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Whiting’s Natalia Trayanova gets to the heart of treating cardiac disease

As the Murray B. Sachs Professor, Trayanova has the freedom to explore new ideas
Posted February 10, 2015

Natalia Trayanova - Computational Simulations of the Heart

Heart disease is the number one killer in the industrialized world, due in large part to heart rhythm dysfunction and the development of arrhythmias. Yet, the treatment for a common arrhythmia – the fast rhythm which accompanies a myocardial infarction or heart attack – currently has a success rate of 50-70%.
Natalia Trayanova, PhD, the inaugural Murray B. Sachs Professor of Biomedical Engineering, and her team within the Institute for Computational Medicine are getting to the heart of this matter, building very complex, multi‑scaled computational models that simulate electrophysiological and electromechanical heart function and test possible treatment scenarios.

“The current therapy for infarct-related fast heart rhythms is ventricular ablation in which a physician will insert a catheter in the patient’s heart to burn a piece of tissue that is believed to sustain the arrhythmia,” says Trayanova, adding that it is crucial to locate the optimal site for ablation delivery and that patients who are hemodynamically unstable have particular difficulty in tolerating this procedure which can take four to 12 hours to complete.

“In my lab, using cardiac MRIs, we create patient‑specific models of the heart that are able to recreate the dysfunction in each patient. Then we use these models to predict what is the best therapy for each patient,” says Trayanova, who also received the 2013 NIH Director’s Pioneer Award.
“And you’re saving human life, if you come up with a better therapy. You truly are,” she says of the potential for this modeling that simulates cardiac functions from the molecular level to that of the entire organ.

Thus far, the work has been retrospective analysis, but the plan is to start enrolling patients in a prospective clinical trial this year through which physicians can use the individualized heart models to develop a treatment plan, according to Trayanova. She adds that in the future it will be possible to couple genomic information with the structural information obtained from the MRI, thereby adding another level of personalization, and that her team will also be studying other kinds of heart dysfunction.
“There have been many advances in individualized health in many disciplines, but there has never been a translation of computational modeling of the heart from basic science into the clinic. It is our hope that we will be the first to do that,” she says.

“Receiving the Murray B. Sachs Professorship has been very important to me because it has enabled me and my team the freedom to embark on a high-risk, but possible high-reward project,” says Trayanova, who adds that the professorship also has personal meaning for her as Sachs hired her at the Johns Hopkins University Whiting School of Engineering in 2006.

Sachs served as the Massey Professor and director of the Department of Biomedical Engineering at Hopkins from 1991-2007.

“Murray is somebody that we all look up to. I have rarely seen a leader of this caliber. So, I'm really proud of being the recipient,” Trayanova says of this professorship that was established in 2012.