The Sydell and Arnold Miller Family Heart & Vascular Institute at Cleveland Clinic is a leader in the heart field. It's long history of innovations, from the first cardiac catheterization to new diagnostic imaging approaches and treatments for heart disease – provides a legacy of excellence in patient care, research and education
Innovations
First gene linked to heart attack, heart disease
The gene, MEF2A, was discovered by methodically studying the genetic makeup of 21 members of an Iowa family plagued for generations by incidents of coronary artery disease and heart attack. The elements missing from this gene represent 21 base pairs of nucleotides and seven amino acids.
This deletion affects coronary artery walls, making them less able to protect themselves from plaque buildup and heart disease. "People with this exact MEF2A mutation have essentially a 100-percent chance of having a heart attack or developing coronary artery disease," said Eric J. Topol, M.D
It is unlikely that many other families will be found who have the exact same genetic mutation. Instead, researchers will seek to pinpoint smaller mutations involving the same gene that may contribute less dramatically to the development of heart disease. Learn more
Pulmonary vein isolation (ablation)
This is a successful treatment option for many patients with the irregular heart rhythm, atrial fibrillation.
The procedure involves the use of special catheters (soft wires) inserted into the left atrium. The catheters are used for delivery of energy (ablation) to the area. Energy is delivered from one catheter into the area of the atria that connects to the pulmonary vein, producing a circular scar.
The scar will then block any impulses firing from within the pulmonary vein, thus preventing atrial fibrillation from occurring. The process is repeated to all pulmonary veins. Learn more
Carotid emboli protection device
A new filtering device, used in combination with antiplatelet medications, increases the safety of carotid artery angioplasty and stenting. Angioplasty involves snaking a slender tube and wire through a blood vessel to manage plaque accumulation on artery walls and to help improve blood flow in a narrowed artery.
The AngioGuard Emboli Capture Filter device was designed for use during angioplasty and stenting of the carotid artery, the large vessel that runs up through the neck and into the brain. The filter captures particles (emboli) that may break away from the artery walls during the stenting procedure. If these particles travel up the artery and into the brain, they can cause a brain attack, or stroke.
Studies led by the Sydell and Arnold Miller Family Heart & Vascular Institute surgeon Jay Yadav, M.D., show that stenting used in combination with the AngioGuard filter is as safe and effective as carotid artery surgery, which involves surgically opening the neck and vessel. Learn more
A new look at LDL levels and treatment recommendation
The first head-to-head comparison of two popular cholesterol-lowering medications showed that only one of the statins successfully stopped the progression of heart disease.
The Cleveland Clinic-led research also found that people's cholesterol levels had to be cut to much lower levels than the recommended national guidelines to achieve this result.
The REVERSAL trial, directed by Cleveland Clinic cardiologist Steven E. Nissen, M.D., compared the highest doses available at the time of two popular statin drugs, pravastatin and atorvastatin. Both medications work to block the liver's ability to produce harmful cholesterol, which can clog coronary arteries.
A second study called PROVE-IT also found that the lower the LDL the better - the PROVE-IT study results stated, "The more intensive lowering of LDL provided a 16% reduction in the risk of all-cause mortality of major cardiac events." Learn more
Infusion of ApoA-I Milano/phospholipid complex could reverse coronary plaque buildup in patients with heart disease
A Cleveland Clinic-directed study, led by cardiologist Steven E. Nissen, M.D., administered the ApoA-I Milano/phospholipid complex intravenously over a five-week period to a randomized group of patients initially hospitalized for acute chest pain.
Researchers measured arterial plaques using intravascular ultrasound (IVUS) before and after the six-week study. Patients who were given the synthetic protein showed a dramatic decrease in arterial plaques, whereas a comparison group given saline showed no change in plaques.
Functional Diagnostics for Heart Disease
Dr. Stanley Hazen, M.D., Ph.D., head of the Section of Preventive Cardiology and Cardiac Rehabilitation, has developed a number of new diagnostic approaches to inflammatory diseases by identifying characteristic signature compounds linked to the origins of specific diseases and using this information to develop diagnostic markers. These include myeloperoxidase (MPO) and Nitrotyrosine.
Irregular heart rhythms occurring after exercise are a significant predictor of death
Dr. Michael S. Lauer's study of more than 29,000 patients revealed that patients who had irregular heart rhythms after exercise had a greater risk of death from all causes within the next five years than those who experienced such rhythms only during exercise, or those who did not have any irregular heart rhythms.
Specifically, the study found that of 29,244 patients tested, 3 percent experienced irregular heart rhythms during exercise only, 2 percent experienced arrhythmias during recovery only and 2 percent experienced problems during both exercise and recovery.
Learn more about our history of innovations.
