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<div>The mission of the Ischemic Heart Disease (IHD) Research Program at the Krannert Cardiovascular Research Center at Indiana University School of Medicine is to better understand the progressive stages of IHD as it relates to structural, compositional and functional changes to the heart. The following update describes some of our research accomplishments between 2021-2024, including our work to establish a four-stage classification of acute myocardial infarction. <br /> <br /> </div> <p>&nbsp;</p> <br class="t-last-br" />

Research Impact, 2021-2024: Ischemic Heart Disease Research

Male and female investigators of the KCVRC Ischemic Heart Disease Research Team pose for a group photo in the Research II Building.

Investigators of the KCVRC Ischemic Heart Disease Research Team pose for a group photo in the Research II Building.

The mission of the Ischemic Heart Disease (IHD) Research Program at the Krannert Cardiovascular Research Center at Indiana University School of Medicine is to better understand the progressive stages of IHD as it relates to structural, compositional and functional changes to the heart.

Led by Rohan Dharmakumar, PhD, executive director of IU Krannert and the Charles Fisch Professor of Cardiology, the Ischemic Heart Disease Research Program uses a multi-disciplinary approach to advanced imaging technologies, including magnetic resonance imaging (MRI) and positron emission tomography (PET), molecular immunopathological studies, biomedical engineering methods, multi-omics and informatics, to help inform their discoveries.

Since Dharmakumar’s arrival in August 2021, the IHD research team has made headway in a few key areas to advance translational research. First, the team discovered that iron
drives the formation of fatty tissue and leads to chronic heart failure
in about half of heart attack survivors.

Their findings were published in Nature Communications and led to a follow-up clinical trial.
 
"Using noninvasive imaging, histology and molecular biology techniques, we have shown that iron from red blood cells is what drives this process," Dharmakumar explained. "When we removed the iron, we reduced the amount of fat in the heart muscle. This finding established a pathway for our first-in-human clinical investigation, which we project may mitigate the effects associated with iron in hemorrhagic myocardial infarction patients."

illustration of a heart shows highlighted area of myocardial infarction. Four stages are shown: aborted MI, acute MI with necrosis, acute MI with microvascular obstruction, and acute MI with intramyocardial hemorrhageThis IHD research was a catalyst for the Krannert Biennial held in May 2023, where 20 world renowned cardiovascular experts came to Indianapolis, to discuss the mechanisms of myocardial infarction and reperfusion injury, the therapies that exist; and tissue injury and inflammation in heart attacks.

Building on the knowledge of heart muscle damage, an expert panel pf cardiovascular specialists, including IU Krannert investigator, Keyur Vora, MD, Michelle Graham, MD, president of the Canadian Cardiovascular Society, Andreas Kumar, MD, from Northern Ontario School of Medicine and Dharmakumar, set out to develop guidelines for the cardiovascular profession.

In October 2023, the Canadian Cardiovascular Society (CCS) became the first cardiovascular society to adopt the four-stage classification of acute myocardial infarction they developed. The classification establishes the essential framework needed for new therapies to be developed to improve patient outcomes.

Along with these accomplishments, the IHD team made several seminal contributions to cardiovascular medicine, including enabling imaging of myocardial infarction without contrast agents and developing novel imaging markers for heart failure and ventricular arrhythmia in IHD. Their investigations continue to unravel the impact of reperfusion injury on myocardial salvage, and how this may help inform risk assessment, acute care management and the development of future therapies.

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Author

Angie Antonopoulos

Angie Antonopoulos is a Communications Generalist for the Krannert Cardiovascular Research Center at the Indiana University School of Medicine. Previously she served the Department of Surgery and promoted regenerative medicine research. She has more than a decade of experience in health communications for higher education, advocacy, government and contract research organizations.

The views expressed in this content represent the perspective and opinions of the author and may or may not represent the position of Indiana University School of Medicine.