With groundbreaking technology and a focus on timely projects, CONHI researchers are doing important work to improve health outcomes. According to Dr. Michael Nelson, Associate Professor and Director of the Applied Physiology and Advanced Imaging Laboratory at CONHI, the key to treatment starts with prevention.

“Ultimately, what we’d love to be able to do is prevent somebody from progressing to heart failure,” Dr. Nelson said. “And so a lot of our studies focus on understanding the pathophysiologic mechanisms of disease, because if we understand what is causing it, we can develop ways to prevent it.”

A team of graduate students, postdoctoral fellows, and faculty at the college dedicate their research to achieving this goal. “There’s so much great research going on in our college—we could be talking for 10 hours straight and not even scratch the surface,” Dr. Nelson said.

One such research area is that of Dr. Yaewon Seo, Assistant Professor in Graduate Nursing. Dr. Seo studies ways to improve quality of life for heart failure patients by investigating how deep and slow breathing training may improve the shortness of breath these patients develop even during mild activities of daily living.

Dr. Paul Fadel, Associate Dean for Research and Professor in Kinesiology, also emphasized the breadth of CONHI’s cardiovascular research. 

Recently, Dr. Fadel’s lab has been working on a project related to COVID-19. Researchers recruit subjects in the 18-29 age range through flyers, classes at the college, and hospitals or clinics to study COVID-19’s lingering effects, such as “COVID brain,” which is characterized by mental fogginess and difficulty thinking. Due to his studies, Dr. Fadel believes there is a cardiovascular element to these lingering symptoms.

Other cardiovascular research at the college includes an ongoing series of studies, conducted by Associate Professor in the Department of Kinesiology Dr. R. Matthew Brothers, comparing the health of Black and white college students. He has recently begun to investigate mechanisms of elevated cardiovascular disease risk in Black men and women. From a public health perspective, studying disease risk in Black women is particularly important, as they represent a historically understudied population despite having amongst the highest prevalence of cardiovascular disease.

Yet another researcher and public health faculty member, Assistant Professor Dr. Ziyad Ben Taleb, is collaborating with Drs. Fadel, Brothers, and Nelson on a series of studies evaluating the impact of vaping or e-cigarettes on cardiovascular health and the sympathetic nervous system. His work is expected to deliver guidance for public health policy pertaining to e-cigarettes.

The pandemic has impacted people’s cardiovascular health in more outwardly apparent ways, too. Daily habits, like commuting to school, sporting events or work, have shifted to be more sedentary, and this has adverse effects on heart health. Research by Assistant Professor Dr. Jody Greaney also points to increased reports of depression and stress caused by COVID-19, conditions which have cardiovascular health implications.

Dr. Fadel’s own research focuses on mechanisms that control the autonomic nervous system. The college’s labs have the ability to perform microneurography, or recordings of sympathetic nerve activity—something only about 30 labs in the world can do, he said.

This allows researchers to compare individuals with high and low sympathetic nerve activity, which has revealed that those with higher activity have worse cardiovascular health and higher morbidity and mortality. Figuring out why this is the case would allow doctors to help individuals suffering from heart failure, chronic kidney disease, type 2 diabetes, and obesity, all conditions associated with sympathetic overactivity.

“Our research is focused on trying to understand those disease states where there is sympathetic overactivity—where it’s coming from, why it’s overactive, and [if we can] figure it out. This would help design a treatment or a therapy that would allow us to lower sympathetic nerve activity in those people,” Dr. Fadel said. 

Dr. Nelson also uses state-of-the-art technology in his work. The Applied Physiology and Advanced Imaging Lab focuses about 60 percent of its resources on cardiac function, mechanics, and metabolism and about 40 percent of its resources on peripheral blood flow regulation, but imaging is at the center of almost every project. In particular, they often use MRI for the high resolution images it provides, as well as important information about tissue composition. 

“The heart is actually more complex than it’s often given credit for,” Dr. Nelson said. “For example, the left ventricle has a unique fiber orientation that actually causes it to twist and behave very differently than the right ventricle, or other muscles in the body. And so we’re interested in what changes are modulating those functional and mechanical outcomes.”

One study Dr. Nelson’s laboratory is leading now uses MRI technology to quantify fat deposits inside cardiac cells of human volunteers. (He deems this research “pretty cool.”) Their goal is to understand if too much fat in the heart causes cardiac dysfunction.

Understanding heart failure remains an important area of study at CONHI. Indeed, Dr. Nelson and Dr. Fadel are part of a large Program Project Grant sponsored by the National Institute for Health, with colleagues in the Dallas-Fort Worth area, to study patients that have a specific for of heart failure known as heart failure with preserved ejection fraction (HFpEF). 

“The theme of the whole grant is that these patients are a growing population,” Dr. Fadel said. “They’re typically older, with women more affected than men. The treatments that we have for other forms of heart failure don’t work in this group, so there’s a need to better understand the underlying pathology. And so my lab is characterizing the sympathetic nervous system and its control. We are also studying oxygen delivery to the skeletal muscle, an often forgotten but equally important target organ in heart failure.” 

Dr. Nelson’s group is performing MRI in the same patients with heart failure to better understand changes in their hearts, lungs, and skeletal muscles. Unique to this group, much of the imagery is captured while the patient is exercising. This allows the researchers to better understand how the heart, lungs, and skeletal muscles are functioning during activities of daily living.

“It has always bothered me to study the body in a rested state,” Dr. Nelson said. “Patient symptoms are often experienced when the individual is actually moving about their environment. That’s what we try to do in the magnet, to simulate that experience and evaluate organ-specific outcomes under real-life conditions.”

It is one of the only testing environments in the world like it, which makes it possible for the research lab to gain a new understanding of cardiovascular disease.

Learning about the diseases that affect cardiovascular health is what motivates researchers at CONHI. Their studies ultimately help find ways for patients to improve, and Dr. Fadel reflects on his own research to emphasize that.

“I think the more we can learn in terms of the regulation of the sympathetic nervous system in these different disease states, the better we’re going to be equipped to treat,” he said. “And I think that’s important, because if you take any disease—although we do a much better job these days than maybe 20 years ago in having effective treatments—it can still be better.”