Most patients with advanced heart valve disease have two options – medical therapy to improve heart failure symptoms and surgical or transcatheter valve repair or replacement. Robert Levine, MD and Jacob Dal-Bianco, MD, of the Corrigan Minehan Heart Center at Massachusetts General Hospital (MGH) aim to shift this late rescue therapy approach towards keeping heart valves healthy and functioning normally by developing preventative therapies.
Healthy heart valves allow the heart to pump blood efficiently to all organs during rest and activity.
Healthy heart valves allow the heart to pump blood efficiently to all organs during rest and activity. When heart valves become leaky (regurgitation, insufficiency) or blocked (stenosis), the heart has to work harder and has to adapt its shape and muscle structure to meet the needs of the body. If heart valve disease progresses, the heart will ultimately fail. Patients then develop congestive heart failure (CHF) symptoms, such as fatigue and weakness, shortness of breath, swollen feet or ankles, abdominal fullness or abnormal heart rhythms.
Heart valve disease comes in several forms: Mitral valve disease is usually due to valve leakage, which is called mitral regurgitation, mitral insufficiency or mitral incompetence. A frequent cause of mitral regurgitation is mitral valve prolapse (MVP), an often inherited disease of abnormally flexible valves, which is the most common reason for mitral valve surgery. Aortic valve disease is mostly due to calcific valve hardening and thickening, which limits valve opening and blocks blood flow. This is called aortic stenosis. Infrequent in developed countries and therefore neglected, rheumatic heart valve disease remains the main and most devastating cause of valve disease in the developing world. Heart valves become leaky and later stenotic, due to rheumatic fever after a strep throat infection, which triggers valve damage and scarring. Progressive valve dysfunction leads to heart failure, stroke and increased maternal and premature death.
Preventing Heart Valve Disease
Led by Drs. Levine and Dal-Bianco, the MGH research team wants to explore the biological mechanisms of why mitral valves become leaky, why aortic valves get calcified and how a simple throat infection can cause so much damage to heart valves. Valve biology is a field that is not well understood, and research is not adequately funded, but having such knowledge is critical for developing therapies that prevent valve disease and its harmful effects on patients.
These discoveries are only the beginning of this MGH team’s exploration into heart valve diseases and have already led to ideas for novel therapeutic approaches that now need to be explored.
With initial support from the Leducq Foundation and National Institutes of Health, this MGH team has already made several exciting breakthroughs including discovering the first genes involved in mitral valve disease and how early treatment of valve disease can preserve healthy heart muscle. The MGH team also identified why the mitral valve becomes stiff and leaks after a heart attack and how this can be prevented. These discoveries are only the beginning of this MGH team’s exploration into heart valve diseases and have already led to ideas for novel therapeutic approaches that now need to be explored.
Dr. Levine and Dr. Dal-Bianco’s vision needs equally visionary supporters. Currently heart valve disease is not well understood, studied or funded. Your contribution will help this expert valve disease MGH team to advance heart valve research beyond conventional thinking and to improve the understanding of heart valve disease.
Thank you for your partnership in turning this vision into a program that will reduce the growing health burden of heart valve disease to the benefit patients and families worldwide. For more information about how you can support this research, please contact us.
To learn more about Mass General’s research into the genes that cause mitral valve prolapse, watch this video.