TMC PULSE

t m c » p u l s e | m a r c h 2 0 1 5 15 who works on Kar's research team, said the disease is more prevalent in women who are African American, mid- dle-aged, diabetic, and those with high blood pressure. Depending on the severity of the case, treatment varies from the use of a balloon heart pump, intravenous medi- cation, or simply changing the diet and adding medication such as diuretics, vasodilators which dilate the blood vessels, or beta blockers, which work as blood thinners. Rajapreyar spoke with excitement when she mentioned a breakthrough medicine called bromocriptine in South Africa. The drug works as an antagonist to prolactin, the hormone responsible for secreting breast milk. Nathan said that a stumbling block they face is trying to keep the baby safe while treating the mother. Sometimes if the mother is far enough along in her pregnancy, they can talk about perform- ing a C-section. Before they could do any research on PPCM and attain any funding, Nathan said their team of medi- cal researchers had to go before UTHealth's Institutional Review Board, to have the legality and value of the research approved. Once they over- came that hurdle, the next one was to attain funding. Last February, through the Memorial Hermann Foundation, Memorial Hermann Heart & Vascular Institute-TMC received a grant from the Alpha Phi Foundation called Heart to Heart. In the past six months due to more funding, their research has taken off as they added a registry. The registry works by screening obstetric patients with heart problems, such as PPCM to study biomarkers in blood samples and echocardiograms, which are then stored in a bioreposi- tory. Five years from now, researchers can then check the blood samples to help identify others with the same bio- markers. Through the registry, Nathan said doctors can determine if PPCM is exaggerated more than heart failure in the average person. Through this process, researchers are hopeful that they will have the ability to find symptoms earlier in the pregnancy and attain a better under- standing of this disease to determine who needs to be screened. Besides helping identify the triggers of the disease along with its signs and symptoms, the registry also has the capacity to help other doctors around the world, especially in Africa, where the disease is prevalent. "We want to ensure that this infor- mation is something other hospitals can use in the Northeast, Southwest, etc.," said Nathan. "I generally believe this is something we should have done a long time ago." As to why this disease happens, Nathan has a few theories. One is a speculative connection with prolactin, the hormone responsible for secreting breast milk. Sometimes its breakdown affects the heart. Another theory is that PPCM is caused from antibodies from baby to mother whose body cannot handle them. "We try to save the mother and the baby, but sometimes we have to tell mothers that they can't have any more children," said Nathan. Russo, now a 54-year-old mother of three, takes the work Kar, Nathan, and Rajapreyar very personally. She made friends with the doctors and nurses who treated her. They and her family gave her "something to hang on to." They also gave her the gift of time. She will be forever grateful for the heart transplant that prolonged her life. Although she still sees a cardiologist every three months, she is happy to be able to help others, and enjoys her family and her career. Tearing up, Russo spoke from the heart. "I am very thankful. I'll feel indebted to these people for the rest of my life." TOP: Indaranee Rajapreyar, M.D., cardiovascular disease specialist with the Center for Advanced Heart Failure at the Memorial Hermann Heart & Vascular Institute-Texas Medical Center (TMC)/UTHealth

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