Ambulance at hospital door
One Ted Rogers Centre innovation project is a world-first algorithm for heart failure that will help Emergency Department physicians better understand if a patient can be sent safely home or needs to be admitted. The answers could save lives and hundreds of millions of dollars. (Photo: Ted Rogers Centre)

As Heart Month 2018 wraps up, the Ted Rogers Centre for Heart Research announced its inaugural $1-million innovation grants.

With collaborations at UHN, The Hospital for Sick Children (SickKids) and the University of Toronto, these projects are positioned to alleviate the massive burden of heart failure on patients, loved ones and healthcare systems.

heart month logo​The Ted Rogers Centre is in a unique position to invest at key moments in emerging technology that brings completely new ideas to the table for heart failure, says Executive Director Dr. Mansoor Husain.

"To support our mission of addressing heart failure across the lifespan, we funded a pair of visionary projects that require a generous level of support that most granting agencies aren't able to provide," he says.

Heart Month, which happens in February each year, is a time to encourage healthy lifestyles and support cardiac patients and their loved ones, but also reflect on the nature of research in transforming the management of heart disease.

The pair of $1-million grants – one led by Dr. Douglas Lee, the other led by Dr. James Ellis – advance compelling solutions for heart failure, which is a disease that affects at least one million Canadians and costs the health system more than $3 billion a year.

Dr. Douglas Lee, Ted Rogers Chair in Heart Function Outcomes, leads a team that will create a new machine learning model to predict prognoses of patients with heart failure, preventing unnecessary admissions to hospital.

Dr. Douglas Lee
Dr. Douglas Lee (UHN, ICES) leads a team that also includes co-investigators Dr. Heather Ross (UHN), Prof. Anthony Gramolini (U of T), Dr. Patrick Lawler (UHN), Dr. Slava Epelman (UHN), Jane MacIver (UHN), Prof. Catherine Kreatsoulas (U of T), and Prof. Anna Goldenberg (SickKids). (Photo: UHN)

Heart failure is a leading cause of costly hospital readmissions. In general, the disease is treated reactively: a patient experiences symptoms, heads to the Emergency Department, and is admitted to hospital.

"We have hit a wall in predicting readmissions using traditional clinical methods," says Dr. Lee. "As it stands, without the right tools in place, low-risk patients may be unnecessarily admitted while high-risk patients could be inadvertently discharged home."

To better predict outcomes and improve care, the team will develop a new algorithm based on an array of information that includes biomarkers, physiologic data, blood samples, and a patient's own reported symptoms. This will be combined with evolving technology such as remote patient monitoring and machine learning.

Together, the aim is to develop a complete, integrated model to predict heart failure readmissions.

Dr. James Ellis, Senior Scientist at SickKids, leads the second funded project, which will use stem cells and bioengineered tissues to test new treatments for patients affected by mutations that cause heart disease.

Dr. James Ellis
Dr. James Ellis leads a team that also includes co-investigators Prof. James Ellis (SickKids), Dr. Seema Mital (SickKids), Prof. Craig Simmons (U of T), Prof. Milica Radisic (U of T), and Dr. Phyllis Billia (UHN).

Cardiomyopathy, a genetic condition, either thins and weakens, or thickens and stiffens, the heart muscle. It is the most common cause of heart failure and sudden cardiac death in children. There are no effective treatments today.

This innovative project combines stem cells, bioengineered tissues and genomics to study if drugs that target myosin – the protein that causes a heart to contract – are effective in treating cardiomyopathy. At the same time, they will see if a patient's genotype can predict response to therapy.

Researchers will leverage next-generation gene-editing technology to create models of disease in which drugs can be studied. To do so, they will take skin or blood cells from patients, reprogram them into stem cells, and convert them into heart cells. If they discover that a drug works best in patients with certain gene defects but not others, it will lay the groundwork for precision medicine in cardiomyopathy.

"We hope that evidence-based use of these medicines will eventually reduce heart failure in these patients and will prolong their lives," says Dr. Ellis.​

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