Look into the Future
| Research Opportunity | Forecast | |
| Biology and pathophysiology | Delineation of new risk factors, most especially the genes and gene products that contribute to premature coronary artery disease and atherosclerosis generally
Identification of patients at increased risk of myocardial infarction (MI) and strokes before they occur and development of effective treatments to prevent their occurrence Elucidation of basic mechanisms of angiogenesis Understanding the molecular basis of myocardial dysfunction in congestive heart failure and cardiac hypertrophy, leading to novel pharmacological and gene therapy approaches Understanding the molecular basis for cardiac development, leading to new approaches to congenital heart disease Understanding the molecular basis for sudden death with improved ability to predict patients at high risk |
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| Diagnostic capabilities | Predisease diagnosis and prognosis based on susceptibility profiling using genome sequencing
Tailored therapies based on genomic information, which allows prediction of differential drug sensitivities and utility in individual patients Noninvasive diagnosis of coronary artery disease and the identification of patients at risk for future MI and strokes using magnetic resonance imaging and computed tomography methods |
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| Pharmacological, cellular, and gene therapy | Angiogenic therapies, including stem cell therapies
Better antiarrhythmics to prevent sudden death Gene therapy and other novel approaches for the treatment of heart failure and coronary heart disease and atherosclerosis New anticoagulants Individually tailored therapies based on genomics |
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| Treatment with surgery and devices | Bioengineered blood vessels to prevent atherosclerosis, hypertension, and aneurysm development
Treatment of restenosis with gene therapy, drug-eluting stents, and other approaches, leading to its elimination Totally implantable artificial heart Minimally invasive surgery Cardiac and vascular regeneration (e.g., stem cells, cell transplants) |
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Authors: James T. Willerson, MD, Department of Internal Medicine, University of Texas Medical School; Robert J. Lefkowitz, MD, Howard Hughes Medical Institute and Departments of Medicine and Biochemistry, Duke University