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Thursday, May 24, 2018
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USF heart institute testing innovative treatments

TAMPA - For nearly 20 years, David Skand has lived with a heart that doesn't pump blood through his arteries as it should. Aside from taking medicine, his treatment choices have been pretty drastic. A heart transplant. An artificial heart. But in a few weeks, Skand will check into Tampa General Hospital and have a genetically engineered medicine pumped into his body for 10 days, eight hours a day — that is if he doesn't receive the inactive form of the medicine as a placebo. The drug was designed to stimulate Skand's own cells to "remodel" his heart, as University of South Florida researchers put it.
"I feel like I'm on the vanguard of medicine," he said. USF Health officials say it's just the beginning. The new USF Health Heart Institute is operating out of a warren of crowded offices in South Tampa now, but in three years doctors expect to have six stories, maybe more, on the north end of the USF campus, near the new medical school that's being planned. It's why renowned cardiologist Leslie Miller came here. USF recruited Miller from the Georgetown University School of Medicine, drawing him in with its ambitions to become a national center for innovative heart treatment. There's nothing in the country like what USF Health Chief Executive Officer Stephen Klasko is planning, Miller said. That vision also persuaded state Rep. Will Weatherford, incoming House speaker and Wesley Chapel Republican, to push $7 million USF's way for construction of the new institute, in a year when university budgets were being slashed. The Hillsborough County Commission followed in April with $2 million. Florida is the "epicenter" of cardiovascular disease because of the age and health of its residents, Miller said. With the proliferation of pacemakers and medications to control blood pressure, great strides have been made in the battle to prevent heart failure. But it's a fight that's far from over, Miller said. People aren't dying at the rate they used to, but sudden cardiac arrest still kills an average of 1,000 people a day, many who exhibit no previous signs of heart trouble. And those who receive heart treatment still suffer as they age and their hearts and bodies get progressively weaker. In Florida, heart problems account for 40 percent of all hospital visits and deaths. Costs statewide are expected to rise by a third, up to $17 billion a year by 2020. "If we're ever going to make a difference, it will be here," Miller said. But that means the institute has to do things differently, he said. One problem is that many people don't respond to existing drugs because of their genetic makeup. That's why USF's heart institute is focusing on the much-heralded practice of personalized medicine, which is tailoring treatments to meet individual needs and characteristics. In addition to luring Miller, USF recruited Stephen Liggett to run its Personalized Medicine Institute. He comes from the University of Maryland School of Medicine, where he directed its Cardiopulmonary Genomics Program. "They're not chasing some pie-in-the-sky idea," said Kevin Fitzpatrick, of the American College of Cardiology. "The things they're doing today will have near-term benefit on Hillsborough County and the Tampa Bay region while setting the stage for Hillsborough County to become a hub for this kind of ongoing research," he said. In one of the new institute's main projects, USF doctors have started collecting blood samples from heart patients to map their DNA. As the collection grows, researchers expect to see genetic patterns that will help them identify who is at risk for developing heart disease and the types of treatment they need. A key to this approach is USF's new partnership with the American College of Cardiology, which has a database with the health records of millions of people, all anonymous. Matching patients with similar characteristics in the databases, researchers will be able to study how genetic makeup affected the disease process and how patients responded to treatment, Fitzpatrick said. USF's collection "will revolutionize the research," he said. "It will help us choose the right drugs and set the right doses" for patients. It also will help researchers understand more about the interaction of genetics and life choices, such as smoking and overeating, and it will help them figure out what new drugs are needed, he said. A clinical trial for one of the latest drugs has just started at USF. The drug comes from a company based in Shanghai called Zensun. USF is one of 12 test sites in the country. The 70-year-old Skand is the first of 10 patients USF plans to enroll in the study. Both of Skand's parents suffered from heart problems, and he began having trouble nearly 20 years ago as heart disease narrowed the vessels that carry blood and oxygen to his heart. The Tampa Bay Downs veterinarian has been in and out of hospitals, though his symptoms are now under control, he said. But he's running out of treatment choices. Skand was excited to find out that he qualified for the Zensun study at USF, the first of five heart drug trials getting started this summer. The drug, created though genetic engineering, is designed to rebuild and strengthen heart cells. Basically, "the heart muscle will be able to work better," said research nurse Bonnie Kirby. Of the 120 people in the study nationally, 80 will receive the drug and 40 will receive a placebo. After the 10 days of treatment, the researchers will monitor Skand. Based on what they know about the drug — if he receives the real thing — they have high hopes. He'll be stronger, able to walk longer and breathe better, Kirby said. Miller told Skand that researchers don't expect him to suffer serious side effects, perhaps some nausea. But he has the option of leaving the study at any time. Skand doesn't plan to quit, he said. He can't wait to get started.

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