Research Update

Steven M. Gootter Investigator Awards

The Steven M. Gootter Foundation, in partnership with the University of Arizona Sarver Heart Center, has created the Steven M. Gootter Investigator Award to foster a greater understanding of the causes and prevention of sudden cardiac death.

Though there is still some mystery behind the causes of sudden cardiac death, there are several therapies and interventions that can save the life of someone who is in ventricular fibrillation. This occurs when the large chamber of the heart is out of rhythm and is no longer pumping or squeezing blood out of the heart; but it is quivering because the electrical impulses telling the heart to beat normally have been interrupted. Julia Indik, MD, PhD, the inaugural recipient of the Steven M. Gootter Investigator Award, remains focused on improving the devices that are used to shock the heart out of fibrillation and back into a normal rhythm.

Dr. Indik’s research is devoted to furthering our understanding of how ventricular fibrillation evolves over time and affects the success of cardio-pulmonary resuscitation. As time elapses, ventricular fibrillation becomes more difficult to successfully shock, and this degeneration in the heart rhythm is worsened by any preexisting heart problems, such as heart failure or a prior heart attack. Dr. Indik analyzes the ventricular fibrillation heart rhythm with the goal that this analysis will allow us to tailor chest compressions and shocks to improve our success in resuscitation.

Study of the neurophysiologic trigger for sudden cardiac death

Richard D. Lane, MD, PhD, Professor of Psychiatry, Psychology and Neuroscience at the University of Arizona, was the recipient of the 2006-2007 Award. His work involves investigating the neurophysiologic trigger of myocardial electrical instability (heart-rhythm disturbance) in the context of emotional stress and coronary artery disease. This year Dr. Vince Sorrell (see below) and Dr. Lane are working together to further both research projects.

Dr. Lane continues to work collaboratively with Dr. Frank Marcus, a Sarver Heart Center member and founder of the section of cardiology at University Medical Center. Dr. Marcus is largely responsible for bringing electrophysiology to the University of Arizona College of Medicine.

Study of the use of cardiac MRI as a predictor of sudden cardiac death

Vincent L. Sorrell, MD is a Sarver Heart Center member, Associate Professor of Clinical Medicine and Radiology at the College of Medicine and the Allan C. Hudson and Helen Lovaas Endowed Chair of Cardiovascular Imaging. He is a two-time recipient of the Gootter Investigator Award.

His research investigates the prediction of sudden cardiac death by using cardiac magnetic resonance imaging (MRI) and he is developing a prospective registry of patients receiving implantable cardiac defibrillators (ICDs). Since first receiving the award, Dr. Sorrell and his team continue to enroll patients in the study. Their work has spawned several other national research projects and inspired a multimillion dollar study by Medtronic.

Study of the protein actin as a possible risk factor for sudden cardiac death

Anke Zieseniss, PhD received her award in 2007-2008. Dr. Zieseniss worked as a research associate in the laboratory of Dr. Carol Gregorio in the department of Cell Biology and Anatomy at the College of Medicine. Dr. Gregorio, co-director of the UA Sarver Heart Center, leads the Molecular Cardiovascular Research Program. Dr. Zieseniss’s study focused on the role of the protein actin in heart failure. Actin
is an indispensable structural element of cells and the major component of muscles - including the heart muscle. Changes in actin, caused by genetic mutations identified in humans, are a frequent cause of sudden cardiac death. Studying these actin mutations may explain how genetic defects in this protein affect muscle-force generation and muscle contraction and, as a result, lead to sudden death. Of special note, as a result of the Gootter Investigator Award, Dr. Zieseniss was able to secure a national American Heart Association grant.

 In 2008, Dr. Carol Gregorio, PhD was granted the Gootter Investigator Award to continue research on actin and its relationship to Sudden Cardiac Death.

Also in 2008, Mohamad Azhar, PhD received the SMG Investigator Award. Dr. Azhar is a member of the Sarver Heart Center and the BIO5 Institute at the University or Arizona.

His project is focused on a certain segment of the population that is at unusually high risk of aortic ruptures - leading them to sudden cardiac death. The disease that Dr. Azhar is working to understand is called Loyes-Dietz Syndrome. Those patients who suffer from the disease have a specific genetic mutation that leads to the development of aortic aneurysms. Through his project, Dr. Azhar hopes to develop new and advanced technologies for tissue assessment (using mice as a model). Currently there are no labs on the UA Campus that has the expertise to carry out the biomechanical and microstructural testing and non-invasive imaging of aortic, valvular and heart tissue of the mouse. Through his award, Dr. Azhar and his team will begin building this program - leading to scientific breakthroughs at the molecular level.

Study of the regulation of vascular inflammation by androgens in human coronary vascular smooth muscle

In 2009, Rayna Gonzales, PhD., Assistant Professor in the Basic Medical Sciences at the UA Sarver Heart Center was granted the Gootter Investigator Award. Her research is focused on the regulation of vascular inflammation by androgens (a steroid found in humans) in coronary vascular smooth muscle. Inflammation of the blood vessel wall contributes to the formation and progression of cardiovascular disease. If left untreated, one consequence could be sudden cardiac death. Previously the role of androgen and protective and non-protective effects in cardiovascular disease have been reported. However there have been few studies of the effects this steroid has when there is inflammation in the vessel walls and what effect this has on the cardiovascular system. If we can understand the interaction between androgens and the intracellular mechanisms involved in the regulation of inflammation on the blood vessel wall, then therapeutic agents can be developed to treat, manage or even prevent detrimental cardiac events that can lead to life threatening situations such as sudden cardiac arrest.

Study of hypertrophic cardiomyopathy (HCM), sudden death and exercise

John Konhilas, PhD., Assistant Professor in Physiology at the UA Sarver Heart Center was also granted the Gootter Investigator Award in 2009. While exercise is good for cardiovascular health, it is commonly believed that even mild exercise is not advised for those who suffer from Hypertrophic Cardiomyopathy (thickening of the heart muscle). This research proposal is aimed at proving just the opposite – that mild exercise is good for those with HCM. The research that Dr. Konhilas is embarking upon is to study an enzyme (AMP-Kinase) that is a key in regulating cellular energy. HCM decreases this enzyme whereas exercise increases it – those that have HCM should benefit because of this rise in the ‘good’ enzyme. The goal of the project is to determine the cellular mechanisms of HCM (one of the primary triggers of SCD in young athletes) and identify novel therapeutics for patients with HCM.

The Steven M. Gootter endowed chair for Sudden Cardiac Death

Our long term goal is to fund the Steven M. Gootter Endowed Chair. An endowed chair will allow the Sarver Heart Center to recruit/retain a top-notch faculty member and implement a program focused on sudden cardiac death.

What is an Endowed Chair?

An endowed chair allows not only for the startup or enhancement of an academic program by helping in the recruitment and retention of a pre-eminent faculty member, but also assures continuing success of the program.Endowed chairs are reserved for those distinguished scholars who are rising or who have risen to the top of their respective areas of endeavor.

An endowed chair has the single most direct impact in academics.