Clinical trials and papers are an integral part of teaching hospitals. Physicians, nurses and research teams across Corewell Health East are involved in a myriad of studies, clinical trials and publications at any given time. The Research Roundup series will provide updates and insights into some of the exciting research and discoveries happening here.
Can a diabetes medication slow the progression of aortic stenosis?
When the valve between the aorta and the heart starts to become thickened, a condition calledaortic stenosis (AS) can occur. With AS, the heart works harder, and the person may experience chest pain, fatigue or shortness of breath. This can lead to heart failure (see below) or other problems.
AS is a progressive disease, and once it starts it will continue to worsen. The valve can be replaced either through surgery or through a catheter technique called transcatheter aortic valve replacement, or TAVR. Until now, there has not been a medical therapy, or medication, that will slow or reverse the progression of AS.
“We’re testing a medication that is technically a diabetes medication, because it lowers blood sugar levels,” said Dr. Amr Abbas, director, Interventional Cardiology Research, Corewell Health East. “Studies overseas found this medication has slowed the progression of aortic stenosis.”
“If we could stop aortic valve disease before it requires replacement, this could be a game changer,” said Deidre Brunk, RN, nurse manager, Cardiovascular Clinical Research. “If we can make the valves last longer, we can prevent multiple surgeries.”
Study participants: The clinical research study has launched and will be recruiting patients over 35 years old with cardiac issues, but not diabetes, to take part in this study. Contact Diedre Brunk for more information.
Do heart failure outcomes improve with cinching device?
To support normal activity, the heart must fill with and pump out enough blood to carry oxygen through the body. Heart failure is a chronic condition where the heart cannot pump blood efficiently, resulting in fatigue, shortness of breath, swelling and other symptoms. In some heart failure cases, “The left ventricle begins to enlarge and get weaker and weaker, and can ultimately fail,” Diedre said, “Kind of like when you pull a rubber band, and you keep pulling it, it loses elasticity. When that happens, the ventricle doesn’t stretch back and can’t pump all the blood out.”
Dr. Ivan Hanson, interventional cardiologist, director, cardiac cath lab, Corewell Health East William Beaumont University Hospital, is a primary investigator on a research study using an investigational, minimally invasive device called the Accucinch Ventricular Restoration System. This device is designed to reduce the size of the left ventricle, which may halt the progression of heart failure.
“We put a series of small anchors connected by a cable around the inside the left ventricle. Then we shorten the cable, reducing the size of the ventricle. This makes the pump mechanism more efficient and helps strengthen the heart wall,” said Dr. Hanson. “Early phases of the study have seen a reduction in symptoms and slight increase in efficiency. Even a 10% increase would be significant for a sick patient.”
Study participants: The study is open to heart failure patients who meet certain requirements, including they must currently be on medical therapy for heart failure and will continue on that therapy for the five-year duration of the study. Contact Diedre Brunk for more information.
Is there a better way to detect pulmonary embolism?
Up to 30% of patients who need an urgent CT scan to detect and treat a pulmonary embolism (blood clot near the lungs), cannot tolerate the contrast material that helps the medical team identify and locate the clot. Through a new technique, pioneered by Corewell Health East physicians and physicists, a patient now gets two scans without contrast – one while they breathe in, and one while they breathe out – to create an image physicians can use to properly diagnose PE.
“We started looking at this two years ago through a clinical research trial in our Emergency Center,” said Dr. Craig Stevens, chair, Radiation Oncology, Corewell Health East. “We developed new software for the CT scanners that we have now licensed to a medical device company so they can expand testing.” FDA approval could come in the next year or two.
“It has great potential to help patients,” said Dr. Stevens, adding, “Every emergency room in the world needs that software. The software will work no matter who made the CT machine.”
Can we make chronic daily antiretroviral therapy easier for HIV-positive teens?
In the U.S., up to half of HIV-positive teens struggle to take their daily medication regularly. Physicians from Corewell Health East and West wrote an invited review on an FDA-approved monthly injectable, long-acting antiretroviral therapy for adolescents. These pediatric infectious diseases experts wanted to share knowledge about long-acting antiretroviral therapy being as effective as a daily dose of pills.
In a paper for the Journal of the Pediatric Infectious Disease Society, Dr. Bishara Freij, chief of Pediatric Infectious Disease, Corewell Health William Beaumont University Hospital, along with Dr. Aileen Aldrich, Infectious Diseases, Corewell Health Helen DeVos Children’s Hospital; Sara Ogrin, pharmacist, Pediatric Infectious Diseases, Corewell Health Helen DeVos Children’s Hospital; and Dr. Rosemary Olivero, , chief, Pediatric Infectious Diseases, Corewell Health Helen DeVos Children’s Hospital, reported that teen HIV-positive patients could receive a single shot of a long-acting antiretroviral therapy every four to eight weeks with few side effects and excellent patient satisfaction.
The physicians concluded that while it may take some time for this type of drug to become more common for adolescents, long-acting therapies “show great promise” in the fight to end the HIV epidemic.