'Behind the Blue': Cardiovascular Health and Research With Alan Daugherty

2021-09-23 BTB - Dr. Alan Daugherty (Cardiovascular Research Day)

[00:00:14.88] KODY KISER: Welcome to Behind the Blue. I'm Kody Kiser with UK Strategic Communications. Recently, UK's Saha Cardiovascular Research Center held its annual Cardiovascular Research Day. An event that showcases innovative research in cardiovascular health. The event features prominent speakers in the field of cardiovascular health. And was the first in-person scientific conference in the field of lipid and lipoprotein metabolism and cardiovascular disease, in nearly two years. With 250 attendees from UK and nearly 40 other universities, the event featured a wide variety of research activity from scientists and researchers, from trainees to prominent senior scientists. Our guest today on Behind the Blue is the director of the Saha Cardiovascular Research Center and chair of the UK Department of Physiology, Doctor Alan Daugherty. Doctor Daugherty is also the Gill Heart Foundation Chair of Preventive Cardiology. He serves as editor in Chief of the American Heart Association's arteriosclerosis, thrombosis, and vascular biology, or ATVB Journal. And his research focuses on molecular mechanisms of vascular diseases, including atherosclerosis and aortic aneurysms.

[00:01:32.93] Thank you so much for joining us on Behind the Blue and you came to us I believe from a different UK? Tell us a little bit about your background and how you ended up here in Lexington.

[00:01:43.54] ALAN DAUGHERTY: Yeah correct, I grew up in the Northwest of England in a town called Liverpool, which is known for people who follow the English Premier League as well as for music. I had an interest in cardiovascular diseases and I did my PhD in a town in the southwest. And then I really was enamored by a publication that came out of a group from Washington University in St. Louis. And I applied to see whether I could continue my training in St. Louis and that's nearly 40 years ago. Now what happened, in terms of I arrived in st. Louis in October of '82 to start a time when I thought was going to be two years in the States before I went back to the UK. And 40 years later I still haven't quite got back.

[00:02:31.56] KODY KISER: You mentioned something that piqued your interest. What was the appeal of going into this particular area of medicine and research?

[00:02:40.66] ALAN DAUGHERTY: So I somehow got embedded in a group of people that really had the fascination about the design of drugs and the development of drugs to treat different diseases. We just had a group when it was a college that was one group really got into the neuro side of it and one group kind of got into the cardiovascular side of it. I'm not quite sure how we came to those two groups, but it was just a really fun environment and I was very fortunate that I was able to progress into graduate school in a specialty of the supervisor was very motivational to me to really keep my interest focused on that. And as I say, coming over to Washington University in the 80s it was just a very exciting time for cardiovascular research. In part because that was the times when people had a heart attack, we really couldn't do much for them-- pray that phase. And that is just in the interval where we were able to come up with ways of very actively treating someone who had a heart attack. So we could actually beat the blood clot that forms that causes the heart attack we actually devised approaches during that era to start changing that. And it was during the era that we actually define that having high cholesterol was bad and that there was as a preventive way to go about it. So it's kind of a real exciting era to show how both preventive means were beneficial and acute therapies were beneficial. It was really kind of a fun time, frankly, it's been kind of a fun road ever since then.

[00:04:14.92] KODY KISER: It does seem like to me in the past-- oh I don't know 40 years maybe-- when I was younger, you would hear of someone having a heart attack and if it was particularly bad there wasn't a lot that could be done. And now, I hear of people who have really serious heart attacks who are able to get treatment in time who make a pretty good recovery compared to where they would have been if it was 10, 20, 30 years ago. Has the field really advanced that much in terms of catching this in time and treating it?

[00:04:54.06] ALAN DAUGHERTY: Yeah, I mean, it has had some huge advances it's caused some downstream problems with that, but acutely now-- I mean, again, when I first came here I was at Barnes Hospital in St. Louis and the patients at that point, were brought in to CCUs, but really were not really actively managed. There was nothing much you could do. You almost actively have them lying in non-active mode as well. So between the way that we manage patients now, both acutely plus as I mentioned it was '85 was when the first evidence that lowering cholesterol could have some beneficial output in terms of cardiovascular disease was realized.

