Libinlifefall2015web by Libin Institute

Libin Life RESEARCH

EDUCATION

CARE DELIVERY

FALL 2015

The Libin Cardiovascular Institute of Alberta Magazine

A DECADE OF EXCELLENCE AND INNOVATION A Look Back at the Libin Institute’s Stephenson Cardiac Imaging Centre’s First 10 Years

Engineering Integral to Research Advances

New Research Offers Cardiac Patients Insights Into Disease

Donor Profile: Bill Andrew

Libin Institute’s Tine Haworth Cardiovascular Research Day

ADHD Drug Used in Novel Study With Hopes of Preventing Fainting

Libin Life

MESSAGE FROM THE DIRECTOR

he Stephenson Cardiac Imaging Centre just celebrated its 10th anniversary with a wonderful event hosted by Mr. Ken Stephenson that showcased the history of the Centre and its impact. The Stephenson Cardiac Imaging Centre has become one of the top rated cardiac magnet resonance (CMR) Centre’s in the world due to an academic focus that has produced high quality novel research contributions along with excellence in training. This has resulted in the largest clinical volume CMR program in the country with approximately 3600 scans completed at the Foothills Medical Centre and South Health Campus each year. Dr. Matthias Friedrich was the inaugural medical director and established the trajectory for the Centre. With visionary help from many people, he and Mr. Stephenson were very successful in engaging the community and establishing the program in 2005. When Dr. Friedrich relocated to Montreal, we were very fortunate to recruit Dr. James White from London, Ontario in 2013 as the second director. Dr. White has invigorated the activities of the Centre and built a very strong team of approximately 30 physicians, researchers, nurses, students and technologists. Greatness requires that special combination of leadership, people and partnerships. With Mr. Stephenson being the catalyst that has helped energize the group, his passion and philanthropy has not only given resources, but more importantly time and vision to the Centre. It is clear the group would not have been as successful if Mr. Stephenson was not fully committed to our work. Resources he and his friends have brought to the Centre have made the difference in our ability to achieve excellence. We are also grateful for the support provided to the Centre through the Calgary Health Trust and Fund Development Office at the Cumming School of Medicine at the University of Calgary. We are very proud of the work done by the Stephenson Cardiac Imaging Centre and we say congratulations on a very successful first 10 years. We know the best is yet to come and are delighted to highlight their activities in this issue of Libin Life.

Dr. Todd Anderson

Director Libin Cardiovascular Institute of Alberta @LibinDirector ABOUT THE INSTITUTE The Libin Cardiovascular Institute of Alberta is an entity of both Alberta Health Services and the University of Calgary. It is the only Canadian health institute to offer a single cardiovascular program that promotes quality standards across the city and region. It is made up of 1,500 members, staff, students, and clinical trainees that coordinate cardiovascular research and education, along with delivering world-class cardiac care to a population of over two million people in southern Alberta, Saskatchewan, and eastern British Columbia. The Institute is committed to developing outstanding cardiovascular health promotion and disease prevention programs by translating innovative research into novel healthcare solutions. To learn more about the Institute and how you can donate, please visit our website at www.libin.ucalgary.ca/donate.

2 LIBIN LIFE

Libin Life is published semi-annually by the Libin Cardiovascular Institute of Alberta, an entity of the University of Calgary and Alberta Health Services (Calgary Zone). The Libin Life mission is to share news and information about the Institute’s impact in research, education, and care delivery. Institute Director Dr. Todd Anderson @LibinDirector Director of Research Dr. Ed O’Brien @EDOBrienYYC Associate Director Al-Karim Walli @aswalli Editor Lauren Sharp Editorial Committee Judy Siu, Al-Karim Walli, Myrna Lynder, Vasilka Saydina, Barb Jones, Suzanne Welsh, and Lauren Sharp Copy Editor Judy Siu Contributors Dr. Todd Anderson, Nancy Clark , Jackie Flewitt, Andrew Jenkins, Barb Jones, Tanya Morton, Shannon Perry, Clare Puzey, Alessandro Satriano Shahr Savizi, Lauren Sharp, Judy Siu Steven Tov, Al-Karim Walli, Suzanne Welsh Dr. James White, Colin Zak, Cumming School of Medicine Communications/Media team and Schulich School of Engineering Design and Layout Steven Tov @madebysteventov Printer McAra Printing @mcaraprinting

Libin Cardiovascular Institute of Alberta University of Calgary HSC 242, 3330 Hospital Drive NW Calgary, Alberta T2N4N1 P 403.210.6271 E libin@ucalgary.ca W libininstitute.org Twitter @libininstitute Editorial Inquiries Lauren Sharp Communications Coordinator lrsharp@ucalgary.ca Send comments, requests for magazine copies, digital magazine issue subscriptions or change of mailing address notifications to libin@ucalgary.ca. Please request permission to reproduce any part of this publication. All rights reserved. © 2015 Libin Cardiovascular Institute of Alberta

CONTENTS

FALL 2015

DEPARTMENTS

13 FEATURES

13 18

2 4 5 6 9 19 28

UPCOMING EVENTS AWARDS & ACCOLADES NEWS & HIGHLIGHTS COMMUNITY ENGAGEMENT DONOR PROFILE NEW RECRUITS

A Decade of Excellence and Innovation A Look Back at the Libin Institute’s Stephenson Cardiac Imaging Centre’s First 10 Years

Engineering Integral to Research Advances Schulich School of Engineering and Libin Institute partner on cardiovascular health

CARE DELIVERY

11 12

MESSAGE FROM THE DIRECTOR

Choosing Wisely Campaign

ADHD Drug Used in Novel Study With Hopes of Preventing Fainting

RESEARCH

20 20 21 22 23 24

Heart Disease You’re Born With Libin Researchers Part of Systemic Cost of High Blood Pressure in Alberta Study Q & A With Mike Walsh, PhD Smooth muscle researcher Mike Walsh, PhD discusses his research collaborations with the Japanese, his experiences, and what he loves most about the land of the rising sun.

Inside The Core Pathology Lab

23 12

New Research Offers Cardiac Patients Insights Into Disease $39.1 Million Awarded to 12 University of Calgary Health Researchers

EDUCATION

26 27

Spotlight On Trainees Libin Institute’s Tine Haworth Cardiovascular Research Day

27 LIBIN LIFE 3

UPCOMING EVENTS

CANADIAN CARDIOVASCULAR CONGRESS OCTOBER

24 - 27 2015

On October 24 to October 27, the Libin Institute will once again be a gold sponsor at this year’s Canadian Cardiovascular Congress (CCC). The CCC is the largest annual medical conference in Canada and will be chaired by Libin Institute Director, Dr. Todd Anderson. Please visit us at booth 407 to learn more about what is happening at the Institute and what we have been up to over the past year. A Q & A period with Dr. Todd Anderson will be held at our booth on Sunday, October 25 from 11 AM – 12 PM after his dyslipidemia guideline update at 9 AM - 10:30 AM in area MTCC 801 AB. [LEFT] Dr. Anderson speaking at the 2014 Canadian Cardiovascular Congress in Vancouver, British Columbia

ALBERTA BIOMEDICAL ENGINEERING GRADUATE CONFERENCE On November 6-8, the 16th Annual Alberta Biomedical Engineering (BME) Conference will be held in Banff, Alberta at the Banff Park Lodge. It is a student led event that includes graduate and undergraduate podium and poster presentations led by the Universities of Calgary and Alberta, national and international guest speakers, and an industry panel. Attendees will have the opportunity to network with BME researchers and industry from across western Canada. Guest speakers include Martin Ebhar, PhD from the University of Zurich in Zurich, Switzerland and Mary K. Cowman, PhD from NYU Polytechnic School of Engineering in New York City, New York. For more information and to register, please go to www.ucalgary.ca/bme/graduate/conference.

MB E V O N

8 0 6 0 2015

ual Alberta r’s 15th Ann s at last yea ee ce d en en tt er a 0 Conf [ABOVE] 15 g Graduate l Engineerin Biomedica

ABOUT THE COVER The image on the cover shows systolic deformation (strain) analysis of multiple cardiovascular structures imaged using a variety of techniques. The left ventricle was imaged using magnetic resonance imaging (MRI), the right ventricle by 3D ultrasound (US), and the left atrium and aorta using computed tomography (CT). These were alligned within a CT image of the patient’s chest. All analyses were performed using GIUSEPPE, a versatile software capable of analyzing MRI, US and CT images, developed by the Libin Cardiovascular Institute’s Stephenson Cardiac Imaging Centre’s Alessandro Satriano, PhD and Libin Cardiovascular Institute’s Elena S. Di Martino, PhD. For more information on the Stephenson Cardiac Imaging Centre, please go to page 13.

