Améliorer le devenir des patients souffrant de maladie cardiaque ischémique : une approche translationnelle du laboratoire vers la clinique, et vice-versa

 

Nicolas Noiseux

Centre hospitalier de l'Université de Montréal

 

Domaine : santé circulatoire et respiratoire

Programme chercheurs-boursiers cliniciens - Senior

Concours 2015-2016

Cardiovascular disease remains the leading cause of morbidity and mortality in industrialized countries. Following heart attack, the irreversible loss of contractile cells will lead to cardiac pump failure associated with high risk of death. Except for heart transplant, there are few options for advance cases. As patients presenting with cardiovascular disease are older and have a worse risk-profile, we are seeking for more efficient treatments to reduce the risk of complications and improve their survival. Combining my unique expertise as a cardiac surgeon and researcher, I will use my knowledge to the benefit of my surgical patients, but also to explore new avenues and less invasive approaches while focusing on surgical and therapeutic treatments tailored to these higher-risk patients underlying complex and various pathologies. Stem cell transplantation can improve the repair and function of the infarcted heart. I am studying in two clinical trials, totalizing ≈60 patients, how bone marrow stem cell can improve the function of infarcted heart and symptoms of the patients. However, massive death of the transplanted cells remains the biggest obstacle, reducing efficacy of the cell therapy.

I developed a new approach by pre-treating the stem cells with various chemical compounds to improve their survival and effects, and I will soon begin a study with these ‘super cells'. I discovered small chemical compounds that can reduce the damage caused by the myocardial infarct, and these compounds will be tested for the reconditioning of human lung to improve their function before transplantation. Finally, I am perfectioning less invasive surgical techniques cardiac surgery patients to reduce perioperative complications, including coronary artery bypass on the beating heart. I am evaluating patency of grafts performed on the beating heart, along with the patency of new type of grafts using non-invasive imaging techniques with 3-dimentional reconstruction