Guide Cardiac Development (Progress in Experimental Cardiology)

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They found that the average length of stay declined among both groups of patients, but there was a significantly greater reduction among TAVR patients. Overall, patients who underwent TAVR had a significantly shorter length of stay and were significantly less likely to be transferred to a skilling nursing facility compared to patients who underwent SAVR. John P. Co-authors are Paula D. Caranasos, MD; Matthew A. Rossi, MD. Congratulations to Cardiology fellow Dr. This highly selective award recognizes excellence in research related to cardiovascular function and diseases by early career investigators; finalists will present their research at the Scientific Sessions of the American Heart Association.

Arora thanks Cardiology Division Chief Dr. Rick Stouffer, Dr. John Vavalle, and Dr. Wayne Rosamond for their continued mentorship. Also interviewed is Prof. Listen to the interview. Sameer Arora, UNC Cardiology fellow, is the lead author on this paper, which reviewed studies comparing transcatheter and surgical aortic valve replacement in the lower surgical risk population, finding that the two approaches appear to be comparable in short term outcomes.

Rose-Jones has been the program's Associate Director since John Vavalle will become the Associate Program Director.

Towards Personalized Cardiology: Multi-Scale Modeling of the Failing Heart

In addition to fellowship education, she spends half of a day each week as a tutor in the Patient Centered Care PCC course with preclinical medical students and as co-Director of the MS1 Cardiovascular Block. Media Contact: Jamie Williams, jamie. Despite a focus on high-risk populations with diabetes, clinical trials found no improvement in health outcomes. In some cases, the screenings actually led to harm to the patient in the form of additional unnecessary tests, arrhythmias, cardiovascular events, injuries, anxiety, labeling and other issues. Their analysis found that screening with ECG can detect more new cases of atrial fibrillation than no screening, but ECG screening has not been shown to be more effective than screening focused on using pulse palpitation to detect atrial fibrillation in older adults.

Her ground-breaking work demonstrated that endogenous cardiac fibroblasts can be directly converted into cardiomyocyte-like cells in their native environment, which translated into functional improvement and scar size reduction in an animal model of myocardial infarction. Since being recruited to UNC in , her lab has developed a system in which cardiac reprogramming can be rigorously studied and implemented. Milestone work from the Qian Lab translating basic science into developing innovative therapeutic strategies for heart disease has been published in journals including Nature, Science , Cell Stem Cell , Cell Reports , Circulation Research , and Cardiovascular Research.

This year, the AHA released a new award mechanism, the Transformational Project Award, to encourage investigators to develop bold ideas on an emerging paradigm. With this research fund, her team will continue a combinatorial utilization of single cell platforms, various omics approaches, and cutting-edge molecular assays to move this cellular reprogramming approach closer to clinical application on a significant population in US who suffer from heart failure. McAllister, Jr. After obtaining his medical degree, he served 22 years in the military at the Armed Forces Institute of Pathology while holding multiple academic appointments.

After retiring from the military in , he joined the Texas Heart Institute as the founding Chair of the Department of Cardiovascular Pathology and went on to hold appointments at Baylor College of Medicine and the University of Texas Medical School. McAllister received numerous awards recognizing his contributions to cardiac pathology including the Casimir Funk Award for outstanding work in the field of cardiovascular disease and the Silver Medallion of the Instituto Nacional de Cardiologia de Mexico, honoring him as a distinguished investigator in the field of cardiovascular disease.

In , Dr. In addition, he donated over pieces of art to the Ackland Art Museum. Its mission is to advance the care of patients with diseases of the heart, blood, and circulation by encouraging basic, preclinical, and applied research to unravel the causes of cardiovascular disease and to provide new tools for its diagnosis and treatment. Vicki Bautch and Dr.

Rick Stouffer stated in tribute to Dr. Following a visit to campus in April, Chip shared with us that he was very pleased with the direction of UNC McAllister Heart Institute, and the innovative research that is being conducted to advance both basic knowledge and the care of all those who suffer from cardiovascular disease. Ron Falk in a podcast on long QT syndrome , an electrical disorder of the heart.

They discuss different forms of long QT syndrome inherited and acquired , genetic testing, and treatments. The PVI registry included patient data from over participating institutions. Its goal is to measure the prevalence, demographics, management and outcomes of patients undergoing percutaneous treatment for peripheral vascular disease — as well as carotid artery stenting CAS and carotid endarterectomy.