4 LIBIN LIFE

AWARDS & ACCOLADES

Alvin Libin OC to be Awarded The Alberta Medical Association’s Medal of Honor This award is given to non-physicians who show outstanding personal contribution to Albertans and the advancement of medical research, medical education, health care organizations, health education, and/ or health promotion to the public. Alvin Libin and the late Mona Libin, through their foundations, were the founding donors of the Libin Cardiovascular Institute of Alberta. Mr. Libin’s business and philanthropic involvement with Alberta’s health care and the University of Calgary has resulted in progressive and ground-breaking research, care-delivery, and educational initiatives. His leadership, strong business acumen, mentorship, and commitment to the health care industry is unparalleled. He will receive this award on September 25 in Edmonton, Alberta.

Dr. Dean Traboulsi Receives FMC’s Outstanding Clinician Award On April 23, Dr. Ed O’Brien, Libin Research Director and Chief of Cardiology, presented Dr. Dean Traboulsi with the Foothills Medical Centre’s 2014 Outstanding Clinician Award. This award is given in recognition of outstanding commitment to patients, staff, students, and to the community. Dr. Traboulsi is the former director of the cardiac catheterization lab and interventional cardiology, a clinical professor at the Cumming School of Medicine at the University of Calgary, and is the leader of the acute myocardial infarction initiative in the Calgary region. [L-R] Dr. Dean Traboulsi and Dr. Ed O’Brien

Dr. Braden Manns Awarded Prestigious Killam Professorship

Dr. Sandeep Aggarwal Named New Division of Cardiology Interim Deputy Chief of Cardiology

Killam Annual Professors are selected because they have demonstrated excellence in research and teaching for 10 years or more while serving their academic discipline and their community outside the University. Dr. Manns is a nephrologist, dual member of the Libin Institute and O’Brien Institute for Public Health, and is a professor in the Departments of Medicine and Community Health Sciences at the Cumming School of Medicine. He is an Alberta Innovates – Health Solutions Health Scholar, who holds the endowed Svare Chair in Health Economics and has held several high profile public roles such as chair of the Canadian Expert Drug Advisory Committee.

As of April 2015, Dr. Sandeep Aggarwal has held the interim Deputy Chief of Cardiology for the Division of Cardiology position. As a Clinical Associate Professor, Dr. Aggarwal has excelled in important portfolios such as Site Chief for Cardiology at the Rockyview General Hospital and the Department of Cardiac Sciences Information Technology representative with Alberta Health Services. In these roles he has demonstrated strong skills as a leader, collaborator, and innovator. The Libin Institute looks forward to his ongoing contributions to the Division in this new leadership position.

LIBIN LIFE 5

NEWS & HIGHLIGHTS

WHO Collaborates With the Cumming School of Medicine Joint Libin Institute and O’Brien Institute for Public Health members Drs. Bill Ghali and Hude Quan part of O’Brien Institute for Public Health’s designation with the World Health Organization’s (WHO) New Collaborating Centre for Classification, Terminology and Standards.

The O’Brien Institute for Public Health, one of seven Cumming School of Medicine institutes, becomes the third academic member of a WHO network. The O’Brien Institute for Public Health along with the Mayo Clinic and Stanford University will collaborate and advise the WHO’s International Classification of Diseases (ICD) standard, which shapes how health professionals, scientists and policy makers around the world communicate and share information for better health. Tasked with tracking disease and mortality on a global scale, this new partnership will help researchers and physicians around the world better track and monitor disease and mortality. “The O’Brien Institute, and more broadly the University of Calgary, has a mandate through our Eyes High Strategy to produce societal impacts locally, provincially, nationally, and internationally. Our partnership with the WHO is thus of major strategic importance to the University, and a way in which we can contribute to the enhancement of global health information systems,” says Dr Bill Ghali, Scientific Director of the O’Brien Institute for Public Health, who was a key member in key in bringing the Collaborating Centre to Calgary.

[L-R] Drs. Bill Ghali, Bedirhan Üstün, Hude Quan and John Reynolds, PhD

The ICD standard aims to develop and refine a common international language on diseases, enabling effective and accurate storage and retrieval of disease information by frontline health-care workers. It also aims to better inform policy makers on the spread, risk and prevention of disease, while providing a tool to track quality of care. As part of this, the collaborating Centre will also review existing classifications to ensure mortality rates from specific diseases such as Ebola all use a consistent code. This will help track mortality from epidemics.

The Libin Institute is proud to have its members part of such an impactful and global initiative.

Libin Institute Strategic Planning Research Retreat

6 LIBIN LIFE

On April 30, the Libin Institute hosted its strategic planning research retreat at Hotel Alma on the University of Calgary Campus. Hosted by the Institute’s Director, Dr. Todd Anderson, approximately 60 people including basic scientists, physicians, students, trainees, and administrative staff took part in lively discussions surrounding areas such as research priorities, organizational structure, community engagement, collaborations, and recruitment opportunities. This interactive afternoon resulted in many brainstorming sessions, strong dialogue, and great insight from a variety of people from the Libin Institute. This event was designed to begin the process of updating the strategic plan for the Institute (2016 to 2021). This work will begin in earnest in the fall and will engage all stakeholders of the Libin community.—Lauren Sharp

CCCN Annual Spring Conference By Nancy Clark On May 9th 2015, 200 Canadian Council of Cardiovascular Nurses (CCCN*) members representing the Alberta/Nunavut/NWT division as well as physicians and nurse practitioners attended the sold-out annual spring conference at the Courtyard Calgary Airport - Marriott in Calgary, Alberta. This full-day conference captured its theme of “Getting to the Heart of the Matter” with three keynote speakers and five concurrent sessions on topics ranging from heart rate management with the heart failure population, syncope, and heart transplant to novel pacemaker innovations, genetic arteriopathies, minimally invasive cardiac surgery, cardiac ablation, myocarditis, cardiomyopathies, peripheral vascular disease, diabetes management in the cardiac population, acute coronary syndrome, and the importance of cardiac rehab. Since May 9th was during Nurses’ Week, the conference planning committee wanted to celebrate nurses with a special conference draw. Three names were drawn to award each winner a free CCCN membership as well as conference fee – congratulations goes to Judy Strike, RN, Tara Stessun, RN, and Joselita Aguilar, RN. The success of this spring CCCN conference would not have been made possible without the dedicated and hardworking efforts of the provincial CCCN executive. The countless volunteer hours given by this committee and the cohesive nature of which this group could work together is a testament to the dedication each member has to enhancing nursing knowledge in the area of cardiac sciences.

CCCN executive members: [L-R] Nancy Clark, Candice Baird, Dr. Karen Then, Clare Puzey, Mae Sumrain, Catherine McIntyre, Lesiha Naphin

On behalf of the provincial CCCN executive, I would like to thank everyone who attended this conference, making it the largest attended conference thus far in AB/NU/NWT CCCN history. This conference showcased wonderful speakers, laughter and comradery and I look forward to seeing you all at next year’s conference! *The CCCN is a national organization comprised of nine provincial divisions and is recognized as a specialty organization by the Canadian Nurses Association (CNA). Its foundation is embedded within the four pillars of Health Promotion & Advocacy, Professional Education, Research, and Excellent Membership Services. The AB/NU/NWT provincial division of CCCN is committed to enhancing nursing education with quarterly journal clubs, participation in national educational webinars, educational support for the Cardiovascular Certification Exam preparation, and an annual spring conference.

Nancy Clark is the provincial director of the AB/Nunavut CCCN and is an acute care nurse practitioner in the medical cardiology coronary care unit at the Rockyview General Hospital in Calgary, Alberta.

5th Annual VT Symposium

[L-R] Matt Hendry (Biosense Webster), Dr. Jean-Francois Sarrazin (IUCPQ, Quebec), Dr. Isabelle Nault (IUCPQ, Quebec), Dr. Edward Walsh (Boston Children’s Hospital, USA), Dr. Yen Ho (Royal Brompton Hospital, UK), Dr. Vikas Kuriachan (UofCalgary/Libin Insitute), Dr. Stanley Tung (Royal Columbian Hospital, BC) & Liese Dickie (Medical Education)

On April 17, Dr. Vikas Kuriachan, director of the Libin Institute’s cardiac electrophysiology training program and clinical associate professor at the Cumming School of Medicine, was co-chair of this year’s Ventricular Tachycardia (VT) Symposium at the Westin Hotel in Calgary. Held for electrophysiologists who are interested in ablation for ventricular tachycardia (electrical problems in the heart that can result in passing out or sudden death), 55 attendees enjoyed a day of presentations from VT specialists from all over the country and from international presenters, Dr. Edward Walsh from Boston Children’s Hospital and Dr. Siew Yen Ho from Royal Brompton Hospital in London, England. This year was the first time it was held in Calgary and its theme was on anatomy and congenital disease. Next year’s symposium will be held April 16-17, 2016 in Quebec City, Quebec.—Lauren Sharp LIBIN LIFE 7

