More than a dozen Rochester physicians, students and scientists are heading to Atlanta this weekend for the annual meeting of the American College of Cardiology. It’s one of the premier meetings of the year for cardiologists and others catching up on the latest in clinical treatments and research in an area that is key to the Medical Center’s strategic plan.
Faculty members Arthur Moss, M.D., Charles Phelps, Ph.D., Ronald Schwartz, M.D., and Wojciech Zareba, M.D., Ph.D., will present at symposia and other sessions, informing others about recent advances in preventing sudden cardiac death, teaching physicians how to recognize and treat heart arrhythmias, and discussing new imaging methods to evaluate the heart.
The highlights for the Rochester contingent include presentations by six medical students working with the Heart Research Follow-Up Program. The students have worked closely with Moss and Zareba as well as Ilan Goldenberg, M.D., a research associate professor in Cardiology and a mentor to the medical students. Presenters include:
- Eric Hansen and Bonnie Choy, who are looking at the relationship of body-mass index to risk of sudden death in cardiac patients.
- James A. Kim, who will discuss auditory triggers for Type 2 Long QT.
- Judy Liu, who will discuss risk factors for having a second cardiac event in people with Long QT who have already experienced a first significant event, such as fainting.
- Edward Sze, who is looking at how measures of blood flow to the kidneys might be used to predict subsequent difficulties in patients who have had a heart attack or who have heart failure.
- Princy Thottahil, who will present data on triggers related to exercise and arousal for Type 1 Long QT syndrome.
The new findings build on decades of research. More than 30 years ago, Moss founded one of the world’s first registries for any disease – the International Long QTS Registry. People from more than 1,200 families, including more than 8,000 individuals, now make up the registry, which has allowed researchers to learn ever more about Long QT in an effort to prevent sudden cardiac death.
People with the inherited disorder – which causes about one-third of sudden cardiac deaths in young people – have at least one of hundreds of mutations in more than a dozen genes known to cause different forms of Long QT. Study of the disorder has provided a gateway for Moss and others to conduct even larger studies focusing on more common arrhythmias. Those studies have led to worldwide changes in the way physicians treat patients for the risk of heart failure or sudden cardiac death, saving the lives of thousands of people who would have died were it not for the new treatments discovered by the large clinical trials led by Moss and his colleagues.
Moss attributes the heavy student involvement with his group to a lecture he gives each year to medical students, along with word of mouth among the students who have worked with his group. Moss notes that every abstract his students submitted to ACC this year was selected for presentation, a rarity for a large group of medical students.
“This level of involvement of students in presentations at ACC is very rare – it simply doesn’t occur at most institutions,” added Zareba, who works closely with the students. “Here, we have a wealth of data about sudden cardiac death, and we also have mentors willing to work closely with the students.”
Fourth-year medical student Judy Liu is looking at episodes of syncope – fainting – and their role indicating the risk of further dangerous events for people with Long QT syndrome. This is the second trip to ACC for Liu, who took a year off from her medical school studies last year to work with the team, investigating the risk factors for future problems in patients with Long QT who have experienced at least one event before. Most other studies have focused on risk factors before a patient’s first serious rhythm problem.
Liu came to Rochester in 2005 after getting her undergraduate degree in psychology, with a minor in Chinese language and Russian literature, from Dartmouth. A native of New York City, she headed back to New York after college and worked in the laboratory of none other than cardiothoracic surgeon and media star Mehmet Oz, pursuing an interest in cardiology and research. After she arrived in Rochester and heard Moss speak to medical students in cardiology, she approached him about doing research.
“I felt that pursuing research is an important part of being a physician,” said Liu. “When you practice evidence-based medicine, it’s important to understand what “evidence” means – how to read it, understand it, analyze it, and apply it. I felt that by trying to do research myself, I would gain a better understanding of the whole process.”
In her first year, she worked with Moss, comparing how a mutation for Long QT Type 1 is expressed differently in Caucasians and Japanese, a phenomenon perhaps related to other genetic differences between the two groups. In her third year, she explored differences between two groups of Long QT Type 3 patients whose mutation differed; her manuscript was published earlier this year by the American Journal of Cardiology.
“Long QT syndrome is not a common condition, but it’s a great window into understanding not only the heart, but also broader topics like genetics and public health,” said Liu.
“This will make me a more rounded physician in the future and will help me understand patients on a whole different level,” she added. “Understanding research provides me with tools to explore new questions, and there are always new questions in medicine. If I can understand the implications of research and apply that knowledge to patients, it will make me confident that I am offering the best care I possibly can to my patients.”
Adds Moss: “Research like this helps future doctors get a sense of what it’s like to advance the fund of medical knowledge.”
After ACC, Moss heads to Washington to testify at a hearing of the U.S. Food and Drug Administration about the results of a large study, MADIT-CRT, which he headed. In a publication last year in the New England Journal of Medicine, his team found that patients who receive devices that act both as an implantable defibrillator and a cardiac resynchronization device (CRT-D devices) had a remarkable drop in their risk for either heart failure or death.
Moss presents the results of MADIT-CRT to FDA next Thursday, March 18, which happens to be Match Day 2010 – the day Liu will learn where she will be doing her residency in internal medicine.