Why should those who care for patients with congenital heart disease understand developmental biology? How will this help patients? See and find out.

1. Why teach
heart development
to cardiologists?
Fraz Ahmed Ismat, MD
Clinical Associate in Pediatrics
The Children's Hospital of Philadelphia

2. Congenital heart disease deaths
doubled
childhood cancer
deaths in 2005…
Congenital heart disease Childhood cancer
AHA website; Cancer Facts & Figures 2005

3. … but our improvements have
stagnated
Welke, et al., 2009

4. Why are we failing
our patients?

5. Is our technology
not cool enough?
flickr.com/people/thedayhascome

6. Do we
not care
enough?
flickr.com/people/30367663@N02

7. What are we missing?
flickr.com/people/30367663@N02

8. It’s how we
think about
heart disease.
flickr.com/people/rainerebert

9. How we think now…

10. How we think now…
“obstruction”
“hole”

11. www.oatey.com

12. Congenital heart disease
is not just a plumbing problem…
www.oatey.com

13. It’s a complex genetic problem…

14. …that we know
a lot more
about it than we
used to,
and…

15. ‘‘
When asked: Would you like to learn more about
’’
cardiac developmental biology and genetics?

16. When asked:
‘‘
Would you like to learn more about
’’
cardiac developmental biology and genetics?
Yes!
…clinicians
No
Not
sure…
want to
bit.ly/DevCardio_Survey_1
learn it!

17. How we need to think…

18. How we need to think…
Tbx1 Zic3
Tbx1 Jag1

19. But how does this
help our patients?

20. Genetic changes don’t just
affect the heart cells…
flickr.com/people/arboreus

21. Genetic changes affect the entire
developing
body
Ed Uthman, MD

22. How I study
heart development…
flickr.com/people/casperonline

23. Nf1 mutations lead to
congenital heart disease…
e normal f g
Nf1 mutants
i j k
Gitler et al., 2003

24. Fatal blood vessel obstruction
with Nf1 mutation
Kanter et al., 2006

25. The right treatment can
prevent these problems.
flickr.com/people/jdvolcan

26. Blood vessel blockage in
Nf1 mice can be prevented.
Nf1 mutant
normal Nf1 mutant + treatment
Xu, Ismat, et al., 2008

28. He’ll thank
you for it.
flickr.com/people/partsnpieces

29. References
Congenital Cardiovascular Defects: Statistics.
http://www.americanheart.org/presenter.jhtml?identifier=4576.
Cancer Facts and Figures 2005. American Cancer Society.
Welke KF, Diggs BS, Karamlou T, Ungerleider RM.
Ann Thorac Surg. 2009;87(1): 216-222.
Kanter RJ, Graham M, Fairbrother D, Smith SV.
J Pediatr. 2006;149(5):718-20.
Gitler AD*, Zhu Y*, Ismat FA, Lu MM,Yamauchi Y,
Parada LF, Epstein JA. Nat Genet. 2003;33(1):75-9.
Xu J*, Ismat FA*, Wang T,Yang J, Epstein JA.
Circulation. 2007 Nov 6;116(19):2148-56.
Cardiac Developmental Biology & Genetics - Initial Survey
http://bit.ly/DevCardio_Survey_1
flickr.com/people/partsnpieces