Drew was discharged in good condition with a left ventricular assist device LVAD and is currently awaiting a heart transplant. WRAL's story includes an interview with Dr.

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Jason Katz. This award has been given out annually since to recognize North Carolina nurses who demonstrate excellence in practice and commitment to their profession.

UNC Cardiology News

Learn more about heart failure care at UNC. UNC Nash earned the award by meeting specific criteria and standards of performance for the quick and appropriate treatment of heart attack patients by providing emergency procedures to re-establish blood flow to blocked arteries when needed. UNC Nash is one of only 37 hospitals nationwide to win this award. To receive the award, Nash Health Care demonstrated sustained achievement in the ACTION Registry for eight consecutive quarters and has performed at the top level of standards for specific performance measures.

UNC Nash received the Silver award last year. Michael Yeung is the physician leader on the Nash team.

Since opening in , the Nash Heart Center has increased the scope of services available for patients in the Rocky Mount area. UNC faculty including Dr. Yeung as well as Drs. Sudhir Prasada and Roy Flood provide cardiac care and perform interventional procedures including stent placement and balloon angioplasty. In February , the available services for Nash patients grew to include a dedicated Heart Valve Clinic where patients can be evaluated for complex valve disease for either minimally invasive percutaneous intervention or surgery.

These three awards recognize the commitment to quality of care and range of options available at the Nash Heart Center for patients experiencing heart attack in the Rocky Mount area. We are very excited to receive these awards, and we are very pleased to work together with Dr. Sudhir Prasada in managing our heart attack patients to improve our community. And hopefully that is ultimately our goal, for all of us to work together in order to improve and deliver comprehensive cardiac care in Rocky Mount.

Matt Cavender and Division Chief Dr. The study was based on retrospective data and has implications in helping us better understand the outcomes and optimal aftercare of patients with NSTEMI. The study is also highlighted in a Cardiology Today overview of the research. Wang is interested in further developing and refining cellular reprogramming approaches to regenerate or repair an injured heart.

Cellular reprogramming of a somatic non-myocyte directly into an induced cardiomyocyte iCM has been achieved by forced expression of defined factors. This novel strategy holds great promise for treating heart failure, a common and morbid disease caused by irreversible loss of functional cardiomyocytes. However, the limited understanding of the underlying molecular mechanisms of iCM reprogramming has significantly hindered its clinical applicability.

Refinement of this technique will not be possible without sufficient understanding on basic mechanisms of iCM reprogramming. Wang proposed to explore how iCMs remodel the existing fibroblast structure and establish a bona fide cardiac program. For this funded project, she hypothesized that autophagy, an evolutionally conserved recycling process, is activated so as to orchestrate the authentic cell fate conversion.

Cardiac Development

She will use the research fund to characterize the dynamics of autophagy and define the role that autophagy plays during iCM reprogramming. Because autophagy can be manipulated through pharmacological approaches i. Smith Jr. UNC cardiologists perform X-ray free atrial fibrillation ablation. The procedure was performed by Dr. Greg Harris. It has long been known that mitochondrial diseases are a group of diseases related to neuromuscular dysfunction and cardiomyopathy 12 , Moreover, in cardiology, the study of the mitochondrial function in the myocyte is a new research frontier, which some have called "mitochondrial bioenergetics" 12 , One of the key areas is HF, due to the role of aerobic metabolism in myocardial performance.

Drugs are being developed that act on mitochondrial pathways, correcting occasional dysfunctions, and it is expected that they can improve myocardial function 14 , The history of cardiac catheterization started in , based on the works of Stephen Hales, who inserted tubes in both ventricles of a horse 1 , 16 - According to Cournnand 17 , cardiac catheterization can be considered the "key that opened the lock to reveal the secrets of the heart. The Nobel Prize in Physiology or Medicine in was awarded to three researchers, due to their researches on catheterization that revolutionized the studies on heart disease 1.

They would not accept with the scarcity of semiotic methods, of which provided diagnoses were rebuffed by autopsies, which served as motivation to initiate their studies 1. Werner Forssmann was a German physician, born in Berlin, who developed the hypothesis that a catheter could be inserted through blood vessels to the heart, aiming to injecting medications, perform contrast studies and measure chamber pressures. In order to test his hypothesis, he performed the first human catheterization in himself, guiding a catheter into his left atrium with the aid of a fluoroscopy device 1 , 16 - Andre Cournard, born in Paris, France and Dickinson Richards, from Orange, United States, were physicians who worked in the development of the cardiac catheterization technique, with emphasis on pulmonary diseases and patterns of circulatory shock.

