Division of Heart and Vascular Diseases

MISSION

The Division of Heart and Vascular Diseases plans and directs the NHLBI's research grant, contract, and training programs in heart and vascular diseases. These programs encompass institute- and investigator-initiated basic research, targeted research, specialized centers and clinical trials. The DHVD maintains surveillance over developments in its program areas and assesses the national need for research on the causes, prevention, diagnosis, and treatment of cardiovascular disease. The DHVD ensures that effective new techniques, treatments and strategies resulting from medical research are transferred to the community through professional, patient, and public education programs in a timely manner.

PROGRAM OBJECTIVES

The Division has three major programs, the Heart Research Program, the Vascular Biology Research Program, and the Clinical & Molecular Medicine Program, in addition to a Research Training and Special Programs Group.

HEART RESEARCH PROGRAM (HRP)

This Program supports basic, applied, and clinical research in cardiac diseases, from embryonic life to adulthood. Targeted areas include heart arrhythmias and electrical abnormalities, cardiomyopathies, cardiac development, pediatric heart disease, heart failure and cardiogenic shock, exercise physiology, ischemic heart disease, inflammation and infectious disorders of the heart, heart transplantation, and myocardial preservation. Selected areas of focus are normal and abnormal cardiac development, diabetic cardiomyopathy, gene-nutrient interactions in the pathogenesis of congenital heart defects, the pathogenesis of heart failure, electrical remodeling, and programs dealing with various aspects of HIV infection as it relates to the heart. Specialized Centers of Research support collaborative studies in ischemic heart disease, sudden cardiac death, heart failure, pediatric cardiovascular disease, and heart disease in blacks. The Program comprises two Scientific Research Groups (SRG) which are described below.

Heart Development, Function and Failure SRG

This SRG supports broad areas of research in heart development, cardiac function and heart failure. Heart development encompasses the embryology of the heart and major blood vessels, including normal functional and structural development as well as the genetic, molecular, environmental, and mechanical etiology of congenital cardiovascular malformations. Also included in this research area are diagnosis and treatment of congenital cardiovascular malformations and acquired pediatric heart disease, from fetal to adult life. Cardiac function includes myocardial energetics; contractile dysfunction; cardiovascular physiology; hypertrophic, dilated, and restrictive cardiomyopathy; heart failure; myocardial preservation; infectious and inflammatory conditions affecting the heart and blood vessels including myocarditis, Kawasaki Disease, rheumatic heart disease, and HIV infection; and cardiac transplantation. Heart failure includes molecular, cellular, hemodynamic, animal, pre-clinical and clinical studies of mechanisms and pathophysiology of heart failure. Specific aspects of heart failure emphasized include heart failure in the pediatric and geriatric populations, diabetic cardiomyopathy, the transition to heart failure, and basic heart failure pharmacotherapy. Research also has focused on developing the tools to study heart failure, such as creating animal models, exploiting genetic and genomic tools, and refining imaging modalities such as PET and MRI. The cardiac transplantation portfolio covers all aspects of pediatric and adult transplantation, including patient selection, diagnosis and treatment of rejection and transplantation atherosclerosis, immunosuppression and immunomodulation, donor preservation, and xenotransplantation.

