Gordon Tomaselli, MD

JAHA: Tell us about the key findings from your recent article in JAHA.

Dr. Tomaselli: This is a prospective observational study of patients who were candidates for ICD implantation for primary prevention of sudden death. These are generally stable heart failure or post-MI patients. As this is a description of the cohort the major findings are to follow. Some of the key features of this cohort are a much larger representation of non-white mostly African-American patients, a rich biorepository with all patients having blood drawn and stored at baseline and follow-up visits in addition to digital ECGs.

JAHA: What are the major implications of this work?

Dr. Tomaselli: The major implications are the development of a well phenotyped cohort to explore the utility of non-traditional biomarkers of risk such as genotype, mRNA and microRNA expression, metabolites, dynamic ECG metrics and in a subset of patients cMRI and CT imaging.  We will also have a rather long followup for this group allowing us to determine the short and long-term benefits of the ICD in this cohort.

JAHA: How did you get the idea to do this study?

Dr. Tomaselli: A well know shortcoming of primary ICD deployment are the limitations in our ability to identify patients with primary prevention indications at risk mostly likely to benefit from this invasive and expensive treatment. 

JAHA: What was your biggest obstacle in completing this study?

Dr. Tomaselli: The recent rates of use of primary prevention ICDs has slowed some either by patient or physician preference. It raises the possibility that the group enrolled may have changed over the enrollment period.

JAHA: What was your most unexpected finding?

Dr. Tomaselli: Perhaps, not totally unexpected, the preliminary data demonstrate that the overall mortality rate is greater than the appropriate shock rate by the ICD. It reinforces the concept that there are competing risks for death in this group that are not prevented by the ICD.

JAHA: What do you plan to do next, based on these current findings?

Dr. Tomaselli: We will be doing a comprehensive analysis of mortality, ICD therapy and risk once enough events are accrued. We have genotype the entire cohort and done RNA, protein, metabolic and ECG studies on the group.

JAHA: What do you like to do in your free time?

Dr. Tomaselli: Free time is in short supply, when there is any spending time with family, helping coach recreation council basketball and baseball

JAHA: What is your favorite sports team or musical group?

Dr. Tomaselli: I know you do not want to hear this: New York Yankees

Eclectic musical taste Classical to Vintage rock e.g. Clapton

To read Dr. Tomaselli's full article, click here

Profile originally published March 19, 2013

Amanda Fretts, PhD, MPH

JAHA: Tell us about the key findings from your recent article in JAHA.

Dr. Fretts:  Our analysis examined the association of plasma phospholipid and dietary ALA with the development of atrial fibrillation among older adults who participated in the Cardiovascular Health Study. Our results indicate no association of either plasma phospholipid or dietary ALA on risk of atrial fibrillation.

JAHA:  What are the major implications of this work?

Dr. Fretts: The burden of atrial fibrillation is increasing as the population ages. As such, it is important to better understand factors associated with risk of developing atrial fibrillation. Although our results showed no association of ALA with atrial fibrillation among older adults who consume an American diet, this is a very important finding.

JAHA:  How did you get the idea to do this study?

Dr. Fretts: Many studies have shown that long-chain n-3 fatty acids derived from seafood, particularly eicosapantaenoic acid (EPA) and docosahexaenoic acid (DHA), are associated with a lower risk of AF. However, the relationship of ALA, a medium-chain n-3 fatty acid derived from plants and found in foods like canola oil and walnuts, is unclear. As plant-derived fatty acids are cheaper and have a greater worldwide availability than seafood, a better understanding of the relationship of ALA with atrial fibrillation is of public health importance. 

JAHA: What was your biggest obstacle in completing this study?

Dr. Fretts:  I have worked with many complex data sets in the past. However, the Cardiovascular Health Study is unique in that there were two recruitment periods (1989-1990 and 1992-1993) and many measures were collected annually. As this was my first analysis using data from the Cardiovascular Health Study, it took me quite a long time to become familiar with the data.

JAHA:  What was your most unexpected finding?

Dr. Fretts: In the Cardiovascular Health Study, fatty acids derived from fish (EPA and DHA) were associated with a lower risk of AF. As such, we expected ALA (a fatty acid derived from plants) to be associated with a lower risk of AF. Although we did not find an association of ALA and AF in this cohort, we need to examine the relationship in non-fish eating populations with other types of diets.

JAHA:  What do you plan to do next, based on these current findings?

Dr. Fretts: We’d like to examine the relationship of ALA with other cardiovascular outcomes in the Cardiovascular Health Study. Additionally, exploring the relationship of ALA and atrial fibrillation in populations with other types of diets is of interest.

JAHA: What do you like to do in your free time?

Dr. Fretts: I live in the Pacific Northwest, so when it’s not raining, I like to take advantage of living close to the mountains and spend time hiking, camping, or snowshoeing. I also enjoy gardening in the summer months. 

To read Dr. Fretts' full article, click here

Profile originally published March 12, 2013