Stanford Medicine Newsletter Updates For the Local Community

 

Community matters

Christopher Dawes, CEO of Stanford Children's Health; Lloyd Minor, dean of the School of Medicine; and Mariann Byerwalter, interim CEO of Stanford Health Care.

   

In 1968, Stanford surgeon Norman E. Shumway, MD, PhD, and his surgical team performed the first successful adult hu-man heart transplant in the United States. That landmark intervention was the first bold stride in Stanford Medicine’s enduring leadership in cardiovascular diagnosis, treatment and prevention that is, today, as promising as ever.

Nearly two decades later, Stanford’s Philip Oyer, MD, implanted the world’s first successful ventricular assist device as abridge to transplantation. And in 2004, Stanford physicians were among the first to use the Berlin Heart, a miniature, externalheart pump attached by tubes, to help a 5-month-old — the youngest patient ever — survive for 55 days until a heart transplant saved his life. The Stanford team also helped a 5-year-old survive for a record-breaking 234 days until transplant, longer thanany child in North America.

Today the Stanford Cardiovascular Institute is advancing stem cell biology, gene-tics, molecular imaging, populationhealth and device innovation that is helping to create the future of cardiovascular care, one that is focused on keeping peoplehealthy and providing care that is tailored to individual variations. We call this Precision Health. And at Stanford Medicine, weare leading the Precision Health revolution toward more personalized, predictive, preventive and preeminent health care.

One extraordinary example of Precision Health in action is the cardiovascular institute’s Biobank, where physician scientists have compiledthe world’s largest collection of induced pluripotent stem cells specifically for cardiovascular diseases. Derived from asimple blood draw, these iPS cells can be converted into any type of cell in the body, such as heart cells. Using a patient’s own heartcells, Stanford CVI doctors can study heart disease on a molecular and genetic level without having to do risky or repeated biopsies of the patient’s heart tissue. This allows precise, personalized approaches, such as testing medications on a patient’sunique heart cells to predict benefits.

Another broad application is “clinical trial in a dish,” which involves testing new pharmaceuticals to show potential effectiveness or risks for patients of diverse ethnicities, gender, age or preexisting conditions. A patient’s own heart cells also can be stored and used for regenerative medicine, to be placed back in a patient’s body when needed — for example, in the event of a heart attack.

Typically, when DNA sequencing identifies a genetic mutation linked to a patient’s extremely rare heart disease, investigators create a mouse model with the same mutation to study it. “But mice and humans diverged on the evolutionary scale 75million years ago, so they’re quite different,” said Joseph Wu, MD, CVI director and a professor of cardiology and radiology at Stanford Medicine. Instead of studying heart disease in a mouse, Stanford scientists will take a patient’s unique iPS cells, differentiate them into heart cells, and use this precise, personalized human model to study the genetic mutation and develop precision treatment for the patient’s heart disease.  

Researchers in the new Clinical and Translational Research Program in the Heart Center at Lucile Packard Children’s Hospital Stanford also are making remarkable advances in the field. Director Doff McElhinney, MD, professor of pediatric cardiothoracic surgery, and his team are leading investigations into the fundamental biology, diagnoses and care of heart disease anddeveloping new medical devices and technologies. They, too, are harnessing “big data” gathered from patients across the continuum of care to advance understanding of the pathological processes of heart disease and to deliver personalized care. Inkeeping with Stanford’s long history of leadership in the field, among their many and diverse projects, investigators in the Heart Center currently are leading the development of the first-ever randomized controlled trial for anti-rejection therapy after heart transplant in children.

As Stanford Medicine continues to lead the biomedical revolution in Precision Health, our multifaceted efforts to predictand prevent heart disease offer a future of hope not only to the patients and families we care for directly but also to physiciansand patients everywhere who can benefit from these advances.

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