[00:05:35.52] And new drugs came out at that time the statin class so suddenly we're into a different environment where people both have a greater awareness and also have an ability to do something about that awareness. There is a bit of a consequence, unfortunately, but people who do get heart attacks unfortunately treat that area of the heart that gets affected by that-- it's a very active field of research, but does not regenerate and unfortunately does not usually regain full function. So that is one of the downstream effects is we do have a lot of people now that have pump function of the heart that's kind of compromised. And that's probably going to be it's a complex thing to do anything about, but it's probably going to need to be the focus of future efforts.

[00:06:23.05] KODY KISER: So let's talk a little bit about your research here at the university and specifically the Saha Center. Tell me a little bit about the team or the staff there and what makes that staff up, as far as personnel, and the types of things that are studied.

[00:06:40.68] ALAN DAUGHERTY: Well, so the Saha Cardiovascular Research Center has sort of grown up quite a lot in the last less than two decades to a group that I think is very well acknowledged-- nationally and internationally-- as being quite a group of experts. And I think what we're recognized as well as a group of experts that really gets on with each other, collaborates a lot with each other and really pushes for rigor in science as well, which is something that's a big focus these days. You know that there is in general probably the biggest expertise is in vascular disease and sort of two areas that they generally have expertise. One is what we just talked about, the disease that causes heart attacks. So that is the process of atherosclerosis, which in general causes a constricted process to the arteries and that's why, especially in the carotid and coronary artery areas the restriction is what causes stroke and heart attacks.

[00:07:42.49] The other area that we're very strong on and very well acknowledged is diseases of the aorta. Which is your main vessel taking blood from your heart to everywhere else, so it's the main conduit you've got. And there is an increasing recognition that conduit is actually kind of complex. And we get some really distinctive regional specific diseases in that aorta, that at the moment, we have no way of giving anyone a pill to overcome it. Our only ability is if we recognize those diseases in those individuals, we only have surgical options. And so we have a very concerted group with a very well-funded group in both individual labs programmatic processes that are really looking for ways that we can look at-- what is the mechanism of why one particular area of the aorta kind of expands. To see whether we can give people at least some thoughts about new therapies that could hopefully target that this particular disease.

[00:08:49.45] KODY KISER: It does seem like that's a difficult kind of area of study just because of not just the generalized ideas behind it, but also everyone's specific genetic makeup and some people are more susceptible to these things than others and finding a medicine that's targeted for that seems like daunting work.

[00:09:11.48] ALAN DAUGHERTY: Yeah I think that the genetics can actually be helpful though because especially diseases that occur up in the thorax so close to the heart. There are a significant number of genetic changes that have been associated with that disease. And as I say that kind of can be helpful because it means that it targets it down to specific molecules that can then give you some insights into the mechanism, especially if we have multiple genetic changes that have very similar manifestation in the disease. It does give us a little bit of help so actually some of our work is-- at least one of our early career faculty Mary Shepherd-- is very focused on a lot of her patients have different genetic variants. And she would really like to sort of pull that together a lot more to maybe give some insight. So the genetics can attribute big insight into sort of giving some leads as to what processes you should think about.

[00:10:19.53] KODY KISER: The Center recently held its annual Cardiovascular Research Day. For those who don't know much about it, what is a Cardiovascular Research Day?

[00:10:30.68] ALAN DAUGHERTY: So we started this 24 years ago and-- this actually is the 23rd event, we missed one last year because of obvious reasons. So the whole philosophy of the research day is to try and have one day where everyone on the campus with any interest whatsoever in cardiovascular, has the opportunity to come and in a very open way display what they're doing in a mode that we try and promote interactions between people. So we're really trying to make sure everyone that has any interest in cardiovascular is brought together and we try and think of any mode we can to make sure that everyone knows each other, everyone knows what work they're doing. And it's meant to be promoting the campus interactions and hopefully the campus good. So that's been one very big feature of the whole day on one big philosophical concept.