University of South China Vice President Visits Libin Institute Dr. Zhisheng Jiang, Vice President of the University of South China, was a visiting researcher in Xi-Long Zheng, PhD`s laboratory from January to June 2015. His research mainly involved investigating the effects of monocyte chemotactic protein 1 (MCP1) on vascular smooth muscle cells. Dr. Jiang also brought a new project idea to investigate the roles of proprotein convertase subtilisin/kexin type 9 (PCSK9) in vascular smooth muscle function. Dr. Jiang will continue his collaboration with the Libin Institute by sending one of his post-doctoral fellows to one of the Libin Institute`s laboratories in January, 2016. “Dr. Jiang had a chance to learn more about the Libin and our university through his visit and I believe his stay here will significantly facilitate further collaboration between the Libin Institute and the South China University,” said Zheng.—Lauren Sharp [L-R] Dr. Zhisheng Jiang and Xi-Long Zheng, PhD

Inaugural Scientific Meetings of the Heart Valve Society From May 7-9, the Heart Valve Society hosted its Inaugural Scientific meeting in Monte Carlo, Monaco. Dr. Paul Fedak, cardiac surgeon was in attendance and presented on the topic: BAV (bicuspidaortic valve) Aortopathy: Should New Science Influence My Patient’s Risk-Assessment? It focused on his research that is using 4D-flow MRI imaging to assess the patterns of abnormal blood flow in the aorta of patients with bicuspid aortopathy. Dr. Kishan Narine, cardiothoracic surgeon, was also in attendance and presented, on behalf of his post-doctoral fellow Yaghoub Dabiri, PhD’s, Improved Heart valve Design by Computer Modelling research poster. He demonstrated the new bio prosthetic heart valve that was developed at the Libin Institute and is currently being tested at the University of Calgary’s Zymetrix laboratories. Attendees learned about t he project, how it uses novel tissue material and mathematical models that are used to design prosthetic valves with superior function, and the valve testing capabilities at Zymetrix. The project is led by Drs. Narine, Janet Ronsky, and John Tyberg. *Yaghoub Dabiri, PhD is a post-doctoral research associate and design engineer at the Libin Cardiovascular Institute and Schulich School of Engineering at the University of Calgary.

8 LIBIN LIFE

[LEFT] Dr. Kishan Narine [RIGHT] His Serene Highness Prince Albert and Dr. Paul Fedak

COMMUNITY ENGAGEMENT

The 5th Annual Hearts VS Minds Golf Tournament

ABOVE [L-R] Clare Puzey, Kyla Craig, Charlotte Petreman, Angie Kelly, Val Hulse, Lindsey Nelson and Lynne Batiste

Stair Climbing Can Be Fun As part of this year’s Heart Month in February, five Libin Institute cardiac wards at the Foothills

The 5th annual Hearts vs Minds golf tournament took place on July 23rd at the BlueDevil golf course. Over 150 healthcare professionals, sponsors, and partners participated in a fun yet competitive tournament that raised funds for the departments of Cardiac Sciences and Clinical Neurosciences at the Foothills Medical Centre. Thanks to hole sponsors Last Best Brewing, Tim Hortons, M&M, Coke, Spud, and Holy Crap cereal, the golfers enjoyed a variety of delicious snacks throughout the sunny day. The atmosphere was energetic and fun with the golfers showing their competitive spirit by dressing up in cheeky costumes to represent their departments. Because of the generosity of participants and sponsors, the tournament raised over $12,000 with both teams taking home the trophy in the tournament’s first historic tie.—Shahr Savizi

Medical Centre participated in a stair climbing challenge. Bragging rights were awarded to clinical nurse educator and registered nurse, Clare Puzey who braved the most steps by an individual with an impressive 288 flights and the Cardiac Cath Lab/ Short Stay unit tackled the most steps as a group with 1150 flights in total. Honourable mentions went to Begum Mohamad from CICU (216 flights), Irene Abdon from CVICU (189 flights), Aliya Bartkiewicz from PCU 91 (133 flights). Fun was had by all with much anticipation for the next year to see how far the teams can go.—Barb Jones [L-R] Trish Glinoga, Amy Wendling, Leann MacDonald and Jaye McCool

LIBIN LIFE 9

Inaugural Syncope Forum Hosted at South Health Campus On July 23, the Libin Cardiovascular Institute of Alberta held its inaugural Canadian syncope (fainting) forum at the South Health Campus. This event was held to educate syncope patients about current research projects and how patients can get involved. Highlights from the day included an introductory demonstration of the new Canadian Syncope support website* (Dr. Robert Sheldon is its Canadian chapter director) where patients can access support and information on their condition, talks by content experts, brainstorming sessions, networking opportunities, and question and answer periods from Libin experts such as Dr. Sheldon and Dr. Satish Raj. The event was funded by the Canadian Arrhythmia Network, in turn funded by the Networks of Centres of Excellence of the Government of Canada. PaCER (Patient and Community Engagement in Research) was also present educating patients on how they can get involved with research and assist with the design and conduct of future research projects.—Lauren Sharp To obtain more information about how to get involved in syncope research, Calgary syncope patients or family members can contact Dr. Svetlana Shklarov (shklarov@ucalgary.ca) at (403) 220-5383.

[ABOVE] Dr. Robert Sheldon

*www.stars-international.org/ca

Heart and Stroke Tours Bring Together Researchers and Community To show appreciation for the outstanding philanthropic support that has resulted vital research in Alberta, the Heart and Stroke Foundation of Alberta, NWT and Nunavut and the University of Calgary’s Cumming School of Medicine welcomed over 150 donors, volunteers, and supporters for an evening of lab tours, refreshments, and a science café on Monday, April 20. The evening began with investigators from the Libin Cardiovascular Institute of Alberta and Hotchkiss Brain Institute hosting 10 different laboratory tours for guests to choose from such as stroke, a zebrafish study, and cardiac imaging. Attendees would then have the opportunity to listen to a science café, which was moderated by Libin Institute Director, Dr. Todd Anderson that featured researchers who study cardiovascular disease and stroke. Presenters included Dr. Ed O’Brien, Chief of Cardiology and Director of Research at the Libin Institute, facilitated a discussion on his novel research that aims to discover new pathways for the treatment of atherosclerosis; joint HBI and Libin member Dr. Michael Hill presented findings from the ground-breaking ESCAPE study; and Theresa Green, PhD from the Faculty of Nursing shared research results on life post stroke.—Tanya Morton

10 LIBIN LIFE

Libin Institute SAB: Hello and Goodbye The Libin Institute’s Strategic Advisor Board (SAB) is compiled of individuals from the community and university who play an integral role in enhancing the potential for the Libin as well as defining and guiding

CARE DELIVERY

Choosing Wisely Campaign By Andrew Jenkins

its vision, strategy, and expectations. The Libin would like to extend a warm welcome to its newest SAB members: Ms. Deborah Yedlin, Ms. Barbara Higgins, and Mr. Tony Dilawri. The institute is excited about the energy and expertise these three will bring and warmly welcome them aboard. Our sincerest appreciations to the following individuals who have stepped down from the SAB go to Mr. George Gosbee, Dr. Francois Belanger, Mr. Charles Fischer, and Mr. Peter Valentine. The Institute has valued their commitment over the years and is grateful for all the support and guidance they have delivered.—Lauren Sharp

[ABOVE] Rhythm strip of an ECG

The Department of Cardiac Sciences is supporting the Choosing Wisely Canada (CWC) campaign: a project, spearheaded by Dr. Russell Quinn, Cardiologist that has been created to reduce the number of electrocardiography’s (ECG) completed in the hospital and clinic environment by 10 per cent in the next year. From 2014-2015, 240,000 ECGs were performed in Calgary; which is nine per cent higher than the previous year. “The goal of the Choosing Wisely ECG project is to take a closer look at the use of limited resources and avoid unnecessary testing, even if it is non-invasive,”says Dr. Russell Quinn. “It shouldn’t be considered a rationing of healthcare or driven by financial savings, but taking a look at our use of ECGs and creating an increased awareness of selecting the appropriate test for the right patient at the right time.” A small group that includes at least one member from each of the Calgary hospital sites will assist Dr. Quinn in the gathering of data to support the project and help determine areas where potential ECG reductions may be higher than others. CWC will result smarter and effective choices that ensure high-quality care; while having no negative impact.

