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Cardiovascular disease does not affect everyone in the same way. One's susceptibility to disease and response to treatment are a complex interplay of genetics with environmental factors, such as diet, exercise, and smoking history. Until recently, cardiologists could not integrate all of these factors in making a diagnosis or a treatment regime, in part because the technology required to do so was not available. Therefore, treatment was often one-size-fits-all. UCLA is now taking a different approach by viewing a patient’s cardiovascular health holistically, tailoring care to match both lifestyle and genetics.
"There are likely numerous genes that work in concert to predestine some people to heart failure. What we learn from the gracious cooperation of our patients and their families will likely shed light not only on inherited conditions, but on the heart failure that affects many other people.” Jessica Wang, cardiologist at Ronald Reagan UCLA Medical Center
“We are trying to develop a molecular EKG,” says Dr. Tom Vondriska, professor of anesthesiology, medicine, and physiology at UCLA. “Analogous to how the electrical activity of the heart informs the doctor about problems with its function, so will evaluation of genes, proteins and other factors provide a doctor with an objective measurement of cardiovascular risk. Combined with the doctor’s clinical decision-making skill and innovative big data tools, these molecular features will revolutionize cardiovascular care.”
Dr. Vondriska emphasizes that the goal of what some called "personalized medicine" is not to implement a unique treatment regime for each patient. Rather, the aim is to define tractable subgroups of patients likely to respond to targeted treatments, an approach that has been successful in oncology and other fields. Borrowing an analogy from his colleague Dr. James Weiss, chief of the Division of Cardiology, Dr. Vondriska says it would be impossible to come up with 300-plus million pairs of shoes to fit everyone in the U.S, but offering only small, medium and large sizes wouldn’t work either.
“But if you had ten sizes, you could make shoes that would be comfortable for probably about 99% of the population,” Vondriska says. “That is what we are trying to do with our approach to cardiovascular disease at UCLA: Assign patients to the right group so that we can accurately diagnose and treat their conditions [and] thereby dramatically improve quality of life and survival.”
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