They described the shock patterns, particularly cardiogenic and hemorrhagic trauma and analyzed the hemodynamic changes with treatment, either by fluid replacement or drug infusion 1 , 16 - He obtained a degree in Medicine in his native country and post-graduated in England. He specialized in the virology area, with important research related to influenza virus and herpes simplex.

He played a key role in virus isolation from human tissue, and the first attempts to develop a vaccine for influenza. After World War II, he also developed researches related to the immune system, especially autoimmune mechanisms and immunological tolerance 1 , 2 , 21 - The family moved to England when he was only 14, where he developed his studies and career. Differences with the Brazilian government, which required his mandatory military service, made him give up his Brazilian nationality. The main objectives were skin grafts in burned skin areas. His studies led to the theory of acquired immunological tolerance, the basis for the development of solid organ transplants in the future 1 , 2 , 4 , 5.

The connection made between his research and Cardiology was the applicability of his results on immunological tolerance for the future development of heart transplantation. Bloch was born on January 21, , in Neisse now Nysa , formerly part of Germany and currently in Poland. He graduated in chemical engineering in in Munich. In , due to the persecution of Jews by the Nazis, Bloch immigrated to the United States and joined the Department of Biochemistry at Columbia University, where he developed the research that led him to be awarded the Nobel Prize.

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Feodor Lynen was born on April 6, , in Munich, Germany, where he graduated in chemistry. He developed his entire career in Germany, living there even during the world wars 1 , Even without performing a real joint work, both researchers carried out important discoveries in their universities on the cholesterol regulation mechanism and the fatty acid metabolism 1 , Starting from the idea that the acetic acid, with slow reaction in the chemical essays, had to show a more rapid and spontaneous reaction in the body, the concept of activated acetic acid was formulated, in which, in addition to adenyl-phosphoric acid as an energy source, also included coenzyme A.

They were able to determine not only the structure of cholesterol, as well as the participation of coenzyme A in the oxidation of the fatty acids 1 , Years later, these discoveries were crucial to demonstrate the importance of cholesterol in atherosclerosis and, more importantly, helped the development of statins, the major class of drugs for treatment of hypercholesterolemia and atherosclerotic disease.

Allan Cormack was a South African biochemist and nuclear physicist born in Johannesburg South Africa , who became a naturalized American in He is considered one of the inventors of computed tomography and shared the Nobel Prize in Physiology or Medicine with British professor Godfrey Hounsfield. Cormack performed his research in radiology initially at the University of Cape Town until he immigrated to the United States, where he worked at Harvard and Tufts University.

There, he tested a mathematical model based on the X radiation, essential to the development of computed axial tomography 1 , Sir Godfrey Hounsfield was an electrical engineer who had the position of "inventor" at the Central Research Laboratories in London. He started his career working on a radar project as a weapon of war and designed the first British transistorized computer in , "EMIDEC ". Based on the mathematical calculations of radiation developed by Cormack, he developed Computed Tomography CT — so that the first machine to "scan" the brain was marketed by EMI. Three years later, he developed the first CT for the entire body.

He continued to make improvements in CT and received numerous awards and honors, in addition to the Nobel prize, with his latest award being the title of Knight of the Queen of England - Sir, in 1 , CT developed further in the following years and now has several applications in cardiology, for instance, determination of the coronary anatomy and the calcium score, and in the assessment of pulmonary thromboembolism. His research involved prostaglandin function, purification, determination of their chemical structure and identification of their mechanism of formation from unsaturated fatty acids 1 , 26 , This information allowed the proposition of acetylsalicylic acid mechanism of action, practically indispensable treatment in coronary heart disease.

In addition to the research on prostaglandins, John Vane is also considered one of the "discoverers" of Angiotensin-Converting Enzyme inhibitors ACE inhibitors 1 , 26 , During the s and s, and with the participation of Brazilian Sergio Ferreira, Vane and his colleagues demonstrated key steps in the synthesis of angiotensin and bradykinin, which, in , culminated in the launching of the first ACEI, captopril 1 , 26 , This class of drugs has a vital role in the treatment of hypertension, heart failure and coronary artery disease.

