Guest Editorial - Douglas E. Vaughan, M.D.  pg. 2

It is critical for us to understand the mechanisms of these phenomena if we are to prevent effectively coronary events in these increasingly prevalent populations.

Over the last several years, no area of cardiovascular science has been more exciting or controversial than the area of stem cell biology. Do we have the capacity to regenerate cardiac tissue and function with resident stem cells in the myocardium (heart muscle) or from cells derived from the blood, bone marrow, or other sources?

As part of the newly formed Cardiac Cell Therapy Research Network, another NHLBI initiative, we recently began testing the efficacy of bone marrow-derived cells for the treatment of patients with acute MI and for patients with chronic left ventricular dysfunction.

Our working group includes basic scientists with expertise in cardiac development and stem cell biology, and a rather remarkable group of physicians from interventional cardiology, bone marrow harvesting and transplantation, cardiovascular imaging, cardiac surgery, electrophysiology and heart failure.

Fusion of two images of the heart—a computerized, tomographic (CT) angiograph and a myocardial perfusion image (MPI).
Courtesy of Murray Mazer, M.D., associate professor of Radiology and Radiological Sciences, Vanderbilt University Medical Center
The confluence of technology, pharmacology, surgery and genetics also is being applied to the identification and prevention of abnormal heart rhythms (arrhythmias) that are a frequent cause of sudden cardiac death. At Vanderbilt, for example, Dan Roden, M.D., and his colleagues are scanning the human genome for gene variants that put people at higher risk for fatal heart arrhythmias.

These examples illustrate how hypotheses about disease that emerge from basic science discoveries can be tested in the clinic and, conversely, how clinical observations can lead to entirely new and unexpected hypotheses. With current and anticipated developments at the cellular and molecular level, including knowledge of the human genome, future opportunities for continuing these advances are enormous.

There are numerous challenges to maintaining this momentum, however.

Cardiovascular research is an extremely expensive activity. The diminishing margins in health care in this country eventually will impact the ability of Vanderbilt and other academic medical centers to invest in research. Federal budget limitations already are affecting cardiovascular research and the training of new investigators.

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