The Training Program in Cardiovascular Disease

The Basic and Translational Research Program

Cardiovascular magnetic resonance imaging
 

The Basic and Translational Research program at the Heart Center of Stony Brook University Hospital is an NIH-funded program focusing on the basic and translational aspects of heart failure research.

On a molecular and cellular level, research is focused on

• Identifying why heart cells stop dividing and to reactivate this ability to provide the heart with a means of repairing itself. A cell cycle protein, cdk6, may be instrumental in unlocking the heart’s potential to heal itself.
• Studying the critical genes involved in cardiomyocyte development during embryogenesis with the goal of genetically orchestrating cells to become myocytes capable of repairing the heart. Our laboratory has identified several homeobox genes, an evolutionarily old and highly conserved family of transcription factors, which may control multiple pathways in heart development.
• Elucidating the necessary surgical techniques and strategies by which cell types can be effectively transplanted into areas that have suffered myocyte loss or injury. Transplantation has included myocytes and stem cells that have been genetically modified.

Clinical research includes the participation in several multicenter studies and site initiated studies, in collaboration with the Programs in Echocardiography, Electrophysiology and Interventional Cardiology, focusing on the detection and management of volume overload and fatigue. In addition, studies are underway to establish novel treatments and diagnostic devices for advanced heart failure and to predict the response to biventricular pacemaker implantation.

The Cardiac Imaging Research Program at St. Francis consists of a group of 8 academic cardiologists dedicated to cardiac imaging, three PhD scientists with expertise in MR physics (2) and biostatistics and 5 research fellows in 1-2 year programs. In addition, clinical fellows are welcome to pursue research projects in the group. The clinicians spend on average approximately 50% effort on research, which is mainly investigator-originated research rather than multicenter clinical trials. In addition, a consultant research radionuclide medical physicist and collaborations with Cardiology and Radiology at Stony Brook further enhance program capabilities. . Funding is drawn from a research endowment as well as extramural support from the American Heart Association, NIH, the NY State Department of Health (research fellowships), private foundations and industry sources. At present, over 40 imaging research protocols are active, with ongoing work in: a) cardiac MRI (examples: predictors of arrhythmic risk; assessment of coronary endothelial and microvascular dysfunction using MRI stress perfusion methods; new methods for MRI myocardial perfusion imaging: new insights into infarct composition and mechanics; effects of age and gender on cardiac structure and function and vascular stiffness; validation of new methods in 3D echo and radionuclide imaging;) b) Cardiac CT(plaque characterization; lumen assessment in calcified coronary lesions; myocardial viability imaging); c) Echocardiography (3D echo assessment of arrhythmic risk; validation study for 3D echo in post MI patients; 3D echo evaluation of the right heart; 3D, tissue Doppler and speckle tracking evaluation of left ventricular asynchrony in heart failure patients; intraoperative assessment of severity of mitral regurgitation; 3D evaluation of the mitral annulus: implications for mitral valve repair; d) Nuclear Cardiology: applications in diabetes; myocardial stunning after adenosine stress; optimal methods for myocardial perfusion imaging in women; utility of SPECT MUGA for right and left ventricular size and function. In 2005-6 the group has presented 68 papers at national and international meetings and published 34 full length manuscripts in leading journals in the field.