The Texas Heart Institute is a not-for-profit cardiology and heart surgery center located within the Texas Medical Center in Houston, Texas. Founded in 1962 by Dr. Denton A. Cooley, its original charter stated its purpose was “the study and treatment of diseases of the heart and blood vessels. Today, the Institute’s mission is to reduce the devastating toll of cardiovascular disease through innovative programs in research, education, and improved patient care. The Texas Heart Institute and its clinical partner, St. Luke's Episcopal Hospital, have become one of the nation's largest cardiovascular centers. Its 160-member professional staff have performed more than 100,000 open heart operations, 200,000 cardiac catheterizations, and 1,000 heart transplants. In 2010, in its annual survey of “America's Best Hospitals,” U.S. News & World Report ranked the Texas Heart Institute at St. Luke's Episcopal Hospital number 4 in the United States for heart care, making this its 20th consecutive year as one of the top 10 heart centers in the country. Wikipedia.
Bandeali S.J.,Texas Heart Institute
Current atherosclerosis reports | Year: 2014
Familial hypercholesterolemia is an inherited disorder associated with early accelerated atherosclerosis with morbidity and mortality resulting from premature cardiovascular disease. Affected individuals have extreme elevations in low-density lipoprotein cholesterol levels. Patients usually do not achieve target reductions in cholesterol levels with conventional antihyperlipidemic pharmacotherapy. This unmet need has resulted in the recent development and approval of novel therapies targeting different cholesterol pathways. This article briefly summarizes familial hypercholesterolemia and then discusses the newer pharmacotherapies available in the management of familial hypercholesterolemia.
Willerson J.T.,Texas Heart Institute
Current Opinion in Cardiology | Year: 2015
Purpose of review This review presents the findings from a select group of clinical trials of stem cell therapy for both acute and chronic heart disease. These studies are used to highlight the insight gained through such investigations and the remaining challenges. Recent findings Clinical trials assessing the use of adult stem cells for treating patients with heart disease have produced encouraging results that suggest these therapies are well tolerated and could potentially improve clinical outcomes, including left ventricular function, infarct size and the occurrence of future adverse clinical events. However, most have shown only modest benefits, and the results often appear to be inconsistent across trials. Nevertheless, analyses from these trials have provided useful information regarding factors that affect the potency of these therapies, the mechanisms underlying their effects and the patient populations most likely to derive benefits. Summary Stem cell therapy has the potential to overcome the limited regenerative capacity of the heart and induce cardiac repair and regeneration. The challenge lies in finding the most effective approach, which can only be determined through larger rigorously conducted clinical trials. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
Wang J.,Texas Heart Institute
Wiley Interdisciplinary Reviews: Systems Biology and Medicine | Year: 2011
Small ubiquitin-relatedmodifiers, or SUMOs, have emerged as versatile regulators of many biological functions that do so by covalent attachment to a variety of substrates via enzymatic reactions. SUMO conjugation has also been shown to be involved in a number of human pathogenic processes. More recent advances in the SUMO field have indicated a potential role for SUMO conjugation pathway in cardiogenesis. This advanced review will describe the basic features of the SUMO conjugation pathway and will summarize the most recent studies implicating the influence of the sumoylation pathway in cardiac function under both physiological and pathological conditions. © 2010 John Wiley & Sons, Inc.
Marian A.J.,Texas Heart Institute
Trends in Cardiovascular Medicine | Year: 2012
Despite the well-documented influence of genetics on susceptibility to cardiovascular diseases, delineation of the full spectrum of the risk alleles had to await the development of modern next-generation sequencing technologies. The techniques provide unbiased approaches for identification of the DNA sequence variants (DSVs) in the entire genome (whole genome sequencing [WGS]) or the protein-coding exons (whole exome sequencing [WES]). Each genome contains approximately 4 million DSVs and each exome approximately 13,000 single nucleotide variants. The challenge facing researchers and clinicians alike is to decipher the biological and clinical significance of these variants and harness the information for the practice of medicine. The common DSVs typically exert modest effect sizes, as evidenced by the results of genome-wide association studies, and hence have modest or negligible clinical implications. The focus is on the rare variants with large effect sizes, which are expected to have stronger clinical implications, as in single gene disorders with Mendelian patterns of inheritance. However, the clinical implications of the rare variants for common complex cardiovascular diseases remain to be established. The most important contribution of WES or WGS is in delineation of the novel molecular pathways involved in the pathogenesis of the phenotype, which would be expected to provide for preventive and therapeutic opportunities. © 2012 Elsevier Inc.
Carroll J.D.,University of Colorado at Denver |
Saver J.L.,University of California at Los Angeles |
Thaler D.E.,Tufts University |
Smalling R.W.,Texas Heart Institute |
And 4 more authors.
New England Journal of Medicine | Year: 2013
BACKGROUND: Whether closure of a patent foramen ovale is effective in the prevention of recurrent ischemic stroke in patients who have had a cryptogenic stroke is unknown. We conducted a trial to evaluate whether closure is superior to medical therapy alone in preventing recurrent ischemic stroke or early death in patients 18 to 60 years of age. METHODS: In this prospective, multicenter, randomized, event-driven trial, we randomly assigned patients, in a 1:1 ratio, to medical therapy alone or closure of the patent foramen ovale. The primary results of the trial were analyzed when the target of 25 primary end-point events had been observed and adjudicated. RESULTS: We enrolled 980 patients (mean age, 45.9 years) at 69 sites. The medical-therapy group received one or more antiplatelet medications (74.8%) or warfarin (25.2%). Treatment exposure between the two groups was unequal (1375 patient-years in the closure group vs. 1184 patient-years in the medical-therapy group, P=0.009) owing to a higher dropout rate in the medical-therapy group. In the intention-to-treat cohort, 9 patients in the closure group and 16 in the medical-therapy group had a recurrence of stroke (hazard ratio with closure, 0.49; 95% confidence interval [CI], 0.22 to 1.11; P=0.08). The between-group difference in the rate of recurrent stroke was significant in the prespecified per-protocol cohort (6 events in the closure group vs. 14 events in the medical-therapy group; hazard ratio, 0.37; 95% CI, 0.14 to 0.96; P=0.03) and in the as-treated cohort (5 events vs. 16 events; hazard ratio, 0.27; 95% CI, 0.10 to 0.75; P=0.007). Serious adverse events occurred in 23.0% of the patients in the closure group and in 21.6% in the medical-therapy group (P=0.65). Procedure-related or device-related serious adverse events occurred in 21 of 499 patients in the closure group (4.2%), but the rate of atrial fibrillation or device thrombus was not increased. CONCLUSIONS: In the primary intention-to-treat analysis, there was no significant benefit associated with closure of a patent foramen ovale in adults who had had a cryptogenic ischemic stroke. However, closure was superior to medical therapy alone in the pre-specified per-protocol and as-treated analyses, with a low rate of associated risks. Copyright © 2013 Massachusetts Medical Society.