Every day, Anna Hemnes, MD, treats patients with pulmonary arterial hypertension.  Every day, she works to find a cure.

Pulmonary arterial hypertension is a rare disease that narrows and stiffens the arteries connected to and within the lungs.  The increased work of pumping blood through these arteries eventually causes failure of the right side of the heart.  Half of those diagnosed with the disease die within five years of their diagnosis.

Dr. Hemnes became interested in the disease when she joined the Vanderbilt faculty in 2008 and began working with Dr. John Newman’s team, which studies insulin resistance in people with pulmonary arterial hypertension.  This, she says, got her thinking about whether systemic metabolic disease might also be affecting the right heart.

So she began to focus on the hearts of people with this disease, and that was when serendipity intervened.  About five years ago, she was sharing space with an unrelated lab group.  The husband of one of the postdocs in that group worked in bariatric surgery, and “he was the one who suggested that we look for lipids in the heart—and it worked.  And now I have a whole R01 on it.”

Many people with pulmonary arterial hypertension have fatty deposits, typically made of triglycerides, in the right heart.  Dr. Hemnes’s R01 focuses on understanding two things: Where the deposits come from, and what they do.  Hemnes has always liked asking questions, and she has plenty about where the lipids come from.  “Is it that more fat is being transported into cells?  Is it that cells aren’t burning fat as fuel?”  The other half of the investigation questions whether the lipids causes myocyte, or heart muscle cell, dysfunction or if it kills heart cells, leading to heart failure.

While writing her R01, Hemnes learned “you cannot do it at the last minute.  It takes months and months and months” to write a grant like this.  Laughing, she adds, “I have done other ones at the last minute, and they didn’t get funded.”  She recommends at least six to eight months of planning and writing.

In part, the extended timeline is to give the grant writer ample time to “shop it around to colleagues and people you think are good writers, even people who don’t know much about your topic.  Ask them to critique your ideas and your plan.”  Hemnes also used a VICTR Studio for expert input on her grant, and notes that the timeline forced her to have a draft ready early.  This ensured she had the time to shop it around to colleagues and mentors in addition to receiving valuable comments from other faculty at the Studio.

Looking forward, Hemnes wants to translate her research into treatments for pulmonary arterial hypertension.  “We’re trying to understand if we could give medications to reverse the process” of lipid buildup in the right heart, she says.  “We have some ideas, but if we understood the mechanisms a little better, we could be more selective about the medications.”  Eventually, she plans to do human trials of metabolic therapeutics such as metformin to see if these drugs decrease lipid deposits in the right heart for people with pulmonary arterial hypertension.

This will lead her right back to patients she sees every day, for whom she is working towards a cure.  “It would be really meaningful,” she says, to not only treat these patients, but also “use my career to try to cure the disease.”

You might even say preventing or reversing heart failure for them is her heart’s calling.

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