Cardiology

The Cardiology Research Program focuses on the investigation of underlying mechanisms and pathophysiology of cardiovascular diseases and the development of novel therapeutics that could eventually impact patient care and outcomes.

 

Cardiology researchers in action


Basic Biomedical Science

The laboratories in the Cardiology Research Program include:

Thomas Parker Lab

Thomas Parker’s lab studies the molecular regulation of cardiac-specific gene expression in cardiac hypertrophy and heart failure, with a focus on the S100 family of EF-hand calcium-binding proteins, including S100A1, S100B and S100A6. Using in vitro models of cultured cardiomyocytes and in vivo models of transgenic and gene knockout strategies in mice to study the molecular physiology of these novel molecules, his lab was the one of the first to define a role for these proteins in cardiac pathophysiology, response to cardiac stresses (acute myocardial infarction and pressure overload) and more recently, in pulmonary hypertension.

Michael Kutryk Lab

Michael Kutryk’s lab focuses on the development of novel stent technologies, and was the first to design, develop and test an endothelial progenitor cell (EPC) capture intracoronary stent which is now in clinical use worldwide. His lab is continuing to refine this strategy, developing coating strategies for newer generation stents, grafts and prosthetic devices, including their use as novel platforms for local drug delivery.

Kim Connelly Lab

Kim Connelly’s lab is exploring underlying mechanisms of diabetic cardiovascular complications, principally diabetic cardiomyopathy and heart failure with preserved ejection fraction, and developing novel therapeutic strategies to prevent and treat these conditions. In collaboration with imaging scientists at Sunnybrook Health Sciences Centre, Dr. Connelly is developing novel magnetic resonance (MR) techniques to assess real time cardiac metabolism in the pathogenesis of cardiac diseases. He is also the Director of the Krembil Stem Cell facility, a GMP facility for the preparation of stem/progenitor cells and nucleic acids for clinical trials.

Howard Leong-Poi Lab

Howard Leong-Poi’s lab focuses on the development of novel non-invasive techniques for gene delivery in cardiovascular diseases, using intravenously administered nucleic acid-bearing carrier microbubbles and external application of triggered high power ultrasound. Using this technique of ultrasound-mediated gene delivery, his lab is exploring targeted gene therapy to treat ischemia-reperfusion injury, heart failure and peripheral arterial disease.

Clinical Research

Clinical Research groups in the Cardiology Research Program include:

Interventional Cardiology

The interventional cardiology group, led by Chris Buller and Michael Kutryk focuses on ACS and AMI, fibromuscular dysplasia and chronic total occlusions (CTO).

Cardiac electrophysiology

The cardiac electrophysiology group, led by Paul Dorian, Paul Angaran and Iqwal Mangat, focuses on device therapy, cardiac arrest and atrial fibrillation.

Heart Failure

The Heart Failure group, led by Gordon Moe and Abdul Al-Hesayen, participates in international multicenter clinical trials, as well as investigator initiated studies of biomarkers and physiological and hemodynamic studies in human heart failure.

Cardiac Imaging

Our imaging group, led by Andrew Yan, Kim Connelly  and Howard Leong-Poi, provides CMR and echocardiography support for trials that use imaging as a surrogate endpoint, and participate in multicenter imaging trials.

Multi-Centre Clinical Trials & Registries

Shaun Goodman, Andrew Yan and David Fitchett perform research using multicenter clinical registries (e.g. the Global Registry of Acute Coronary Events (GRACE)) and clinical trials (e.g., the Trial of Routine ANgioplasty and Stenting after Fibrinolysis to Enhance Reperfusion in Acute Myocardial Infarction (TRANSFER AMI) of a broad spectrum of cardiovascular diseases. 


Featured Clincial Trials

ENACT-AMI

The ENhanced Angiogenic Cell Therapy in Acute Myocardial Infarction (ENACT-AMI) trial (NCT00936819), a phase IIb, double-blind, randomized, placebo-controlled trial evaluating the safety and efficacy of intracoronary delivery of autologous circulating angiogenic cells in patients after large anterior ST-elevation myocardial infarction, led by Duncan Stewart (prior Division Head of Cardiology at St. Michael’s Hospital, now at OHRI) and Michael Kutryk.

