
Appearing at a fundraising event to benefit the Cedars-Sinai Heart Institute’s Women’s Heart Center on August 4, singer and actress Barbra Steisand helped highlight the fact that heart disease is the leading cause of death for women in the United States. Dr. C. Noel Bairey Merz, a Pacific Palisades resident and director of the Women’s Heart Health center, told an audience gathered at the new Bloomingdale’s in Santa Monica Place that 500,000 women die each year from heart disease, and that surprisingly, 20 percent of them are typically in their 40s or younger. ‘Even though heart disease is less prevalent in young women than their older counterparts, it is still the leading cause of death in young women,’ said Merz, who received the McCue Woman Cardiologist of the Year award in 2009. ‘Yet less than 10 percent of women think that heart disease will impact them.’ In the United States in 2006, all cardiovascular diseases combined claimed the lives of 432,709 females while all forms of cancer combined to kill 269,819 females (including 40,821 from breast cancer). Only in the last 10 years has it become common knowledge that there is a difference between men’s and women’s bodies and diseases, like those of the heart. Women experience different symptoms then men and need different diagnostic tests. ’During the Bush years [2001-2008], there were cuts for women’s health research,’ said Merz, who had to actively search for benefactors to help fund this research and an education campaign. She met Streisand, who is committed to women’s health causes, and Streisand agreed to provide support by setting up a $5 million Barbara Streisand Heart Research and Education Program endowment at Cedars-Sinai. As Streisand reiterated last Wednesday night at Bloomingdale’s, ‘We’re behind in research for women. Heart disease presents itself differently in men than women. It’s not just a man’s disease anymore, and once I learned these facts, I met with a brilliant woman, Dr. Merz, so we could make a difference.’ Merz would like to find an additional $20 million endowment in order to insure her Women’s Heart Center ‘will not have periods of feast or famine,’ and research won’t have to depend on the financial whims of the federal government. Basically, in terms of heart disease, both sexes suffer large-artery blockage, which means the artery lining becomes hardened and swollen with plaque (calcium and fatty deposits and abnormal inflammatory cells), minimizing or stopping blood flow. An angiography is used to diagnosis this condition. Unlike men, the plaque lining in women is smooth and even, which means the condition isn’t diagnosed through an angiogram and, quite often, is misdiagnosed. ’Symptoms in women can include persistent chest pain or pressure,’ Merz said. ‘Patients describe it as a constricting band or ‘elephant on my chest.’ They have fatigue and shortness of breath. Often the women have already had an angiogram and were told that nothing is wrong.’ Additionally, more women are likely to suffer microvessel disease in which the small arteries fail to respond when demands for blood to the heart are higher. This can lead to a starving to the heart tissue of oxygen and the results are the same as plugged up arteries, resulting in a heart attack. Why do more women have small-artery disease? Women have smaller arteries than men and although size might be part of it, more probably it is sex related. Data is lacking because tests that have been developed over the years have been geared towards the male and large-artery blockage. Merz is also excited about the latest stem-cell research and the impact this may have on women’s heart disease. Stem cells are considered a person’s master cells because they have the ability to develop into any type of cell and they can self-renew. Eduardo Marb’n, director of the Cedars-Sinai Heart Institute, is conducting an ongoing clinical trial in which patients who suffered recent heart attacks undergo a minimally invasive biopsy to retrieve a peppercorn-sized piece of heart muscle.’Scientists then use it to grow stem cells in a lab.’A month later, millions of the patient’s own stem cells are re-inserted into the patient’s heart via a catheter in an effort to repair muscle damage to the heart.’ ’This is an exciting area; it has so much potential,’ Merz said. ’Research is time consuming and one has to think outside the box,’ she continued. ‘Maybe one in 10 ideas will work, which means you have to be merciless in your persistence.’ That also means that research is expensive, which is another reason she’s thankful for Streisand’s endowment. Currently, Merz is treating a woman in her 30s who has three children and has had numerous heart attacks. ‘They (attacks) are in the process of ‘knocking’ her heart out,’ Merz said. ‘She will likely need a heart transplant.’ With the latest stem-cell research, there’s hope that eventually a heart transplant may be an option that is no longer used. Instead, the stem cells will be taken from the patient, ‘souped up and corrected in a Petri dish,’ and put back in the person, Merz said. ‘There are reasons to be optimistic.’ The $1,000-a-plate dinner benefiting the Women’s Heart Center at Cedars-Sinai was underwritten by Bloomingdale’s and hosted by chairman and CEO Michael Gould at the company’s new store at Santa Monica Place. Bloomingdale’s will donate 100 percent of the proceeds from ticket sales to the Center.