Research

Area 2

Arrhythmias, resynchronization and cardiac imaging

Team leader

Strategic objectives

The aims for the coming year is to continue and stabilize the six main research lines of the group: genetic in cardiovascular diseases, atrial fibrillation, cardiac resynchronization, ventricular tachycardias, experimental models of etiological factors in atrial fibrillation, and Sports Cardiology. Furthermore, we wish to continue promoting prospective multicenter projects without abandoning practical clinical research, to improve patient care. On the other hand, we will keep on working with the Bioengineering team at the UPF and Galgo Medical in modeling and software development for image processing.

Main lines of research

1. Cardiovascular genetic diseases:

  • The group is focused in recruiting patients and following them, in order to analyze prognosis of several genetic arrhythmias. The incorporation of Dr. Elena Arbelo has increased the activity and opened new research projects. Furthermore, genetic testing will continue to be done in collaboration with the group of Dr. Ramón Brugada

2. Experimental models for the study of etiological factors in atrial fibrillation:

  • We wish to continue analyzing the mechanisms that promote atrial and ventricular fibrosis in the rat model of endurance exercise.

3. Atrial fibrillation (AF):

  • On one hand we are continuing the study of etiological factors in primary atrial fibrillation.
  • Several multicentric studies about new ablation techniques and new antiarrhythmic drugs are in course: EAST, FIRE AND ICE and RAFAELLO.
  • We are also developing new ablation approaches based on imaging techniques such as MRI.

4. Ventricular tachycardia (VT):

  • Multicenter study of antiarrhythmic drugs versus ablation in ischemic patients with automated implantable defibrillators.
  • Different prospective studies are being conducted, evaluating the clinical usefulness of epicardial ablation in different substrates.
  • Software has been developed to delimit the slow conduction zones within myocardial scars by means of magnetic resonance studies and their fusion with images obtained from threedimensional navigation systems.
  • Siemens has sponsored a prospective study to evaluate remodelling and sudden death risk predictive capacity with MRI and biomarker levels in patients with structural heart disease.
  • 5. Cardiac remodelling in the athlete and prevention of sports -related cardiac sudden death:

    • Right ventricular performance during exercise and chronic adaptation to training. Identification of individual patterns of adaptation and relationship with performance.
    • Atrial performance during exercise and chronic adaptation to training in relation with experimental work performed in research line 2.
    • Preparticipation screening programmes to detect cardiac abnormalities.
    • Early imaging cardiac biomarkers of disease Identification of subclinical disease with imaging biomarkers based on strain echocardiography and cardiac MR (T1 sequences) in different clinical settings.
    • Analysis of cardiac mechanics with imaging Understanding mechanistic insight of heart failure and cardiomyopathy to develop therapies based on electrical stimulation with pacing devices (CRT in heart failure, HOCM).
    • Valvular heart disease Epidemiology and etiology of valvular disease Outcomes after therapy.

    6. Vascular cell and molecular biology of genetic thoracic aneurysms: the Marfan syndrome.

    • Phenotypic modulation of aortic vascular smooth muscle cells.
    • Redox biology and oxidative stress.
    • Membrane trafficking, cytoskeleton dynamics and cell signaling applied to aortic aneurysms.
    • New animal experimental models to evaluate the formation and progression of thoracic aortic aneurysms.
    • Development of aortic bioreactor and evaluation of mechanical forces in the progression of aortic aneurysms.

Research Group

Atrial fibrillation biopathology and therapy

Lluis Mont

(HCB)

Our grup is focusing in the study of etiologic factors, with the aim to understand the development of the disease and prevent its development. Furthermore, we are focused in improving therapy improving ablation techniques and participating in multicenter studies pursuing improvements in AF management.

  • Analysis of the effects of endurance exercise in a murine model, to study the limits of healthy adaptation to exercise, vs excesive training leading to atrial disease.
  • Estudi of the sympathetic/parasympathetic balance in healthy volunteers, to analyze the relationship of stature and autonomic balance.
  • Development of an custom made semiauthomatic software, devoted to identification of fibrosis at the atrial level, to guide ablation.
  • Multicenter studies, establishing the usefulness of early rythm management strategy in atrial fibrillation.

Research Group

Cardiac Imaging

Marta Sitges

(HCB)

Our group has a pluridisciplinary team of people dedicated to non-invasive cardiac imaging and its application in the knowledge and research into cardiovascular pathophysiology and therapy within the field of cardiac mechanics and remodelling in cardiovascular diseases. Our lines of research include:

  • Application of cardiac imaging in the study of cardiac mechanics in patients with cardiac dyssynchrony treated with resynchronisation therapy.
  • Study of atrial morphology and function in patients with atrial fibrillation and elite sportsmen and women.
  • Study of right ventricular morphology and function in elite athletes at rest and exercising.
  • Detection of latent ventricular dysfunction in different disorders such as Chagas disease, cirrhosis of the liver and cardiotoxicity caused by chemotherapy in blood disorders.
  • Analysis of post-infarction remodelling using three-dimensional echocardiography and cardiac magnetic resonance imaging.
  • Collaboration with MaternoFetal Medicine Group in the assessment of cardiac remodelling in response to intrauterine growth restriction or artificial reproductive techniques.
  • Non-invasive analysis of endothelial function through ultrasoundof the humeral artery in myocardial infarction patients with pulmonary hypertension.
  • Analysis of the epidemiology and etiology of valvular heart disease in our area and impact of current therapies.
  • Imaging support in experimental models of research such as exercise, pressure overload and Marfan Syndrome.

Research Group

Vascular cell biology

Gustavo Egea

(UB)

The main objective of this group is to understand which are the molecular bases impaired in the formation and progression of syndromic thoracic aorta aneurysms particularly in Marfan syndrome.In this respect, we are focus on in the contribution of: (i) the oxidative stress, (ii) mechanical forces, (iii) membrane trafficking of TGFbeta receptors, and (iv) the the crosstalk between vascular smooth muscle cells and extracellular matrix in terms of mechanotransduction. To all these aims, we utilize aortic aneurysm samples of Marfan patients subjected to reparatory surgery and animal (mice) experimental models. On the other hand, we keep on the study about the interaction of the transport intermediaries (vesicles and tubules) with the actin cytoskeleton and lipid homeostasis associated with membrane trafficking at the Golgi apparatus.

Research Group

Arrhythmias and physical activity

EDUARD GUASCH

The Arrhythmias and physical activity group, led by Dr. Eduard Guasch, was officially established in 2015 under the IDIBAPS 50/50 program. Main research topics include the study of the etiology, pathophysiology and therapy of cardiac atrial and ventricular arrhythmias through a multifactorial approach involving animal models, ex vivo and in vitro techniques and studies in humans. In this regard, the group has developed a special interest in the study of extreme intensity exercise as an emerging etiologic factor for arrhythmias such as atrial fibrillation and right ventricular tachycardia, driving to the exploration of further unknown deleterious cardiovascular conditions of “excessive” doses of exercise.