Heart :: Cause and treatment of pediatric heart failure

The National Institutes of Health has provided $11.5 million in support to the Indiana University School of Medicine for the only institutional grant looking at the cause and treatment of heart failure in children.

Congenital heart disease is the most common birth defect in children and many of those structural abnormalities can lead to heart failure. This pediatric cardiology research grant is part of a strategy to encourage new collaborations among basic scientists, clinical cardiologists and heart surgeons.

Loren J. Field, Ph.D., professor of medicine and of pediatrics, is the principal investigator of the integrated project involving six IU School of Medicine faculty, all affiliated with the Herman B Wells Center for Pediatric Research and the Pediatric Cardiology Division of the James Whitcomb Riley Hospital for Children.

?The focus is to perform basic research to understand the origins and potential treatment of heart failure in the young,? said Dr. Field. ?There is virtually no comprehensive research program looking at the whole picture. This funding will allow us to evaluate everything from what happens when the fetal heart develops to how damaged heart tissue can regenerate in infants who experience heart failure.?

Three teams are involved in investigating pediatric heart disease. They are:

  • Tony Firulli , Ph.D., and Simon Conway, Ph.D., who will explore what causes heart abnormalities in development;

  • Mark Payne, M.D., and Lei Wei, Ph.D., who will look at how heart cells die ? either naturally or through disease ? and how that may contribute to heart failure.

  • Dr. Field and Weinian Shou, Ph.D., who will study how heart cells can be made to regenerate.

The grant supports projects that will first analyze how abnormal regulation of genes can lead to abnormal heart formation. Another project will look at the developed heart and seek ways to block the signals and pathways that that cause heart muscle to die. The researchers also will try to determine what actually controls the number and size of heart muscle cells as the heart develops.

Dr. Payne, a pediatric cardiologist, noted that this research may also impact adults with congenital heart defects.

?Surgical interventions in youth can lead to functional problems that manifest later in life,? said Dr. Payne. ?Yes, we can fix the heart very early in life but we can?t restore it perfectly. So if we can find clues about how heart formation goes wrong, and how to repair or regenerate the damaged young heart, we may be able to prevent the complications which currently occur in later life.?

Randall Caldwell, M.D., director of pediatric cardiology at the IU School of Medicine, said the funding and research can have a profound effect on how heart failure in children is treated in the future. In the past 18 years, 105 heart transplants have been performed in children at Riley Hospital. In recent years, only four or five transplants have performed yearly due to advances in surgical interventions and treatment of congestive heart failure, which reduce the need for transplants.

?Ideally, physicians will need to do many fewer heart transplants in children if scientists find the answers to the questions being addressed in this research project,? said Dr. Caldwell.

The grant funding will boost the research at Riley Hospital and hopefully will lead to innovative clinical treatments. Moreover, the research recognition from the grant will help IU recruit top flight cardiologists and pediatric cardiology researchers, enhancing the quality of care Hoosier children with heart disease will receive at Riley Hospital.

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