South Florida Hospital News
Friday August 23, 2019
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June 2007 - Volume 3 - Issue 12

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The Florida Heart Research Institute and the "User-Friendly" Research Relationship

As this issue of the South Florida Hospital News focuses on technological and other support services for physician practices, it is similarly important for our community’s physicians to be aware of the resources available to them through the Florida Heart Research Institute. Although we do have an aggressive program of exploration into the leading edge issues in cardiology research – bone marrow stem cells, genetics, cellular signaling mechanisms, etc. – the Research Institute has always maintained an active interest in clinical research. As such, we have provided the infrastructure and follow-up to develop research knowledge from clinical experience.

Cardiac surgery is really the first area of medicine to introduce the use of large clinical databases into clinical practice. As a high profile common activity with both life-saving and financial implications as well as relatively definable endpoints, cardiac surgery and its outcomes can and should be studied. Since its inception over a decade ago, the majority of sites performing heart surgery now participate, at their own expense, in the Society of Thoracic Surgeons database. Many years ago, the Florida Heart Research Institute had the vision to develop collaborative relationships with two local centers of cardiac surgery. Through the cooperative exploration of the information in their databases, the Research Institute has been able to explore many issues that would have otherwise remained dormant between the lines of the database: the impact of the use of arterial grafting on the higher mortality generally observed for coronary surgery in women; the quality of life following heart surgery in octogenarians; the impact of coronary artery disease on quality of life following valve replacement; the impact of choice of valve—tissue vs. mechanical—on mortality and quality of life following valvular heart surgery. At present, we are still concluding valuable projects regarding coronary surgery in octogenarians, as well as on the long-term impact of single vs. bilateral internal mammary artery grafting.

Even as these studies are coming to fruition, we are exploring research partnerships with select clinical practices to investigate the role of CT imaging in the identification and prevention of heart disease in high risk and in young populations. The correlation of known imaging strategies with less invasive markers is also being explored.

The most important aspect of these collaborative efforts is not merely the research findings, but rather, the fact that none of this valuable clinical information would have been available to the medical community without the unique ability of the FHRI to partner with clinicians to explore areas of direct clinical relevance and importance. With the advance of the electronic medical record, there will be increasing opportunity to convert clinical care into research knowledge. The simple fact is that, outside of a University practice (and even there sometimes), the clinician of today is simply too busy or distracted to devote much effort to scientific research. There is no mystery as to why 80-90% of the clinical research performed in this country is product based, be it drug or device manufacturer-sponsored. Although this sort of research has permitted the introduction of valuable therapies into the clinical arena, and has even generated interesting scientific hypotheses (such as the unexpected role of statins in reducing inflammation and improving survival after heart attack), the necessary "bottom line" focus deprives the medical community of maximal scientific benefit. It is for this very reason that the Research Institute devotes the effort necessary to help clinicians bring their clinical experience into the realm of scientifically meaningful research. For the medical profession, these sorts of relationships may ultimately prove to be just as important, if not more so, than the many enabling technologies that are increasingly becoming available.

Dr. Paul Kurlansky, board certified cardiothoracic surgeon, Director of Research at the Florida Heart Research Institute, can be reached at (305) 674-3154 or pak@floridaheart.org.
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