Research Group

  • Dr David S. Feldman, Principal Investigator
  • Dr Terry Scott, Co-Investigator
  • Dr Raman Subha, Co-Investigator

Location

  • Minneapolis Heart Institute, Minneapolis, USA

Title

  • A Strategy of Using Molecular Mechanisms to Prolong the Lives of Heart Transplant Patients

Heart transplantation is one of the most effective methods of treatment for end-stage heart failure, but long-term survival remains less than ideal. These investigators propose that following a heart transplant, the newly transplanted heart begins to fail long before it becomes apparent to the physicians managing these patients. The new ‘heart failure’ after transplant manifests itself as shortness of breath, swelling, and an inability to exercise. In the more severe cases, it eventually leads to organ failure, heart attacks and sudden cardiac death. The post-transplant ‘heart failure’ that leads to progressive and insidious decline in a patients’ status is called transplant related heart failure (TRHF). This unique form of heart failure limits the success of transplantation, but no studies have defined the key mechanisms responsible. The central goal of this proposal is to better define mechanisms responsible for TRHF, and to allow for the rational optimization of therapy. To accomplish our goal, a group of new heart transplant patients will be recruited subsequent to their transplant, and then carefully followed and studied over several years. Serial measurements of cardiac structure (anatomy) and function (physiology) will be causally linked to biochemical and molecular investigations. This is the first study of its kind, designed to investigate long-term and simultaneous physiological, biochemical, and molecular aspects of cardiac transplantation in humans. Results of these studies may include an increase in post-transplant quantity and quality of life; a better understanding of the mechanisms involved in TRHF; and an opportunity for rational development of new therapeutic targets. Thereafter, the results of this study may be cautiously extrapolated to a larger group of heart failure patients who suffer from a condition called diastolic heart failure which impacts hundreds of thousands of patients a year.