Scientists have a heart-to-heart for Children's Health

Fall 2014

One out of every 100 babies born worldwide has some kind of heart problem, making congenital heart defects the most frequent pre-existing malformation in newborns.  These heart defects range from those that will never require treatment, to complex problems with severe, life-threatening symptoms.  

Through Children’s Health Research Institute (CHRI), the third largest hospital-based child health research institute in Canada and the largest program within parent organization, Lawson Health Research Institute, a group of dedicated professionals is striving to help children born in southwestern Ontario with a heart condition to live long, healthy and productive lives.  

“The causes of heart problems, as well as the solutions and therapies to help mitigate the risks of living with a heart condition are very complex and require a multi-faceted approach,” says Dr. Kambiz Norozi, Chief of Paediatric Cardiology at LHSC’s Children’s Hospital. “We have doctors and researchers coming at the issue from all angles - looking at the genetic, environmental and behavioural factors that combine and contribute to being born with a heart condition.  We also work very hard to lessen the side effects and ensure these patients live happy and productive lives.”

On beat with heart development

According to Dr. Tom Drysdale, a scientist at CHRI, “Very little is known about the causes of heart defects or how to predict or prevent them. This is largely because heart development is a very complex process that must be very tightly orchestrated in order to create the hard-working organ we rely on our whole life.”

According to Dr. Drysdale, the heart first forms a simple tube and then undergoes a series of coordinated looping movements that generate the four chambers we see in mature hearts. 

“My lab is examining how the movements of cells are controlled to cause those complex changes in shape,” he says. “By doing so, we hope to understand where errors in the process can occur and how these may be important in causing the congenital heart defects we see in children. From this information, we can find ways to correct or prevent defects.” 

Dr. Drysdale also believes that by identifying the underlying genetic causes, they can help determine the likelihood of having a child born with a heart defect. Being prepared and knowing what to expect can be very beneficial to a young child and his or her family faced with living with a heart defect.

Pulse on technology

Twenty-six per cent of Canadian children aged 2-17 years old are overweight. As with many chronic health problems, the rise of childhood obesity in Canada is taking its toll on our families and our health-care system. Dr. Norozi and his team are exploring the effect of obesity on the heart and heart function. The Smart Heart Trial uses telemedicine (remote counselling) to deliver treatment for overweight children and teenagers from across southwestern Ontario, aged 7-17 with a heart defect. The project is assessing whether fitness and nutrition coaching through regular phone calls and the internet can have a positive impact on health, well-being, body composition and other measures of heart health including quality of life.  

Where the heart is 

Dr. Jason Gilliland has spent the last 12 years researching the influence of the physical environment on children’s health and well-being. A researcher at Lawson and CHRI, Dr. Gilliland has been mapping patients with congenital heart defects to see where they come from.

“Children are a population who are particularly influenced by the characteristics of their immediate, local environment,” he says. “Many times the location of these clusters (where the incident rate of heart defects is greater than expected) is not random, and we can ask ourselves is there something about the social and physical environment that is influencing this outcome?” 

Dr. Gilliland’s new research suggests that the physical environments in which children live, play, shop, work, and go to school, may have an important influence on their heart health. With obesity, for example, certain aspects of cities make it hard or easy for kids to be physically active and eat healthy foods. “We want cities to be planned with children’s well-being in mind,” says Dr. Gilliland.

Pumping up discovery

Thanks to a generous donation of over $1.3 million from Canadian Pacific (CP), title sponsor of the Women's Open, and support from the Children’s Health Foundation, the team at CHRI will be receiving some much needed tools that will enhance their capability to research and care for kids.

According to Dr. Norozi, CP’s gift will equip Children's Hospital and CHRI with a cardiopulmonary stress testing laboratory specifically designed for paediatric heart health monitoring.

“This new lab will be a state-of-the-art facility that will enable our team to evaluate a child’s heart, lungs and metabolism during strenuous physical activity,” says Dr. Norozi. 

Exams, such as a V02 max exercise test will tell the doctors if a child’s heart beats in a regular way when he or she engages in activities  like running, or riding a bike. These exams give more precise information to patients and parents allowing for better peace of mind.

“Play is a natural and vital part of being a child, and understanding and knowing where your limits are during exercise is important for these children and their families,” says Dr. Norozi.

Each year, more than 3,500 kids with congenital heart disease and other heart conditions are closely followed by the team at CHRI.

“These children are very brave - living with a heart condition can be a scary thing,” says Dr. Norozi.  However, thanks to recent progress in research and technology, great strides have been made in paediactric cardiology. “It’s a privilege to work with these kids and their families and witness them living happy and active lives - they have much to look forward to.” 

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Dr. Norozi (left), paediatric cardiologist, checks in on young Heinrich's heart health while his mother, Ava, holds him in one of the colourful rooms in Children's Hospital's Paediatric Cardiology Department.