The project, led by Tamer M.A. Mohamed, assistant professor of medicine in the UofL Division of Cardiovascular Medicine and the UofL Institute of Molecular Cardiology, has received a five-year, $3.8 million grant from the National Heart, Lung and Blood Institute.

“After a patient suffers a heart attack, the heart loses muscle cells, reducing the heart’s ability to pump blood to the rest of the body. Muscle cells in the heart do not regenerate on their own, leaving the heart permanently impaired,” Mohamed said. “We are developing a transient gene therapy approach to regenerate these muscle cells to heal the heart.”

The therapy involves transient overexpression of a combination of four cell-cycle regulating proteins to induce cell division in the heart muscle. The four cell-cycle regulators, cyclin-dependent kinase 1 (CDK1), CDK4, cyclin B1, and cyclin D1, are known collectively as 4F, or four factors. In , the process stimulated cell division in cardiomyocytes, or heart cells, leading to improved heart function.

The new study will determine further the effectiveness and safety of the therapy in animal models as well as in human heart segments using of a developed at UofL by Mohamed that keeps slices of human hearts alive for a longer period of time. The system mimics the environment of a living organ through continuous electrical stimulation and oxygenation, maintaining viability and functionality of the heart segments for six days, allowing more extensive testing. The for use by researchers outside UofL.

In addition to further testing the therapy’s effectiveness, Mohamed and other investigators will focus on approaches for the process that do not lead to tumor development in other cells.

“The challenge comes in avoiding development of cancer in other areas of the body, which appears to be a side effect of the process as seen in mice,” Mohamed said.

If it is successful, the work will lead to the start of in-human clinical trials.

The annual Outstanding Investigator Award, one of the society’s highest and most prestigious, recognizes a scientist who is making major and independent contributions to the advancement of cardiovascular science, and is leading a growing research program likely to play a major role in the future.

Jones is a senior faculty member at UofL’s and a professor at the . A goal of his research is to understand the mechanisms of cardiac muscle damage during a heart attack, and to develop novel therapeutics to preserve the heart. He also is investigating the confounding influence of risk factors, such as diabetes, on the development of heart disease, and the molecular explanations of ventricular remodeling and heart failure.

Jones was chosen by an international panel of experts from among some of the best scientists in the world. The winner presents a major lecture and receives a $1,500 honorarium and plaque. Jones delivered his lecture Tuesday morning at the meeting, which is taking place July 16-19 at in Amsterdam. The meeting is focused on basic and translational research in cardiology. The topic of his lecture was “Non-catabolic Fates of Glucose in the Heart.”

The International Society for Heart Research, which has 3,000 members on five continents, is an international organization devoted to promoting cardiovascular research. It is dedicated to the discovery and dissemination of knowledge in cardiovascular science worldwide, and publishes the Journal of Molecular and Cellular Cardiology.

The Outstanding Investigator Award was created by UofL researcher , when he served as the society’s secretary general nearly two decades ago. Bolli is the director of UofL’s Institute of Molecular Cardiology and scientific director of UofL’s . He is also a professor and chief of the at UofL. The award is for established investigators in the intermediate phase of their academic career.

“The roster of previous recipients for the Outstanding Investigator Award is simply amazing,” Bolli said. “We are proud of Steven, and grateful for his support in the research mission of the Institute of Molecular Cardiology here at UofL. He has been one of my best recruits ever.”

Jones serves on the editorial boards of several journals, including the Journal of Molecular and Cellular Cardiology, Basic Research in Cardiology, and Circulation Research. Since 2012, Dr. Jones also has been associate/consulting editor for the American Journal of Physiology — Heart and Circulatory Physiology.

He regularly serves on editorial boards and review panels for the and the . He recently started a term as chairperson of the Myocardial Ischemia and Metabolism Study Section of the NIH’s . In addition to Jones, the study section consists of 18 experts from around the U.S.

Jones received his doctorate in physiology in 2002 from Louisiana State University. After graduation, he joined Johns Hopkins University, where he focused on mitochondrial function with the goal of developing a deeper understanding of the metabolism-dependent mechanisms of cell death and survival. He came to UofL in 2004.

“As we end American Heart Month, it’s the perfect time to share this wonderful news,” said Mark Slaughter, MD, surgical director of heart transplant for University of Louisville Physicians and Jewish Hospital, and professor and chair, Department of Cardiovascular and Thoracic Surgery, UofL School of Medicine.

Dr. Slaughter performed the 500^th transplant on Feb. 21, on a 59-year-old man who had a left ventricular assist device implanted to support his heart until the donor heart was available for transplant. An LVAD is a surgically implanted mechanical pump attached to the heart.

The first heart transplant at the hospital, which was also the first heart transplant in Kentucky, took place on Aug. 24, 1984, performed by the University of Louisville’s Laman Gray Jr., MD. The state and region waited in suspense as 40-year-old Alice Brandenburg received a new heart. The surgery, which took seven hours, was groundbreaking at the time. The UofL and Jewish Hospital transplant team is one of the leading providers of organ transplantation in the country.