LIBIN LIFE 11

ADHD Drug Used in Novel Study With Hopes of Preventing Fainting By Colin Zak

n a Libin Cardiovascular Institute laboratory at the University of Calgary’s Foothills Campus, Alesha Dupont is secured to a stretcher, surrounded by researchers. She is being tilted from a horizontal to a vertical position, then back again. Their goal: to make her faint. Dupont who suffers from syncope – or frequent fainting – is the first to participate in a new Calgary study which looks at the effectiveness of a common ADHD (attention deficit hyperactive disorder) medication in preventing fainting. “I first started fainting when I was 12 and since then it’s gradually gotten worse. I faint about once a month and often hit my head when it happens. It’s unsettling because I never know when I’m going to faint,” says the 26 year old Calgary woman. “I haven’t been on any drugs for my syncope, because there are none.” The year-long study of 74 patients, led by researchers at the Libin Cardiovascular Institute of Alberta, is the first study ever to look at the effectiveness of the ADHD drug Atomoxetine in preventing fainting. Participants are either given the drug or a placebo and then undergo a ‘tilt test’ where researchers attempt to induce a fainting episode. “In most cases this condition is not life-threatening, but it can be life-altering and can affect patients’ ability to drive, to work, and can cause anxiety. It can be debilitating,” explains Dr. Satish Raj, a Libin Cardiovascular Institute member and Associate Professor of Cardiac Sciences at the Cumming School of Medicine. “Currently, there are no drug treatments and we are trying to look at drugs that are on the market already that may be helpful to treat our fainting patients.” Fainting is caused by a rapid drop in blood pressure and a lack of blood flow to the brain. This may be caused by a drop or pause in heart rate or by a widening of the blood vessels. Approximately 50 per cent of Canadians experience syncope at some point in their life or faint at some point in their life, but a small number of patients will faint over and over again. Atomoxetine blocks the norepinephrine transporter in the body’s sympathetic nervous system – the body’s fight or flight response.

12 LIBIN LIFE

[ABOVE] Dr. Satish Raj, left, and research assistant Derya Ilhan strap Alesha Dupont to a stretcher.

“When you see a bear, it’s that part of the nervous system that gets you really revved up so you can run away, or fight it if you’re really brave,” Raj says, also a cardiologist with Alberta Health Services. “This drug blocks this part of the nervous system, which keeps norepinephrine in the system for longer, which in turn causes vaso-constriction or a tightening of the blood vessels.” Raj says that this tightening of the blood vessels may in turn prevent fainting in syncope patients. He also says this study will build on the success of past studies of similar drugs. “We’ve already seen promising results and we hope this study will be followed up by a much larger, international study,” he says. “The first step is trying it in the lab. The next step will be seeing if we can prevent fainting in real life.” Dr. Todd Anderson, Libin’s Director and Department Head of Cardiac Sciences, says he believes this study is an important step in treating patients suffering from frequent fainting. “Syncope can have serious implications for a patient’s quality of life – it can prevent them from driving, working or pursuing other activities,” Anderson says. “This research is an important step in learning how we can reduce or eliminate syncope in many patients and is one more example of how the research happening at Libin translates into better patient outcomes and quality of life.” To find out about participating in the study or more about syncope, email autonomic.research@ucalgary.ca.

FEATURE

A DECADE

OF EXCELLENCE AND INNOVATION

A Look Back at the Libin Institute’s Stephenson Cardiac Imaging Centre’s First 10 years

BY LAUREN SHARP

in, Dr. James

rth, Mr. Alvin Lib

Hawo [L-R] Dr. Andrew

rmen Lydell, phenson, Dr. Ca White, Mr. Ken Ste

Dr. Todd Anderso

LIBIN LIFE 13

[ABOVE] Stephenson Cardiac Imaging Centre’s team: Dr. Sarah Weeks, Alessandro Satriano PhD, Vijay Kandalam PhD, Rosa Sandonato, Dr. Yoko Mikami, MD PhD, Jacqueline Flewitt, Anna Schmidt, Carrie Smart, Sandra Rivest, Dr. James White, Loreen Thon, Cheryl Dickinson, Dr. Andrew Howarth, MD PhD, Jian-Nong Wu, Dr. David Patton, Michelle Seib, Nicole Blenkin

t was the first Centre of its kind in Canada to devote itself to cardiac magnetic resonance imaging (CMR), and is now the busiest in North America. It has become a catalyst for leading edge research initiatives, generated world-class specialists from its educational programs, and fostered a decade of innovation and excellence in cardiac health care. This year, the Libin Cardiovascular Institute of Alberta’s* Stephenson Cardiac Imaging Centre is celebrating 10 years of achievement in the field of Cardiovascular Magnetic Resonance (CMR).

THE BEGINNING Before the centre’s inception, there were plenty of imaging facilities in Canada, but nothing dedicated solely to MRI imaging of the heart. CMR was still in its early years but growing rapidly and Libin cardiologist, Dr. Neil Filipchuk, saw the need for a centre to be in Calgary. “These scanners produce images that are truly remarkable and you can do a lot of great things with them such as being able to visualize the heart, see the contraction, and measure the chambers,” says Dr. Filipchuk. “It is a truly extraordinary tool that can result in life changing decisions.” With the development of a CMR centre, people from Calgary, southeastern B.C., and Saskatchewan would be able to receive a variety of scan techniques that could better determine what the cause of a patient’s heart problem was, and how best to treat their condition. 14 LIBIN LIFE

To achieve this goal Dr. Filipchuk needed a community champion that had a visionary perspective on healthcare, an open-mind to new technologies, and a believer in the improvement of Albertans’ health. It had to be a friend and it had to be Ken Stephenson. “Ken is a unique individual. He is why the centre has become what it is today,” says Dr. James White, Director, Stephenson Cardiac Imaging Centre. “He has been there since the beginning, through both the prior and my directorship, spear-heading all the fundraising required to establish and sustain the Centre’s activities. He offers counsel, advice and support on a regular basis.” *The Libin Cardiovascular Institute of Alberta is an entity of Alberta Health Services and the University of Calgary

“It was a very natural fit from the beginning,” says Ken Stephenson, the Centre’s naming donor and lead fund-raiser. “I felt attached immediately to the idea, was drawn to the images, and believed in what it could do for individuals.” “The Centre’s success is all about the people and we’ve enjoyed preeminent leadership and a highly skilled and dedicated team of professionals. All of the Centre’s wonderful achievements would not be possible without the funds contributed by our donors and they can indeed be proud of what their funds have accomplished, our gratitude goes out to them every day.” The premise of the Centre was coming to fruition, but needed a great leader with strong vision. This came in the person of Dr. Matthias Friedrich: a CMR specialist from Berlin, Germany. With his leadership and the right individuals in place, the Centre opened its doors in 2005 in its newly renovated space in the Foothills Medical Centre.

“I had the honour and pleasure to start the program at the Stephenson Cardiac Imaging Centre and it is one of the greatest achievements of my professional life,” says Dr. Friedrich. “I can vividly remember coming to work in the morning feeling like I was in my second home. A place where I was surrounded by good friends that worked together on something truly important. This spirit is what makes it so special.”

THROUGH THE YEARS Over the last decade, the Centre has achieved global recognition through the pioneering of CMR development in Canada, its strong academic programs, and its ability to deliver high volumes of clinical scans. It has since opened its second location at the South Health Campus and has expanded its academic portfolio to include research in the fields of echocardiography, CT heart scans, and basic science research. From this expansion, research has flourished with a variety of collaborative projects from Libin researchers, such as Dr. Paul Fedak’s study of heart repair following heart attacks, Dr. Nowell Fine’s study of heart mechanics across a variety of heart diseases using novel “strain” analysis, and Dr. Derek Exner’s study of sudden cardiac death and how it relates to the amount of scar in the heart. At a national level there are on-going multi-centre studies run by the Stephenson Cardiac Imaging Centre such as MAPIT-CRT, a randomized controlled trial evaluating how CMR-based models of the heart can improve delivery of pacemaker leads to improve heart function, and CANCARD-MR, a national registry of patients receiving implantable defibrillators to prevent sudden death that is evaluating the influence of heart scar visualized on CMR. International

collaborations are also expanding with academic centres such as Cedars Sinae in Los Angeles, Brigham and Women’s in Boston, Northwestern University in Chicago and Birmingham, UK, hosting a range of projects from early technique development through to population based studies. The Centre’s dedication to education throughout the years has resulted in the training of world-class cardiac imaging specialists. Training is at the core of the Centre and has supported the development and education of clinical imaging fellows, post-doctoral fellows, PhD students, and graduate students from around the world including France, Italy, Japan, Australia, and Singapore. This training has been supported by a rapidly growing clinical service; now performing over 3800 CMR tests per year. This large clinical program is partnered between the Departments of Cardiac Sciences and Diagnostic Imaging, each represented by a Clinical Co-director: Dr. Andrew Howarth and Dr. Carmen Lydell. Major achievements of the Centre include the recent launch of Canada’s largest cardiac imaging registry CIROC (Cardiovascular Imaging Registry of Calgary), a cross-modality initiative to study the cost-effectiveness and clinical benefit of CMR, Cardiac CT and echocardiography in a prospective study of 35,000 patients. The Centre has led the development and validation of new imaging techniques, such as cardiac Blood Oxygen Level Dependent (BOLD) imaging, and innovative image analysis tools which has catalyzed the launch of two software companies focused in the field of medical imaging. The Centre was core lead of the Lake Louis Consensus Criteria*, a set of recommendations now used internationally for the CMR diagnosis of myocarditis, an inflammatory disease of the heart. It has also established itself as a leader in the field of scar analysis for the prediction of cardiac events. Overall, the Stephenson Cardiac Imaging Centre has established itself as one of the premier sites for CMR clinical and academic work around the world. “Over the last 10 years, the Centre has stayed on the forefront of CMR technology, developing exciting techniques and constantly positioning its research where innovation meets clinical need,” says Dr. White. “With our technology evolving, imaging should not remain solely a diagnostic tool, but rather should insert itself into therapeutic decision making to provide better impact. As a team, I believe the Stephenson Cardiac Imaging Centre can contribute to a better delivery of therapy to those that will benefit the most, in-turn leading to longer and healthier lives for those with cardiovascular disease.” *Cardiovascular Magnetic Resonance in Myocarditis: A JACC White Paper: J Am Coll Cardiol. 2009 Apr 28; 53(17): 1475–1487.

