have both diabetes and heart failure. 

Howlett said physicians now have several tools to help them treat the growing number of heart failure patients, including new medications and devices. He is optimistic about the future for these patients.

Howlett is the director of the Heart Failure clinics at Calgary’s Foothills Medical Centre and South Health Campus.