Heart attacks are the leading cause of death in the industrialized world. Interest is growing in the use of stem cells to treat the irreversible damage caused by a heart attack. Recent studies have shown hematopoietic stem cells (HSCs), stem cells in the bone marrow, can form heart cells. HSCs are easy to obtain, avoid the ethical issues associated with embryonic stem cells, and their use in bone marrow transplants is well established. The major challenge facing the use of stem cell therapy to treat heart disease is cell survival after transplantation. Heather Heine is comparing different subpopulations of these cells to determine the optimal type to use for treating the heart, how best to administer the stem cells, and how to improve cell survival in the oxygen-depleted environment created by a heart attack. This research could contribute to more effective therapy for improving cardiac function and survival following a heart attack.
Research Location: St Paul's Hospital
HIV, STDs and drug use: an examination of the interplay between these factors and their influence on treatment seeking delays
Drug use, poverty, homelessness and sexually transmitted diseases (STDs) such as HIV are endemic in Vancouver’s Downtown Eastside. Melanie Rusch believes that improving the sexual health of marginalized populations is important for curbing the spread of STDs. She is studying a large sample of people who live in the Downtown Eastside to determine how behaviour patterns among these vulnerable populations affect sexual health. Her first aim is to study how different drugs and combinations of drugs affect sexual behaviours and STD rates. This includes estimating the impact of needle use, as opposed to sexual contact, on STD rates. Melanie’s second goal is to estimate STD rates of a group of women living in the Downtown Eastside. Melanie is investigating how their knowledge of STDs, exposure to outreach programs, and feelings of stigma affect use of health care services. Results of this research could be used to better define high-risk groups, identify barriers to accessing care, and tailor interventions to improve health of vulnerable populations.
Developing a computer simulation model for patient flow in health care system: access to coronary revascularization
In response to unprecedented pressure, the health care system has and continues to restructure systems of core delivery to achieve greater efficiency and effectiveness. While this points to the need for research to assess the effects of reorganization, there is a lack of such research, partly because analyzing the flow of patients through the health care system can be extremely complex. In previous research, Dr. Christos Vasilakis developed a computer simulation model capable of evaluating the interactions between the different streams of patient flow in a hospital department. This simulation model was also used to test an alternative hypothesis of the causes of hospital bed crises in England. Now he is developing a computer simulation model to evaluate the effects of proposed organizational changes at BC cardiac care centres that will affect patient access to revascularization procedures, which are used to improve blood flow to the heart. Hospital managers could use the completed model as a tool to manage patient access. Policy-makers could use the model to assess the impact of other proposed changes to the health care system to better inform how these changes should be made.
Mechanism of myocardial dysfunction in sepsis
More people die each year from sepsis, a severe, overwhelming infection and inflammation, than from breast or colon cancer. The infection is also 20 times more deadly than a heart attack. Septic shock (severe sepsis) causes multiple organ failure and is the leading cause of death in North American intensive care units. Sepsis impairs the heart’s ability to use oxygen, which is necessary for the heart to pump normally. Dr. Ryon Bateman is investigating whether damage to capillaries (the smallest blood vessels) prevents oxygen from being delivered within the heart or whether dysfunction of the mitochondria (the parts of the cell that consume oxygen) prevents oxygen from being used by the heart. Dr. Bateman is using advanced microscopic imaging techniques to generate three-dimensional images of heart capillaries to look for changes in their number and spacing. He is also assessing whether regions of the heart with low oxygen have tissue damage, and if mitochondria are damaged in these regions. The research could explain why the heart is damaged during sepsis, leading to new treatments for critically ill septic patients.
Clinical outcomes of cardiac surgery are influenced by genetics of inflammatory mediators
Open heart surgery usually requires a cardiopulmonary bypass (CPB) pump to manage blood circulation while the heart is stopped for repair. Use of the pump and the surgery itself can cause inflammation and, although some inflammation is needed for the wound to heal, too much can prolong organ dysfunction and recovery time in hospital. The intensity of inflammation after surgery varies substantially among individuals. Age of the patient, pre-surgery health and the amount of time on the pump are factors, but they do not fully account for the differences. There is evidence indicating that genetic factors may contribute to a greater susceptibility to infection and inflammation following cardiac surgery. David Shaw is researching whether two types of cytokines (hormone-like proteins) affect the severity of inflammation following cardiac surgery. These proteins, interleukin 18 and interleukin 10, have been implicated in complications from cardiac surgery. Identifying the genes involved in inflammation may lead to the development of new therapies to improve prognosis and treatment of inflammation.
Role of apoptosis repressor with caspase recruitment domain (ARC) in attenuation of chronic heart transplant rejection associated with transplant vascular disease
More than 2,500 heart transplants are performed worldwide every year. Chronic rejection of the transplanted heart due to transplant vascular disease (TVD) is the greatest obstacle to long-term survival after the operation. TVD causes structural changes in the arteries, leading to blockage that restricts and ultimately cuts blood flow. Despite improvements in anti-rejection drugs, about 40 percent of heart transplant recipients develop the disease within five years. The protein ARC has been shown to prevent death of cardiac cells. Arwen Hunter is investigating the ability of ARC to prevent cell death in blood vessel walls after transplantation. In particular, she is looking at the ways ARC inhibits cell death in blood vessels and ways of optimizing the delivery of ARC into heart tissue. The research could contribute to strategies for preventing organ rejection associated with transplant vascular disease.
The James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research
This unit brings together a multidisciplinary group of researchers, in the UBC departments of Pathology and Laboratory Medicine, Medicine and Pharmacology & Therapeutics, whose efforts are directed at developing effective strategies and interventions to prevent, detect and treat heart, lung and blood vessel diseases. The researchers are particularly interested in discovering how interactions between genetic and environmental factors lead to the development of particular disease manifestations, including variations in susceptibility to these diseases, severity of symptoms and the rate at which symptoms progress.
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