In This Video
- Robert Levine, MD, is a senior physician in Massachusetts General Hospital's Cardiac Ultrasound Lab
- He was recently named an AHA Distinguished Scientist
- Here, he discusses his team's focus on discovering the genes that cause mitral valve prolapse, the most common cause for operation for mitral regurgitation
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My career started in cardiac ultrasound imaging the heart and describing geometric mechanisms of valve disease, valves that are too long, valves that are too short. The question came, what makes valves too long or too short so that they are either stenotic or regurgitant?
And that led to creating an international network that addressed basic questions in valve biology, really spanning the arenas of clinical cardiology and imaging and basic science, genetics, developmental biology. And we had the wonderful opportunity of forging an international network spanning these disciplines to address these questions at a very basic level so we could find solutions.
Some of the things we're doing in our team and associated people throughout the world is discovering the genes causing mitral valve prolapse, the most common cause for operation for mitral regurgitation. And by understanding these basic mechanisms, we hope to address the question of how do we block the progress from mutation to disease. Where can we intervene to prevent people from getting sick? But in another area, it's kind of the opposite of prolapse where the valves are too short after myocardial infarction. We've been discovering the mechanisms, this battle between adaptive valve growth and maladaptive inflammation and fibrosis, and how we can tip the balance in the direction of adaptive growth by combating inflammation and fibrosis. And some of those questions are getting ready for clinical application.
Imagine you could take a patient after a myocardial infarction and treat them in a way that their valves would change along with the heart and they would change in parallel so the valve would never leak and they would have much less heart failure. Imagine you had a patient with hypertrophic cardiomyopathy. Many patients come to Mass General and they have long valves that obstruct exit of blood from the left ventricle. Imagine that you could prevent those valves from growing because you understood why they're too long. Paul Dudley-White, who founded cardiology at Mass General, said there are three principles for treating disease: Prevention, prevention, prevention.
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