I believe we can prevent heart attack. We can put in place strategies to reduce risk. We can literally plan to change your future. Welcome. My name is Dr. Oreck Bishop. I'm a cardiologist. I'm an author and a keynote speaker. Together with that, I'm CEO of the Healthy Heart Network and I'm all about trying to help people live as well as possible for as long as possible. You probably know, heart disease is huge in Australia. Every 20 minutes someone suffers a heart attack and we know that over 20 people per day die from heart disease. This is on the backdrop of over 9 million people globally being impacted by this condition. Truthfully, most of these could probably have been avoided if only we knew what to do. This podcast is all about helping you understand better where blood pressure, weight, cholesterol and all the other bits and pieces around there can help together with general health literacy for general better health. I am on a mission to impact not just heart health but general health on a global scale. If you enjoy this podcast, I would be honoured for a five-star review and... You can share it with your family and friends. Who knows? It may well save someone you love. Hi, my name is Dr. Warrick Bishop and welcome to my podcast and videocast station. I really do appreciate you taking the time to listen. Today I've got a couple of things I'd like to cover and they were things that popped up at Cardiac Society 2022 run at the Gold Coast and put on by the New Zealand. uh chapter of the cardiac society well there's always interesting stuff but there's a couple of things that really stuck out for me and i would like to share those with you first of all was how important m rna appears to be now we know what dna is that's really the blueprint for The design of our body, the proteins and compounds that our body generates. mRNA, of course, is what we call the transcription factor. Another way of thinking of that is mRNA is what takes the blueprint from the DNA and carries it, if you like, to the factory for printing. Well... We have become aware of mRNA broadly because of COVID and the Pfizer and Moderna vaccines, which are mRNA based. But it remains a bit of a mystery. And what's really interesting about mRNA is it will provide an awful lot of medical opportunity for us in the future. The mRNA vaccines tell us that we can use mRNA in a way to, if you like, insert information into cells. So the mRNA vaccines Pfizer and Moderna put into the cell. a protein sequence that mimics the spike protein of the COVID virus. And by inserting that spike protein triggers an immune response from the body. So we can use that mRNA to insert information. approaches to mRNA and we can block mRNA and therefore block particular proteins being formed. Now we're seeing this occur in the cholesterol space in particular where there's small interfering particles that mess up the mRNA within the liver that produces a protein that we refer to as PCSK9. Well, that turns out to be extremely useful. We currently have technologies that use antibodies to sit on PCSK9 and block it that way. But imagine if we can stop the body producing it altogether. So this we are sure we are going to see more and more of where interfering proteins attack an mRNA or interfere or mess up the function of mRNA and therefore we can stop particular proteins being produced by the body. So in the first instance, we're inserting proteins. In this instance, we're preventing proteins or modifying. production of proteins within the body. But it's far more complicated than that. It turns out that over the last few years, there's been over 50 Nobel Prizes in Medicine awarded to mRNA research. That tells you it's an enormous body of work. And to date, there's been over 2,500 mRNA proteins identified. which is an incredible library of data and information. What we are seeing as well is that these mRNA proteins can be a result of different strains and influences on the cell. So, for example, a heart in cardiac failure may upregulate one of its mRNA proteins. And so we could, in theory, measure that specific mRNA protein. And by doing that, see if it's elevated, that it's representative or reflective of the stress and strain on heart cells. So watch this space for mRNA. We can insert. We can block or alter protein production, or we can directly measure mRNA to get a feeling and use it as an indicator for particular functions within the body. In this particular situation, I'm talking about the heart because, well, it was a heart-related event that I went to. So mRNA, absolutely fascinating. significant topic that was covered through cardiac society 2020 in the gold coast was really around amyloid and amyloid is a difficult concept but try and imagine that for some reason the body produces proteins and those specific proteins drift around in the body, but instead of being cleared and broken down, they accumulate and collect in different organs. Well, amyloid can collect in the heart and therefore it becomes a very important consideration for people if amyloid is potentially collecting in their hearts. Now we know amyloid can collect in the brain and we think it's contributory to the processes of Alzheimer's. In the heart, it's contributory to the heart becoming stiff because that protein sits in there and thickens it all up. It makes it harder for that heart to relax. And there's a number of things that drive that protein production. One of them is what we call from the bone marrow or from a, if you like, a cancerous single cell line producing a a protein that accumulates to excess in the body. Someone who has a plasma cell tumor or a myeloma may well suffer from this sort of problem. We also see amyloid collecting in individuals as they age. And we also see amyloid collecting in people by way of a genetic predisposition from their liver and their liver production. So a complicated space. But the reason it's becoming more and more important is as we get better and better at identifying it, we're starting to find opportunities for treating it. And it looks like we've got multiple areas for potential intervention, and particularly so because some of the interventions may well swing off mRNA interventions, which is what I talked about before. Finding targeted mRNA therapies that literally stop or block or interrupt the production of these proteins, which are detrimental. And so these two sort of aspects tie together. Anyway, fascinating space. Watch. how this will develop we will see more and more mRNA use both through both for therapeutic and for diagnostic purpose and amyloid there's more and more of it around as people are aging and we're identifying it better we are going to find more and more opportunities to improve the way we manage it well i hope you found that interesting If you would like to share this podcast with someone you know, please feel free to. If you'd like to give me a positive review, I'd appreciate that. If you haven't got anything good to say, don't have to say anything at all. I'm going to wish you the very best till next time. I hope you live as well as possible for as long as possible. Take care and bye for now. Did you know that coronary artery disease kills one in four people? So most of us... are likely to carry some risk or know someone who does. If you're interested in finding out more about how to evaluate that risk, check out www.virtualheartcheck.com.au. It will give you information about risk and what else can be done to be even more precise.
