Every day, advances are being made in the field of cardiac care. From new medications to treat heart problems to less invasive ways of diagnosing the disease, patients are benefiting from the strides made by cardiovascular researchers.

“Within the field of cardiology, there have been advances made in many different areas,” explained Dr. Gervasio Lamas, director of Cardiovascular Research and Academic Affairs at Mount Sinai Medical Center in Miami, Florida. “There have been advances made in device therapy, like pacemakers and defibrillators; advances in catheter-based therapies; and advances in pharmacology, or the drugs used to treat heart disease.”

According to Dr. Lamas, one of the most exciting potential advances in the device therapy field is a new pacemaker-like device that is used to strengthen the heartbeat of patients with heart failure. “It’s a very novel therapy that has been used in pilot studies with a small number of patients,” he said. “This high-output pacemaker stimulates the heart as it is beating, which appears to make the heart beat more strongly.” Mount Sinai, which is the only south Florida hospital currently involved in this multi-center trial, is still looking for patients with heart failure to participate.

Continually evolving technology is making a difference in catheter-based treatment, including the use of different filtering devices to catch the debris that accumulates in the bloodstream as the result of having a stent implanted. “There have been seminal advancements made in terms of intercoronary stents and drug-eluting stents,” said Dr. Lamas. “Where before we were seeing revolutionary advances, now we are seeing evolutionary advances.”

“Within the next two to five years, I also see a real change in the way we diagnose coronary artery disease,” he added. “The computer technology of CAT scans has improved so much that the pictures we get from this non-invasive method are equal to the ones we get when we use a catheter and squirt dye directly into the coronary arteries. I think that in the future, catheters will only be used for therapeutic reasons, like closing a hole in the heart or opening an artery.”

On the pharmacological side of things, stem cells are being used to regenerate heart tissue lost after a heart attack or viral infection of the heart. “This is looming out there as a major advancement,” said Dr. Lamas, “though this technology is not yet ready for primetime.” In the next two months, Mount Sinai also plans to participate in a drug therapy trial in which an oral antithrombin agent will be substituted for Coumadin, a potent anticoagulant that can cause complications in some patients.

Dr. Lamas is also spearheading a clinical trial at Mount Sinai to test chelation therapy, an alternative medical treatment for coronary artery disease. “Though rejected by mainstream cardiologists, chelation therapy has been used since the 1970s by alternative medicine physicians,” explained Dr. Lamas. “More than 1 million chelation infusions are given in the U.S. yearly, without clear evidence of benefit or harm.” Chelation therapy uses a man-made amino acid, called EDTA, to grab heavy metal molecules in the blood and excrete them from the body.

At A Glance Dr. Gervasio A. Lamas Director of Cardiovascular Research and Academic Affairs Mount Sinai Medical Center Education: B.A. in biochemical sciences (cum laude), Harvard College M.D., New York University School of Medicine Internship, residency, and cardiology training: Brigham and Women’s Hospital of Harvard Medical School Honors: Served as president of the Miami Chapter of the American Heart Association Served as District Counselor for the American College of Cardiology Named Latino of the Year in 2005 by the Latin Business Club of America Proudest Career Accomplishment: “I’m proudest of the role I played in the development of ACE (angiotension-converting enzyme) inhibitors for high-risk heart attack patients in studies performed at Brigham and Women’s Hospital. This medication has resulted in a 20 to 30 percent reduction in the rate of death from a heart attack in the sickest patients.” Most Valuable Lessons Learned: “In medicine, so-called truths or classic teachings are not true unless they have been proven. Until you do your homework, experiment, and perform clinical trials, you really don’t know the answers. A healthy skepticism is the best scientific attitude.” “Most of the time, if you listen to a patient, they will tell you what’s wrong with them.”

Dr. Lamas designed a trial to test the therapy, and has currently given more than 30,000 infusions to the 850 patients enrolled. “Sometime in the next two to three years, we’ll know if this therapy works,” said Dr. Lamas. “If it does, it will benefit patients by causing a reduction in coronary and other vascular events, in turn reducing the rates of death, stroke and hospitalizations. It could also open up the door to a lot of other alternative therapies.”

Even with all of the advancements in the field, however, Dr. Lamas says he expects to see cardiologists continue to be in demand in the near future. “We are seeing the incidence of premature heart attacks in young people decreasing in proportion to having their cholesterol and hypertension treated, and because fewer people are smoking,” he said. “Yet Americans continue to be obese and sedentary, including children as they enter adulthood. Until people stop smoking, lose weight, exercise and take care of their cholesterol, we cardiologists will not enter that exalted state of unemployment.”

One benefit of these new technologies as they become available is that they will enable doctors to try to help patients take control of their futures, added Dr. Lamas. “We will be able to diagnose problems much earlier because of the technology, which means I will be able to tell a 35-year-old inert, overweight man that I see plaque and fatty deposits already forming on his arteries,” he explained. “I will be able to tell him that the process has started and that he’s on track for a heart attack in his 50s. Hopefully, with that ammunition in hand, he will change his behavior.”