As part of our “Meet Yale Internal Medicine” series, today’s feature is on Lauren Baldassarre, MD, assistant professor of medicine (cardiology) and radiology & biomedical imaging.
Q: Why did you choose Yale?
A: I wanted to go somewhere where I could focus my career on advanced cardiac imaging, cardiac MRI, cardiac CT and cardio-oncology. I wanted to go where there would be a good opportunity for me to develop in these fields and where I would have support, because they are smaller, relatively new sub-specialties but very important for not only teaching trainees and other specialties in cardiology, but for the patients they serve. When I came to Yale, they gave me the time and resources to grow these programs, so that was a big plus for me.
Additionally, I wanted to work closely with trainees and we have an amazing fellowship program here.
Also, I wanted to go somewhere that would support me from a research standpoint, where I would have more senior mentors and where I could do clinical and translational research. At Yale, we have very strong, basic science translational researchers and clinical researchers. Yale is a unique place where you can work with people within the medical school, but also in departments outside of the medical school, such as biomedical engineers and do collaborative translational research. This was a huge benefit that I didn't see anywhere else.
Q: What led you into cardiology?
A: I wanted to do cardiology since I was a medical student. I loved the physiology, the innovation, the procedures, and as I learned more about the cardiac imaging, I loved that piece as well. The ability to see the heart in a three-dimensional live image in detail is amazing. It really enhances your understanding of cardiology in general, but also what it can do, as far as diagnosis and management of cardiac diseases, is quite remarkable. I have always had an interest in cardiovascular disease in women, and as the field of cardio-oncology started emerging, that had a lot of appeal for me because originally the focus of that field was in breast cancer patients. It tied together my interests really nicely - cardiac imaging, prevention, and cardiovascular disease in women.
Q: What do you see as the future for cardiac imaging?
I have always had an interest in cardiovascular disease in women, and as the field of cardio-oncology started emerging, that had a lot of appeal for me because originally the focus of that field was in breast cancer patients. It tied together my interests really nicely - cardiac imaging, prevention, and cardiovascular disease in women.
Dr. Lauren Baldassarre
A: We've been able to do so much with cardiac imaging. To start, we have been able to perform testing from a more non-invasive approach. Procedures in cardiology are often necessary and warranted. That is an important part of the field and always will be, but imaging has really allowed us to make a lot of diagnoses and better manage patients without having to do some invasive procedures. More importantly, imaging can help guide those necessary invasive procedures. This imaging gives us a greater understanding of the heart. For example, with a cardiac MRI, we can look at tissue characterization of the heart muscle, allowing us to see if there's inflammation or fibrosis.
In a general cardiac catherization, we can see the lumen of the coronary arteries to see if there's any blockages. On a coronary computed tomography angiogram (CTA), not only do we see the lumen, but we see all the surrounding plaque outside of the lumen. We can look at the characteristics of it, as well as the surrounding tissue, and the heart structure.
Q: What is your research focus?
A: Right now, my research focuses on the use of advanced cardiac imaging for evaluation of different ischemic and non-ischemic types of cardiovascular disease. Most specifically, looking at the cardio-toxicity that can be associated with chemotherapy, immunotherapy and other targeted agents that are used in the treatment of cancer.
Immunotherapy is revolutionizing cancer care and is significantly improving survival in many different types of cancer. But unfortunately, these agents can have a fair amount of side effects throughout the different organs of the body, including the heart.
I’m looking at how more advanced imaging techniques, like cardiac MRI, can detect toxic cardiac side effects in patients receiving these therapies ideally early on. Currently, we have ongoing clinical trials for patients on these therapies and are looking at the use of these cardiac MRI techniques for detection of cardio-toxicity. I also collaborate with our translational imaging center to look at pre-clinical studies and models for early detection of cardio-toxicity with immunotherapy.
We are also collaborating on a multi-center registry with other lead cardio-oncology programs around the country. Our registry tracks cardio-oncology patients with all different types of cancers and therapies received to see the cardiac effects of these treatments over time.