Incidence of coronary artery disease, which involves narrowing or blocking of the arteries and vessels that provide oxygen and nutrients to the heart, has increased two to four times among people with diabetes. Almost 70 to 80 per cent of diabetes patients die from heart failure. Smooth muscle cells form tissue that contracts without voluntary control. These cells significantly contribute to narrowing or blocking of the arteries in diabetes patients. However, the cellular mechanisms underlying the accelerated rate of smooth muscle cell migration in diabetes are not well understood. Dr. Mitra Esfandiarei is investigating these mechanisms and also assessing the role of integrin signaling – cell communication that involves connecting the cell interior to its exterior or one cell to another. Integrin signaling may help regulate the internal framework of cells that affects muscle contraction and smooth muscle cell migration in diabetes. The research could contribute to development of therapies that prevent or delay accumulation of atherosclerotic plaque and blocking of arteries in diabetes type 2 patients. She ultimately aims to reduce the frequency of disease and mortality due to the cardiovascular complications, and improve the health of patients with type 2 diabetes. In 2001, Mitra Esfandiarei was also funded by MSFHR to study how heart muscle cells can survive infection by coxsackievirus B3 during the course of enteroviral myocarditis, an inflammatory heart disease.