Puzzling Particles in the Heart

Many forms of heart disease are little understood, but one is especially mysterious: heart failure that strikes husky and seemingly healthy men and women in their prime, apparently without cause. Doctors, who now find the condition is by no means rare, say it is frightening to watch the often rapid, inexorable progress of the disease toward early death. They call it idiopathic cardiomyopathy (unexplained disease of the heart muscle), and treat it with drugs, which may be only briefly effective.

Now a British research team reports in the Lancet that the cause of this baffling disease may be a new kind of organism that fits no known classification. Whatever its nature, it appears to live and multiply only as long as the heart itself is living; it vanishes from dead heart tissue. This would explain why it has not been found in postmortem examinations, even when these are performed soon after death.

To get on the trail of the infectious particles, Surgeon Mark Braimbridge of St. Thomas's Hospital in London had to make a daring innovation and remove pieces of heart muscle from a living patient for the sole purpose of diagnosis. This was ethically permissible, he says, in the hope of finding a better treatment for a lethal disease. The patient was a man of 20 whose heart had been failing for three months. Under study by special microscope techniques at The Kennedy Institute, the muscle specimens were found to contain particles that could not be identified. The one certain thing about them was that they were neither bacteria nor true viruses. From a second patient's heart, the researchers got samples of particles that seemed to be in four or five successive phases of a life cycle.

To prove that they had really isolated an infectious agent, the researchers had to grow it; they found it would multiply only in a medium containing living heart muscle itself. When the crop was injected into mice, the animals died in much the same way as heart-failure patients. What can the particles be? The investigators can only speculate that they may be a hitherto unknown form of life, with some of the properties of protozoa (such as malaria parasites) and some properties of viruses. If they are right, they may be on the track of other unexplained diseases.

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