Six months ago a center was formed; this week its
researchers want to lift the curtain on the center's
future.
On Thursday afternoon, the Donald W. Reynolds
Cardiovascular Clinical Research Center will host its
inaugural Symposium on Sudden Cardiac Death. The event will
present an overview of the center's scientific goals, which
are to discover the causes and warning signs of and
ultimately prevent sudden cardiac death, one of the leading
causes of death among American adults. It will be held from
1 to 4 p.m. in the School of Nursing's Carpenter Hall
Auditorium, on the East Baltimore campus.
Gordon Tomaselli, professor of
medicine at
the School of Medicine and the center's co-director, said
that the symposium is intended to introduce the Johns
Hopkins community and the public to the center's
investigators and to set the stage for future projects.
"We're really just now getting past the run-up phase,"
said Tomaselli of the center, which officially began its
work on July 1. "We felt now was the proper time to tell an
interested audience what it is we are going to be up to
here."
In May, the School of Medicine was awarded a four-year
$24 million gift from the Las Vegas-based Donald W.
Reynolds Foundation to establish the multidisciplinary
center focused on understanding the biology of and reducing
the rate of sudden cardiac death.
Also called cardiac arrest, SCD results from an abrupt
loss of heart function, commonly brought on by an abnormal
heart rhythm. This is to be distinguished from a heart
attack or myocardial infarction, which results from a
cessation of blood flow to a region of the heart resulting
in the localized destruction of heart cells and replacement
with scar tissue.
According to Tomaselli, 70 percent to 80 percent of
the 450,000 Americans who die annually from SCD have
coronary artery disease. As the occurrence's name implies,
it can happen suddenly and without much warning, even to
those in good physical shape. Such was the case of the
three physicians that Johns Hopkins lost to sudden cardiac
death in 2002: David Nagey, 51, and Rick Montz, 47, both
with the Department of Gynecology and Obstetrics, and
Jeffery Williams, 50, a neurosurgeon. Nagey and Montz died
while jogging, Williams while exercising at the Cooley
Center on the East Baltimore campus.
"The occurrence of SCD in young, otherwise healthy
individuals is particularly devastating for families,
friends and colleagues," Tomaselli said. "Unfortunately,
although the rate of SCD is greatest in patients with
serious underlying heart disease, the greatest number of
individuals who experience SCD have minimal or no known
heart disease."
Tomaselli said that in the majority of victims of
sudden cardiac death, major coronary arteries are narrowed
by fatty buildups, which deprive the heart of oxygen. He
added that while a person suffering a heart attack is more
likely to develop abnormal heart rhythms and cardiac
arrest, SCD differs from a heart attack in that the two
have different causes, warning signs and affects on the
heart and body.
The Donald W. Reynolds Cardiovascular Clinical
Research Center is directed by Eduardo Marban, the Michel
Mirowski, M.D., Professor of
Cardiology and director of the Institute of Molecular
Cardiobiology.
"Sudden cardiac death is ripe for a biological
revolution," said Marban when the center was formed. "If we
can understand why specific patients have arrhythmias, we
can target those patients for intensive therapy while
sparing others. Therefore, treatment will become
increasingly customized to the patient based upon knowledge
of the individual abnormalities underlying a person's risk
for sudden death."
Scientists supported by the center pursue novel
biological therapies, including stem cells, to prevent
abnormal heart rhythms and sudden death in patients
recovering from heart attack. They also use modern imaging
techniques to better define the functional, structural and
metabolic features of the heart posing the greatest risk
for life-threatening arrhythmias in post-heart attack
patients, according to Tomaselli. In addition, they look to
identify novel genetic- and protein-related and functional
indicators of sudden cardiac death, and to develop new
methods to study genetic markers among patients at varying
levels of risk for the condition.
"We are looking for the telltale signs to identify
those at risk of sudden cardiac death," Tomaselli said.
"One of the questions we ask ourselves is, Why is it that
some people who have coronary artery disease live to ripe
old ages — even those who have had a heart attack
— while other people at the time of their first heart
attack and first clinical evidence of coronary artery
disease experience sudden death?"
Specifically, the eight physicians and scientists
scheduled to speak at the symposium will discuss:
Novel therapeutic strategies to
prevent arrhythmias
Noninvasive imaging techniques to
determine risk
Genomic and proteomic determinants
of sudden cardiac death risk
New technologies for genomewide
scans and candidate gene assessment
The center's approaches to
training a new generation of cardiovascular clinical
researchers
The center has established a registry of high-risk
patients, which will be populated with some of the hundreds
of thousands of Americans who currently have implanted
cardiac defibrillators. Tomaselli said that the center's
researchers are looking to study the specific details about
the heart structure and manifestation of coronary artery
disease in this high-risk population.
"This group is the tip of the iceberg, and the hope is
[that] through them we can learn more about the iceberg
itself," he said.
The symposium will feature welcoming remarks from
Steven Knapp, university provost, and Richard S. Sharpe,
executive vice president of the Donald W. Reynolds
Foundation, a national philanthropic organization founded
in 1954 by the now-deceased media entrepreneur for whom it
is named. The foundation is one of the 50 largest private
foundations in the United States, and it was responsible
for the establishment of three other cardiovascular
clinical research centers with which Johns Hopkins
investigators collaborate.
Following Knapp and Sharpe, Marban will offer "An
Overview of the Reynolds Center and Discovery Platforms."
Myron Weisfeldt, the William Osler Professor of Medicine
and chairman of the Department of Medicine, will present
the symposium's closing remarks.
Tomaselli said that in addition to informing the
community about the center's work, the symposium is
intended to attract medical colleagues who can learn of the
latest research involving patients with coronary artery
disease and also help add high-risk patients to the
registry.
For more information about the event, contact Barbara
Salkin at
bsalkin@jhmi.edu.