Caption: Cynthia St. Hilaire (pictured above) is leading the new Center for Aortic Valve Disease Prediction and Integrated Research through an award from the American Heart Association.
By Kat Procyk
The University of Pittsburgh is part of a new $15 million initiative from the American Heart Association to improve the diagnosis and treatment of heart valve disease through the Strategically Focused Research Network on Earlier Detection and Delaying Progression of Valvular Heart Disease.
Cynthia St. Hilaire, associate professor of medicine (Division of Cardiology), School of Medicine, will lead the Center for Aortic Valve Disease Prediction and Integrated Research as its director and part of the four-year award. The center will collaborate with teams at Worcester Polytechnic Institute in Worcester, Massachusetts, and Creighton University in Omaha, Nebraska, for three projects focused on the prediction, disease pathogenesis and treatment of aortic stenosis, the narrowing of the aortic valve. The condition commonly develops during aging as calcium or scarring damages the valve and limits the amount of blood flowing through.
The center aims to link lipoprotein(a) (Lp(a)), a genetic blood factor that increases aortic stenosis risk, to disease progression and develop predictive models using machine learning; define how Lp(a), inflammation and heart biomechanics combine to drive disease in laboratory settings; and, lastly, understand how Lp(a) initiates calcification of valve cells and develop treatments that block these processes.
“We know that high Lp(a) increases the risk of aortic stenosis, but it doesn’t tell the whole story,” St. Hilaire said. “Many people with elevated Lp(a) never develop valve disease, which tells us other forces are at play. Inflammation, abnormal valve motion and disrupted blood flow may act together with blood-based risk factors to damage the valve over time.”
The center utilizes machine learning, realistic valve motion and flow models, and a new screening platform to study cellular reprogramming and potential inhibitors, capturing interactions often missed in standard experiments. The center’s goal is to move aortic stenosis care away from late-state surgery, which is normally the only option for treatment.
Two more centers led by researchers at Brigham and Women’s Hospital and Cincinnati Children’s Hospital Medical Center are also part of the initiative.