A celebration of cardiac research
By Eleni Kanavas
In its 10th year, the Schulich Heart Program at Sunnybrook Research Institute (SRI) hosted its annual research day showcasing its latest cardiac interventions. On Nov. 23, 2015, more than 150 people, comprised of scientists, clinicians and trainees, gathered to discuss the ongoing work in cardiovascular imaging, surgery and clinical outcomes.
Dr. Michael Julius, vice-president of research at SRI and Sunnybrook, welcomed the attendees and described the program’s research excellence in his opening remarks. “The Schulich Heart Program over the last decade actually epitomizes the framework that we have driven to create at SRI, most notably discovery all the way to clinical impact through the medical marketplace,” he said. “[This] is one of the most innovative programs we have on board, and it’s changing the way we deliver our care.”
Dr. Graham Wright, director of the Schulich Heart Research Program, gave an overview of the day, which was organized into 12 presentations split among three sessions along with three keynote lectures. He then introduced the first keynote speaker, Dr. Michael Laflamme, the Robert McEwen Chair in Cardiac Regenerative Medicine and senior scientist at the University Health Network. Wright described his work as “helping to galvanize the translational aspects of moving stem cells toward cardiac regenerative medicine therapy.” Laflamme then spoke about the remuscularization of injured hearts with human embryonic stem cell-derived cardiomyocytes, the muscle cells of the heart. His research aims to be able to repair hearts damaged by infarct with cardiac muscle derived from mature stem cells.
During the third presentation in the session on cardiovascular imaging methods, Dr. Eranga Ukwatta, a postdoctoral fellow working with Wright, discussed his research on evaluating different magnetic resonance imaging techniques to estimate infarct structure using computer simulations of cardiac electrophysiology.
Dr. Danny Dvir, an interventional cardiologist in the Centre for Heart Valve Innovation at St. Paul’s Hospital in Vancouver, BC, gave the second keynote lecture. He spoke about the treatment of failed valves after cardiac surgery and the fundamentals of using a valve-in-valve technique derived from lab bench testing and clinical data. Dvir leads the Valve-in-Valve International Data registry, which is looking at 742 patients who underwent valve-in-valve procedures at 69 sites worldwide.
The heart and stroke connection
The next session focused on interventions, surgery and electrophysiology in cardiac care. Within this section Dr. David Gladstone, a scientist in the Hurvitz Brain Sciences Research Program and senior stroke neurologist at Sunnybrook, presented a neurological perspective of atrial fibrillation (an irregular heart rhythm) and stroke prevention.
His research focuses on better understanding the connection between the heart and the brain. “Every nine minutes in Canada someone is experiencing a stroke, so this is a huge public health problem and a leading cause of cognitive and physical disability, and dementia,” Gladstone said. “One of the very best ways to prevent stroke is to identify and treat atrial fibrillation, which is common and highly treatable, with effective anticoagulant medications and other strategies for risk reduction.”
The afternoon keynote lecture was presented by Dr. Pamela Douglas, the Ursula Geller professor of research in cardiovascular disease at Duke University School of Medicine and the director of the imaging program at Duke Clinical Research Institute. She presented the results of the PROMISE trial, also known as the prospective multicenter imaging study for evaluation of chest pain.
The trial involved 10,003 patients who presented with new symptoms suggestive of coronary artery disease that required further evaluation. The patients were randomly assigned to an initial strategy of anatomical testing with the use of computed tomographic angiography (CTA) or to functional testing, such as a stress test. The researchers found that there was no significant difference in long-term clinical outcomes between groups. Douglas says these results can help inform noninvasive methods for testing patients with chest pain and provide guidance for future diagnostic strategies in cases of heart disease.
Cardiovascular outcomes
In the final session, which was about cardiovascular management, Dr. Harindra Wijeysundera, a scientist in the Schulich Heart Research Program and staff cardiologist at Sunnybrook, gave the last presentation. He discussed the results of a national audit on the quality indicators of transcatheter aortic valve implantation (TAVI). Researchers found there were 1,136 TAVI procedures in Canada between April 2013 and March 2014. Ontario had the highest number of TAVI cases compared to other provinces.
Wright concluded by thanking the sponsors, organizers, speakers and attendees for participating. He also encouraged everyone to read the 2015 SRI Magazine, available online and in print, to learn more about cardiac research within the Schulich Heart Research Program at SRI.
