(Excerpt from 2010 NIEHS Non-competing grant update report, section 18.104.22.168)
Drs. Janette Strasburger (Pediatric Cardiology-electrophysiology specialty), Peter Frommelt, MD (Pediatric Cardiology-echocardiography specialty) and Dr. McCarver began developing studies to evaluate neonatal functional cardiac outcomes among infants whose intrauterine and peripartum exposures to trichloroethylene, as well as 17 other organic solvents, have been measured. This project uses novel echocardiographic techniques to perform regional, as well as global myocardial mechanics in human newborns, by determining myocardial velocities, strain, strain rate and displacement. Feasibility assessment and normative data from 175 normal newborns [recruited under R01 ES11739; Abstract submitted to American Society of Echocardiography, 2010] have been performed. Of note, this work is an example of Center translational studies; it builds on observations of Center member Susan Smith NIEHS R01 ES11738 and prior work by Dr. McCarver [PI for R01ES111739]. Dr. Smith demonstrated altered cardiac function (as opposed to structure) in chick embryos treated with trichloroethylene. Specifically, these chick embryos demonstrated decreased active ventricular filling and regional blood flows which can now be measured in human infants. Utilization of the echocardiographic tapes from subjects whose environmental exposures were quantified (both controls and congenital heart disease patients) will permit the cost effective use of this new technology.
In conjunction with the Community Unit (Dr. Cronk and Ms. Cossette), Drs. Pelech and Gangnon (a biostatistician from the University of Wisconsin-Madison) completed a GIS analysis of three severe congenital heart defects in communities in Eastern Wisconsin. This study was a response to a clinical perception of an elevated prevalence of a specific defect (hypoplastic left heart syndrome, HLHS) in the Fox River Valley in east central Wisconsin where the presence of a large number of paper and pulp mills has resulted in PCB contamination of the river. Cluster analysis and disease mapping revealed a south to north gradient for HLHS and Tetralogy of Fallot with elevated prevalence in four counties, two in the Fox River Valley. This study, although utilizing the services of the Community Subunit, is reported here within the Clinical Cardiovascular Disease research development as part of efforts to build critical mass. However, it also demonstrates the close associations of the Key personnel among the IHSFC subunits.