Often under recognized, the cardiac endothelial cells are highly abundant in the heart, and may have important roles in modulating cardiac function, besides simply serving as structural component of blood vessels. Evidences of ours and others have indicated an emerging role of cardiac endothelial cells signaling to cardiomyocytes to mediate important pathophysiological responses. Nonetheless, detailed mechanisms of... more »

What is the secret behind the “resilience” some people have to heart, lung, blood, and sleep (HLBS) diseases?

Are epigenetic changes the cause or the consequence of changes in cell function that contribute to cardiovascular disease?

If they are the cause, what are the mechanisms that lead to changes and how do they impact disease pathogenesis?

If the consequence, do they play any role in disease pathogenesis?

What methods can be used to test if epigenetic changes play a causal role in disease pathogenesis? Thus far studies... more »

Society is ageing and chronic degenerative diseases including COPD are increasingly occurring together.
The critical question is whether certain diseases occur together by chance or are they occurring together because they share pathobiological commonalities and mechanisms? This leads to a series of practical consequences and questions
1. Which diseases are occurring concurrent with COPD more than chance alone would... more »

Does treating depression improve survival and reduce major adverse cardiac events in acute coronary syndrome patients?

What are the specific contributors of obesity that lead to chronic positive energy balance and surplus energy storage?

What are the consequences, clinically and immunologically, of ABO or Rh type specific vs. non-type specific platelet transfusions? There is widely varying practice as to ABO and Rh matching of platelets for transfusion. Most studies demonstrate that use of ABO unmatched (non-identical) platelets are associated with increased 1) platelet refractoriness (small randomized trials), 2) red cell transfusion needs and hemolysis,... more »

As a clinician, over the years I have noted major differences in adverse cardiovascular outcomes in diabetics who are treated with insulin +/- oral agents compared to those only treated with oral agents. Cardiovascular events occur much less often and at a much later timeframe in diabetics ("Type 2/adult onset") treated with insulin as the primary method. Even with newer agents, there may be slight improvement, but... more »

The fact that diet contributes significantly to prevention and treatment of disease is now a foregone conclusion. National and international guidelines offer evidence based recommendations advocating nutrients, foods and eating patterns that are most closely associated with reduced risk. Patients assume that physicians are knowledgeable regarding the role of diet in health and that they are trained to counsel patients... more »

What is the effect of sleep disorders on child development? Specifically, how sleep apnea with intermittent hypoxia and or sleep deprivation alters the normal trajectory of maturation of brain regions controlling cognition, behavior and the cardiovascular system?

Heart Failure (HF) remains a major public health burden. A working group was convened by NHLBI and ODS in June, 2013 to address the role of diet and nutrition in management of HF. A review of existing evidence produced no clear rationale for appropriate dietary interventions. On the contrary, the group developed recommendations for conducting additional research specifically on the role of sodium, fluid, nutrients, and... more »

What are the critical mechanisms that account for progression from reversible to irreversible ischemia and reperfusion injury?

Compelling Question (CQ)

There are many novel imaging modalities, including radiographic, scintigraphic, sonographic, MR-based, and molecular for the heart and vessels. Patients have unique medical "signatures"- genetic risk factor profiles, epigenetic markings, "omics" profiles, and personal clinical and family history as well as symptom constellation and physical exam findings. Can these all be integrated into a single personalized profile... more »

Liver arteriovenous venous malformations creates a high flow shunt that over time creates high output cardiac failure with no effective treatments.