Investigating the Relationship Between Heart Failure and Cardiometabolic Disease
Research at BIDMC into heart failure and obesity-related heart disease is focused on understanding what causes the heart to change in heart failure and obesity-related cardiometabolic disease. Directed by Jennifer E. Ho, MD, the group seeks to understand better a subtype of heart failure in which the left chamber of the heart is too stiff to fill properly. This condition is called heart failure with preserved ejection fraction (HFpEF). More than half of patients with heart failure have HFpEF, yet current treatments are limited.
The research group works with tools that span large population-based cohorts with deep phenotyping, including biochemical profiling, patient-oriented studies focused on cardiopulmonary physiology, and machine learning approaches to understand real-world data across health systems. The three focus areas include:
Clinical and Biochemical Determinants of HFpEF
Prior work in the Framingham Heart Study demonstrated that clinical precursors to HFpEF were distinct from risk factors preceding HFrEF. These initial studies highlight differences in pathophysiology long before the clinical development of HFpEF and HFrEF. This work motivated an international collaborative effort of 4 major community-based cohorts with over 22,000 individuals followed prospectively for incident HF by subtype. The team has developed and validated distinct clinical risk prediction models for HFpEF and HFrEF, and have also demonstrated that adiposity particularly predisposes to HFpEF. These studies support the notion of HFpEF as systemic disease and laid the foundation for the funded NIH R01 focused on upstream inflammatory mediators that may contribute to the pathobiology of HFpEF.
Association of Vascular Dysfunction and HFpEF
The group and others have demonstrated that vascular dysfunction including increased arterial stiffness and endothelial dysfunction contributed to the pathobiology of HFpEF. An active collaboration with Naomi Hamburg, MD, at Boston University is studying endothelial effects of COVID-19 in obesity. The team hopes to elucidate mechanisms underlying heightened cardiovascular risk after COVID-19 infection.
Machine Learning Approaches To Disentangle HFpEF
Through collaborations at the Broad Institute, the group has leveraged diverse machine learning approaches applied to electronic health record and cardiac imaging datasets. They have shown that natural language processing models are able to improve accuracy of HF classification when compared with billing codes. An active collaboration with Patrick Ellinor, MD, at Massachusetts General Hospital is investigating deep learning models on electrocardiograms and echocardiograms to better understand future HF risk.
About Jennifer E. Ho, MD
Dr. Ho is an Associate Professor at Harvard Medical School, Director of Research, Division of Cardiovascular Medicine, a faculty member of the Heart Failure Program at Beth Israel Deaconess Medical Center, and Associate Member of the Broad Institute at Harvard and MIT. She completed her undergraduate studies at UC Berkeley, Harvard Medical School, followed by internal medicine residency at BWH, cardiology fellowship at UCSF, and heart failure/transplant fellowship at BWH.
She is a nationally recognized physician-scientist focused on clinical and translational research to understand mechanisms driving HFpEF, has published over 130 peer-reviewed original investigations and is the recipient of multiple NIH awards, including a K24 mid-career mentoring award. Dr. Ho co-directs the T32 training grant in Cardiovascular Medicine at BIDMC and serves on the Board of Directors of the Sarnoff Cardiovascular Research Foundation. She is the recipient of multiple teaching and mentoring awards, including the 2021 MGH Cardiology Fellowship Mentoring Award, and the 2023 Clifford A. Barger Mentoring Award at Harvard Medical School.
Lab Members & Collaborators
Faculty
- Emily Lau, MD, MPH
- Jenna McNeill, MD
- J. Sawalla Guseh, MD
Trainees
- Mythri Ambatipudi, BS
- Mandana Chitsazan, MD
- Leah Kosyakovsky, MD
- XiaoDan (Vivian) Huo, BA
- Janet Ma, MD
- Ndidi Owunna, BS
- Abigail Pan, BS
- Juhi Parekh, MBBS, MPH
- Mirav Parekh, BS, MA
- Athar Roshandelpoor, PhD
- Dongyu (Daniel) Wang, MD, MPH
Alumni
- Nona Jiang, MD, MSc
- Mariana Ramirez, MD, MSc
- Christy Taylor, MD, MPH
