New evidence, showing the root of heart failure lies in misfolded proteins in the heart’s cells, may pave the way for dramatically new treatment approaches.

An analysis by Cam Patterson, MD, and Monte Willis, PhD, researchers at the University of North Carolina School of Medicine, shows new breakthroughs could be closer than previously believed. The analysis points to striking similarities between heart cells in patients with heart failure and brain cells in patients with Alzheimer’s disease, raising the possibility that some treatment approaches being developed for Alzheimer’s may also help reverse the damage from heart failure.

“We know that Alzheimer’s is a process of wear and tear on the brain, and the same sort of wear and tear affects the heart,” said Dr. Patterson, UNC’s chief of cardiology. “The good news is now that we recognize that — and can understand how the wear and tear actually affects proteins in the heart — it offers us a new chance to identify strategies to reverse that wear and tear. It’s like providing a key to preventing aging of the heart.”

The analysis, co-authored by Patterson and Willis, brings together three main lines of evidence.

First, studies of heart tissue from patients with heart failure reveal large accumulations of misfolded proteins within damaged heart cells, similar to the accumulations in the brain cells of patients with Alzheimer’s.

Second, recent studies using mice show heart problems can result from defects in the body’s quality-control system for monitoring proteins.

Finally, studies of a rare genetic disorder link severe heart problems to misfolding of two proteins, known as desmin and CryAB.

The new conclusion opens enticing avenues for possible treatments. Scientists studying Alzheimer’s and other neurological disorders have long focused on ways to correct or prevent protein misfolding and have even developed drugs that accomplish this feat.

“This raises the possibility that that same type of strategy, and maybe even some of those compounds, will be beneficial in heart failure,” said Dr. Patterson. “It’s an entirely new treatment paradigm.”