LIBIN LIFE 15

TOP 10 IN

10 YEARS

Follow along through the years as we look at the top 10 highlights from the Stephenson Cardiac Imaging Centre’s first decade.

9 0

Information compiled by Dr. James White Design by Steven Tov

On January 27, 2004 the Libin Cardiovascular Institute of Alberta constituted

2005

7 0 0 2

0 2

Clinical volumes reaching 1500 scans per year with development of a strong academic team.

Opening of the Stephenson Cardiac Imaging Centre at the Foothills Medical Centre with installation of a 1.5 Tesla MRI dedicated to cardiac imaging

“The collaborative environment at the Centre is just remarkable,” says Dr. Louis Kolman, Cardiologist. “Between cardiologists, radiologists, and the staff this Centre provides a training experience that is probably only available in a handful of places around the world.”

16 LIBIN LIFE

A Stephenson Cardiac Imaging Centre led initiative to standardize the diagnosis of inflammatory heart disease results in the publication of the Lake Louise Criteria - an international standard for the diagnosis of Myocarditis.

“As a heart failure cardiologist, I greatly appreciate the clinical service provided by the Stephenson Cardiac Imaging Centre which has dramatically improved our approach to diagnosing and treating heart failure,” says Dr. Nowell Fine, Clinical Assistant Professor and Cardiologist. “As a research collaborator, I have greatly enjoyed working with the Stephenson team and together we are producing state-of-the-art imaging research which we hope may one day change the way we manage patients’ heart diseases.”

“I remember the first time I walked through the doors of the facility and had a chance to appreciate its depth and the collaborative spirit of all the members,” says Dr. Paul Fedak, Cardiac Surgeon and Scientist. “It’s truly a state-of-art facility with outstanding people and it’s really something everyone at the Libin Institute is proud of.”

Dr. James White recruited from Western University / Robarts Research Institute as the new Director of the Stephenson Cardiac Imaging Centre, bringing a new scientific vision towards studying image-guided care pathways for electrophysiology-based therapies (pacemakers and implantable defibrillators) and early onset heart disease.

2013 Opens a second cardiac dedicated MRI facility at the South Health Campus. This facility uses a 3 Telsa MRI system capable of performing higher quality studies, inclusive of perfusion imaging and coronary artery imaging.

Clinical volumes grow to exceed 3600 cases per year, establishing the Stephenson Cardiac Imaging Centre as one of the busiest cardiovascular MRI centres in the world. Total team size now over 34 individuals, inclusive of 10 expert clinical readers.

“The Stephenson Cardiac Imaging Centre provides world class academic cardiac care to the patients in Southern Alberta, says Dr. Todd Anderson, Director of the Libin Cardiovascular Institute of Alberta. “We are proud of their accomplishments over the last decade and as a key platform within the Libin Cardiovascular Institute it has enhanced the research programs of all our members.”

0 2

Launches the Cardiovascular Imaging Registry of Calgary (CIROC), a 10,000 patient registry partnered with Alberta Health Services to track health quality and outcomes among patients referred for cardiovascular imaging. This initiative is supported by the Calgary Health Trust.

Launches a provincial initiative (CAPRI) to study heart disease in patients undergoing chemotherapy for Breast Cancer and Lymphoma, partnering over 20 investigators across Alberta. This initiative is supported by the Alberta Cancer Foundation.

Replacement of the original 1.5 Tesla MRI scanner with a state of the art 3 Tesla “Prisma” scanner, the most advanced clinical MRI system available for cardiovascular imaging.

“Collaboration is important as it allows everyone to learn from each other’s expertise and assemble an incredibly talented yet diverse team that is focused on the same issue,” says Jackie Flewitt, Stephenson Cardiac Imaging Centre Biomedical Engineer/Research Collaboration Coordinator. “I am constantly learning and being inspired from the teams we work with and I know these relationships allow us to be stronger and better at what we do.”

2011

4 1

Clinical referral volumes exceed 2000 per year, justifying plans to expand the Centre with a second MRI machine.

LIBIN LIFE 17

FEATURE

ENGINEERING INTEGRAL TO RESEARCH ADVANCES

Schulich School of Engineering and Libin Institute partner on cardiovascular health Provided by the University of Calgary’s Schulich School of Engineering

esearchers from the Schulich School of Engineering at the University of Calgary are investigating new approaches to make a difference in cardiovascular health. As members of the Libin Cardiovascular Institute of Alberta, biomedical engineers are finding new ways to keep the heart healthy. “Engineering innovation is integral to cardiovascular research and the development of solutions for improved diagnosis, treatment and prevention,” said Kristina (Tina) Rinker, director of the Centre for Bioengineering Research and Education and an associate professor in the Schulich School of Engineering. “Mechanical and electrical forces are a fundamental part of cardiovascular health and disease. The engineering perspective is vital for visualizing, quantifying and mimicking forces and activities occurring in the body. Applying these principles will improve our understanding of complex processes, and enable the development and translation of new solutions,” she said. Current biomedical engineering research projects include developing new computational methods to evaluate the risk of aneurysms rupturing, creating new experimental systems for testing aortic stents, and developing devices and tissue engineering approaches for better cardiovascular drug target discovery and pharmaceutical testing. In addition, electrophysiological imaging and instrumentation is used to assess the functional consequences of inherited conditions with the potential to cause cardiac arrhythmias. A unique factor among these researchers is how well they work with colleagues across multiple disciplines. The University of Calgary has created a Confederation of Scholars that includes top researchers from engineering, medicine, nursing, kinesiology and veterinary medicine working together to find 18 LIBIN LIFE

new approaches to critical issues like preserving and improving cardiovascular health. “The University of Calgary has a long and successful history of collaborative biomedical engineering research and high-quality cross-disciplinary training across the institution,” said Michael Kallos, professor in the Schulich School of Engineering and director of the multi-faculty Biomedical Engineering Graduate Program. “We are focused on using engineering tools and approaches to improve cardiovascular health as part of the larger institutional Biomedical Engineering initiative.”

The Schulich School’s involvement is aligned with the University of Calgary research theme of Engineering Solutions for Health: Biomedical Engineering Research Strategy that was launched this spring. [ABOVE] Vascular surgeon and biomedical engineering researcher Dr. Randy Moore deploys a stent graft in an abdominal aortic aneurysm model designed by the Schulich School of Engineering researchers

DONOR PROFILE

Bill Andrew By Lauren Sharp

ty to work for the Senior Vice President of Finance. In early 1956, I reassessed what my strengths and interests really were and found I wanted to find something that involved finance – live figures. My wish was to get into something where I would be meeting people – sales - and be my own boss. My father had impressed that upon me as I was growing up. I decided to go into the life insurance business, starting with London Life who had the best training program. I eventually incorporated my own company. In addition to life insurance, employee benefits and pensions, we tried to help people through estate planning to keep together what they had put together.

WHAT WAS YOUR INCENTIVE TO GIVE TO THE LIBIN? In 1988 I had a very serious heart attack and throughout the experience became interested in cardiac research. In the early 1990s Dr. Eldon Smith, OC was one of my cardiologists. We became fast friends and soon I was giving to the Institute in the form of a professorship in heart research and I’ve been doing it ever since.

WHY DOES THE LIBIN MATTER TO YOU? In 1993, Bill Andrew, a philanthropist and businessman, made a gracious donation to the Cumming School of Medicine which resulted in the Andrew Family Professorship in Cardiovascular Research. This ongoing professorship has gone towards smooth muscle* cardiovascular research and allowed Libin and University of Calgary scientists to be leaders in their field and assist with changing the future of health.