Joseph L. Brown, who later would become his collaborator and together, they won the Nobel Prize 3. During the two following years, he worked at the National Heart, Lung, and Blood Institute of the United States, which contributed to increase his skills and taste for scientific experimentation from the perspective of molecular biology in human disease 1 , 28 - Similarly to Goldstein, he first obtained a degree in chemistry and only then in Medicine. He also worked at the National Heart, Lung, and Blood Institute of the US, but in the area of gastroenterology and hereditary diseases.

In biochemistry laboratory, he learned enzymatic manipulation techniques, among which, an enzyme that could be related to familial hypercholesterolemia 1 , 28 - Goldstein and Brown were awarded the Nobel Prize for scientific research in which they identified receptors on the surface of cells that mediate the uptake of Low-Density Lipoprotein LDL circulating in the bloodstream. Furthermore, they found that severe familial hypercholesterolemia is closely related to these receptors, as with the decrease in the number of membrane receptors, there is a lower uptake of circulating cholesterol in the form of LDL, thus increasing levels of the substance in the bloodstream from 1 , 28 - In this example, once again, one can observe the close association between high cholesterol levels, atherosclerosis, and ischemic heart disease.

James W. Black, from Uddington, Scotland, studied medicine at the University of St. In , he started an investigation on cardiac adrenergic alpha and beta receptors, resulting in the synthesis of propranolol, the prototype of beta-blockers, essential medications for the treatment of heart failure and coronary artery disease. Later, in , he concluded the synthesis of cimetidine, histamine H2-receptor antagonist, used in peptic disease treatments.

Together with James W. Black, researchers Gertrude B. Hitchings Hoquiam, United States were also awarded the Nobel Prize of Medicine, for the development of drugs used in chemotherapy, antibiotics and antivirals 1 , Joseph Murray was born on April 1 st , in the city of Milford, State of Massachusetts United States and died in due to a stroke.

He graduated from Harvard medical school and specialized in plastic surgery. When caring for burned patients, he observed that many patients responded well to donor skin grafts and decided to develop a research related to organ transplantation. On December 23, , he was part of the team that made the first renal transplantation and, some years later, the first transplantation using a cadaveric source. Over the years, he participated in studies on immunosuppressive drugs such as azathioprine, aimed at reducing graft rejection 1 , He graduated from medical school at Harvard and, early in his career, he devoted himself to laboratory studies related to bone marrow transplantation.

Together with Joseph Edward Murray, he received the Nobel Prize in Physiology or Medicine as his studies helped to develop the transplantation of organs and tissues. In the field of HF, heart transplantation was indicated for patients that remained very symptomatic despite optimal medical treatment, which was performed for the first time in history in South Africa by Dr. Christiaan Barnard 1 , NO is a soluble gas naturally found in the human body, which acts on the signaling of several biological processes.

There are three types of NOS, two of them called constitutive and calcium-dependent NOS cNOS , which are the endothelial and neuronal forms that synthesize NO in normal conditions and the calcium-independent form iNOS , which is not expressed or is in a much lesser amount under physiological conditions. NO plays an important role in endothelial homeostasis, contributing with its vasodilating and anticoagulant properties.

There is evidence that a decreased NO production is an important factor in ischemic events in patients with coronary artery disease and other suggesting that NO can exert antiatherosclerotic actions. Furthermore, the nitrates, the most widely used drugs in coronary artery disease and heart failure, act by indirectly increasing NO bioavailability 33 - Peter Mansfield was born on October 9, in London and a received his Ph.

In the course of his career as an investigator he received several awards, including the Gold Medal of the Society for Magnetic Resonance in Medicine in , the European Prize of Magnetic Resonance in , the title of Sir of the British Crown in , the Gold Medal of the European Congress of Radiology and the European Association of Radiology in and the Nobel Prize for Physiology and Medicine, for his discoveries related to nuclear magnetic resonance imaging in 1 , 37 - Based on the initial findings of Lauterbur and Mansfield, MRI has developed and now has wide application in cardiology.

It is considered, for instance, the gold standard in non-invasive myocardial and heart function assessment. Carlos Chagas — an unjustly overlooked scientist in relation to the Nobel Prize. Carlos Chagas Figure 3 was the first researcher in the world's scientific history to describe the complete cycle of a disease, currently known as Chagas disease His research with Trypanosoma cruzi started between the years and , when he was sent to the countryside of the state of Minas Gerais to help fight malaria among workers building the Brazilian Central Railway 7.