Ischemia, Arrhythmia & Sudden Cardiac Death SRG

This SRG includes basic, applied and clinical research studies dealing with the etiology and pathophysiology of ischemic heart disease and its consequences, as well as the control and treatment of cardiac electrical activity, rhythm and rate, especially as they relate to sudden cardiac death. Basic studies on arrhythmias and electrical activity include work on cardiac membrane biophysics, membrane structure and organization, ion pumps and channels, transport, and exchange and gap junction proteins, as they determine electrogenesis. These also include work on adrenergic and cholinergic control mechanisms and related pathways of cell signaling and their pharmacological manipulation to regulate cardiac rate and rhythm, as well as the integration and control of various mechanisms controlling the heart. Work on genetic contributions to arrhythmogenesis and sudden cardiac death, such as mutations that underlie particular arrhythmic diseases (e.g., long Q-T syndrome) and genetic procedures to address these disorders, are of particular interest. Applied studies include research on implantable pacemaking and conducting systems for the heart and dynamic aspects of cardiac conduction. This also entails support of detailed electrocardiography approaches, as well as invasive diagnostic and therapeutic techniques involving selective tissue ablation. Important clinical issues include: development of effective antiarrhythmic drugs; better, safer pacemaking and defibrillating systems; identifying patients at risk for sudden cardiac death; and new, effective approaches to arrhythmias likely to accompany other manifestations of cardiac disease that occur, for example, following infarction in hypertrophic cardiomyopathy and in cardiac failure. Fundamental studies in ischemic heart disease include myocardial infarction, angina pectoris, coronary thrombosis, coronary blood flow studies, and myocardial reperfusion and revascularization as well as investigations directed at improving diagnosis and treatment of myocardial ischemia due to coronary vessel disease, coronary occlusion, and vasospasm. Other research areas are: the measurement and limitation of infarct size and protection of jeopardized myocardium, including studies of myocardial stunning, hibernation and reperfusion injury; and myocardial ischemic effects on coronary arteries, collateral vessels, the coronary microcirculation and the cells involved.

VASCULAR BIOLOGY RESEARCH PROGRAM (VBRP)

This Program supports research in atherosclerosis, hypertension, basic vascular biology and gene therapy for the prevention and/or treatment of vascular diseases. Other targeted areas focus on the etiology, pathogenesis, and treatment of excess cardiovascular disease in diabetes mellitus and cardiovascular complications of HIV/AIDS. Specific programs include Specialized Centers of Research focused on molecular medicine and atherosclerosis, molecular genetics of hypertension, and basic and clinical gene therapy studies. The Program comprises two Scientific Research Groups (SRG) which are described below.

Atherosclerosis SRG

This SRG plans, conducts, and directs research programs in the etiology, pathogenesis, diagnosis, prevention, and treatment of atherosclerosis. Programs include the pathobiology and genetics of the vasculature; vascular growth and angiogenesis; interactions of the vascular wall with systemic and humoral factors promoting atherogenesis; and lesion progression, complication and regression. Targeted studies include programs such as characterization of the vulnerable atherosclerotic plaque, pathogenesis of abdominal aortic aneurysms, role of homocysteinemia in atherosclerosis, mechanisms of atherosclerosis in various vascular beds, and research on atherosclerotic lesions using human autopsy tissues. This SRG supports targeted basic and clinical research programs such as the Specialized Centers of Research in molecular medicine and atherosclerosis, the effects of protease inhibitors on atherosclerosis development in HIV infection, and the pathobiological determinants of atherosclerosis in youth.

Hypertension SRG

The scientific goals of this SRG are: to understand the regulatory mechanisms of blood pressure control from the level of the whole animal to the molecular; to identify the causative factors for essential hypertension, as well as rarer forms of high blood pressure; to clarify the mechanisms by which high blood pressure increases the risks of, or occurs concomitantly with, other diseases, such as kidney failure, stroke, and left ventricular hypertrophy; to develop preventive strategies as well as novel interventions for hypertension; and to understand at a basic level the normal function of the vascular system as a foundation for future research on cardiovascular disease. Almost all of the research supported by this SRG is conducted at the basic laboratory or clinical level. Specific research areas of interest include: renal, neural, vascular, and hormonal studies on blood pressure control and essential hypertension; identification of genes and intermediate phenotypes involved in hypertension and hypertensive target organ damage; hypertension in pregnancy; development of new antihypertensive therapies and preventive strategies; minority and gender effects related to blood pressure control; immune and developmental biological aspects of blood pressure control; and integrated systems analysis and modeling of blood pressure regulation. Additional research areas on fundamental mechanisms and the normal regulation of vascular function are: the cerebrovascular circulation, including the function of the blood-brain barrier and abnormalities related to stroke; numerous facets of vascular endothelial biology, such as biologically active vascular substances, receptors, ion channels, and second messengers; regulation of vascular smooth muscle contraction and differentiation; regulation of capillary permeability; regulation of microcirculatory function; exercise and the vasculature; and vascular pharmacology.

