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Cardiovascular Disease Research at the Johns Hopkins Institute for Basic Biomedical Sciences

Cardiac Infarct in a dog

Cardiovascular disease remains the leading cause of death worldwide. IBBS researchers are developing better diagnostics and treatments for cardiovascular disease, as well as exploring how the disease develops.

Although cardiovascular disease primarily affects older people, poor diet, smoking, diabetes, obesity, lack of exercise and genetics can contribute to earlier onset. The most common causes of cardiovascular disease are hypertension and atherosclerosis. Hypertension, or high blood pressure, forces the heart to work harder to circulate blood through the body. Atherosclerosis occurs when fats and cholesterol build up in the arteries, causing inflammation, accumulation of scar tissue and possible blockage; blockage in turn leads to a stroke or heart attack.

Treatment for cardiovascular disease typically starts with lifestyle changes: eating healthier, exercising and losing weight. But some people don’t respond to these modifications and need drugs to lower cholesterol levels or blood pressure. Severe cases may require surgery to remove blockages or scar tissue, or transplantation of a new valve or whole heart.

Peter Espenshade of the Department of Cell Biology studies how the body senses cholesterol. Cell membranes require cholesterol in their architecture, but too much cholesterol can build up in the heart and arteries and lead to disease. Espenshade investigates how yeast and mammalian cells detect levels of cholesterol and adjust their cholesterol production in response. He uses the easy-to-manipulate yeast to identify components required for cholesterol detection, and then compares this to the mammalian cells to see if the processes work the same way. Espenshade’s work may identify new targets for drugs that control blood cholesterol levels.

Solomon Snyder of theSolomon H. Snyder Department of Neuroscience studies gases that behave as chemical messengers, some of which control blood pressure. In the 1990s, his lab discovered the enzyme that makes nitric oxide (NO), a gas that relaxes blood vessel walls and thus decreases blood pressure. Several years ago, Snyder’s group identified another gas, hydrogen sulfide (H2S), and the enzyme that makes it. Like NO, H2S is a chemical messenger that controls blood pressure. Snyder’s research identified new therapeutic targets that others are now using to develop new classes of blood pressure drugs. He continues to study the role of H2S in hypertension and neurodegenerative diseases.

ARVD/C mutation heart cells

Specializing in magnetic resonance imaging (MRI) of the heart, Elliot McVeigh, director of the Department of Biomedical Engineering, pioneered some of the techniques used in today’s cardiac MRI exams, such as evaluating heart muscle contraction, detecting damaged tissue and using contrast agents that label blood for imaging. McVeigh’s lab currently focuses on using real-time MRI to guide therapies such as heart valve replacements, or to detect injected therapeutics like drugs or stem cells. Although stem cell therapies for the heart aren’t yet ready for prime time, McVeigh’s work seeks to perfect the delivery process for when they are. Additionally, McVeigh’s team takes detailed electrical and mechanical measurements of beating hearts and extremely high-resolution images of the heart’s damaged tissue after a heart attack, which they share with Natalia Trayanova, also of the biomedical engineering department.

Trayanova’s team uses this data to create computerized representations of healthy and diseased hearts. These models enable her to make predictions about heart function that could be used to identify the origin of irregular heartbeats, also known as arrhythmias. Arrhythmias are caused by heart cells that erroneously send electric pulses through the heart, initiating new, out-of-sync beats. Knowing the precise location of these malfunctioning heart cells allows doctors to kill them off, stopping the irregular heartbeat. Through simulations, Trayanova intends to make arrhythmia treatments quicker and more effective than the currently available methods.