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Cardiologist Receives Prestigious Glorney-Raisbeck Award

New York Academy of Medicine Recognizes Decades of Leadership by Arthur Moss

Thursday, December 4, 2008

Arthur Moss, M.D., professor of Medicine at the University of Rochester Medical Center, has won the highest honor of the New York Academy of Medicine, the Glorney-Raisbeck Lecture and Award in Cardiology.

Established by Corlette Glorney in 1988 to honor her longtime physician, Milton Raisbeck, the award is endowed by the Corlette Glorney Foundation and presented annually to a clinician or scientist for outstanding contributions to the field of cardiovascular disease. The award included an honorarium and the honor of giving a lecture on a cardiology topic of Moss’ choosing to an audience of his peers at the academy headquarters in New York City on Nov. 20, 2008. 

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 sufferers, gene hunters used the registry to track down more than 500 genetic mutations involving ten genes that cause versions of LQTS. By analyzing LTQS population data, Moss and colleagues have been able to hone patients’ risk factor assessments 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 of this year, long years of basic research into LQTS paid off as Moss reported at the American College of Cardiology meeting on his study had found a new angina drug, ranolazine, effective at treating one form of LQTS. That same month, 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, he has spearheaded the research that led to the use of implantable cardioverter defibrillators (ICDs), which shock the heart back into proper rhythm when then sense an arrythmia. ICDs have been used more widely since studies found that the devices could reduce sudden death by up to 54 percent in heart attack survivors. Led by Moss, the 2002 MADIT II study (Multicenter Automatic Defibrillator Implantation Trial II) in particular changed medical guidelines nationwide and made a hundred thousand heart attack survivors eligible for ICD therapy.

Moss and colleagues are currently investigating a preventive strategy to reduce the risk of heart failure in ICD patients 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, especially because many of the former winners of this award were also winners of the Nobel Prize,” Moss said. “It has been tremendously exciting to continue this line of research, and to see it progress to the point of developing new therapies.”

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