RESEARCH BACKGROUND This generous gift has allowed for Bill Cole, PhD (Andrew Family Professorship holder since 2005) and other University of Calgary researchers to increase their knowledge about what is happening inside the smooth muscle cell and advance their understanding of the molecular basis of blood flow regulation. By using cerebral arteries, they’re hoping to identify novel ways to correct blood flow in the brain which will then confidently lead to correcting blood flow abnormalities in other areas such as the heart. By implementing these corrections, using new technologies and non-invasive ways to study the blood flow, they’re hoping to create new therapies that will inhibit life-threatening conditions such as a stroke or heart attack.

TELL US ABOUT YOUR BACKGROUND I grew up at the Dome Mine near Timmins in Northern Ontario. After graduating from University of Toronto in Commerce and Finance, Ford offered me a one year junior executive program; a fantastic introduction to business. I spent two years working in the budget department at Ford Windsor and Ford Oakville. TransCanada Pipelines in Calgary then offered me an opportuni-

I know the Libin is doing some great work and seeing the progress in the research and what is coming from it is very exciting.

YOU’VE BEEN INVOLVED WITH PHILANTHROPY FOR MANY YEARS, WHAT MOTIVATES YOUR DECISION TO GIVE? I am a believer in giving while living. When you can see progress in what you give it prompts you to want to give more. You give to what you’re passionate about, to what has affected your life, and where you can make a difference. Interestingly, the more I give, the more I get.

BESIDES PHILANTHROPY, WHAT ARE SOME OF YOUR OTHER HOBBIES AND INTERESTS? My wife Nancy and I belong to golf courses both here and in Maui where we have been going each year for the last 46 years. We love to spend time with our family and go to our cottage at Sylvan Lake. Church, community and politics are also important to us. I play duplicate bridge and we have been on cruises around the world. We are involved in social and philanthropic activities through Rotary and the Shriners. We are keen sports people, supporting the Flames, Stampeders, and synchronized swimming where our youngest granddaughter, Kelsey Marks, has been a keen competitor.

*Smooth muscle cells wrap around every millimeter of vasculature in the body. Their role is to respond to changes in blood pressure and other factors to determine how quickly blood containing oxygen and nutrients are delivered to our organs. A healthy vasculature containing fully functional smooth muscle cells are key to ensuring the heart and brain stay healthy. LIBIN LIFE 19

RESEARCH

Heart Disease You’re Born With By Al-Karim Walli

bout one per cent of babies are born with congenital heart disease, an umbrella term for a wide variety of abnormalities of cardiovascular structures that occur prior to birth. Historically, the percentage of patients with more severe congenital defects who lived to adulthood was low, but with advancement in care, most are now surviving. These patients require care through transition into adulthood and often throughout their lives. Unfortunately, less than 25 per cent of Canadian patients moving from pediatric to adult care make it to an adult congenital heart disease clinic. In an effort to assist congenital heart patients with their transition to adult care and to facilitate research, the Libin Institute is developing a new outcomes research platform for southern Alberta. Outcomes research helps us understand what medical interventions work best, when they are needed, and how the health system can become more efficient. Knowledge extracted from the envisioned outcomes database will be conducted by graduate students, clinical trainees and principal investigators. Over time, it will not only improve care in Calgary but will inform how we serve this important group of patients across the country and beyond.

Libin Researchers Part of Systemic Cost of High Blood Pressure in Alberta Study

ypertension is a major risk factor for heart disease and stroke — common, deadly, and costly diseases. New research out of the Cumming School of Medicine, published in the September issue of the journal Hypertension evaluated the economic impact of hypertension in Alberta. In fact, high blood pressure is the leading risk for death and disability globally, and reducing uncontrolled hypertension is one of nine United Nations targets to reduce non-communicable disease. The study estimated that in 2010 Alberta spent $1.4-billion on treating high blood pressure and its consequences, about 10 per cent of the annual health budget. The team estimated the cost to treat high blood pressure across Canada during the same year was approximately $13.9-billion, accounting for 10.2 per cent of direct health-care spending. Approximately 21 per cent of adults in Alberta had diagnosed hypertension or high blood pressure in 2010, and an estimated nine in 10 people who live an average life span will develop the condition in their lifetime.

20 LIBIN LIFE

[L-R] Carter Pusey and Swetang Desai

The catalyst to make this a reality is the APPROACH (Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease) database. A product of Calgary innovation now used coast to coast, APPROACH is a gold standard in heart related outcomes research. Over 200 peer-reviewed publications have been produced from APPROACH and it currently holds data on approximately 200,000 cardiac patients in Alberta. What is needed for use by the congenital program is the creation of a congenital heart disease module, subsequent systems integration, and in time, data analysis. With support from the community including via the Beat Goes On Gala, the Institute looks forward to this vision becoming reality.

Using Alberta health-care data which included hospital stays, emergency room visits and regular doctor’s visits, from 2002 to 2010, the research team calculated the annual healthcare cost for every adult resident. They then identified those who had been diagnosed with high blood pressure and calculated, on average, how much more their health-care costs were, in comparison to those without high blood pressure. The researchers also took into account other factors such as age and other diseases that could impact health-care costs. Some examples of interventions proven to reduce the impact of hypertension include: policies to reduce dietary salt, policies to make eating fresh fruit and vegetables more affordable and accessible, weight loss and exercise programs and utilizing blood pressure lowering medications. Libin researchers from the study include Drs. Norm Campbell, OC, Brenda Hemmelgarn, Matthew James, and Marcello Tonelli. Their hopes are for this information to be used as a driving force to implement policies aimed at improving treatment and prevention of hypertension. This type of study falls under the health promotion and disease prevention research priority at the Libin Institute. Some proceeds from this year’s Beat Goes On Gala, will go towards research areas such as this one.

Q&A With

Mike Walsh, PhD Smooth muscle researcher Mike Walsh, PhD discusses his research collaborations with the Japanese, his experiences, and what he loves most about the land of the rising sun. By Lauren Sharp YOU ARE A SMOOTH MUSCLE RESEARCHER WHO HAS COMPLETED STUDIES ALL OVER THE WORD — WHY PICK THE JAPANESE TO COLLABORATE WITH? Japan has a long and distinguished record of research in the smooth muscle field, as exemplified by the large number of highly productive and internationally recognized smooth muscle researchers (e.g. Setsuro Ebashi, PhD, Tadeo Tomita, PhD, and Hirosi Kuriyama, PhD). It also has the Japanese Society of Smooth Muscle Research, now 56 years old, which is the only national society devoted specifically to this field and publishes The Journal of Smooth Muscle Research. HOW DID YOU BEGIN THIS COLLABORATION? Back in 1994, Dr. Mitsuo Mita, Associate Professor, in the Department of Pharmacodynamics at Meiji Pharmaceutical University in Tokyo reached out to me to see if he could complete a yearlong sabbatical in my lab from 1995-1996 which sparked a collaboration that continues to this day. WHAT IS THE MAIN FOCUS OF THIS COLLABORATION? To reveal the molecular mechanisms that regulate contraction of vascular smooth muscle that controls blood flow, blood supply, provides oxygen, and nutrients to tissues and organs. WHAT STUDIES HAVE RESULTED FROM THIS FOCUS? We have elucidated the molecular basis of contractions caused by blood-borne agents as well as neuronal stimulation and identified deficiencies in the contractile mechanisms that occur in an animal model of type 2 diabetes. TELL ME ABOUT THE OTHER JAPANESE RESEARCHERS YOU’VE WORKED WITH IN YOUR LAB? I have been very fortunate to welcome three excellent postdoctoral fellows from Japan to my lab for postdoctoral training: Yoshiaki Uyama, PhD (from Nagoya City University, 1994-1995), Mitsuya Shiraishi, DVM, PhD (from Miyazaki University, 2001-2004) and Kosuke Takeya, PhD (from Hokkaido University, 2005-2010), as well as another visiting scientist, Dr. Takeshi Kobayashi (from Sapporo Medical University, 2011-2012), and a visiting PhD student, Hiromitsu Nagumo, PhD (from Asahi Chemical Industries in Fuji Shizuoka, 1996). I have also had successful collaborations with Yasuharu Sasaki, PhD (from Asahi Chemical Industries) and Yuji Imaizumi, PhD (from Nagoya City University).

[RIGHT] Mike Walsh, PhD, Kosuke Takeya, PhD, Rodger Loutzenhiser, PhD.

