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Cardiologist Receives Prestigious Kaiser Medal for Decades of Leadership

Tuesday, May 20, 2008

Arthur Moss, M.D., professor of Medicine at the University of Rochester Medical Center, has won the highest honor of the Rochester Academy of Medicine, the Albert David Kaiser Medal. Moss received the award on May 13 at the academy’s annual meeting.

The medal was presented to Moss for his decades of distinguished service and contributions to the medical community as a clinician, teacher, researcher and leader. The award was initiated in 1939 to recognize the work of Rochester pediatrician Albert H. Kaiser, M.D.

Moss attended Yale as an undergraduate then Harvard Medical School. He interned at Massachusetts General Hospital and finished his residency in Rochester, where he also did a fellowship in cardiology. Since his first publication in 1960, he has published over 500 scientific papers, books, chapters, and editorials. Many of the publications focused on cardiac arrhythmias, electrical malfunctions that can throw the heartbeat out of rhythm, and stop it in the worst cases.

Arrhythmias cause many of the 330,000 sudden cardiac deaths each year in the United States. Most fatal arrhythmias occur in aging patients when scar tissue left by a heart attack interferes with the heart's electrical system. As many as 1,000 deaths each year, however, are caused by Long QT Syndrome (LQTS). LQTS occurs mostly in teens with otherwise healthy hearts. While rare, LQTS is yielding insights into the much more common post-heart attack arrhythmias.

The QT interval is part of the heart’s electrical signature as recorded by an electrocardiogram (ECG). It represents the time it takes for the heart’s lower chambers to “reset” electrically after each heartbeat. QTc is QT corrected for heart rate, a more accurate measure. In LQTS patients, QTc reset time is prolonged, which makes the heart more susceptible to fatal arrhythmias. As a result of work led by Moss over more than two decades, researchers have achieved an 80 percent reduction in life-threatening LQTS events via drug treatment (e.g. beta blockers) and device advances.

In 1979, Moss helped to launch the International LQTS Registry, a database of families with the LQTS trait. By following generations of patients with this disorder, gene hunters used the registry to track down more than 500 genetic mutations involving ten genes that cause various versions of LQTS. By analyzing LTQS population data, Moss and colleagues have been able to identify patients at risk for life-threatening heart rhythm disorders and to develop even more effective treatment to prevent sudden death in this and related conditions.

His life’s work continues to gain momentum as well. In April, long-standing basic research into LQTS paid off. Moss reported at the American College of Cardiology meeting this past April on a new anginal drug, ranolazine, that is also effective in treating one form of LQTS. This week, Moss’ team won a four-year, $2.3 million grant from the National Institutes of Health (NIH) to continue its study of Long QT syndrome. With the latest award, the team will have received continuous NIH funding for 23 years – one of the longest, continuous, investigator-initiated research projects at the University of Rochester.

In addition, Moss has spearheaded the research that led to the use of implantable cardioverter defibrillators (ICDs), a device that shocks the heart back into proper rhythm when it detects a dangerous heart rhythm disorder. ICDs have been used more widely since Moss found that the ICD could reduce sudden death by up to 54 percent in heart attack survivors. Led by Moss, the MADIT-II study (Multicenter Automatic Defibrillator Implantation Trial II) published in 2002 changed medical guidelines nationwide and made a hundred thousand heart attack survivors eligible for ICD therapy each year.

Moss and colleagues are currently investigating a preventive strategy to reduce the risk of heart failure in a large follow-up study to MADIT-II -- The Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy (MADIT-CRT). MADIT-CRT is designed to determine if the combination of ICD and resynchronization therapies can reduce the risk of mortality and heart failure events by approximately 25 percent.

“I am greatly honored to receive this award from my friends and colleagues at the academy,” Moss said. “It has been tremendously exciting to continue this line of research, from the early days of trying to understand the nature of the disease to recent successes in developing new therapies for it.”

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