Heart Failure and Transplantation

Cedars-Sinai researchers aim to prevent heart failure and, in case of occurrence, improve heart function. The major focus points of their preclinical projects are:

• Sodium calcium exchanges
• Connexin43
  
• Ischemia and reperfusion
  
• Stem cells

Researchers understand the causes of abnormal heart pump function at the molecular and cellular levels by studying specific proteins regulating heart contraction through manipulation of intracellular calcium, known as sodium calcium exchanges (NCX). Using an advanced, high-speed, laser-scanning confocal microscope, researchers study these calcium movements inside single heart cells of genetically modified mice while recording their electrical activity. The belief is that we can manipulate NCX by using drugs or genetic therapies to strengthen the heart’s pump function and thereby treat heart failure.

• Principal investigator: Joshua Goldhaber, MD

• Principal investigator: Roberta Gottlieb, MD

• Principal investigator: Eduardo Marbán, MD, PhD

Cedars-Sinai is are participating in multicenter trials that will help determine the optimal course of therapy for patients with heart failure. The objective is to advance new therapeutics and devices to assist patients in advanced stages of heart disease. Clinical research includes clinical trials and observational studies in:

• Heart failure
• Heart transplant
  
• Mechanical circulatory support devices

Researchers are identifying noninvasive methods to detect rejection and are discovering more effective immunosuppressant drugs with fewer side effects to fight organ rejection in transplant patients. The clinical trials are:

• ACE Inhibition and Cardiac Allograft Vasculopathy
• The DeNovo Use of Eculizumab

Researchers seek to improve total artificial heart and mechanical circulatory support devices, which are bridges to heart transplantation. They hope to improve outcomes and quality of life in patients with mechanical circulatory support devices in these clinical trials:

• Interagency Registry of Mechanically Assisted Circulatory Support (INTERMAC): A National Registry for Mechanical Assist Device Patients
• HeartWare: Endurance – A Prospective Randomized, Controlled, Unblended, Multicenter Clinical Trial to Evaluate the HeartWare Ventricular Assist Device For Destination Therapy of Advanced Heart Failure

• Marbán Laboratory
• Goldhaber Laboratory
• Gottlieb Laboratory