HOW MANY TIMES HAVE YOU BEEN TO JAPAN FOR RESEARCH? I have visited that magnificent country on eight separate occasions, including twice in 1992. This included a six-week visit in 2004 through an exchange program between the University of Calgary and Sapporo Medical University during which I spent three weeks (February-March) in the lab of Dr. Noritsugu Tohse. BESIDES RESEARCH, WHAT OTHER JAPANESE ENDEAVORS HAVE YOU BEEN APART OF? I was privileged to be invited in 2010 to join the Editorial Board of The Journal of Smooth Muscle Research group, delivered the Plenary Lecture at the 2013 annual meeting of the Japanese Society of Smooth Muscle Research in Asahikawa, Hokkaido, Japan, and I have organized two conferences with my Japanese colleagues: the International Symposium on New Developments in Smooth Muscle and Endothelial Cell Signaling (Nagoya, Japan in 1999) and the International Symposium on Post-Genomic Advances in the Physiology of Smooth Muscle (Nagoya, Japan in 2009). BESIDES RESEARCH, WHAT IS YOUR FAVORITE PART ABOUT WORKING WITH THE JAPANESE/THE COUNTRY? The people are incredibly kind and courteous. I also love travelling the country and following the cherry blossoms!

LIBIN LIFE 21

Inside The Core Pathology Lab By Judy Siu

n April 2014, the Libin Cardiovascular Institute of Alberta established its Core Pathology Lab, a shared resource centre that assists researchers by processing heart and blood vessel tissue and providing high quality images of those tissues. For example, many laboratories are working with genetically engineered animal models that allow them to focus on the effects of increasing or decreasing (e.g., “knocking-out”) a particular gene. Using such an approach, researchers can better understand the importance of a particular gene (and the protein that the gene encodes for) in cardiovascular health and disease. When researchers require analysis of a tissue or cell, they can simply have the Core Pathology Lab process and deliver results back to the researcher, or in some cases, staff at the Core Pathology Lab can provide further diagnosis and analysis for those experiments. Formed from a portion of several Canadian Foundation for Innovation grants, more than $500,000 in equipment was invested into the facility where researchers have access to a full service that helps support their research. “The facility is equipped with all of the necessary equipment to carry out routine and personalized histopathological studies,” says Dr. Ed O’Brien, Director of Research at the Libin Institute. “It is highly specialized and an incubator for collaborations.”

[ABOVE] Dr. Yong-Xiang Chen

The Core Pathology Lab supports a growing number of researchers in need of in vivo experimentation and photomicrographs—magnified photos of images taken through a microscope. “Photomicrographs are finding their way into abstracts, conference proceedings and manuscripts,” says Dr. O’Brien. In conjunction with the Libin Institute, the Core Pathology Lab is managed by Dr. Yong-Xiang Chen, who completed his MD at Norman Bethune Medical College in Changchun, China, before pursuing a PhD in Experimental Pathology at Kyushu University Faculty of Medicine in Fukuoka, Japan. He has worked with Dr. O’Brien for more than a decade and brings a plethora of experience to the Core Pathology Lab. The Core Pathology Laboratory is opening up new collaborative research opportunities and increasing the quality of scientific output from participating laboratories. In doing so, researchers are further increasing their competitiveness, publishing higher quality work and increasing their chances of securing additional peer-review grant funds. In just over a year, the facility has helped more than 15 laboratories. As of April 2015, the Core Pathology Lab is now open to all University of Calgary researchers, students and staff. For details, please visit libin.ucalgary.ca/LibinCorePathologyLab.

22 LIBIN LIFE

[L-R] David Guzzardi and Dr. Paul Fedak

New Research Offers Cardiac Patients Insights Into Disease Research may inform personalized options for open heart surgery Courtesy of the Cumming School of Medicine’s Communications and Media Relations team

p to two percent of people are living with a bicuspid aortic valve (BAV) – a condition where people are born with only two flaps in their aortic valve instead of the normal three flaps. These patients are also known to have weakness of the aorta— the main blood vessel of the heart—that can suddenly rupture leading to death. While the medical community has long believed that those with BAV were genetically predisposed to having aortic weakness, new research out of the Libin Institute, in partnership with the Martha and Richard Melman Family Bicuspid Aortic Valve Program at Northwestern Medicine in Chicago, has discovered there may be more at play in managing BAV-related diseases. New research using 4D flow MRI technology (an imaging technique that allows for visualization of blood flow in real-time) in a cohort of 20 BAV patients in the Chicago area, with tissue samples analyzed in Calgary, has revealed that abnormal blood flow from the two flap valve can create the weakness in the aorta. Currently, open-heart surgery is the single best option for treatment and is recommended to most patients to prevent life threatening complications. This research provides encouraging data for improving risk assessment and the surgical treatment of BAV patients going forward. “As surgeons we have always treated these patients with invasive surgery to ensure the weak aorta was removed, preventing rupture,” says Dr. Paul Fedak, lead author on the study and cardiac surgeon and scientist at the Libin Cardiovascular Institute, University of Calgary, and Adjunct Associate Professor at Northwestern University Feinberg School of Medicine in Chicago. “Patients with BAV are not all the same but we treat them, with respect to the timing and extent of surgery, as if they are all the same. Based on these new findings, we found we can use 4D flow MRI technology to look inside a patient’s aorta and assess the unique blood flow pattern of that individual patient to plan the optimal surgical approach.” The researchers compared the shear stress levels in the patients’ aortas (as measured through 4D flow MRI), with biopsy

samples taken from those same patients, and looked for specific tissue biomarkers of the disease. “We found that the blood vessel wall is very abnormal in the region where we tracked abnormal blood flow, compared to the region where normal blood flow was tracked,” says David Guzzardi, PhD student at the Libin Cardiovascular Institute and first author of the study. “This provides the most conclusive evidence to date that abnormal blood flow through the bicuspid valve may play a role in causing the disease.” Most patients are unaware they have the condition and may only find out incidentally through tests for other medical conditions, or when there are aortic complications such as aneurysms or rupture. Phil Mittertrainer is a BAV patient who had aortic surgery by Fedak to prevent it from rupturing. “I was very fit and active in sports yet the doctors told me I needed open-heart surgery to remove my bicuspid aortic valve and enlarged aorta. I was lucky they discovered it. The public needs to know more about this common problem. If the aorta ruptures it is game over.” While the 4D MRI technology in Calgary is only currently used for research, researchers hope this study will eventually lead to its use for clinical purposes. “This study is important for patients as it may change how we treat people with BAV who require open-heart surgery to remove an enlarged aorta,” says study collaborator Dr. Patrick McCarthy, Executive Director, Bluhm Cardiovascular Institute and Chief, Division of Surgery-Cardiac Surgery, Northwestern University in Chicago. “Our work suggests that using 4D flow MRI may help us identify the diseased areas from the healthy ones, and by using this map we can plan a more personalized surgical approach for each patient we treat. We can be less aggressive in some patients and perhaps avoid invasive surgery, and more aggressive in others who are at higher risk.” Funding for the study was provided by the National Institute of Health (NIH). LIBIN LIFE 23

$39.1 million Awarded to 12 University of Calgary Health Researchers To increase the betterment of Canadians’ health, University of Calgary (U of C) researchers will receive grant funding from the Canadian Institutes of Health Research (CIHR) in the form of $13.1 million from the currently running Open Operating Grant program and $25.8 million in the form of its new Foundation Grants program. Twelve University of Calgary research projects have been awarded under the new Foundation Grant program. Many fall under the University’s priority areas of Brain and Mental Health and Infections, Inflammation, and Chronic Diseases. Both programs were created to support academics and clinicians who are assisting to solve some of Canada’s most critical health issues as well as supporting up and coming researchers. Libin Institute researchers who will receive Foundation Grant funding include:

[ABOVE] Dr. Marcello Tonelli

Dr. Marcello Tonelli ($2,941,008): Patient-centred care of comorbidity for people with chronic kidney disease

Richard Frayne, PhD ($1,293,565): Quantitative MR Imaging of Vascular Contributions to Aging, Cognitive Decline and Stroke

Dr. Matthew James, MD PhD ($855,843): Better Prediction and Decision Support Tools to Improve Care and Outcomes for Patients with Acute Kidney Injury (AKI)

This funding will support the multi-disciplinary and groundbreaking research in the Cumming School of Medicine, the Schulich School of Engineering and the faculties of Arts and Kinesiology. Libin researchers who will receive Open Operating funding include Andy Braun, PhD, Dr. Hude Quan, Dr. Satish Raj, and Dr. Pietro Ravani.

Meet the Libin’s new Clinical Research Coordinator Darlene Ramadan RN, BN, CCRP is the new Clinical Research Coordinator for the Libin Cardiovascular Institute and Department of Cardiac Sciences. Darlene has worked in a variety of cardiac and research areas at the University and her role is to assist with the quantity and quality of the clinical research and aid investigators in accessing new opportunities for its patients. Welcome, Darlene! 24 LIBIN LIFE

thanks all the sponsors and supporters of

Thank you to all our generous sponsors, donors and guests. Proceeds from this yearâ&#x20AC;&#x2122;s Gala will support research that will enhance care for patients born with congenital heart conditions and improve the lives of Canadians through cardiovascular health promotion and disease prevention. With your support, we are creating greatness! SIGNATURE SPONSOR

GOLD SPONSORS

SILVER SPONSOR

BRONZE SPONSORS

EXCLUSIVE MAGAZINE SPONSOR

VIP TABLE SPONSORS

Balmon Investments BCW Architects / Krita Investments Ltd.

