Montefiore Einstein Receives $5.2 Million from NIH to Study Heart Failure in Hispanic Populations

Cardiology researchers at Montefiore Einstein have received a five-year, $5.2 million grant from the National Institutes of Health (NIH) to explore the underlying causes of heart failure among Hispanics/Latinos who are at heightened risk for heart disease. Investigators will take a novel approach to assess risk by simultaneously evaluating heart function and the relationship between the heart and the aorta, the large artery that conveys oxygen-rich blood from the heart’s left ventricle to the rest of the body.

The Importance of Diversity in Clinical Research

“Hispanics make up 20% of the U.S. population and, as we found in our earlier research, they have a higher risk of heart failure compared to whites and are underrepresented in cardiac clinical trials,” said Carlos J. Rodriguez, MD, MPH, Attending Physician, Echocardiology and Cardiology, Director, Clinical Cardiology Research and Cardiovascular Epidemiology, Montefiore Einstein, and Professor, Medicine and Cardiovascular Disease, Epidemiology & Population Health, Albert Einstein College of Medicine, who is also principal investigator on the grant.

According to the U.S. Centers for Disease Control and Prevention, heart disease was the leading cause of death in Hispanic males in 2018 and the second-leading cause of death in Hispanic females. Compared with non-Hispanic whites, Hispanics/Latinos have a higher incidence of heart failure, tend to develop heart failure earlier and tend to have more comorbidities accompanying heart disease, such as diabetes, obesity and hypertension.

The Heart-Aorta Link

“Previous cardiac research focused on the heart while failing to account for the relationship between the heart and the aorta, despite their intimate connection,” said Dr. Rodriguez. “For example, aortic stiffness significantly increases with age and is associated with heart failure and hypertension, but how that occurs isn’t well understood. We hypothesize that aortic stiffness impairs the mechanical interaction, or ‘coupling,’ between the aorta and the heart, which in turn contributes to heart failure. We’re hoping this study will shed light on these mechanisms and that we can use the heart-aorta relationship to help identify people who are at risk for heart failure earlier.”

Researchers will recruit approximately 1,600 Hispanic/Latino men and women over the age of 45 who previously enrolled in the Echocardiographic Study of Latinos (ECHO-SOL), part of the NIH-funded Hispanic Community Health Study/Study of Latinos (HCHS/SOL), which is an ongoing clinical study with more than 16,000 participants over 18 years of age at four U.S. sites, including Montefiore Einstein. In the new study, participants will receive echocardiograms along with other tests focused on determining the stiffness and functioning of the aorta, aorta-left ventricle coupling abnormalities and the possible presence of heart failure and pre-heart failure.

Once the research is complete, Dr. Rodriguez and colleagues will compare their findings to data on vascular function in non-Hispanic white and Black men and women from the Framingham Heart Study and the Jackson Heart Study, with the goal of recognizing similarities and disparities among racial and ethnic groups.

“We hope our study leads to new ways of identifying people at high risk of heart failure or for detecting it earlier, providing an opportunity to intervene to prevent severe disease,” said Dr. Rodriguez. “Our ultimate aim is to lower the burden of heart failure in this understudied population.”

The grant, titled “Vascular Determinants of Stage B HF among Hispanics: the role of the Heart-Vascular Interaction,” is funded by the National Heart, Lung, and Blood Institute, part of the NIH (1R01HL158156).