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Gene map - speedier & easier treatment

CARDIAC disease is on the increase in this part of the world including the UAE due to wrong life style and lack of exercise. Yet hope lies ahead in the form of the human genome project which may soon see people moving about with a CD-ROM containing their genetic make-up to facilitate speedier and easier treatment, said Dr J M Muscat-Baron, professor of medicine and head of department of cardiology, Dubai Hospital.

Speaking about "recent advances in interventional cardiology" at a symposium on "interventional cardiology in the new millennium" held in Dubai recently, Dr Baron - a UAE resident for the past 26 years -- said the DOHMS has been the pioneer in developing treatment for heart disease and had announced last week upgradation of related services. It is also making special efforts to introduce new methods of treatment for the local population.

Dr Baron, who won the Sheikh Hamdan Award for Excellence in Medicine, said schemic heart disease is the main cause of heart attacks and the only solution lies in adopting good habits, exercise, quitting smoking, and remaining alert about diabetes and obesity. However, cardiac care had witnessed improvement in treatment over the last 50 years where the cardiologist's main tools then were just clinical skills, stethoscope, sphygmomanometer, ECG (one channel) and chest x-ray.

Today, the field of medicine is equipped with ECG multichannel machines, pacemakers (including ones you can communicate with), electrophysiology, ultrasound, various types of imaging, cardiac catheterisation which allowed accurate diagnosis of all types of congenital and valvular diseases besides therapeutic interventions (correction of acquired abnormalities), he said.

Dr Baron said the present is seeing a change in practice of cardiology, which has spawned a number of sub-specialties and coronary angioplasty is the most commonly preferred operation in the world.

"The factor responsible for the advancement of treatment techniques is the understanding of heart conditions. Over the past 150 years, numerous attempts have been made to explain about "athersclerosis" which is the leading cause of death in the industrial world," he said while describing aspirin as a vital and cheap ingredient in the treatment even today.

Enlarging on beyond the present scenario, Dr Baron said technical advances in medicine of the future will be based on molecular medicine and in which the human genome project - which is almost complete -- will play a major role. This project is being conducted in many countries and its success would ensure building of future treatments and prevention measures in the field of medicine, he said.

"In the next three years, we will know more about this project which studies the genetic makeup of a person comprising three billion pairs of bases present in the 50,000 genes, of which 200 to 300 have been identified as the causes of diseases," said the doctor, adding "The future will probably see us carrying in our pockets a CD-ROM containing our genetic make-up to facilitate easier treatment strategy. I am told this will be available in five years time"

Speaking on "primary angioplasty - a promise fulfilled," Dr Abhay Pande, consultant interventional cardiologist at Al Zahra Private Hospital in Sharjah, described "acute myocardial infarction" as the number one culprit in cause of deaths in the UAE, with the percentage of fatalities in road accidents taking second place.

Emphasising angioplasty as the "best treatment" for those developing acute heart attack, he said this had a better 98.5 per cent success rate compared to thrombolytic treatment, which is still being continued worldwide but has a comparatively barely 50 per cent success rate.

"Fifty per cent of deaths due to acute MI occur in one hour and treatment has to be done within three to six hours of a heart attack as further passage of time leads to deterioration of the heart tissues," said the doctor, adding "Thrombolytic treatment features dissolving the clots but has its limitations like causing intro-cranial haemorrhage and leaving residual blockages, besides necessitating further treatment."

Primary angioplasty (balloon angioplasty) is beneficial as it ensures better coronary flow and less occurrence of paralytic strokes, besides leading to 40 per cent decrease in short-term mortality, he said while pointing out that these results indicated this form of mechanical treatment is far better than the medicinal kind (thrombolytic treatment).

Courtesy: Gulf Today


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