In , he identified the parasite in the blood of a child with "fever, anemia, edema and generalized lymphadenopathy" and later described the life cycle of T. Aided by a small team, he changed history as a scientist that inspired a new era of knowledge, as he was able to draw a clinical profile from his own observations. Source: Lagoeiro B, Gemal P. Carlos Chagas. UFF; Throughout his career, he received honors of national importance, such as public health management positions, as well as international prizes, such as the Schauddinn award in Germany, for the most important discovery of protozoology.

For these reasons, he was nominated four times for the Nobel Prize, but none fructified. Researchers and historians have assessed, among other sources, files from Oswaldo Cruz Foundation and the Karolinska Institute to identify the reasons why Carlos Chagas was not awarded the Nobel prize 6 , 7 , 41 - Bestetti et al. These researchers even went to the Swedish institute in person to review the original documents of the time; their research, published in prestigious international journals, are less disseminated than they should be in Brazilian cardiology.

Although now recognized as renowned researcher, Chagas had opponents in South America and Brazil. A group linked to the Bacteriology Institute in Buenos Aires, including a Brazilian member, insisted in the early years of Chagas' discovery, that there was no association between the symptoms reported by Chagas and the presence of T.

Another group, from the very Oswaldo Cruz Foundation and the School of Medicine of Rio de Janeiro, disagreed with Chagas for political reasons and, on several occasions, questioned the importance of trypanosomiasis 6. Chagas also lost prestige among the local population for unpopular measures at the time when he was appointed Director of Public Health, an equivalent post at the time of the "Minister of Health". The mandatory vaccine for smallpox was one of those most criticized measures, being even the reason of a popular revolt 6 , It is suggested that he excessively valued researches related to physiology, rather than those related to clinical medicine It persists, though, in the light of the centenary of the discovery by Chagas, our pride in a great Brazilian who, with all the honors and merits, made such a contribution to humankind.

Bernard Lown — a brilliant clinical cardiologist that received the Peace Nobel Prize of Bernard Lown was born on June 7, , in the city of Utena, Lithuania, and moved at age 13 with his family to the USA and settled in the state of Maine, where he became a medical doctor and completed his specialization in cardiology at the current Brigham and Women's hospital in Boston 1 , Together with engineer Baruch Berkowitz, in , he created the direct current used in the defibrillator, allowing greater safety and efficacy in relation to the then AC defibrillator created by Paul Zoll.

Heart Embryology Animation

Lown also discovered the correct moment of the cardiac cycle in ECG for the electrical discharge in ventricular tachyarrhythmias. This therapy received the name of "cardioversion". The defibrillator designed by Lown and Berkowitz was used as standard therapy in cardiac arrhythmias until the s, when the models with biphasic current were created. He also has researched the use of lidocaine as an antiarrhythmic drug and the importance of serum potassium in digitalis intoxication.

Lidocaine, until then, was basically used as a local anesthetic by dentists. In the presence of HF, electrical therapies are essential in preventing sudden death of which ventricular dysfunction is one of the most important risk factors and in the treatment of symptomatic arrhythmias, highly prevalent in this group; digoxin is one of the drugs indicated for patients with reduced ejection fraction and symptomatic ones with functional class III or IV 1 , Despite all these contributions to Medicine, his Nobel Prize was won by other merits: a peacekeeper, he created the International Physicians for the Prevention of Nuclear War, in association with the then Soviet citizen Yevgeniy Chazov.

His association has also had the participation of Brazilian physicians.

Heart 2020

The Nobel Prize aims to reward researchers whose actions and discoveries have contributed exceptionally to the progress and the good of society. Regarding heart failure, the final pathway of several forms of heart disease, 33 researchers in 16 awards performed studies that yielded great contributions to its diagnosis and treatment. Brazil, despite its growing scientific contributions in recent decades, in the fields of Physiology and Medicine, has no "genuinely" Brazilian laureates, despite the contributions of Dr. Peter Medawar and Dr. Carlos Chagas - the latter unjustly not a recipient of this honor.

Nobel, o premio o homem: anos de medicina. Transplantation at years: Alexis Carrel, pioneer surgeon. Ann Thorac Surg. Peter Brian Medawar: father of transplantation.