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Brian Garibaldi Lab
Research in the Brian Garibaldi Lab focuses on acute lung injury (ALI) resolution. Recently, we evaluated the mechanisms underlying mobility therapy and found that therapeutic exercise reduces neutrophilic lung injury and skeletal muscle wasting in ALI mice.
Our work is focused on the translational human in vivo and ex vivo assessments of right ventricular (RV) function in the setting of pulmonary hypertension.
Among patients with group I pulmonary arterial hypertension PAH, those with systemic-sclerosis-associated PAH (SSc-PAH) have a particularly poor prognosis and less optimal response to PAH-guided therapy. Using in vivo pressure-volume catheterization of the right ventricle, we have uncovered key deficiencies in resting and reserve RV function in the SSc-PAH group when compared to idiopathic PAH (IPAH) patients. These studies have uncovered key discoveries with regards to right ventricular-pulmonary arterial (RV-PA) coupling in PAH. In the lab, by studying myofilament function from RV endomyocardial biopsies from these same patients, we have uncovered corresponding deficiencies in myofilament contractility and calcium sensitivity as well. Ongoing work is directed towards determining the underlying mechanism of these findings, which... will hopefully lead to therapeutic applications for RV failure in SSc-PAH.
Further endeavors are directed towards studying RV failure in other populations, including exercise-induced PH, PH secondary to left-heart disease, and the left ventricular assist device population. view less
We started Kata to bridge the gap between professional experiential production and neuroscience, clinical neurology, and medical hardware. We strive to build experiences and technology from the ground up, with a focus on mission, and at a level that is consistent with the best productions in the industry. We mirror the thousands of hours that go into a level design in a video game, but with the crucial difference that the focus is on the subtleties required for patient treatment or wellness. Our designs require high-frequency iterative development with patients and users in countless game-play sessions in which they provide crucial feedback. Characters have been painstakingly crafted to elicit profound emotional responses. Some of the requirements for patients or the elderly population in this space are qualitatively different from what is needed in the entertainment marketplace. That said we have also understood the critical artistic similarities.
The core ethos of Kata is that the... challenge of complex movement has profound benefits for cognition, wellness, and brain repair. Specifically, there is growing evidence that complex motor movement can have cognitive benefits that go beyond what has been reported for exercise alone. When designing experiences to treat motor impairments after stroke, maximizing rigorous and dynamic motor input is a requirement. New interactive technologies will allow people to engage in diverse and complex motor movements, even in the home, which was previously impossible.
Overall it has been a very exciting journey, combining art, medicine, technology, and neuroscience. We continue to build, discover, and craft immersive experiences, side by side with physicians, physical therapists, and scientists, with the common goal of pushing clinical care and wellness forward. We believe this is only possible by having a mission focused design group embedded in an academic hospital. Ultimately, we wish to scale and perfect these innovations into other hospitals. Kata is a true hybrid of academia, and industry, doing what neither can do in isolation. We hope the ethos and design philosophy behind Kata provides the impetus for its expansion, partnerships, and growth. view less
The MR Research Laboratory focuses on developing and applying nuclear magnetic resonance (NMR) techniques and on measuring energy metabolites and metabolic fluxes with phosphorous (31P) and proton (1H) MRS in patients with ischemia, infarction and heart failure.
Specific studies include: Phosphorus MR studies of myocardial energy metabolism in human heart: We have used spatially localized phosphorus MR spectroscopy (MRS) to noninvasively measure high-energy phosphate metabolites such as ATP (adenosine triphosphate) and phosphocreatine (PCr) in the heart. The PCr/ATP ratio can change during stress-induced ischemia, and a protocol for stress-testing in the MR system has been developed which can detect the changes noninvasively in the anterior wall. Additionally, we've developed methods for noninvasively measuring the creatine kinase (CK) ATP energy supply and used it to measure the CK ATP energy supply in the healthy heart at rest and exercise, in human myocardial infarction, and in ...human heart failure.
Interventional MRI technology: We are developing an RF dosimeter that measures incident-specific absorption rates applied during MRI independent of the scanner and developing MRI-safe internal detectors for higher field use. Outcomes of this research include the "MRI endoscope" that provides real-time, high-resolution views of vessel anatomy and a radiometric approach to detect any local heating associated with the device.
The Barouch Lab
The Barouch Lab is focused on defining the peripheral cardiovascular effects of the adipocytokine leptin, which is a key to the understanding of obesity-related cardiovascular disease. Interestingly, many of the hormonal abnormalities seen in obesity are mimicked in heart failure. The research program will enhance the understanding of metabolic signaling in the heart, including the effects of leptin, exercise, sex hormones, and downstream signaling pathways on metabolism and cardiovascular function.
The lab also is working to determine the precise role of the “metabolic” beta-3 adrenergic receptor (ß3AR) in the heart and define the extent of its protective effect in obesity and in heart failure, including its role in maintaining nitric oxide synthase (NOS) coupling. Ultimately, this work will enable the exploration of a possible therapeutic role of ß3AR agonists and re-coupling of NOS in preventing adverse ventricular remodeling in obesity and in heart failure.
Lili Barouch, MD,... is an associate professor of medicine in the Division of Cardiology and a member of the Advanced Heart Failure and Cardiac Transplantation group at the Johns Hopkins University School of Medicine. view more