Medical Student Research Fellowship for Summer 2011

Mentor: Brian Bethea, MD              
Department: Cardiothoracic Surgery        
Room number: HA9.134
Mail Code: 8879
Phone number: 214-645-7700
E-mail: brian.bethea@utsouthwestern.edu (and/or leah.gaither@utsouthwestern.edu)
Project title: Pulmonary Vasculature Changes and the Role in Right Ventricular Dysfunction (RVD) in Left Ventricular Assist Device (LVAD) Recipients      

Human subjects IRB approved project number (where applicable):       NA

Animal subjects IRB approved project number (where applicable):       NA

Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects): Patient based

Brief Description of Project: Study heart and lung tissue obtained at LVAD implantation (pre-LVAD) as well as at cardiac explantation (post-LVAD) for analysis and comparison. This will allow us to study and characterize the longitudinal changes in the pulmonary vasculature and their clinical influence on right ventricular function in patients with severe congestive heart failure who undergo left ventricular assist device (LVAD) therapy as a bridge to heart transplantation. It is our hope that the insights derived from these studies will have significant clinical relevance to patients supported by mechanical assist devices or in those with end stage heart failure.  eIRB #092010-093

The student will participate in our large patient based study. They will be involved in literature searches, tissue collection and analysis, patient data (including hemodynamic data) and interpretation, as well as participating in database reviews which should yield a peer reviewed publication. The goal of working with our group is to avoid any pure “service” oriented activities but teach them the initial steps of being involved in both a large ongoing study and also smaller literature review studies which not only augments the large study but should allow them to get the opportunity to present at either a regional or national meeting.

CONCISE SUMMARY OF PROJECT: Tissue of the left lung (lower lobe wedge resection) and left ventricle (transmural; apex or tissue close by) will be obtained from patients in end-stage heart failure at the time of LVAD implantation (pre-LVAD, failing) and from the same, pre-LVAD hearts at cardiac explantation (post-LVAD).  Pre- and post-LVAD tissue will be studied as paired samples.  For all heart and lung tissue, the respective tissues will be flash frozen in liquid nitrogen and stored at -80ºC.  The remaining tissues will be stored in -80ºC for future use.
Medical histories will be obtained from all of these patients, the components of which include, but are not limited to, risk factor profiles, heart disease etiology, duration of LVAD support, medications, ejection fraction, areas of LV scar, prior surgeries (e.g. CABG, PCI) and concurrent structural disease (e.g. valvular or not). Further, pre- and postoperative hemodynamic data(standard of care measurements) will be obtained: Cardiac output, cardiac index, left ventricular ejection fraction (LVEF), right atrial pressure (RAP), mean pulmonary artery pressure (PAP), pulmonary capillary wedge pressure (PCWP), pulmonary vascular resistance (PVR), right ventricular stroke work index (RVSWI)

Previous Research Activities or Publications with Medical Students: none