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Pediatric Cardiology Research

Dr. Lee pipetting

Members of the Division of Pediatric Cardiology are engaged in multiple research projects to advance the care of children with heart disease. We have four dedicated physician and Ph.D. scientists on our faculty who focus on improving understanding of pediatric cardiology conditions. Our faculty also participate as editors, reviewers, study section members, and representatives to academic subspecialty societies.

Basic Science

The study of pulmonary arteriovenous malformations represents an exciting new area of investigation. This line of research aims for personalized care to support patients impacted by these malformations and the development of tools to prevent their formation in others. Using various techniques, including advanced imaging or even preclinical mouse models, an investigation is underway to evaluate proteins potentially responsible for injury and overall gain better insight into this pathological condition.

For pulmonary hypertension, continued research into proteomic markers associated with poor outcomes is being actively pursued. The focus is on the development of techniques in pulmonary hypertension assessment and monitoring.

Another new area of investigation is the optimization of cardiovascular support therapy for pediatric patients with end-stage heart failure. Using multimodality data (imaging and cath lab), computational models are being developed to assist in the determination of optimal management to improve liver and kidney function. This can include mechanical support (ventricular assist device, or VAD), pharmacological intervention, or the decision on the listing for organ transplantation.

Thanks to secondary appointments of our imaging faculty with the Advanced Imaging Research Center at UT Southwestern (AIRC), they contribute to existing research, design their own research projects, and contribute to the teaching within the Biomedical Engineering Graduate Program.

A new surgical procedure called ventricular recruitment has been shown to promote the growth of small ventricles in children with single-ventricle heart disease. When it is successful, ventricular recruitment allows some children to obtain a normal biventricular circulation. This approach is actively advanced within the Children’s Health Heart Center.

We participate in developing methods of identifying whether the “borderline”-size ventricle of a given patient has the potential to grow/remodel. Biological approaches, such as multiomic profiling of cardiac tissue for responders versus nonresponders using single-cell RNA sequencing and proteomic analysis, are underway, as are biophysical approaches, such as estimating myocardial tissue properties including stiffness, contractility, or contractile reserve, using in vivo multimodality data and computational models.

The biomechanical approaches also contribute to the prediction of a potential acute patient’s course after establishing their biventricular circulation, namely the associated risks when the “borderline” ventricle (after the growth induced by the recruitment) is incorporated as a pump for a given circulation. The biventricular repair team is actively engaged in advancing techniques and preparing clinical studies.

Clinical Sciences

The Division participates in various multicenter trials. In interventional catheterization, some selected ongoing trials are assessing devices closing the defects in atrial septum or evaluating the outcomes of stenting the patent ductus arteriosus versus surgical management.

We are contributing to a quality initiative to assess the care of patients with hypoplastic left heart syndrome. A multicenter effort is also underway to evaluate the use of ventricular assist devices in the pediatric population. In the patients with end-stage heart failure, our center is actively involved in multi-institutional studies investigating newer therapies, such as SGLT2-inhibitors or ventricular assist device support.

Ongoing areas of research interest include:

  • Epidemiologic studies of congenital heart disease, both locally and utilizing international registries (Denmark)
  • Studies targeting pulmonary vein stenosis in neonates
  • Noninvasive pulmonary hypertension evaluation using MRI
  • Postoperative evaluation of patients with tetralogy of Fallot
  • Exercise cardiology
  • Markers for cardiac transplant rejection
  • Innovations in noninvasive cardiac monitoring

Our imaging team is also studying modifiable factors involved in the prenatal mental health of parents of children with concern for complex congenital heart disease.

Efforts are underway to expand our Cardiac Fitness Training Program for patients with complex congenital heart disease, including studies of body composition pre- and post-cardiac fitness training or exercise training in complex patients, including those with heart failure, pulmonary hypertension, transplant, or VAD.

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