How nanotechnology is helping find new treatments for abnormal heart rhythms

Nanotechnology is helping us map heart cells to learn about the causes of harmful heart rhythms. Sarah Brealey sets out Professor Julia Gorelik’s cutting-edge work.

Nanotechnology - heart muscle

The receptors that help tell the heart to beat are located in T-tubules (the vertical lines above)

Imagine mapping a world that is too small to see. That’s what Professor Julia Gorelik does.

Professor Gorelik is focused on surface heart cells, down to the level of individual molecules. Her work could help us understand how heart failure can lead to potentially fatal heart rhythm problems, and what causes atrial fibrillation.

The study of objects at such a small scale is called nanotechnology. It’s a new and growing field made possible by advanced microscope and scanning techniques. One nanometre is a millionth of a millimetre. You’d need 100,000 nanometres to make up the thickness of a newspaper page.

Arrhythmia is responsible for more than 50 per cent of deaths among patients with heart failure, so solving arrhythmia is a major clinical need

Professor Gorelik, based at Imperial College London, has spent her whole career studying the relationship between the structure of cells and the work they do.  She's using nanotechnology to look at details as small as 20 nanometres inside heart cells.

When heart muscle cells contract in unison, this causes the heart to beat. Professor Gorelik is studying the receptors in cells that are involved in this process. “We are using very complex cutting-edge techniques, which allow us to see that these receptors are not distributed randomly,” she says. “They are concentrated in particular areas of the cell, in specialist structures called T-tubules [transverse tubules].

“But in heart failure, these structures are destroyed, and the receptors end up in different locations. We have found that when this happens, it can lead to abnormal heart rhythms [arrhythmia]. Arrhythmia is responsible for more than 50 per cent of deaths among patients with heart failure, so solving arrhythmia is a major clinical need.

“If we understand this, it could lead to a new generation of anti-arrhythmia drugs.”

Investigating atrial fibrillation and heart failure

Professor Gorelik is comparing cells from patients with heart failure with those from healthy hearts. In a separate BHF-funded project, she is looking at the location of the receptors in atrial fibrillation. So far, there seem to be similarities between how the structure of the heart cells changes in both atrial fibrillation and heart failure. She has also found the structure of the cells differs between chambers of the heart, and even in different areas of the chambers.

People don’t always think of scientists as creative, but Professor Gorelik disagrees. “I think science can be very creative,” she says. “To be creative is to have a lot of ideas. If you plan an experiment, you can change things during the experiment.

The BHF is very good at recognising how fundamental science can lead to clinical developments, and that’s important

“Often I am thinking about one experiment in parallel with another one. You might be at a party and you just have an idea and write it on a napkin. Sometimes you have an idea and it’s not possible but it’s great to try. You have to just love your work and go to work with enthusiasm.”

The importance of BHF support

Much of Professor Gorelik’s nanotechnology research has been funded by the British Heart Foundation. “The first BHF grant I got was a New Horizon grant, focused on new technologies,” she says. “It can be difficult to go from technology to science and that grant was a bridge between the two, which was wonderful.

“I have had two more grants since then. The BHF is very good at recognising how fundamental science can lead to clinical developments, and that’s important. I have 12 people in my lab and most of them are funded by the BHF.”

This work is just one of several current BHF-funded projects using nanotechnology to help patients with heart and circulatory disease. At Queen Mary, University of London, Dr Thomas Iskratsch is looking at how damage to the heart, such as a heart attack, can cause heart cells to become stiffer, and whether this stiffness causes heart failure. This research could lead to new drugs to treat heart failure in future

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