Medical director of heart failure Kavita Sharma is identifying the molecular mechanisms behind Heart Failure with preserved ejection fraction (HFpEF) in order to find new treatments.
Hi, My name is Kavita Sharma. I am a heart failure transplant Cardiologists at Johns Hopkins. I am the director of heart failure and cardiac transplantation, and I also direct the heart failure with Preserved Ejection Fraction Clinic at Johns Hopkins. I'm very excited to present in the session at this week's American Heart Association Scientific Sessions meeting that is focused on treatment of heart failure with preserved ejection fraction or Hef path, as we call it. And the topic I'm going to be speaking on is a phenotype based approach to treatment, so it's a little bit of background. Hef PEF is a form of congestive heart failure where the ejection fraction in our patients with this condition is generally in normal range, or 50% or greater by echocardiography. And yet these patients have signs and symptoms of heart failure, including swelling in the legs, abdominal bloating, shortness of breath and exercise intolerance. Their survival can often be as limited as those with low ejection fraction, heart failure or heart failure with reduced ejection fraction. Unfortunately, we have really a very limited understanding as to the underlying mechanisms of how have path develops, and we have no proven treatments to date that have shown a benefit in this population. And yet half of all patients with heart failure in the United States have Hef path estimated at about 3.5 million Americans today. So what? Hopkins. We are leading the way in a dedicated hefty clinic for the clinical care of these patients and for understanding clinical and translational mechanisms for how this condition develops. In the talk this weekend, I hope to present to you some new data from our group looking at myocardial tissue gene expression for the first time in human patients to understand whether there are subgroups of half path that we can target for specific therapies as we try to phenotype better this condition. Yeah, in the Hopkins Have program, we have a multifaceted research program that covers clinical trials of new therapeutic agents, as well as translational studies to understand mechanisms of disease. As part of our translational research program, we haven't irby protocol to obtain research and a myocardial biopsies which are heart biopsies from the right ventricular septum, which we collect to better understand at the tissue level what might be driving the underlying molecular mechanisms that developed into half path we have a thing is a first in human bio bank of tissue that we are collecting at Hopkins to understand half path better and in the American Heart Talk This weekend, I plan to present some of our findings that were published in circulation just two weeks ago. Ipab ahead of print Where we describe Human. My cardio gene expression signatures in 41 half path patients compared to those with have rough or low ejection heart ejection fraction, heart failure and control tissue from unused donor hearts. And what we found is that health path subjects have a distinct gene expression profile compared to have breath and controls. And more importantly, there are sub groups that we have identified, determined by gene expression, signature in half path that suggest, um, varying molecular mechanisms at play and pathways involving structural components in the myocardial inflammation Metabolic co. Morbidity ease um, that distinguished patient subgroups that actually have implications for their outcomes. We identified a subgroup of patients that actually looks transcription Aly closer to heart player with reduced ejection fraction, suggesting that there may be a subgroup of health path that might benefit from low ejection fraction therapies that were not currently pursuing or are looking into it this time, whereas there are other patient subgroups that might benefit from, um, therapies that are completely unique. And so again, this is part of our effort to deep phenotype path path to improve targeted, precision based treatment of this condition.
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