The Candidate is a pediatric cardiologist who is completing a post-doctoral research fellowship in cardiovascular genetics and developmental biology to gain the skills necessary to pursue an academic career in patient-oriented research. His long-term goal is to become an independent physician scientist, and to contribute to the understanding of the molecular mechanisms underlying pediatric heart disease. By applying the complementary approaches of human genetics and cardiac development, he will cultivate a 'bedside to bench to bedside"""""""" approach to investigate the genetic causes and pathogenesis of pediatric aortic valve disease. Such an approach promises to provide a foundation for developing improved and novel diagnostic modalities, therapeutic interventions and preventive strategies for this important clinical problem. The objective of this proposal is to identify new genetic loci linked to aortic valve malformation and to elucidate the pathogenesis of pediatric aortic valve disease. The central hypothesis is that aortic valve disease pathogenesis is mediated by gene mutations that regulate extracellular matrix (ECM) organization during valve development thereby resulting in valve disease. Using families identified by a hypoplastic left heart syndrome (HLHS) proband, parametric and nonparametric linkage analysis will be performed to identify aortic valve disease-causing genes. The hypothesis is that HLHS is a severe form of aortic valve disease and is inherited as an autosomal recessive form of bicuspid aortic valve (BAV). Using explanted pediatric BAVs, the relationship between BAV morphology, ECM organization and valve disease type will be determined. To better define dysregulation of ECM remodeling as a cause of pediatric aortic valve disease, mechanistic analyses of ECM organization will be performed using a mouse model of elastin haploinsufficiency. The hypothesis is that elastin haploinsufficiency mediates dysregulation of ECM protein synthesis resulting in valve ECM disorganization and valve dysfunction. The rationale for the proposed studies is based upon preliminary data. Successful completion of the proposed studies will advance our understanding of pediatric valve disease. The Candidate is dedicated to a research career in pediatric cardiovascular medicine. His environment is exceptionally supportive as evidenced by an invested and accomplished Mentor and a generous and collaborative research environment renowned for its molecular and clinical cardiology programs. These factors create an ideal environment for professional development. A Career Development Award will allow the Candidate to devote 80% effort to patient-oriented research, and to obtain the training necessary to transition to an independent investigator.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23HL085122-02
Application #
7270484
Study Section
Special Emphasis Panel (ZHL1-CSR-R (M1))
Program Officer
Scott, Jane
Project Start
2006-08-03
Project End
2011-04-30
Budget Start
2007-07-01
Budget End
2008-04-30
Support Year
2
Fiscal Year
2007
Total Cost
$132,719
Indirect Cost
Name
Cincinnati Children's Hospital Medical Center
Department
Type
DUNS #
071284913
City
Cincinnati
State
OH
Country
United States
Zip Code
45229
Wirrig, Elaine E; Gomez, M Victoria; Hinton, Robert B et al. (2015) COX2 inhibition reduces aortic valve calcification in vivo. Arterioscler Thromb Vasc Biol 35:938-47
Godby, Richard C; Munjal, Charu; Opoka, Amy M et al. (2014) Cross Talk between NOTCH Signaling and Biomechanics in Human Aortic Valve Disease Pathogenesis. J Cardiovasc Dev Dis 1:237-256
Krishnamurthy, Varun K; Evans, Ashlie N; Wansapura, Janaka P et al. (2014) Asymmetric cell-matrix and biomechanical abnormalities in elastin insufficiency induced aortopathy. Ann Biomed Eng 42:2014-28
Munjal, Charu; Opoka, Amy M; Osinska, Hanna et al. (2014) TGF-? mediates early angiogenesis and latent fibrosis in an Emilin1-deficient mouse model of aortic valve disease. Dis Model Mech 7:987-96
Hangge, Patrick T; Cnota, James F; Woo, Jessica G et al. (2013) Microcephaly is associated with early adverse neurologic outcomes in hypoplastic left heart syndrome. Pediatr Res 74:61-7
Cnota, James F; Hangge, Patrick T; Wang, Yu et al. (2013) Somatic growth trajectory in the fetus with hypoplastic left heart syndrome. Pediatr Res 74:284-9
Krishnamurthy, Varun K; Opoka, Amy M; Kern, Christine B et al. (2012) Maladaptive matrix remodeling and regional biomechanical dysfunction in a mouse model of aortic valve disease. Matrix Biol 31:197-205
Acharya, Asha; Hans, Chetan P; Koenig, Sara N et al. (2011) Inhibitory role of Notch1 in calcific aortic valve disease. PLoS One 6:e27743
Wirrig, Elaine E; Hinton, Robert B; Yutzey, Katherine E (2011) Differential expression of cartilage and bone-related proteins in pediatric and adult diseased aortic valves. J Mol Cell Cardiol 50:561-9
Krishnamurthy, Varun K; Guilak, Farshid; Narmoneva, Daria A et al. (2011) Regional structure-function relationships in mouse aortic valve tissue. J Biomech 44:77-83

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