[00:11:20.56] The other is that we bring very high profile people to campus. And so these are speakers that to this year and previous years we've given the award that Linda and Jack Gill have generously provided for a very senior level investigator and for a more early career investigator. We also bring in other speakers with the concept that-- first off, our faculty to get to know these very senior people is helpful. And the other is frankly, to do a bit of PR for the UK itself. Because when people come to our campus-- I mean, frankly we have got a great campus, it's a beautiful campus in general and in terms of the research domain we've got great facilities with some very impressive people. So we're trying to do a bit of PR in this as well to bring a sort of almost targeted people that we think should make sure they know UK better. To make sure they come here, we go out of our way to make sure that they're educated about what we get here. So it's kind of a twofold it's a very open event that we have both social and scientific interactions to make sure that we promote the research and in every way possible.

[00:12:37.36] KODY KISER: How important is it to have an event like this that showcases not only senior scientists, but also researchers who are basically trainees? They're just getting started with their careers and works but yet they're presenting things that they've been working on.

[00:12:54.46] ALAN DAUGHERTY: I think it's critically important for early career. I mean, early career people they-- part of the whole process is recognizing that networking on all levels is going to be incredibly important to your career. So networking with senior people, making sure that the early career people feel comfortable going off and talking to these senior people and asking them questions that can help them and making sure these senior people recognize the talent is important. But also on a parallel sort of among your peers, making sure that you build up your network among there is something we try and emphasize as well. I mean, obviously I've been around for quite a long time now and I've had connections that have been with me for 40 years. Just having someone who knows is in a similar career stage, to be able to be so friendly with you can chit chat to them about, maybe have a more detailed conversation about a technique that you're doing because they're more likely to be actually in the trenches doing it than a senior level person. So we've had this as a very heavy focus on early career where we're really trying to emphasize that for you to go out network at all levels is going to make a huge difference to your future development.

[00:14:12.28] KODY KISER: This year's event was also held in conjunction with the Don Frederickson and Lipid Research Conference, which is another exciting addition to the event I would assume. That also gives great national exposure to the work or research being done at UK. Tell us a little bit about that.

[00:14:28.72] ALAN DAUGHERTY: Yeah so this is an event that's actually been going on for 27 years, but it was renamed for this year's event. So Don Fredrickson was a very high profile research and cardiovascular research he actually was director of the NHLBI, which is where most of our funding comes from, it's a subsection of NIH. He was director of NIH, National Institutes of Health, and he was also director of the Howard Hughes Institute which is also another major biomedical area. He was a mentor to several of the people who started this meeting and so it was renamed in his honor. It is actually now-- it's very changed in its structure. So again, it's always been a very early career orientated with a few senior people that come in. This year, we put it either side of our Cardiovascular Research Today. So it was on Thursday and Saturday with the participants being invited to join us on the Friday. And we had 35 different institutes represented, which for a early sort of regional meeting that's fairly phenomenal participation. And some of them came from-- we had one speaker from UCLA, we had a couple of Canadian, we actually one from the Karolinska Institute in Sweden come.

[00:15:43.16] So this was a meeting that's now going to rotate among about four institutes, so it's going to be a Duke next year. And UK is actually the administrative home of this so the University of Kentucky has now got a long term commitment to making sure that this national meeting is administered in a helpful way. And it's basically going to rotate it'll probably come to the UK about every maybe four to five years, but we're really I mean we're getting huge recognition for being sort of the lightest that's already kept this smallish conference explode into something quite big.

[00:16:23.48] KODY KISER: That's excellent. I want to be mindful of your time for people who look at this who aren't in the know on a lot of these things, but are curious about it, is there a way that people can kind of look at this to see how does this research affect Kentuckians directly? Where should we look to see this type of work impacting our lives?

