Dr. Brittany Weber Wins IANC Research Fellowship Award

• By: admin
• On: 10/19/2021 07:50:38
• In: Annual Meeting

Dr. Weber is an Instructor of Medicine at Harvard Medical School and an associate physician in the Division of Cardiovascular Medicine and the Cardiovascular Imaging Program at Brigham and Women's Hospital in Boston. Her mentor is Marcelo F. Di Carli, MD, MASNC.

The IANC Research Fellowship Award was established in 2018 to encourage and support careers in nuclear cardiology research while growing the science of cardiac imaging and advancing the specialty. The award is presented annually to an early-career investigator who proposes research that will add important new information to the cardiac imaging literature.

“Dr. Weber's project will evaluate the effect of COVID-19 infection on coronary flow reserve using N-13 ammonia PET imaging,” said Committee Chair Raymond Russell III, MD, PhD, MASNC. “This timely research will help us to understand the perturbations in myocardial perfusion caused by the virus and may offer insights into how we may provide cardioprotection to individuals infected by COVID-19.”

Dr. Weber's win was announced at ASNC's 26th Annual Scientific Session and Exhibition. We connected with her soon after for a conversation about being selected, her research and its impact. Here are excerpts from our conversation:

ASNC: Congratulations on winning this year's 2021 IANC Research Fellowship Award! Your work is particularly timely, considering the status of the pandemic. We hear that many ASNC members and their hospitals are still overwhelmed by acute COVID-19 plus the longer-term impacts on of SARS-CoV-2 infection on survivors. Your research is focused on the longer-term impacts, correct?

Would you explain your project's potential to further the field's understanding of COVID-19's effects on the heart and vasculature? What questions are you aiming to answer, and why are they important now?

BW: Absolutely, and thank you for the great question. We know that SARS-CoV-2 can affect the vascular endothelium. We also know that patients who develop acute COVID-19 infection can have evidence of myocardial injury, as detected by hs-cTnT, and that this prevalence is high, which is related to in-hospital outcomes. However, we do not know what the relationship is between the initial insult and the longer-term effects of COVID-19 on the coronary vasculature. Furthermore, we are finding that patients can continue to have symptoms long after infection, referred to as “long-haul COVID” or “PASC, post-acute sequelae of COVID.” Yet, the pathophysiology of PASC is still unclear as are the possible treatment options.

We would like to understand two key questions:

(1) Does COVID-19 infection lead to impairment in coronary vascular health and coronary microvascular dysfunction, assessed by coronary flow reserve as measured by cardiac PET; and

(2) Are patients with ongoing long-haul COVID/PASC symptoms more likely to have coronary vascular impairment compared to patients without ongoing symptoms?

ASNC: Your team is uniquely positioned to perform this study because of Brigham and Women's cardiac PET program. Can you explain how you will leverage cardiac PET data to answer your questions?

BW: Absolutely. I am so fortunate to work with such a wonderful research group and my amazing mentor, Dr. Marcelo Di Carli—who is a true role model in all aspects. Dr. Di Carli has built an amazing cardiovascular PET program over the last 15 years, and we have a large registry of patients. In addition, we have worked closely with Dr. Ann Woolley, a COVID-19 leader from infectious disease, since the beginning of the pandemic and created a COVID-19 registry of patients with clinical and biomarker data that we will be able to leverage for this study.

Using our PET registry, we first examined patients at our hospital who developed COVID-19 and later had a cardiac PET ordered clinically by their physicians. When we compared these patients to a comparator population who did not develop COVID-19 and had similar cardiovascular risk factors, we found that patients with prior COVID-19 infection had higher prevalence of coronary vasomotor dysfunction, detected by lower coronary flow reserve. We presented this work at ASNC2021 just this month. However, in order to truly understand if this was pre-existing vascular disease versus direct longer-term effects of the virus, we need to have a comparison cardiac PET prior to COVID-19 infection. This is particularly important because we know that patients with cardiovascular risk factors are more likely to develop severe disease from COVID-19 yet these cardiovascular risk factors are also associated with coronary vasomotor dysfunction. 

We will leverage our PET registry and the high number of patients with COVID-19 infections within our health system to perform a prospective longitudinal study in which we will follow-up patients with prior cardiac PET scans in our registry who then developed COVID-19. We think that this will be an important way to understand the relationship between SARS-CoV-2 infection and the longer-term effects on vascular health.

ASNC: May we ask you to speculate on how the answers to these key questions may inform clinical practice and patient outcomes?

BW: We have a lot to learn about the longer-term effects of COVID-19 infection. The cardiovascular consequences of COVID-19-infection are important for understanding clinical risk, including increased risk of myocardial infarction and stroke from vascular/endothelial damage as well as heart failure, and for informing therapeutic strategies for potential long-term sequelae. Given the ongoing pandemic with emerging variants and the number of people who have recovered from COVID-19, this work may help us understand potential clinical implications for recovered individuals and also help explain symptoms, such as shortness of breath and chest discomfort that develop in up to one-third of patients after recovering from the acute infection.  

ASNC: We are looking forward to your results presentation next year at ASNC2022. Any final words before we let you get to work?

BW: I would like to first thank ASNC for the amazing opportunity to be able to pursue this work! Without this support, this work would not be possible. I would also like to thank my mentor Dr. Di Carli, our entire cardiovascular PET research group, and Dr. Ann Woolley. I am truly honored to be able to pursue this work and look forward to sharing what we learn!
 
Tweet your congratulations to Dr. Weber at @bweber04.  
Read more about the ASNC/IANC Research Fellowship Award.