Emerson Perin’s end goal isn’t to treat heart failure. The medical director of The Texas Heart Institute says that he has his sights set firmly on curing the malady altogether. And, with the power of innovation and a strong team, the Houston-based cardiologist has a good chance of meeting his objective.

Perin first came to THI for fellowship training in 1988, following his residency in Miami and medical school in his birthplace of Brazil.

“This is a very special place,” the physician and researcher, whose titles also include director for THI’s Center for Clinical Research and vice president for medical affairs, tells InnovationMap. “It has a worldwide-reaching reputation. I’ve always liked research and this is a great place in terms of innovation and practicing high-level cardiology.”

For decades, Perin has followed in THI founder Denton Cooley’s footsteps with world-changing research. In 2001, the founding medical director of THI’s Stem Cell Center was the first person to inject stem cells into a failing human heart. It led to a trial of 17 patients that year.

“A couple of the patients did remarkably well — more than you could ever expect. These guys who couldn’t’ walk across the room pretty much were jogging on the beach. That gave me the initial insight that this works,” Perin recalls.

What exactly is heart failure? The term refers to the condition of a heart that can’t pump enough blood to sustainably power the body through oxygenation of the tissues from blood flow. It may sound like a death sentence, but with appropriate care, it can usually be managed with medicines and if worsening occurs, devices and, ultimately, heart transplantation.

And Perin is proving that there’s a lot of life ahead for heart failure patients. Earlier this year, he published another groundbreaking clinical trial, DREAM-HF. The largest clinical trial of cell therapy for patients with chronic heart failure to-date included 580 patients at 52 sites throughout North America.

With the goal of getting a new cell therapy approved for heart failure, the primary endpoint was to prove that the therapy could prevent recurrent hospitalizations.

“It was a total negative,” says Perin. That’s because the cells don’t have a decongestant effect such as the medicines currently used to treat heart failure.

But that doesn’t mean that the trial was a failure. Quite the opposite. That’s because Perin and his team proved something else: The trial was able to prove that there was significant improvement in patients with inflammation. After those patients were injected with mesenchymal precursor cells (MPC), they showed a 70-percent reduction in heart attacks and strokes. Cardiovascular deaths also decreased.

These are blockbuster numbers, and big news for patients dealing with heart failure. What it means is that the cells addressed a different aspect of heart failure that until now had been left untreated which was the inflammation — how heart failure starts and what keeps it going.

So what’s next? Going to the FDA.

“They said, ‘We can’t approve it with one trial, but we’ll approve it with two,’” says Perin.

This time, his primary endpoint will be tailored to suit the positive outcome he knows he’ll be able achieve. This next round will begin in 2024.

Once the FDA approves a new catheter system for injecting the heart with stem cells and genes, the team will proceed with new studies. Gene therapy will be another frontier for Perin — and patients with heart failure.

“I think the combination of cells and genes is even more powerful,” he says. “That will help save lives in a completely new way and do away with heart failure.”

Perin's work is just one piece of the puzzle, and Dr. Joseph Rogers, who was appointed president and CEO of THI in 2021, is leading the organization's initiative in several ways. THI, recently buoyed by a $32 million donation from a patient — the largest charitable donation in its history — is exploring several innovative therapeutics, devices, and treatments.

THI recently received a two-year, $1.14 million grant from The National Heart, Lung, and Blood Institute to develop a novel, first-in-class drug to treat the cardiovascular disease that arises from atherosclerosis. Another THI innovator, Camila Hochman-Mendez — along with her research team — is studying the effects of regenerative medicine on hearts.