[00:16:48.57] ALAN DAUGHERTY: Well unfortunately, Kentucky does have a very high incidence of cardiovascular disease, despite the fact that, in general has been large gains made on this. And some of the benefits we can have are based on very routine very well-known evidence. So certainly, that the Saha Cardiovascular website could be a point of reference. Both for getting some information on the work that's going on at UK, plus individuals that I'm sure if people would like to contact them all the contact information is on the website. So that they could feel comfortable contacting these individuals to see if they'd want to get a little more tailored information towards what would be helpful to them. But I would say to both in the cardiovascular world, cardiac disease on foot is still a major problem in the state of Kentucky and so it is definitely relevant. And aorta diseases that I've just mentioned, for good or bad actually the manifestations of this were actually defined in Kentucky. Because we have unfortunately, a very large population of patients in which the aorta disease is sort of one of their unfortunate major consequences of the disease-- that is actually the fatal consequence of the disease. So again these diseases are very common in this area. And so, we think that we've tailored a program that's very relevant to the citizens of the locality.

[00:18:27.14] KODY KISER: And I do want to mention-- you brought it up-- for people looking for more information, you can visit the website for the Saha Cardiovascular Research Center at cvrc.me.uky.edu.

[00:18:40.40] ALAN DAUGHERTY: Correct. And hopefully, Saha CVRC just going Google will easily pull it up as well. So it's hopefully a good resource to at least start, but we would always invite people to contact us directly.

[00:18:58.25] KODY KISER: What does the next six months to a year of your life and your work look like?

[00:19:05.54] ALAN DAUGHERTY: So we're still actively planning stuff for next year, this is a long process that begins for these research days. In a broader scope as well know, the cardiovascular research is one of the research priority areas that the university has designated. So some of the listeners might know that University of Kentucky is defined seven areas now of inordinate strength at the Institute that they'd really like to nurture and grow. And fortunately cardiovascular research is one of the ones that was recognized by that. So we do have now a process where we're really going to have to think about the resources that the Institute is providing us. How can we turn that into a much more encompassing? So we have great areas of strength, but can we make sure that we nurture those areas of strength? While also reaching out to other areas we could involve in. So one just recent example-- and I've known about-- for example, is that our vascular surgeons and radiologists and our mechanical engineers have just got together in a very unusual interaction. Which is just mind blowing in terms of the way to really be able to diagnose patients with certain diseases and also help their treatment.

[00:20:26.20] So it's always an ongoing process to try and think about which areas can we stimulate. How can we do that? How can we get the people together? How can we help those people really want to work together? How can we get equipment that is needed to facilitate it? Because a lot of the equipment we use is very expensive, bluntly, and it's usually specialty equipment that you can't just go and push a button. We also need highly trained people that will be able to get the best out of this equipment. So it's an ongoing process to make sure that we think about all facets in the environment to really try and provoke work that will hopefully give meaningful insight to disease processes.

[00:21:13.00] KODY KISER: Anything I haven't asked you you'd like to mention or talk about?

[00:21:18.47] ALAN DAUGHERTY: I think other than just we are very fortunate that the University of Kentucky to have donors that have been very involved and not just donors Linda and Jack Gill first gave their award 24 years ago to create the Linda and Jack Gill-- well what's now name the Heart and Vascular Institute. And it's not just been their fiscal health, it's been their enthusiasm help. I mean they-- unfortunately because of conditions of the world at the moment-- they didn't participate in this Research Day, but they've always been very actively contributing being at the day, being very active about talking to individuals, and really speaking up the university. And then the Saha Foundation as well, we've been fortunate that there's been a very long term support from them since they created the Cardiovascular Research Center 11 years ago. And have recently created an Aortic Center as well, which they've endowed. So we have some tremendous benefits the University of Kentucky through the generosity of our donors.

[00:22:24.48] KODY KISER: This is all excellent to hear a lot of really great research work going on, very exciting to see this. Dr. Alan Daugherty thank you so much for joining us on Behind the Blue and good luck with your future research projects and your work with the Saha Cardiovascular Research Center.

[00:22:41.19] ALAN DAUGHERTY: Thank you.