Dr. Padala Receives Prestigious Research Award from the American College of Cardiology

January 2015

The editorial board of the Journal of the American College of Cardiology has selected Dr. Muralidhar Padala to receive the 2015 William W. Parmley Young Author Achievement Award on the basis of the manuscript, "Temporal Changes in Interpapillary Muscle Dynamics as an Active Indicator of Mitral Valve and Left Ventricular Interaction in Ischemic Mitral Regurgitation," which was published in the November 4, 2014 issue of JACC. Dr. Padala directs the Structural Heart Disease Research and Innovation Program of Emory University.

The award, named for Dr. William Parmley, past editor-in-chief of JACC, honors two young authors per year and provides each recipient with a stipend to defray the cost of attending an American College of Cardiology educational event. The award is underwritten by Elsevier Science Inc., the publisher of JACC. The nominee must be lead author on a paper that was published in JACC in the preceding year, and must have completed training less than five years before the date that the paper was submitted. The papers selected best fulfill the standard criteria for acceptance for publication, including originality, methodology, presentation, and importance.

The paper described the confirmation of Dr. Padala's hypothesis that the loss of lateral shortening of the papillary muscles was the chief contributor to the development of ischemic mitral regurgitation. Research associate Weiwei Shi and then-research fellow Dr. Bryant McIver, both members of Dr. Padala's research team, developed a porcine model of functional mitral regurgitation. They found that the swine with a loss of lateral papillary muscle shortening developed mitral regurgitation, while those with preservation of the shortening did not. This result was tested further in an anatomically accurate mitral regurgitation computer model designed by Dr. Wei Sun of the Mechanical Engineering Department of the Georgia Technological Institute and his graduate student assistant Qian Wang.

The Parmley award not only commends the young investigator, but also the mentor for the project and the particular research program. Therefore, Dr. Robert Guyton will accept the award with Dr. Padala at the American College of Cardiology 2015 Meeting in San Diego.

In addition to Dr. Guyton, the coauthors that contributed to the success of the study included research fellows Dr. Kanika Karla and Dr. McIver, now Emory PGY1 and PGY4 surgical residents, respectively; Weiwei Shi; Dr. Wei Sun; Qian Wang; and Emory cardiothoracic surgeons Dr. Eric Sarin and Dr. Vinod Thourani.

With the hope of translating these findings for use in the patient, Dr. Padala began working with Dr. Sarin to develop a surgical technique that could help restore this shortening and repair the valve leak. The team devised a new mitral repair technique called intra-ventricular papillary muscle banding (PMB), which reduced the lateral distance between the two papillary muscles. The work was reported as "Intra-ventricular Papillary Muscle Banding vs. Undersized Mitral Annuloplasty to Treat Ischemic Mitral Regurgitation in a Chronic Swine Model" at the 2014 Scientific Sessions of the American Heart Association. Dr. Padala is now testing PMB by simulating the technique on virtual models of patients' hearts created from cardiac MRI and 3D echo imaging.

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