Women's Heart Disease

Researchers at the Barbra Streisand Women’s Heart Center are investigating the pathophysiology of ischemic heart disease as well as the pathophysiological differences between men and women with the disease. In preclinical and clinical projects, researchers have identified sex-specific testing strategies and conventional therapies to optimize gender-based medicine, especially in the diagnosis and evaluation of coronary microvascular dysfunction in women.

Preclinical Research

In preclinical research, Cedars-Sinai researchers aim to identify key sex-specific biomarkers and novel therapies in the diagnosis and treatment of cardiovascular disease in women. The major focus areas include stem cells and troponin.

Stem Cells

Investigators are studying the unique abilities of female cardiac-derived stem cells in the treatment of coronary artery disease.

Principal investigators: C. Noel Bairey Merz, MD, and Eduardo Marbán, MD, PhD.

In collaboration with the Gottlieb Laboratory, researchers are focusing on a group of cardiac stem cells called c-kit positive cells, which are important for making capillaries and small blood vessels—key players in coronary microvascular disease.

Principal investigator: Roberta Gottlieb, MD

Troponin

Researchers are studying cardiac troponin I (cTnl), one of three proteins in the troponin complex that, when elevated, can indicate cardiac muscle cell death. For decades, physicians have used one standard measure. The result was that women were underdiagnosed because their disease was different and their hearts were typically smaller compared to men.

Principal Investigator: Jennifer Van Eyk, PhD

Clinical Research

Researchers are examining the nature and scope of gender differences in both chronic and acute cardiac ischemia in terms of clinical manifestations, detection and treatment. Clinical projects are evaluating noninvasive strategies for accurate and reliable diagnosis of coronary microvascular dysfunction, the effects of chemotherapy on the heart and whether functional hypothalamic amenorrhea is an early sign of cardiac vascular disease.

Microvascular Dysfunction

Cardiac Magnetic Resonance Imaging Normal Reference Control Group Testing: Ancillary Study to Coronary Endothelial Function and Microvascular Disease in Women
- Principal investigator: C. Noel Bairey Merz, MD
Coronary Microvascular Disease and Endothelial Function in Women and Men
- Principal investigator: C. Noel Bairey Merz, MD
Women's Ischemia Syndrome Evaluation
- Principal investigator: C. Noel Bairey Merz, MD

Cardiomyopathy

Brain-Heart Connection in Takotsubo Cardiomyopathy

Principal investigators: C. Noel Bairey Merz, MD

Cardio-Oncology

Myocardial Structural, Functional, and Metabolic Changes in Women Undergoing Breast Cancer Chemotherapy

Principal investigator: Puja Mehta, MD

Cardiac Vascular Disease

Estrogen Deficiency and Cardiovascular Disease Biomarkers in Premenopausal Women

Principal investigator: Chrisandra Shufelt, MD, MS

Pregnancy and Heart Disease

Studying the Relationship Between Spontaneous Preterm Delivery and Vascular Dysfunction as Well as Preeclampsia and Hypertension

Principal investigators: Margo B. Minissian, PhDc, and Sarah Kilpatrick, MD

Vitamin D Deficiency and Heart Disease

Is Treatment of Vitamin D Deficiency Associated with Resolution of Statin Induced Muscular Symptoms?

Principal investigators: C. Noel Bairey Merz, MD, and Margo B. Minissian, PhDc

Collaborations

Researchers are collaborating with UCLA and Cedars-Sinai infectious disease specialists in a project by the UCLA Clinical and Translational Science Institute, UCLA AIDS Institute and the UCLA Center for AIDS Research to study the effects of HIV and hepatitis C treatment on endothelial function in men and women.

Investigators are also collaborating with the Texas Heart Institute to determine if women who stop their menstrual cycle due to low estrogen levels as a result of stress, over-exercising or weight loss have worse blood vessel function than women with regular monthly menstrual cycles.

Collaborating with the Harvard School of Public Health and Mongolian health officials, Cedars-Sinai investigators are studying pregnant women with preeclampsia to determine if it causes ischemic heart disease (IHD). Mongolia has a high rate of preeclampsia, which gives researchers a large patient population to study. Vascular endothelial dysfunction has been implicated in the cause of both preeclampsia and cardiovascular disease, but questions remain as to whether vascular dysfunction leading to preeclampsia occurs at the time of pregnancy or prior to pregnancy.

Researchers also collaborate with the Harvard Medical School to determine whether the dose, formulation or route of delivery of menopause hormone therapy changes the risk of IHD.

Labs

Bairey Merz Laboratory
Gottlieb Laboratory
Marbán Laboratory
Van Eyk Laboratory