Robert B. Hinton Jr., MD
Part of the Heart Institute’s mission is to facilitate meaningful translational research. Robert B. Hinton, MD is studying the mechanisms of human valve disease. Recent findings in human diseased aortic valves show that maladaptive angiogenic remodeling is an early finding in valve disease pathogenesis, which is surprising since this has long thought to be an end stage disease process associated with atherosclerosis. Further investigation in animal models of aortic valve disease has demonstrated that angiogenic remodeling is due in part to elastic fiber fragmentation. This work provides further evidence that valve disease has its origins in dysregulation of developmental programs and provides an opportunity to test new treatment strategies. It is not known if these early pathologic changes are identifiable by circulating biomarkers before the onset of overt clinical disease. Preclinical studies are underway to test the ability of biomarkers to predict disease progression and the efficacy of angiogenesis inhibition to treat aortic valve disease. Presently, there are no medical treatments for valve disease. This work seeks to elucidate developmental mechanisms of valve disease and identify new therapeutic targets to treat heart valve disease and improve child health.
Elaine M. Urbina, MD
This year Preventative Cardiology successfully competed for an R01 grant from the National Heart Lung and Blood Institute of the National Institute of Health titled “Accelerated CV Aging in Youth Related to CV Risk Factors.” Our previous data showed that youth with obesity were developing stiffer arteries and thicker hearts, risk factors for adult CV disease, well before they went on to develop type 2 diabetes. This new grant will allow us to continue to follow these patients. Not only will we determine the rate of ‘normal’ arterial aging in healthy, lean youth, we will also find out which clusters of CV risk factors such as obesity, type 2 diabetes, high blood pressure or cholesterol are more damaging to the arteries and heart. These data will then be used to design more effective preventive and treatment strategies for high risk youth to prevent adult heart attack and stroke.
Preventative Cardiology is currently completing data collection on an ARRA (American Recovery & Reinvestment Act) stimulus grant. Our preliminary data were presented at the national meeting of the American Diabetes Association in June 2011. Our data demonstrated that youth with type 1 diabetes have thicker carotid arteries, stiffer central and peripheral arteries and have abnormal autonomic tone as measured by heart rate variability. These findings will help us identify which youth with diabetes are developing early hardening of the arteries so more aggressive therapy can be started.
Cincinnati Children's Hospital Medical Center Preventive Cardiology also continues to demonstrate leadership in the field of Pediatric Vascular Function by providing the only training seminar in Non-invasive Assessment of Vascular Function in Children available in the United States. We conduct the 2-day seminar 3 times yearly and have trained Pediatric researchers around the country with one international participant receiving training this year. We are also the data coordinating center for many multi-center grants performing vascular assessment.