How does love affect the heart?

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Originally published at www.bhf.org.uk, written by Leanne Grech

It’s often said that the most beautiful things in the world cannot be seen or touched, they are felt with the heart — that’s the muscle about the size of your fist that is currently keeping you alive.

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Is it love or atrial fibrillation?

Love is one such beautiful thing, and it happens when you’re least expecting it: you’re in a café drinking a cup of coffee, reading a book, and the person you’re going to spend the rest of your life with walks in slow motion through the door. Your heart skips a beat and the rest is a love story for the ages.

Now, it’s normal for your heart to race when you are excited or nervous, or to add or skip a beat once in a while. In most cases, it’s caused by something that’s easy to fix, like not enough sleep or too much caffeine — or perhaps it’s a sign that you’re falling in love. Occasionally, however, repeated and prolonged occurrences of an irregular heartbeat could be a sign of atrial fibrillation (AF).

AF is the most common abnormal heart rhythm, affecting over 1.6 million people in the UK. It happens when electrical impulses fire off from different places in the atria (the top chambers of the heart) in a disorganised way. In turn, this causes the atria to twitch, and can be felt as an irregular heartbeat or pulse. AF can lead to a heart attack or stroke.

BHF-funded researcher Dr Katharine Dibb and her team at the University of Manchester are investigating a new way to treat AF — and it’s all about calcium. Yes, the mineral in milk and cheese that helps build strong bones and teeth — but that’s not all calcium does.

Calcium also plays an important role in regulating heart rhythm. In a healthy heart, calcium enters the heart cells during each heartbeat and in turn causes more calcium to be released from stores inside the cells. Overall, this triggers a coordinated and strong contraction. In people with AF, however, it has been found that calcium leaks out of the stores, meaning that less is available to coordinate contraction.

Dr Dibb discovered that people taking Viagra, a drug normally used to treat erectile dysfunction, are less likely to have AF. Viagra works by blocking a protein called phosphodiesterase 5 (PDE5), which is known to control the store of calcium in heart cells in the atria of the heart.

So, in this project, the question that Dr Dibb is asking is: could we prevent calcium from leaking out of the stores in heart cells by blocking PDE5? If the answer is yes, then this knowledge could one day lead to a potential treatment for people living with AF.

Arterial healing

Love don’t come easy, and some partners can face challenges in their relationship. Sometimes, those challenges are of a sexual nature. In people over 40, for example, erectile dysfunction (ED) or impotence is a very common problem.

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ED is diagnosed in those having difficulty getting or maintaining a strong enough erection for sexual intercourse or other sexual activity — an erection occurs when the arteries carrying blood to the penis dilate and more blood flows into the penis, causing it to swell.

ED has many causes, including peripheral arterial disease (PAD). PAD is a condition caused by atherosclerosis (a build-up of fatty deposits in the arteries), meaning less blood can pass through. In turn, this causes problems getting or maintaining an erection.

PAD also affects the legs and often leads to a painful ache in the legs when walking. In some cases, blood flow restriction is so severe that leg amputation is required. BHF-funded researcher Dr Tijana Mitic at the University of Edinburgh is studying ways to restore blood supply in the legs when blood flow is compromised. Specifically, the aim is to encourage new blood vessels to grow, which is not possible with current treatments. Dr Mitic will study genes in the endothelial cells that line our blood vessels. Similar to a light switch in a dark room, genes can be switched on or off — and molecules called long non-coding RNAs (or lncRNAs) help control the switching.

Dr Mitic and her team believe that lncRNAs help turn off genes involved in new blood vessel formation, and so blocking these molecules may encourage blood vessel growth. However, they first need to understand what lncRNAs do in the endothelial cells and whether they affect genes involved in new blood vessel formation. Ultimately, their question is: could targeting lncRNAs encourage growth of new blood vessels in the legs? If so, lncRNAs might become a treatment target to help people with PAD.

A new arrival

It seems like forever since that chance encounter at the café, doesn’t it? You’re now at the hospital having just been told that you’re expecting a baby boy — a little miracle of the love you have for each other. Life as you know it is changing.

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Unfortunately, however, pregnancy is not straightforward for everyone. During pregnancy, some women develop severe high blood pressure called pre-eclampsia. While this blood pressure often settles after pregnancy, the changes can persist, and these women are at higher risk of heart disease and stroke in later life.

In a past trial, BHF-funded Professor Paul Leeson and his team at the University of Oxford have shown that giving new mothers the chance to monitor their own blood pressure, and adjusting their medication immediately after birth, can improve their blood pressure for up to six months.

Now, they are going to repeat this trial using updated Bluetooth blood pressure monitors. They will also use MRI scans to take pictures of the mother’s brain and heart, six months after birth, to show whether regulating blood pressure improves the structure of the brain and the function of the heart and blood vessels. If successful, this could revolutionise how doctors care for new mothers in the time after birth.

Till death do us part

Romeo kisses Juliet and takes out the poison.
Jack freezes in the North Atlantic Ocean while Rose lies comfortably and safely on the raft.
Alas, some of the greatest love stories have tragic endings, and while it may be better to have loved and lost than never to have loved at all, it’s painful to lose someone you love.

Broken heart syndrome, also known as stress-induced or takotsubo cardiomyopathy, can be brought on by major physical or emotional stresses, such as sudden illness or bereavement. It is a rare condition which causes the left ventricle of the heart to change shape and get larger. In turn, this weakens the heart muscle which means blood cannot be pumped around the body as effectively as it should. Usually, people with broken heart syndrome recover well after their initial episode but they can go on to develop heart failure.

In a BHF-funded pilot project at the University of Aberdeen, Professor Dana Dawson and her team will explore if they can improve the heart health of people with this condition through prescribed physical activity or psychological interventions. Specifically, volunteers who’ve had a recent episode of broken heart syndrome will be prescribed either a three-month schedule of exercise or mental wellbeing training. Ultimately, this trial will indicate whether these two rehabilitation programmes could help people with broken heart syndrome, for whom no treatment currently exists.

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In the spirit of Valentine’s Day, here’s a little poem for our readers:

Roses are red.
Violets are blue.
The British Heart Foundation
is here to help you.

If you’re reading this, it means you’re alive. You have a fist-sized organ in your chest that’s continuously pumping about eight pints of blood around your body. It is this red liquid flowing through our veins that keeps us alive — but the question is: can the liquids we drink help us to stay alive longer?

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How does love affect the heart? was originally published in British Heart Foundation on Medium, where people are continuing the conversation by highlighting and responding to this story.

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