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February 2007
Feature Story
Pediatric Cardiology: Research efforts going strong
The pediatric cardiology department is pushing forward in the field, and that means strengthening and expanding its research efforts.
The program combines all aspects of taking care of and treating patients with congenital heart disease, says Dr. Philip Saul, director of the Division of Pediatric Cardiology.
"We do all patient care, and part of that is our clinical research program," says Dr. Saul. "We have a dedicated faculty who all spend at least some of their time doing research."
The clinical faculty in the division is unique. "They're all relatively young, and all have the same belief that in order to push forward in the field, more of what we do needs to be driven by evidence-based research," says Dr. Saul.
Because there are relatively few patients with each form of congenital heart disease at any one medical center, the Division actively participates in multi-center trials, studies that involve multiple hospitals.
"One way we do that is through a grant funded by the NIH," says Dr. Saul.
MUSC's pediatric cardiology division is one of eight nationwide chosen to participate in the Pediatric Heart Research Network, a group of hospitals in the United States and Canada that conduct clinical research studies in children with congenital or acquired heart disease. The network sets protocol, enrolls patients and ensures that all the centers are conducting the same studies.
"We often recruit the highest number of patients, even though we're one of the smaller centers in the network," explains Dr. Saul. "We make sure all our eligible patients get into the studies, because we know its both good for the patients and good for the field."
There are also dozens of research protocols being conducted in the Division that are focused just on patients at MUSC, including diagnostic, therapeutic and review studies.
The division's basic research efforts are channeled into understanding the development of the heart.
"If we can understand how the heart is formed, we have a better idea of how to fix it using the body's own system to manipulate the heart tissue," says Dr. Saul.
"For instance, if there's a hole in a heart, we can close it by using a catheter-delivered device or surgery. But in the future, we want to determine how to turn on the gene that controls heart tissue and have the hole close on its own," suggests Dr. Saul.
This is the focus of the Division's newest investigator, Dr. Kyu-ho Lee, a researcher with a valuable combination of clinical and basic science research training (see below).
Stem cell work is an important aspect of Dr. Lee and his colleagues' research. Investigators are examining ways to use adult stem cells, rather than sutures, patches or devices, to repair heart tissue.
Investigator Dieter Haemmerich is also working on technologies to modify heart tissue using ablation, refining and developing new techniques using radiofrequency energy and cryo-energy to freeze or heat small areas of the heart, destroying the tissue responsible for heart rhythm abnormalities.
"Our real goal is to translate these research findings into the clinical environment," says Dr. Saul. "We want to make enough progress in the lab that we can then use those successes to develop new therapies that will help patients."
That's associate professor and researcher Dr. Tim McQuinn's job. "He's bringing discoveries from the basic science lab into the clinical environment," explains Dr. Saul.
Currently Dr. McQuinn is examining heart inflammation that results from cardiac surgery and the use of a heart-lung bypass machine. "He's found that the inflammatory reaction of the heart muscle is severe, and an excellent target for special anti-inflammatory agents," says Dr. Saul.
Dr. McQuinn is also developing a new heart valve with no moving parts that may be applicable to both children with congenital heart disease and adults with acquired heart valve problems.
New recruit strengthens research efforts
The unique chance to work in a pediatric cardiology department but also with a group of skilled and collaborative basic investigators focused on disease-related, developmental cardiovascular biology is what lured Dr. Kyu-Ho Lee to the Darby Children's Research Institute.
"This was a rare opportunity for me, because I'm clinically trained but also have a strong basic science training and interest," says the young recruit, who first worked with Dr. Saul at Boston Children's Hospital. He holds a joint appointment in Pediatric Cardiology and Cell Biology and Anatomy.
"It's always been my goal to be a scientific researcher, and to be involved in discovery. MUSC's resources and the Cardiovascular Biology Developmental Center (CDBC), led by Dr. Roger Markwald (also head of the Department of Cell Biology and Anatomy), were a big draw," explains Dr. Lee.
His recruitment is facilitated by the NIH's renewal of a large program project grant that provides continuing funding for the expansion of the SC Center of Biomedical Research Excellence (COBRE), and for the development of young investigators like him. This is the second, five-year renewal for the grant.
Impressed with the growth at MUSC and the focus on translational research, Dr. Lee joined DCRI and CDBC in June. "It was a good match between my training and interests, and what's being accomplished at MUSC," he says.
Dr. Lee is already finding many avenues for collaboration with fellow MUSC researchers. "Heart development is complex; it's bigger than any one investigator's effort," he notes, explaining that he aims to be part of an expanding dialogue between the Pediatric Cardiology and Cell Biology departments.
"The hope is that together, between our scientific efforts and our understanding of the outcomes, we can all begin to have insight into what causes certain types of congenital heart disease, and provide new tools for its treatment."
Dr. Lee says he and his wife, Dr. Kimberly Gronsman Lee, who was recruited as associate professor in Neonatology at MUSC, fell in love with Charleston and look forward to being a part of its friendly and vibrant community.
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