ArticlePDF Available

The Importance of Cardiovascular Research: What are we looking for?

January 2015

January 2015

DOI:10.15436/2378-6914.15.009

Authors:

Takeshi Tsuda

Alfred I. duPont Hospital for Children

Content uploaded by Takeshi Tsuda

Content may be subject to copyright.

Journal of Heart and

Cardiology

Editorial

Takeshi Tsuda*

Corresponding author: Associate Professor of Pediatrics,

Sidney Kimmel Medical College of Thomas Jefferson, Uni-

versity, and Philadelphia, PA 19107 Tel: (302)651-6677; Fax:

(302)651-6601; E-mail: ttsuda@nemours.org

Received Date: December 29, 2014

Accepted Date: December 30, 2014

Published Date: December 31, 2014

Citation: Tsuda, T. The importance of Cardiovascular Research: What

are we looking for? (2014) J Heart Cardiol 1(1): 1-2.

J Heart Cardiol | Volume 1: Issue 1

www.ommegaonline.com

Editorial

I used to naively and optimistically believe that the ad-

vance in medical science and technology would eventually solve

the majority of clinical problems. In the mid 80s when I was

a medical student in Japan, cancer disorders were perceived as

“progressive and lethal” by both physicians and patients. Treat-

ment strategy was still empiric and far from strategic and com-

prehensive. Without question, they were the biggest challenges

and threats to the entire society at that time. Thanks to marvelous

progress in integrated management with chemotherapy, surgical

intervention, and radiation therapy, etc., the modern medicine

has been able to conquer some types of cancers. Instead, howev-

er, we began to see increased number of heart failure in cancer

survivors secondary to specic cancer chemotherapy[1]. By solv-

ing one existing problem, we simply created another problem:

chemotherapy-induced-cardiomyopathy. Its pathogenesis and

effective treatment are still not fully understood. Although a

potent chemotherapy has signicantly improved survival and,

in part, quality of life, it is not always complication-free. Some

complications are just as bad as the original disease. With new

therapeutic modalities, we started to see a number of unexpected

new pathological conditions never experienced in the past.

Heart failure is a progressive lethal disease that has

signicant morbidity and mortality. Nearly 5.7 million people

suffer from heart failure in the United States alone (2008)[2], and

20% die within rst year after the diagnosis[3]. This is a signif-

icant social impact. According to the textbook of Colucci and

Braunwald (“Heart Disease”, 6th Ed, 2001, McGraw Hill), heart

failure is dened as “the pathological state or clinical syndrome

in which the heart is unable to pump blood commensurate with

the requirements of the metabolizing tissues or can do so only

with an elevated lling pressure.” Although the nal common

physiological outcome is the same, the underlying mechanisms

that cause heart failure are diverse and complex. The underly-

ing mechanisms of heart failure are poorly understood. Heart is

known as the most durable, integral, and indispensible organ to

maintain life. Besides the natural end of life, we have not yet elu-

cidated the underlying mechanisms of heart failure; nonetheless,

there must be strong factors at play that cause this diligent organ

to stop functioning. What are they? Why does myocardial tissue

fail to work properly? The understanding of molecular biology,

cell and matrix biology, and gene regulation is critical in answer-

ing these questions.

Heart failure is indeed a clinical syndrome involving

multiple organ systems. It is not merely a hemodynamic disabil-

ity of the heart as a pumping organ, but also represents loss of

regulation of the complex network communication among multi-

ple organs including heart, lungs, kidneys, liver, brain, gut, skel-

etal muscles, and endocrine organs, as all depend upon essential

supply provided by the heart. The disruption of these cross-talks

can be both the cause and/or result of failing circulation. What

are the methods in communicating with the distant organs? What

are the hormones that the heart can produce other than natri-

uretic peptides? The understanding of an endocrine role of the

heart is limited and needs to be further investigated[4]. Alteration

in immune system and dysregulated inammatory process are

heavily involved in the development of heart failure[5] and vas-

cular diseases[6]. To better understand the heart disease and the

patients with heart disease, it is imperative for all practicing car-

diologists to appreciate the importance of medical research, both

basic and clinical. Research is an unending human endeavor to

tackle unanswered questions we encounter for the patients and

for ourselves.

In the modern era, there are much more to learn than

what we used to learn in the past. As Hippocrates said, “Art is

long, life is short, opportunity eeting, experience treacherous,

judgment difcult”, there is so much to learn and so little to ac-

quire within a limited time. We sometimes lose ourselves in

the midst of the enormity, complexity and diversity of available

medical information. But this is who we are as medical profes-

sionals to be able to serve our patients. Any research experience

in the professional career would likely to help each individual