Sarine Mustapha

SVP BMO Nesbitt Burns

Ted Poppitt Lighthearted DONORS AMP Financial Inc Brian & Stephanie Felesky First Energy Capital

Joseph Colangelo Dick & Lois Haskayne Jai Hawker Homes by Avi

Philip & Harriet Libin Allan Markin M. Ann McCaig Gord Olitch

EVENT PARTNERS:

Rob & Ruth Peters Riddell Foundation Dr. Eldon Smith OC Star Valley Oil & Gas

StoneBridge Merchant Capital Corporation W. Brett Wilson

EDUCATION

SPOTLIGHT ON TRAINEES Compiled by Lauren Sharp

DR. JACQUES RIZKALLAH CURRENT PURSUIT Adult Cardiac Electrophysiology Fellowship (Brigham & Women’s Hospital, Boston, MA, United States) SUPERVISOR Dr. Usha Tedrow DEGREES Bachelor of Science (with distinction), Biochemistry, University of Calgary (2002); MD with special training in research, University of Alberta (2006); Internal Medicine, University of British Columbia (2010); Cardiology, University of Manitoba (2013), Adult Cardiac Electrophysiology Fellowship, University of Calgary (2015). RESEARCH INTEREST Research interests include the evaluation of cardiovascular physical examination techniques, implantation strategies for cardiac electronic devices, and post-operative atrial fibrillation. ABOUT ME I’m very grateful for all the support and guidance received over the years from family, friends, and mentors. Future aspirations include a diverse clinical and academic career in cardiac electrophysiology.

26 LIBIN LIFE

DAVID GUZZARDI CURRENT PURSUIT PhD, Cardiovascular and Respiratory Sciences SUPERVISOR Dr. Paul Fedak, MD PhD DEGREES PhD, Cardiovascular and Respiratory Sciences (2013 – present) University of Calgary; BSc (first class honours), Zoology, University of Calgary RESEARCH INTEREST My research interests lie at the intersection of structural heart disease (specifically aortopathies), wound healing, and inflammation. I am particularly interested in patients with congenital heart defects such as bicuspid aortic valves. ABOUT ME In addition to spending time outdoors, hiking, camping, cycling and skiing, I am an avid soccer fan and play men’s soccer for the Calgary Callies. I enjoy learning new languages and hope to master German before completing my PhD studies.

DR. ALLISON HALL CURRENT PURSUIT Interventional Cardiology Fellow, PGY7-Foothills Interventional Cardiology Service. SUPERVISOR Dr. Michael Curtis DEGREES B.Sc. (Hons) Biology, Minor in Biochemistry, Memorial University of Newfoundland, 2005; Doctor of Medicine, Memorial University of Newfoundland, 2009; Internal Medicine Residency Training Program, University of Ottawa, completed 2012; Adult Cardiology Training Program, University of Calgary, completed 2015. RESEARCH INTEREST I am working on the vascular component of the Alberta Heart Failure Etiology and Analysis Research Team study. AB-HEART is a prospective observational cohort study of patients either with, or at risk for, heart failure. Our aim is to characterize endothelial function in subjects with HFpEF vs. HFrEF and controls. I am also interested in pursuing clinical outcomes research in the cath lab and cardiac critical care. ABOUT ME I fill my spare time with a wide array of outdoor activities, play violin and guitar, undertake amateur home improvement projects/crafty stuff, and make elaborate cooking creations.

Libin Institute’s Tine Haworth Cardiovascular Research Day By Judy Siu On April 17, the Libin Institute hosted the newly named 2015 Libin Institute’s Tine Haworth Cardiovascular Research Day. Over 200 staff, students, researchers and physicians attended. The event featured a variety of presentations from Dr. Bijoy Menon, Donald Welsh, PhD, Tina Rinker, PhD, and Libin Institute trainees, Ramesh Mishra, PhD, Dr. Jacques Rizkallah, and Andreas Brodehl, PhD. This year’s rapid fire talks were delivered by 10 trainees who presented their research and fielded questions from the audience. Donald Bers, PhD, Professor and Chair in the in the Department of Pharmacology at the UC Davis School of Medicine in Davis, California delivered the E.R. Smith Lecture with a presentation titled, “Cardiac Calcium and CAMKII Signaling in Heart Failure and Arrhythmias.” His research on cellular and molecular factors involved in the control of cardiac muscle contraction is internationally recognized.

d Tine Haworth

[L-R] Alvin Libin an

TRAINEE

CATEGORY nt

MSc Stude

& Resident

WINNERS • Michael

Chiu

rt Miller

• Dr. Robe

llow

Clinical Fe

te D Candida

llow & Ph

Clinical Fe

• Dr. Holly

Mewhort arraz, PhD

• Osama H

s her Sarson

• Christop

PhD Studen

l Fellow

Postdoctora

• Andreas

Brodehl, Ph

[L-R] Andreas Brodehl, PhD, Osama Harraz, PhD, Dr. Holly Mewhort, and Dr. Robert Miller

LIBIN LIFE 27

DR. BRYAN HAR

NEW RECRUITS Compiled by Lauren Sharp

DR. SCOTT MCCLURE POSITION Cardiac Surgery, Clinical Assistant Professor HOME TOWN Calgary, AB DEGREES Fellowship, Thoracic aortic surgery, University of Pennsylvania (2012-2013); Fellowship, Adult cardiac surgery, Brigham & Women’s Hospital, Harvard University (20112012); FRCSC, Cardiac Surgery, Western University (2011); MS, Clinical Epidemiology, Harvard School of Public Health (2008); MD, University of Calgary (2004); BA (Hon) Lake Forest College (2001). DESCRIBE WHAT YOU DO Surgical treatment of the heart/aorta and clinical outcomes research. INSPIRATION/REASON BEHIND YOUR CAREER CHOICE Going into medical school I had predetermined that I wanted to be a surgeon. My introduction to the cardiovascular system in medical school (physiology, impact on health, treatments and outcomes) and a respect for the technical aspects of the surgical procedures, lead me toward a career in cardiac surgery. YOUR ULTIMATE GOAL To always be challenging myself, to be part of a dedicated team focused on the betterment of patient care for diseases of the thoracic aorta, and to make meaningful contributions to the field of cardio-aortic surgery. HARDEST LESSON LEARNED Failures are inevitable – own it; learn from it; let it go and move on. HOBBIES I like to play hockey, read, and travel. SURPRISING FACT PEOPLE DON’T KNOW ABOUT YOU My first job was a forklift operator at Home Depot.

libininstitute.org

@libininstitute

POSITION Interventional Cardiologist, APPROACH research group, Clinical Assistant Professor HOME TOWN Calgary, AB DEGREES MD - University of Calgary (20022005); Internal Medicine - Western University (2005-2008); General and Interventional Cardiology - University of Calgary (2008-2013); Masters of Public Health - Harvard (2013-2014) DESCRIBE WHAT YOU DO Clinical, invasive, and research cardiology INSPIRATION/REASON BEHIND YOUR CAREER CHOICE I find it interesting and fun YOUR ULTIMATE GOAL To become a successful clinician scientist HARDEST LESSON LEARNED Time is valuable and limited. Always ask if there is a tangible benefit to what you are spending time on. Prioritize the important things in life. HOBBIES Swim, bike, and run (aka: triathlon), but I like running the most. SURPRISING FACT PEOPLE DON’T KNOW ABOUT YOU Go, Oilers Go!

DR. BRIAN CLARKE POSITION Advanced Heart Failure & Cardiac Transplant Cardiologist HOME TOWN Churchill Falls, Newfound Land. DEGREES BSc (Hons) Biology: St. Francis Xavier University – 1996-2000; MD: Dalhousie University – 2000-2004; Internal Medicine & Cardiology Residency : Dalhousie University – 2004-2010; Advanced Heart Failure & Cardiac Transplantation Fellowship: Stanford University – 2010-2011. DESCRIBE WHAT YOU DO Participate and manage patients across the spectrum of heart failure including patients with mechanical circulatory assist devices and heart transplantation. INSPIRATION/ REASON BEHIND YOUR CAREER CHOICE Cardiology is an exciting, multifaceted area of medicine that combines clinical care, imaging and invasive techniques. I became particular attracted to the area of heart failure early in my residency. YOUR ULTIMATE GOAL To help shape and advance the field of heart failure and cardiac transplantation in Canada. HARDEST LESSON LEARNED You only live once. Take time to stop and smell the roses! HOBBIES I love to socialize and I am an avid winter sports and travel enthusiast. SURPRISING FACT PEOPLE DON’T KNOW ABOUT YOU I almost went into plastic surgery.