ASSIST-MI

The ASSIST-MI Trial (NCT01818960) which compares two revascularization strategies – same sitting multivessel primary PCI and culprit vessel only primary PCI, with primary endpoint being myocardial infarct size as determined by cardiac magnetic resonance imaging in patients presenting with STEMI and multivessel disease. Led by Asim Cheema and Akshay Bagai.

EX-IMPROVEHF 

EX-IMPROVEHF  (NCT00601679)- a multicentre Phase IV study investigating the utility of the biomarker serum NT-proBNP in the management of ambulatory patients with chronic HF. Led by Gordon Moe.

SCARF

The Saxagliptin and Cardiac Structure and Function (SCARF) Trial (NCT02481479) – investigating the effect of dipeptidyl peptidase-4 inhibitors (DPP4i), specifically saxagliptin, on cardiac structure, global and regional function in patients with type 2 diabetes, using cardiac magnetic resonance imaging and echocardiographic end points. Led by Kim Connelly and Subodh Verma.

Impact of In-centre Nocturnal Hemodialysis on Ventricular Remodeling and Function in End-stage Renal Disease

Impact of In-centre Nocturnal Hemodialysis on Ventricular Remodeling and Function in End-stage Renal Disease (NCT00718848) – investigating the effects of Nightly In-centre Nocturnal Hemodialysis vs Three-times a week conventional hemodialysis on left ventricular function and hypertrophy by CMR in patients with end-stage renal disease. Led by Andrew Yan and Ron Wald (Nephrology).

ISCHEMIA

International Study of Comparative Health Effectiveness With Medical and Invasive Approaches (ISCHEMIA) Trial (NCT01471522) is a large multicentre clinical trial comparing an initial invasive strategy of cardiac catheterization followed by optimal revascularization (if feasible) in addition to optimal medical therapy (OMT) vs OMT alone (catheterization reserved for failure of OMT), with a primary composite endpoint of cardiovascular death or nonfatal myocardial infarction in patients with stable ischemic heart disease and at least moderate ischemia. Shaun Goodman is the Canadian Lead for ISCHEMIA. Asim Cheema is the Principal Investigator and Site-Lead.Shaun Goodman is a Co-National Leader the Canadian Lead for ISCHEMIA.

ISCHEMIA-Chronic Kidney Disease Trial

ISCHEMIA-Chronic Kidney Disease Trial (ISCHEMIA-CKD) is a companion ancillary trial to ISCHEMIA. This is a multicenter controlled trial that will randomize patients with stable ischemic heart disease (SIHD), at least moderate ischemia and advanced chronic kidney disease (CKD; estimated glomerular filtration rate [eGFR] <30 or on dialysis) to either a routine invasive strategy (INV) with cardiac catheterization (cath) followed by revascularization plus optimal medical therapy (OMT) or to a conservative strategy (CON) of OMT, with cath and revascularization reserved for those who fail OMT. Akshay Bagai and Ron Wald (Nephrology) are is the Canadian LeadCo-National Leaders and Site Leadfor ISCHEMIA-CKD. Asim Cheema is the Site Principal Investigator.

The Prevalence of Thiamin Deficiency in Ambulatory Patients With Heart Failure

In collaboration with Dr. Mary Keith (PI) (Dept of Nutritional Sciences), Andrew Yan and Howard Leong-Poi are helping completing a randomized, double blind, placebo controlled trial using oral thiamin supplementation to determine its effects on exercise tolerance, quality of life, and cardiac structure and function using cardiac magnetic resonance imaging (CMR) and echocardiography in ambulatory patients with heart failure and reduced ejection fraction. This study (NCT00953823; funded by Heart and Stroke Foundation) will determine the true therapeutic potential of a clinically feasible course of thiamin supplementation as an adjunct to the current medical treatment of heart failure.

Assessment of Cardiotoxicity by Cardiac Magnetic Resonance (CMR) in Breast Cancer Patients Receiving Trastuzuma

In a prospective, multi-centre, observational study (PI: Dr. Christine Brezden-Masley, Division of Medical Oncology; NCT01022086; funded by CIHR and Roche) of early stage breast cancer patients receiving adjuvant trastuzumab therapy, Andrew Yan and Kim Connelly are helping to determine whether CMR is a useful and potentially more accurate imaging alternative to MUGA scans in assessing the cardiotoxicity of adjuvant trastuzumab treatment. We will also examine the relationships between cardiac biomarkers and changes in cardiac structure and function, and the long-term prognostic significance of reduced left ventricular ejection fraction and myocardial injury detected by CMR.

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