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Research

Cardiology

Building on a storied reputation for innovative cardiac care, ASRI scientists are leading the way in the development of groundbreaking treatments for pulmonary hypertension, drug resistant hypertension, myocardial infarction and other cardiovascular conditions.

For patients with pulmonary hypertension (PH), new medications are giving them hope. “While one-year survival for most patients with PH has improved to the upper 80 percentile range, that still has not translated into prolonged survival,” said Raymond Benza, MD, Director, Advanced Heart Failure, Transplantation, Mechanical Circulatory Support and Pulmonary Hypertension Program at WPAHS. “We are testing various combinations of drugs to learn if that will produce a better result than by using one drug alone. In particular, we are interested in learning if chemotherapeutic drugs show the potential for prolonging the survival of PH patients.” Dr. Benza is also developing novel predictive models to help physicians determine the best form of treatment for PH patients. As part of this study, Dr. Benza has designed a special calculator that indicates whether a patient will respond better to one drug, a combination of drugs or lung transplantation. Additionally, Dr. Benza is investigating novel mechanisms of PH, using the rodent monocrotaline/pneumonectomy model of pulmonary hypertension to test new therapeutic modalities.

In a related study, Michael Passineau, PhD, is looking at gene therapy as a way to better control and ultimately prevent pulmonary hypertension, while minimizing the side effects associated with certain medications. As part of this study, Dr. Passineau is testing the effectiveness of viral vectors as vehicles to deliver the therapeutic gene.

Other cardiology researchers at ASRI are conducting equally groundbreaking studies. Led by Srinivas Murali, MD, Director, Division of Cardiology, Allegheny General Hospital, and Medical Director, The Gerald McGinnis Cardiovascular Institute, a team of researchers are partnering in a landmark study that could fundamentally change the way drug-resistant hypertension is treated. These scientists are testing a device that is designed to reduce blood pressure by using mild electrical signals to influence the body’s blood pressure regulation system, called the baroreflex. Cardiology researchers are also examining the effectiveness of a new anti-clotting drug in treating acute coronary syndrome patients with unstable angina/non-STelevation myocardial infarction who are medically managed; and evaluating the benefit of a percutaneous left ventricular assist device during high-risk coronary interventions.

Robert Biederman, MD and a team of researchers are involved in a number of landmark cardiac imaging studies. Using high-resolution, 3D cardiovascular magnetic resonance imaging (MRI), these researchers have presented, for the first time, visual evidence that the compositional vulnerability — or instability — of atherosclerotic plaque in the carotid arteries does not correlate with the degree of vessel narrowing as a predictor of adverse ischemic or thrombotic events. These investigators have also discovered a precise anatomical marker that identifies which patients with patent foramen ovale (PFO) are at risk for stroke or heart attack. This could herald a significant advancement leading to earlier and more aggressive therapeutic intervention.

Furthermore, Dr. Biederman’s team is involved in the first mesenchymal stem-cell infusion that has been performed in Pittsburgh chiefly for the reduction in inflammation and fibrosis within the heart in patients with acute myocardial infarctions. This groundbreaking effort is only being performed at centers that have a Center of Excellence for Advanced Cardiac MRI in close association with a strong Interventional Cardiology program. Continued work in the NHLBI supported WISE study has shown that cardiac MRI remains an important adjunct, if not the ‘go to’ test for women with chest pain and non-occlusive CAD as demonstrated by Mark Doyle, PhD, working in conjunction with Dr. Biederman’s lab.

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