When the heart is stressed by having to pump blood against increased pressure, it adapts by increasing its muscle mass. Long-term hypertrophy often leads to congestive heart failure. The changes in the regulation of transcription and translation resulting from hemodynamic overload, and the identification of the signal mechanisms responsible for initiating and maintaining these processes in hypertrophy and those leading to failure, are under investigation at MUSC. The molecular processes and genetics that play a causative role in the cardiomyopathy associated with chronic tachycardia are also being investigated.

Participating Investigators: George Cooper, Dhan Kuppuswamy, Don Menick, Paul McDermott, Terrence O'Brien, Frank Spinale, Michael Zile

The role of cellular movements and interactions, growth factors and extracellular matrices in the differentiation and morphological formation of the embryonic heart, its conduction system and the morphogenesis of blood vessels is being studied by this group of investigators. Specific areas of investigation include vasculogenesis, morphogenesis of the heart, genetic control of cardiac and vascular cell differentiation, gene regulation of cardiovascular patterning, cell-cell and cell-matrix interactions, RXR signaling in cardiac morhogenesis, cardiac electrophysiology, and cardiac wound healing and fibrosis.

Participating Investigators: Scott Argraves, Chris Drake, Rob Gourdie, Steve Kubalak, Tim McQuinn, Rupak Mukherjee, Phil Saul

Of special concern to MUSC physicians and scientists are a group of diseases and disorders that exhibit significantly higher rates of incidence, morbidity, and mortality among African American residents of South Carolina than among other population groups or even African Americans in other parts of the country. Notable among these are components of the metabolic syndrome: hypertension, coronary heart disease, diabetes mellitus and obesity, as well as related conditions involving dyslipidemia, macrovascular disease and renal failure. Other on-going studies with high visibility at MUSC that specifically address health disparities include the Charleston Study of Kidney Disease in African Americans; Project Sugar that studies positional cloning of diabetes-related genes among Gullah-speaking African Americans from the coastal SC "sea islands"; a research program project grant funded by AHRQ titled "Understanding and Eliminating Minority Health Disparities"; a national "Resource Center for Minority Aging" funded by the NIA; and the new Multidisciplinary Clinical Research Center (MCRC) for the Study of Rheumatic Diseases in African-Americans.

Participating Investigators: Brent Egan, Leonard Egede, Dan Lackland, Maria Lopes-Virella, John Raymond, Barbara Tilley

Sarcoidosis and sickle cell anemia are the subject of concerted laboratory and patient-oriented research efforts, including participation in NIH-supported clinical consortia conducting research for these special diseases. Sickle cell disease and sarcoidosis both represent significant minority health problems in South Carolina. MUSC is a center of research excellence in systemic scleroderma and fibrosing diseases with impact on lung tissue and pulmonary function. A recent NIH award has helped established the Multidisciplinary Clinical Research Center for Rheumatic Diseases in African Americans at MUSC. An additional focus is protective mechanisms for lung membrane in neonates, including premature and low birthweight infants.

Participating Investigators: John Baatz, Chris Brunson, Sherron Jackson, Marc Judson, Rick Silver, Maria Trojanowska