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In This Issue:
The Craft of Combining Clinical Care, Molecular Biology and Genetics
For clinical cardiologist Carolyn Ho, MD, patient care extends well beyond the patient. The new medical director of the BWH Cardiovascular Genetics Center combines genetics and molecular biology with clinical care for patients and their family members.
Under the leadership of Ho and prominent genetics researcher Christine Seidman, MD, director of the center, Francis Street is sure to be the primary address for the next era of medicine and clinical care. Clinicians treat the symptoms of inherited cardiovascular disorders like hypertrophic cardiomyopathy - (HCM) unexplained thickening of the heart caused by gene mutations - while geneticists map the patient's heredity. The center's disease management loops back from the lab, as parents, siblings and children of a patient with HCM can undergo genetic tests for HCM for early diagnosis and ultimately early treatment. “This is a new approach to patient management where we combine our comprehensive, cutting-edge research and excellent clinical care,” Ho said.
Patrick O'Gara, MD, vice chairman of Clinical Affairs in the Department of Medicine, said Ho was a natural choice to assume the role of medical director of the center. “Carolyn is uniquely qualified because of her proven expertise in the basic, echocardiographic and clinical aspects of hereditary cardiac disorders. She has received extraordinary training with Dr. Seidman, is a proven authority in cardiovascular imaging and always provides superior clinical care.”
For Ho, the center combines her passions of clinical care, molecular biology and genetics and continues her connection with Seidman with whom she worked since her residency and cardiology fellowship. “Unraveling the molecular and genetic mechanisms for disease, discovering how genetic mutations lead to specific a disease and then applying that knowledge to improve patient care defines the next era of medicine,” Ho said.
For example, the heart-thickening disease HCM affects one in every 1,000 people, and it may be caused by a single mutation in only one of a family of genes spanning more than 15,000 base pairs of DNA. “We can pinpoint the precise mutation that causes the disease,” Ho said.
Immediate family members of someone with HCM have a 50 percent chance of inheriting that same gene mutation and an increased likelihood of developing heart disease. “We want to make sure their families are properly cared for,” Ho said.
“We realize there can be psychological issues for families who find out they could have a hereditary condition, and, quite often, they are confused and concerned for their children and grandchildren,” said Ho, who explained the center's genetics counselor guides and educates patients and family members through what can be a trying ordeal.
She added, “We are on the cusp of basic science breakthroughs here at BWH, and not in just treating the disease, but also applying what we know to help families.”