CLINICAL & MOLECULAR MEDICINE PROGRAM (CMMP)

This Program supports clinical, basic and engineering research on cardiovascular disease and health. Its scope includes genetic, genomic and proteomic research; engineering theory and practice applied to biology and medicine; informatics and simulation; and cohort, case-control, and randomized clinical trials.   Selected areas include revascularization, hormone replacement therapy, the implantable artificial heart, and understanding minority and women's health. The program comprises two Scientific Research groups (SRG) which are described below.  

Cardiovascular Medicine SRG

This SRG supports research on cardiovascular diseases with a significant clinical and/or nutritional component in adult and pediatric patients, including cohort, case-control studies and randomized trials.   Although the primary focus is on studies in patients with cardiovascular disease, rather than the general population, it also extends to clinical studies in areas such as the role of lipid interventions, nutrition, exercise, and hormone replacement therapy in the prevention of heart disease.  Its scope generally does not include basic science or animal studies, except for those with research aims and designs closely linked to supported clinical studies. Current areas of emphasis include: development of new treatments or new applications of existing medical and surgical strategies for acute and chronic ischemic heart disease, hormone replacement therapy, dietary and medical management of dyslipidemia, quantitative measurement of atherosclerosis, diagnosis and management of arrhythmias, cardiomyopathies of different etiologies (e.g., ischemic, valvular, metabolic, HIV-related, other infectious), congenital malformations, peripheral vascular disease, restenosis after revascularization procedures, cardiovascular applications of radiotherapy, and cardiovascular dysfunction in long-term pediatric cancer survivors.

Bioengineering and Genomic Applications SRG

Bioengineering is an interdisciplinary field that applies engineering theory and practice to the increase of knowledge at the genetic, molecular, cellular, tissue, and organ levels; and to the development of new and novel biologicals, materials, processes, and devices for the cardiovascular system.  Research supported includes: innovative ventricular assist systems, implantable total artificial hearts, genetically enhanced cardiovascular implants, magnetic resonance angiography, physical stress and strain, micromechanics, self-assembly, mathematical models and simulation, imaging, biomaterials, tissue engineering and therapeutic devices. Also supported are resources related to genetics, genomics, and gene therapy, as well as their application, for cardiovascular, pulmonary and hematological diseases.  Examples include: gene mapping and gene interactions (e.g. pharmacogenetics); the development of genetic and genomic tools, resources, and services (e.g., SNPs, array technologies, genotyping service); the support of human and model organism genomic resources (e.g., rat genome and EST projects, rat genome database); the development of genetically altered animals for broad use by the scientific community; the development and production of novel vectors for gene therapy and functional genomics; training related to the use and application of advanced genomic and genetic strategies and technologies; and the development and support of bioinformatics and biocomputing for heart, lung, and blood diseases.  

RESEARCH TRAINING AND SPECIAL PROGRAMS SRG

This Group is responsible for planning, conducting, analyzing, and directing a program for developing highly specialized human resources and career development for research in the area of cardiovascular diseases. Research training and career development programs are available for all stages in the professional development of the investigator, from the pre- and postdoctoral levels to the senior investigator level. Such programs include the National Research Service Award (NRSA), which provides research training support through either the Individual Fellowship or the Institutional Research Training Grant; the Mentored Clinical Scientist Development Award; the Mentored Patient-Oriented Research Career Development Award; the Midcareer Investigator Award in Patient-Oriented Research; the Career Transition Award; the Independent Scientist Award; the Minority School Faculty Development Award; the Research Development Award for Minority Faculty; and Minority and Disability Investigator Research Supplements.

For further information, contact:

Division of Heart and Vascular Diseases
National Heart, Lung, and Blood Institute
Two Rockledge Center - Suite 9160
6701 Rockledge Dr. - MSC 7940
Bethesda, MD 20892-7940

Phone numbers are available in the Abbreviated Staff Directory.