Jahnigen Award Helps Academic Researcher Probe Mysteries of the (Dysfunctional) Heart

As a clinical cardiac anesthesiologist, Leanne Groban, MD, spends much of her time in the operating room caring for patients who have heart failure, or are at high risk of developing it. As a researcher, she's been able to devote considerable time to investigating a common cause of this potentially debilitating and deadly condition -- thanks in large part to the Dennis W. Jahnigen Career Development Scholars Award she received in 2004.

"The Jahnigen award "opened the door,"" says Dr. Groban, an associate professor in Wake Forest University School of Medicine's department of anesthesiology, who has made diastolic dysfunction -- a leading cause of congestive heart failure in older adults -- the focus of her research over the last several years. "The award provided the time, resources and support to get my research career in aging started. Since the award, I've been working on several projects, all related to diastolic dysfunction of aging.

"In addition, I've given numerous lectures on aging and diastolic dysfunction and diastolic heart failure, and, in other ways, disseminated information about the aging heart among other researchers, clinicians, residents, and medical students," adds Groban, who is also mentoring a junior colleague now doing clinical research concerning the perioperative implications of diastolic dysfunction.

The Jahnigen Scholars Awards are intended to help academic specialists like Dr. Groban start and sustain careers in both education and research focused on aging. Each year, at least 10 junior faculty in various medical specialties, including anesthesiology, win the awards and, over the course of two years, $150,000 stipends that allow them to devote more time to research. (Each winner's home institution provides an additional $50,000 in matching funds.) Administered by the AGS, the awards are supported by the John A. Hartford Foundation and the Atlantic Philanthropies.

Diastolic dysfunction, the inability of the heart to fill adequately between beats due to impaired relaxation of the heart muscle, is common in older adults because the heart and vessels normally stiffen with age. With the support of her Jahnigen award, Dr. Groban was able to step up her research into the roles that age-related declines in growth hormone (GH) and insulin-like growth factor-1 play in the onset of the condition. In a series of trials with aged rats, she found, among other things, that those who got GH replacement had less of an age-related decline in diastolic function, while those who went without developed signs of diastolic dysfunction.

With the further support of a Paul B. Beeson Career Development Award she received in 2005, Dr. Groban has been able to extend her research and shed new light on possible causes, implications -- and potential avenues for prevention and treatment -- of diastolic dysfunction. Recipients of the Beeson awards receive upward of $600,000 over three to five years to support their research.

Recent studies in a hypertensive female rat model that Dr. Groban and Mark Chappell, PhD, an associate professor at the Hypertension and Vascular Disease Research Center at Wake Forest Medical Center, have conducted, for example, suggest that estrogen withdrawal (as in menopause) may have profound effects on the buildup of collagen in the heart and in the onset of diastolic dysfunction. Results from research she undertook with Michelle Nicolle, PhD, assistant professor of internal medicine and gerontology at Wake Forest, have linked diastolic dysfunction with cognitive impairment: rats given long-term GH replacement therapy have shown both improved diastolic function and cognitive performance, as have rats treated with the angiotensin II receptor blocker drugs losartan and candasartan. In another recent study, Dr. Groban has found that aged rats undergoing short-term treadmill exercise training show enhanced exercise tolerance and diastolic function compared to sedentary old rats." Interestingly, the "fit" old rats performed equal to young adult rats; that is, it's never too late to exercise!" says Dr. Groban.

"The Jahnigen award has led to so many opportunities," adds Dr. Groban, who has also managed to find the time to coauthor a soon-to-be released pocket manual on transesophageal echocardiography with John F. Butterworth, VI, MD, Chairman of the Department of Anesthesia at Indiana University School of Medicine.

"The Jahnigen experience has been invaluable and it has made me a much more independent thinker."