I den lille svenske landsby Kisa syd for Linköping blev der for nylig skrevet medicinsk verdenshistorie. En større gruppe af byens ældre har medvirket i et videnskabeligt forsøg, hvor nogle af landets førende kardiologer med en noget utraditionel behandling har formået at halvere de ældres hjertedødelighe samtidig med at styrke hjertefunktionen betydeligt. sund-forskning.dk tog turen til Kisa for at se præsentationen af verdensnyheden.
Af Bjørn Falck Madsen.
Artiklen er bragt i magasinet sund-forskning.dk – sensommer 2012
Hjerte-kar-sygdomme er den absolut førende dødsårsag i Skandinavien, men i den lille landsby Kisa, som ligger 50 kilometer fra Linköping i det sydøstlige Sverige, har man tilsyneladende fundet en måde at snyde manden med leen på. 443 af byens cirka 4.000 borgere – et repræsentativt udsnit af de ældre – har medvirket i et banebrydende forsøg, hvor nogle af Sveriges mest erfarne kardiologer har afprøvet en ny og noget utraditionel behandling for at se, om den kan forebygge risikoen for hjerte-relaterede dødsfald. Det lykkedes, og da forskerne løftede sløret for deres videnskabelige arbejde på et pressemøde i byens forsamlingshus, hvor journalister fra Skandinavien og det øvrige Europa var stimlet sammen, kunne de blandt andet fortælle, at behandlingen medfører en 54 % reduktion i risikoen for at dø af hjerte-kar-sygdom samtidig med at styrke hjertets pumpekraft betydeligt.
Meget overraskede
Lederen af forsøget, kardiologen Urban Alehagen, som er tilknyttet Universitetet i Linköping, sagde selv: ”Jeg er både overrasket og glad,” imens han med en forskers kendetegnende ydmyghed forklarede om forsøget, der i øvrigt blev offentliggjort i det ansete tidsskrift International Journal of Cardiology i slutningen af maj i år. Den nye behandling involverer hverken lægemidler eller kirurgiske indgreb, men består derimod af en kombination af to naturligt forekommende stoffer, som vi får fra føden – nemlig sporstoffet selen samt det vitaminbeslægtede stof coenzym Q10. Det er første gang, at disse to stoffer gives som tilskud i kombination i en decideret interventionsundersøgelse, og resultatet af behandlingen er opsigtsvækkende.
Vigtige for hjertet
Man ved, at selen-indholdet i den skandinaviske kost er relativt lavt, og man har blandt andet set, hvordan mangel på selen påvirker hjertet negativt. For eksempel kan udtalt selenmangel føre til Keshan’s syge, som er en ødelæggelse af hjertemuskelvævet. Det andet stof, coenzym Q10, som er nødvendigt for cellers energiomsætning, har ligeledes en velkendt betydning for hjertets pumpefunktion, og man har set, hvordan personer med kronisk hjertesvigt har lavere Q10-indhold i hjertemusklens celler, sammenlignet med raske. Derfor gav det god mening at undersøge de to stoffer kombineret.
Stærkere hjertemuskel
Ikke nok med at dødeligheden blev halveret hos dem, der fik daglige tilskud af de to naturlige stoffer i en fem-årig periode. Deres hjerter blev også stærkere, fandt forskerne ud af. Dels viste ultralydsmålinger (ekkokardiografi), hvordan hjertemusklen arbejdede væsentligt mindre besværet i tilskuds-gruppen. Dels observerede forskerne en forskel i de to grupper med hensyn til stoffet NT-proBnp, som er en såkaldt markør for hjerteanstrengelse. Når hjertet skal ”slide i det” for at pumpe øges NT-proBNP-niveauet, og det var netop, hvad der skete i den gruppe, som ikke fik selen og coenzym Q10. Hos de personer, der tog stofferne, forblev niveauet uændret.
Positive, men forbeholdende
En anden forsker bag Kisa-forsøget, nemlig professor Ulf Dahlström, som ligeledes er tilknyttet Linköpings universitet og i øvrigt er en af Sveriges mest respekterede hjertespecialister, er ligesom de øvrige forskere i gruppen positiv over for de opnåede resultater. Han understreger dog, at det er nødvendigt at lave flere og større undersøgelser, eventuelt på yngre personer, før man kan drage endelige konklusioner. Indtil videre har man dog, hvad der med rette kan kaldes for verdens første offentliggjorte forsøg, der viser, at en kombination af selen og coenzym Q10 gør det muligt at forebygge dødsfald forårsaget af hjerte-kar-sygdom, og samtidig ser behandlingen ud til at have en styrkende indvirkning på hjertefunktionen. “Jeg er både forbavset og glad over vore forskningsresultater,” siger Urban Alehagen til pressen. Han er kardiolog med tilknytning til Linköping Universitet og stod i spidsen for det spændende forsøg med selen og Q10, hvor ældre havde 54 procent reduceret dødelighed.
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