Week 4

This week I have continued to work on the paper that Dr. Weinsaft's lab has been working on with regards to mitral regurgitation and exercise tolerance. We are identifying changes in ability to perform a treadmill stress test in relation with mitral valve regurgitation. At this point we are working to narrow down the main causes of a decrease in exercise tolerance with the different forms of mitral regurgitation (MR). There are two major categories for MR: one is degenerative and the other is functional. Degenerative MR is related to the leaflets of the valve itself. This includes mitral valve prolapse and calcification. The other, less obvious, functional MR is related to the dysfunction of the ventricle. The mitral valve has chordae that attach to papillary muscles toward the apex of the left ventricle. These chordae hold the valve shut when the heart is in systole in order to prevent MR. Reduced function of the left ventricle in the regions of these muscles can lead to regurgitation through inability for the chordae to maintain tension. 

I have been in charge of running stats on the database that has over 3000 patients and over 400 variables. Doing this has taught me more about practical statistics than my undergraduate stats class. I may not have to do any large scale statistics during the rest of my PhD but I definitely think this experience will be useful when I have to do statistics in the future. 

On the clinical side I have still been seeing a lot of the cardiology department, especially in imaging. I have been sitting in on MRI and Echo readings. These have been very interesting because they often use unique cases for teaching. I was able to see an MRI from a patient with Ebstein's anomaly which I had never heard of. It is a congenital condition where the tricuspid valve is much closer to the heart's apex than it should be for normal ventricular function. The patient had had corrective surgery and Dr. Weinsaft used the images to teach about reading the images before revealing the patient's history.