Message from the Division Chief, Sanjay Rajagoplan, MD

cardiovascular-medicine-sanjay-rajagopalan

The Division of Cardiovascular Medicine is the driving force of the University Hospitals Harrington Heart & Vascular Institute (HHVI), a transformative integrated institute that has changed cardiovascular care in Ohio in a mere 10 years since its creation by its President Daniel Simon, MD, through innovation in patient care, research and education. Viewed from the larger lens of the evolution of University Hospitals (UH), which is celebrating its sesquicentennial year of creation in 2016, this blistering trajectory of exceptional growth and innovation, underscores one simple reality, that the ultimate differentiator for any organization is not competition, compensation, markets or technology, but the right combination of people that have come together to provide exceptional care.

The Division of Cardiovascular Medicine is one of the largest divisions in the Department of Medicine and is the academic hub of the HHVI. The HHVI includes physicians and staff engaged in groundbreaking patient care spanning every aspect of clinical cardiovascular medicine including interventional cardiology, structural heart disease, advanced imaging, electrophysiology, advanced heart failure and transplantation, as well as prevention and vascular medicine. These activities are based at the academic flagship, UH Cleveland Medical Center and extends to 14 community medical centers and eight ambulatory health centers in a “new hub and spoke” model. The latter although superficially similar to the traditional structure of primary, secondary and tertiary care settings within a network, is transforming cardiovascular care through redirecting flow of patients within the care network by delivering the best care in a patient friendly manner through exceptional access and integrated care in the most efficient setting. Over 13,000 cardiac catheterizations/interventions, 5000 electrophysiology and 15,000 non-invasive cardiovascular imaging procedures are performed annually in the HHVI. The President of the HHVI, Marco Costa, MD, PhD, practicing interventional cardiologist is true believer in the application of innovation in cardiovascular care delivery, also leads UH’s innovation efforts as the Chief Innovation Officer.

UH has a unique reputation for groundbreaking discovery that dates back to over a century that involve novel surgical treatments for coronary artery disease, pericardial disease, the role of renin in hypertension, stem cell treatments for heart failure and more recently groundbreaking work in advanced imaging such as optical coherence tomography (OCT) coronary artery, CT-derived fractional flow reserve (FFR-CT) imaging, magnetic resonance imaging and leading-edge structural intervention and peripheral endovascular therapy. We have also lead the way in developing unique interdisciplinary programs in oncocardiology, dyspnea and multimodality imaging that has transformed integrated care delivery for the patient.

Our exceptional fellowship program within the Department of Medicine, trains some of the world’s best physicians and physician scientists who have gone on to lead successful programs around the globe. Our clinical and research and educational programs are closely aligned with the Louis Stokes Cleveland VA Medical Center, which serves as a regional center for cardiovascular services within the VA health care system and is a major site teaching affiliate for our residents and fellows.

Our research programs are arguably the most comprehensive and entrepreneurial and easily qualifies as one of the nation’s most ambitious projects to develop next generation discoveries in cardiovascular medicine and a new breed of physician scientists. The scope and scale of the Case Cardiovascular Research Institute (CVRI) within the HHVI, has soared in the last 10 years of its creation. The CVRI occupies over 13,000 square feet of laboratory space in the Wolstein Research Building and is home to over 70 faculty members, post-doctoral fellows, students and technicians. The strengths of the CVRI include vascular biology, gene regulation, hypertrophy, signal transduction, imaging and new programs in cardiovascular drug development and theranostics. The CVRI has garnered over 35 R01 grants from the National Institutes of Health, over 15 career development awards (K-level awards from NIH and SDG from the American Heart Association), a T32 training grant and numerous industrial and foundation awards. Total current grant support from the NIH now exceeds $32 million. We are particularly proud of our global research activities in Uganda, China and India in recognition of the burgeoning challenge of non-communicable diseases (NCD) in these countries.

Under the leadership of Jonathan Stamler, MD, President of the Harrington Discovery Institute, and Mukesh Jain, MD, Chief Scientific Officer of HDI and University Hospitals, the approach to fundamental research has pivoted in a paradigm-shifting manner through creation of innovative academic private partnerships. The Harrington Discovery Institute is a unique example of such a partnership, designed to address the gaps in research opportunities that have arisen owing to the profound changes in research funding, regulatory challenges and a culture that demands new approaches and treatments for a better cardiovascular tomorrow.

A partnership with the Case Center for Imaging Research (CCIR), leverages the strengths in radiology, imaging tools, physics, electronics, and computer science to provide state of the art imaging tools to further drug development and diagnostics.

The Center for Research & Innovation created within the HHVI provides a unique forum for progressing new therapies and shepherding these down the regulatory road to eventual clinical application. The center is home to leading-edge translational and clinical research activities with strengths in cardiovascular imaging, electrophysiology and interventional cardiology drug and device trials. We have over 100 active clinical trials following greater than 2,500 patients and multiple grants and contracts from Industry, National Institutes of Health and other funding agencies. The Cardiovascular Imaging Core Laboratory is an independent academic research organization that turnkey services for imaging-based surrogates used to propel the development of novel medical and device therapies at all phases of development. We are a global leader in optical coherence tomography, cardiac computed tomography and advanced cardiovascular magnetic resonance imaging methodologies and are the national core laboratory for multiple trials involving these approaches.

While there are current challenges in the health care environment, what separates us are the talent we hire and work we do to prepare ourselves to face and solve the most important challenges in medicine. I am confident that the Division of Cardiovascular Medicine and HHVI are well-poised to continue our commitment to pursuing cardiovascular innovation, delivering exceptional clinical care and training the next generation of talented trainees for a better world.

 

Sanjay Rajagopalan, MD, FACC, FAHA
Chief, Division of Cardiovascular Medicine
Director, UH Case Cardiovascular Research Institute
Herman Hellerstein Chair in Cardiovascular Research
Professor of Medicine, Case Western Reserve School of Medicine