Cardiovascular Center: Innovative Trials and Screening for Advanced Heart Disease

Directed by Kenneth L. Baughman, MD, the Advanced Heart Disease Program – part of the Cardiovascular Center – is comprised of a multidisciplinary team of leading specialists dedicated to the care of patients with congestive heart failure and other severe cardiac conditions. New clinical trials at the Program include:

Jarvik 2000 Heart Assist System – Gregory S. Couper, MD, and James Fang, MD, are directing this trial assessing a new ventricular assist device (VAD) that is quieter, smaller, and more durable compared with older generation VADs. Patients with end-stage congestive heart failure who are failing medical therapy and considered appropriate candidates for cardiac transplantation may qualify for this clinical trial. (For more information, please call Gregory S. Couper, MD, at 617-732- 7678 or email eborde@partners.org.)

OPCAT – For patients with diastolic heart failure, this National Heart, Lung, and Blood Institute (NHLBI)-sponsored, international multicenter trial is testing the efficacy of an aldosterone antagonist in the treatment of heart failure patients with preserved ejection fraction. Patients 50 years of age or younger with a left ventricular ejection fraction of less than or equal to 45 percent and signs and symptoms of heart failure with either a heart failure hospitalization in the past 12 months or elevated brain natriuretic peptide levels are eligible for the study. TOPCAT is led internationally by Brigham and Women’s Hospital senior cardiologist Marc A. Pfeffer, MD, PhD, and locally at Brigham and Women’s Hospital by Dr. Fang, along with Eldrin F. Lewis, MD, MPH, Scott D. Solomon, MD, and Akshay S. Desai, MD. This trial is only the second major trial that has offered a medical therapeutic option for patients with diastolic heart failure. (For more information, please contact Eldrin F. Lewis, MD, MPH, at 617-525-7057 or eflewis@partners.org, or James Fang, MD, at 617-732-7367 or jfang@partners.org.)

HF-ACTION (Heart Failure – A Controlled Trial Investigating Outcomes of Exercise Training) – Sponsored by the NHLBI, this randomized, controlled, multicenter trial is designed to evaluate the impact of exercise on advanced heart disease, including its effects on mortality, morbidity, hospitalizations, and over- (continued on page 6) all quality-of-life. Class II, III, and IV systolic heart failure patients with ejection fraction less than or equal to 35 percent may qualify for participation in this trial, that is overseen locally in three locations by Brigham and Women’s Hospital specialist Daniel E. Forman, MD. (For more information, please call Research Study Coordinator Maria M. Lopez, MA, at 617-525-7638 or mlopez0@partners.org.)

Milestones in Transplantation
Adding to a long history of accomplishments in organ transplantation at Brigham and Women’s Hospital, specialists completed the Cardiovascular Center’s 500th heart transplant in December 2005 – more than any other center in New England. Brigham and Women’s Hospital physicians performed the first heart transplant in New England more than 20 years ago and the world’s first successful human organ transplant in 1954.

Cardiovascular Genetics Center
The Cardiovascular Genetics Center – also part of the Cardiovascular Center – offers comprehensive evaluation, diagnosis, and management for individuals and families with hypertrophic cardiomyopathy (HCM), familial dilated cardiomyopathy (DCM), inherited aortic aneurysms, inherited arrhythmias (including QT syndrome), and Marfan syndrome. Center Director Christine E. Seidman, MD, and Medical Director Carolyn Ho, MD, along with other Center clinicians, provide:

• Individual genetic screening with clinically approved DNA analysis;
• Family screening;
• Genetic counseling;
• Risk stratification for sudden cardiac death.

Disease-specific experts carefully monitor patients with genetic mutations for cardiac disease, and early medical intervention is available to delay the onset of disease. Careful longitudinal evaluation may also prevent or minimize the incidence of high risk cardiac events and sudden death. The Center is currently evaluating patients with pre-symptomatic hypertrophic myopathy in an effort to avoid development of the disease.

Information and Referrals
To refer a patient to the Cardiovascular Center at Brigham and Women’s Hospital, please call a Referral Coordinator at (617) 732-9894.