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Dr. Davinder S. Jassal
Principal Investigator, Cardiovascular Imaging
Institute of Cardiovascular Sciences
Research Focus
Dr. Jassal’s research focuses on the complementary use of multimodality cardiovascular imaging in the noninvasive assessment of heart failure syndromes. Using a combination of echocardiography (ultrasound of the heart), cardiac CT (computed tomography) and CMR (cardiac MRI), Dr. Jassal’s Cardiovascular Imaging Laboratory is dedicated to translational research focusing on three heart failure models:
1. Herceptin Induced Cardiomyopathy
Breast cancer is a major public health problem worldwide, afflicting 1 in 7 women during their lifetime with a mortality of approximately 1/33. Herceptin (Trastuzumab), a humanized monoclonal antibody that targets HER-2 positive breast cancer cells, has been widely used to treat breast cancer after chemotherapy. It helps to decrease mortality due to breast cancer, but increases the chance of developing heart failure. Dr. Jassal is currently evaluating the role of echocardiography, CMR and cardiac biomarkers in the early detection of Herceptin induced cardiomyopathy (heart failure) prior to the development of irreversible cardiac damage.
2. Obstuctive Sleep Apnea and Heart Failure
Obstructive sleeping apnea (OSA) is a sleeping disorder characterized by periodic reduction of breathing. It has direct adverse cardiovascular effects, where OSA patients can develop biventricular failure. Continuous positive airway pressure (CPAP) is used to treat OSA, yet the long term effects of this treatment on cardiovascular remodeling is ill defined. Dr. Jassal is currently evaluating the effects of CPAP on a heterogeneous population of individuals with OSA by assessing cardiac remodeling using echo and CMR over a one year followup.
3. Metabolic Syndrome and Heart Failure
Obesity plays a major role in cardiovascular diseases. Hyperlipidemia and altered NO production have be implicated in the pathogenesis of ventricular remodeling. Dr. Jassal is studying the effects of a high lipid diet on cardiac remodeling in a murine model of the metabolic syndrome.
Why is this work important?
Diagnostic medical imaging has undergone a dramatic evolution over the past decade, owing to rapid technological advancement and innovative clinical applications. Today's diagnostic imaging technologies, in particular echocardiography and cardiac MRI, are rapidly being adopted in Canada as new tools for understanding mechanisms of disease including Herceptin induced cardiomyopathy, obstructive sleep apnea and the metabolic syndrome.
Although Herceptin has demonstrated considerable therapeutic benefits in decreasing the rates of disease recurrence and death in the setting of breast cancer, it is associated with a 5-10% risk of cardiotoxicity. Early detection of cardiac dysfunction using echocardiography and cardiac MRI may allow one to adjust treatment with Herceptin prior to the development of irreversible heart failure.
With the increasing epidemic of obesity in Canada, the prevalence of OSA will continue to rise. A composite of mechanisms including mechanical, neurohormonal, inflammatory, endothelial and oxidative stress are involved in the increasing cardiovascular disturbances observed in OSA patients. The anticipated outcome of the current research proposal is that Dr. Jassal will demonstrate for the first time that CPAP will favorably improve biventricular remodeling in a heterogeneous population of OSA patients, as assessed noninvasively by echocardiography, cardiac MRI, and biomarkers over a one year followup.
There is increasing evidence that obesity and the metabolic syndrome plays a major role in cardiovascular disease. By studying the effects of a high fat diet on adverse cardiac remodeling, and understanding the various mechanisms involved, the insights gained will help with the development of novel dietary and pharmaceutical strategies to limit heart failure and its associated morbidity and mortality.
What techniques and equipment are used in this laboratory?
Dr. Jassal’s small animal cardiovascular imaging laboratory provides expertise in murine echocardiography. A dedicated GE Vivid 7 echocardiography machine with probes for small animal imaging (13 MHz) is housed in the animal facility at St. Boniface Research Centre. Five dedicated postprocessing work stations are located in Dr. Jassal’s laboratory, Rm 4010 for analysis of the images using standard M-Mode, 2D echocardiography, color Doppler and Tissue Doppler imaging. The work stations are also used for postprocessing of cardiac MRI images.
To delineate mechanistic pathways involved in the cardiovascular remodeling assessed by murine echocardiography, the lab is also equipped with histological and immunohistochemistry techniques.
About Dr. Davinder S. Jassal
Dr. Jassal was born in Thompson, Manitoba, obtained an International Baccalaureate Degree at Sisler High School in Winnipeg, and graduated from the University of Manitoba with an MD in 1998. He completed a residency in Internal Medicine at the University of Manitoba from 1998-2001 and a residency in Cardiology at Dalhousie University in Halifax, Nova Scotia, Canada. Subsequently, he completed a clinical and research fellowship in Cardiac Imaging specializing in echocardiography, computed tomography, and MRI at Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Dr. Jassal recently rejoined the Cardiac Sciences division as an Academic Clinician Scientist, where half of his time is devoted to patient care in CCU and cardiac imaging and the other half devoted to translational research. He is currently Assistant Professor of Cardiology and Radiology, Affiliated Scientist of the Institute of Biodiagnostics at National Research Council of Canada, Principal Investigator of the Cardiovascular Imaging Laboratory as a member of the Institute of Cardiovascular Sciences, and holds the F.W. DuVal Clinical Research Professorship.
For more information, please contact:
Dr. Davinder S. Jassal
Rm. 4010, St. Boinface Research Center, 351 Tache, R2H 2A6
Lab Phone: (204) 237-2599
Lab Office: (204) 235-3056
Hospital Office: (204) 237-2023
Fax: (204) 233-2157
Email:
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Tielan Fang, M.Sc
Research Technician
Rm. 4010, St. Boinface Research Center, 351 Tache, R2H 2A6
Lab Phone: (204) 237-2599, (204) 235-3741
Fax: (204) 233-6723
Email:
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In Detail
INSIGHTS INTO CHEMOTHERAPY INDUCED CARDIOMYOPATHY
In women who have been diagnosed with HER-2 positive breast cancer, studies have shown that when treated with a drug called Herceptin (Trastuzumab), the rate of recurrence and death decreases substantially. Despite these positive effects, Herceptin also increases the change of developing heart failure in 10% of women. At the basic science level, Dr. Jassal has evaluated the use of Tissue Doppler imaging in murine echocardiography to predict a decrease in overall left ventricular ejection fraction and apoptosis (programmed cell death) in a chemotherapy induced model of heart failure in mice. Translating this to the clinical bedside, his research will focus on the early detection of heart failure using cardiac imaging including echocardiography and MRI in patients with breast cancer, such that alterations in treatment with Herceptin can be made prior to irreversible heart damage.
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