“Jewish Hospital is a place where miracles happen every day and patients’ lives are changed forever,” said Ronald Waldridge II, MD, president of Jewish Hospital. “Five-hundred hearts is much more than a milestone. It represents the life-changing impact on our patients, their families and the entire region. Together, with UofL, Jewish Hospital’s Trager Transplant Center is investing in research, technology and advance procedures to increase access to transplant services.”

On Wednesday, doctors and heart transplant recipients gathered at the Jewish Hospital Rudd Heart and Lung Center to celebrate the 500^th milestone and the many lives that have been saved over the years thanks to heart transplantation. 

“The 500^th heart transplant is a reminder of the commitment by Jewish Hospital and the University of Louisville to provide advanced therapies for patients with advanced heart failure,” Slaughter. said. “We’ve come a long way since Dr. Gray broke ground with that first heart transplant more than 30 years ago. Every day, we continue to advance the science of heart transplantation here at UofL and Jewish Hospital. I’m excited about the future of this program, and I’m confident that we’ll mark a lot more milestones over the next 30 years.”

For Dr. Gray, Wednesday’s celebration marked decades of dedication to the heart transplant program.

“After performing the first heart transplant, it means a lot to me to see the 500^th and where we are today,” Gray said. 

Gray continues to research new ways to help patients with heart disease at UofL’s Cardiovascular Innovation Institute, a center focused on bio-adaptive heart innovations, including the integration of heart-assist device, biodfeedback sensors and related technologies. In 2001, Gray and the Trager-UofL surgical team implanted the first fully implantable replacement heart, the AbioCor.

Today, patients like Jeffrey McMahan continue to benefit from the heart transplant program. McMahan was the center’s 479^th heart transplant, and he attended the celebration on Wednesday along with other recipients.

Before his heart transplant, McMahan, 61, was no stranger to the procedure – it had helped save many of his family members. The Memphis, Indiana, resident had four family members receive heart transplants – two by University of Louisville surgeons at Jewish Hospital. In 2015, McMahan learned he, too, needed one.

“I was serving in the military at Fort Knox when I developed a cough,” said McMahan. “It finally got bad enough that doctors flew me to Jewish Hospital, where I was diagnosed with a cardiomyopathy, a condition where the heart muscle is weakened. I learned that I would need a transplant in the next 10 years, but that timeframe quickly changed to 10 months after my condition worsened.”

On Aug. 15, 2015, McMahan was added to the organ donor transplant list. A month later, he received the transplant that forever changed his life.

“I wouldn’t have lived without the transplant,” McMahan said. “It means a lot to be here to celebrate the 500^th. I’m forever thankful to the transplant team that helped save my life and gave me more time with family.”

It has been an exciting year for the Jewish Hospital Trager Transplant Center and University of Louisville team. In December 2017, the center – a joint program with the UofL School of Medicine and KentuckyOne Health – broke its all-time record for number of organs transplanted in the center’s 53-year history, with 175 organs transplanted in a year. The center also achieved several other milestones in 2017, including its 5,000^th transplanted organ, its 3,000^th kidney transplant and its 900^th liver transplant. In addition to Kentucky’s first heart transplant, the program is known for performing Kentucky’s first adult pancreas, heart-lung and liver transplants.

But the 500^th heart transplant and other milestones wouldn’t have been reached without organ donors, noted David Lewis, director of Transplant Services at the Jewish Hospital Trager Transplant Center.

“We often encourage people to sign up as organ donors to help save lives. The need for organ donors is unfortunately greater than the number of people who donate, so each day, an average of 20 people pass away while waiting for a transplant in the United States,” Lewis said. “Knowing that we have helped save 500 people in need of a new heart is a wonderful feeling, and it would not be possible without the donors and their families.”

Video of the first heart transplant at Jewish Hospital is .����

“The benefits of not smoking, in particular to the heart, are huge. And with February being American Heart Month, it’s a good time to think about quitting,” said the University of Louisville’s Rachel Keith, PhD, APRN, a specialist in cardiovascular medicine and tobacco treatment. “But it’s a lot more than just halting a bad habit. That’s why we can say our relationship with tobacco is, ‘complicated.’”

Keith, who runs the new UofL Physicians Tobacco Treatment Clinic, said there are “strange dynamics” with tobacco.

“Smoking cessation is hard in general,” she said. “Helping patients to quit smoking often involves a lot of talking and figuring things out.

“We have to really get at WHY they smoke. Perhaps their grandmother died at age 100 even though she smoked, so they don’t believe there’s a connection. Or, she got them smoking and that’s their connection to her now that she’s gone.”

She said many people who come to the clinic have smoked for 30 or 40 years, and they are hesitant to quit. “That’s because it’s almost a part of them. In their view, you are taking away something they don’t know how to replace.”

She said she encourages patients to try different things and look for healthier alternatives when they have the urge for a cigarette.

“But when I ask them, ‘What are some other things you like to do for 10 to 15 minutes?,’ a whole lot of people can’t name those things. Many don’t have anything else. We try to help them find them, whether it’s a hobby or something like taking a walk,” she said.

But again, it’s complicated.

“A lot of patients feel sick, so they think they can’t get out and walk, even though they know it will be easier when they quit. There’s just a lot that goes into smoking, culturally and hormonally.”

People “can’t see the immediate effects of quitting, but they can quickly gain the rewards of smoking, because it’s almost instant. The body actually gets hard-wired to anticipate the effects from tobacco.”

That’s why the new clinic approaches all the factors that make it hard for people to stop, making it Louisville’s only comprehensive tobacco treatment program.

Keith meets with patients and develops a personal, individualized approach that best suits each patient’s needs. During sessions, Keith and patients discuss the benefits of stopping smoking, medication options, and different skills, such as mindfulness and relaxation, to help overcome anxiety.

Medications to treat withdrawal symptoms are paired with the cognitive-behavioral therapy to help patients sustain attempts to quit. Any medical issues also are addressed. One treatment Keith is studying is how to increase people’s motivation with virtual reality therapy, where an immersive session allows patients to imagine what life will be like once they’ve quit.

“The good news is, this type of program has been proven over and over as the most effective method for long-term cessation,” Keith said. “But until we opened, it was hard to find one in this area to get into.”

She said those who try to quit on their own have about a 6 percent chance of succeeding. If they work with a health provider, their chances improve to 10 percent to 15 percent. But with the comprehensive program, patients see a success rate of 30 percent and above.

“Those who have come through the program have done really well,” she said. “Almost everyone who comes through has quit.”

It generally takes about six sessions, usually once a week or every other week, to complete. Afterward, patients return on a more limited basis, and Keith follows up by phone.

Anyone who wants to quit smoking can come to the clinic, and many insurance plans will cover the program at little or no cost to the patient. It is located in Suite 310 of the UofL Physicians Health Care Outpatient Center, 401 E. Chestnut St.

To make an appointment, call 502-588-4600.

On Valentine’s Day, people may find themselves celebrating their relationships, or contemplating their lack of one. However, it’s not just love in the traditional sense that affects the heart, but also social bonds with friends and family

University of Louisville cardiologist Lorrel Brown, MD, studies the heart and says there is definitely a correlation between heart attacks, heart failure and other cardiac problems and loneliness, depression and anxiety.

While doctors know about the effects of diet, blood pressure and cholesterol on the heart, “now the medical community is interested in other components of heart health, that whole body connection,” Brown said. “Emotions are definitely part of this new way of understanding the body. Ideal cardiovascular health is now going beyond things you’ve already heard.”

In fact, some experts – including former U.S. Surgeon General Vivek Murthy, MD – are calling loneliness and social isolation a sort of epidemic, noting the increased risk for cardiovascular disease, among other health problems. Last month, the United Kingdom even appointed a “Minister for Loneliness” to address the finding that 9 million British people often or always feel lonely.

In in September, Murthy wrote, “Loneliness and weak social connections are associated with a reduction in lifespan similar to that caused by smoking 15 cigarettes a day and even greater than that associated with obesity.

“But we haven’t focused nearly as much effort on strengthening connections between people as we have on curbing tobacco use or obesity.”

Brown said Eastern medicine has long correlated the connection between emotions, love and health, and Western medicine is now starting to apply science to those observations.

“There’s ongoing research now into the question, ‘Is there some way to intervene?’” Brown said.

She said “Broken Heart Syndrome” (clinically named stress-induced cardiomyopathy or takotsubo cardiomyopathy) is the most clear and dramatic example of the effect of the emotions on heart health.

The phenomenon, where people actually suffer from a broken heart, is common in medical literature, and named after a Japanese takotsubo, a ceramic pot used to trap octopus, as the stressed heart takes on the pot’s shape. The condition was first identified in Japan.

It starts abruptly, with chest pain and often shortness of breath, usually triggered by an emotionally stressful event, Brown said, and it is not uncommon to see after spouses argue or one passes away. People experiencing Broken Heart Syndrome often end up in the emergency room because they think they are having a heart attack, which is caused by a blocked coronary artery.

Tests will show an unusual shape of the heart’s left ventricle (the pumping chamber), with a narrow neck and ballooned lower portion, giving the condition the “takotsubo” name. While cause is still unknown, it may be due to an increase in stress hormones such as epinephrine and norepinephrine, and is treated with medication to block those hormones.

While all of our social bonds are important, “it does seem that married people live longer than those who aren’t,” Brown said.

There are a few small studies that show the benefits of traditional love on the heart, and “we do know that people react most positively to stress when they are in love,” she said. The hormone released in love is the powerful oxytocin, which also acts as a neurotransmitter in the brain. When oxytocin levels go up, blood pressure goes down, and the heart rate slows. Inflammatory markers also tend to go down.

“However, love can apply to other types of relationships as well,” Brown said. “Happiness and companionship are an important part of heart health. People with strong bonds, whether it’s a spouse, many friends, or a close family, tend to have healthier hearts. While we don’t understand yet the nuances, there’s certainly a significant connection.”