Heart and Lung Impact Report 2022

HEART+ LUNG 2022 DONOR UPDATE

We couldn’t do it without you.

YOUR GENEROUS GIFT TO ST. PAUL’S FOUNDATION IS VITAL IN GROWING OUR UNDERSTANDING OF HOW TO PREVENT, TREAT AND RECOVER FROM HEART AND LUNG DISEASES. Together, we are: Developing and implementing innovative new treatments Advancing and accelerating world-leading research Improving the quality of life of our patients - and saving lives

What your support has made possible this year:

To our valued Heart + Lung donors, After another dynamic year, I have tremendous gratitude for you – our generous donors – who have supported our health care workers and patients throughout these challenging pandemic times. Our work would not be possible without you.

With your help, we’ve recruited bright new researchers to the Centre for Heart Lung Innovation, launched a new Lung Nodule Clinic to improve access to care for people with suspected lung cancer, and successfully trialed new heart valve technologies to improve outcomes for patients with valvular disease. I hope you enjoy reading about these achievements – and more – in the 2022 Heart & Lung Donor Update.

Launched a new Lung Nodule Clinic to improve access to care for people with suspected lung cancer.

Successfully trialed new heart valve technologies to

Your gift supports our cardiologists, respirologists, cardiac surgeons, researchers, nurses and allied health care workers at the Heart Centre and Centre for Heart Lung Innovation at St. Paul’s. Because of you, we can continue to deliver compassionate and patient-centered care.

improve outcomes for patients with valvular disease.

Thank you for making a difference in the lives of cardiac and respiratory patients from across BC.

First in the world to perform a new, less invasive heart surgery for patients at

Dick Vollet, President and CEO, St. Paul’s Foundation

high risk. The procedure was pioneered by Dr. Anson Cheung.

2022 Donor Update

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Advancing Our Knowledge of COVID

“The Centre for Heart Lung Innovation is at the top of its game, with a really good team of researchers. It’s very productive and collaborative,” says Dr. Russell, a principal investigator with HLI and past director of St. Paul’s Hospital ICU and past Chair of the Department of Medicine. As an investigator for the past 30 years, he’s known worldwide for his expertise on sepsis and septic shock.

Your support funds critical research into how Long COVID affects the heart and lungs

Donor generosity throughout 2020 and 2021 allowed Dr. Russell’s team to investigate the course of patients’ health during their hospitalization for COVID-19, for signals that could predict the severity of their Long Covid symptoms.

At the height of the pandemic, the public understanding of COVID-19 infection was recognized – and feared – as primarily an infection of the respiratory system.

Today, more than two years after the first infections, thousands of BC residents are still struggling with the fatigue, shortness of breath, abnormal heart rate, brain fog and sleep disturbances typical of Long COVID, a condition that can linger and incapacitate for months after the initial infection.

Now, through the foresight of St. Paul’s Foundation donors, the research findings of senior scientists like Dr. Jim Russell are transforming the ways we understand the multiple symptoms of COVID and predict how patients fare after the acute infection, or if they suffer from Long COVID. Over the last two years, he and his team of researchers at the Centre for Heart and Lung Innovation (HLI) have been busy with studies that could lead to great advances in COVID-19 clinical care.

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Examining the health of patients three months and then six months after their discharge from hospital in specialized Long COVID-19 clinics in Vancouver, the scientists found that fully a third of patients still suffered from restrictive lung disease, or lungs that are scarred and smaller than they should be.

Russell and his team also noticed a novel condition among these hospitalized patients: those who had already had liver dysfunction when they had been hospitalized with COVID, presented with more severe lung problems months after they were discharged.

The investigators will probe how–and why– those patients with liver dysfunction may be more susceptible than others to even greater lung complications.

Finally, the research team is exploring why patients who’d been hospitalized with severe COVID-19, and treated in intensive care, present with blood thicker than expected. Thick blood, which is more likely to clot, heightens the risk of clots traveling to the lungs and even the brain – which could be lethal.

Dr. Jim Russell, Principal Investigator (second from right), and research team in the Critical Care Research Laboratory at the Centre for Heart Lung Innovation.

“Why did the liver problem lead to lung disease, and why does being in the ICU lead to this thicker blood?” he says, reflecting on his research team’s investigations in progress. ​​ This research came on the heels of his team’s earlier findings that discovered the frequent occurrence of acute cardiac injury, acute kidney injury, and shock and how that increases risk in the long-term well-being of patients suffering from Long COVID. Donor funding is also being leveraged even further as the lab launches into more projects over the next year. The team is hoping to create new ways to help doctors monitor a patient’s health remotely, once they’ve settled in their own homes after hospital discharge, for instance.

Dr. Russell says his team’s busy schedule in 2021 was eased through the hiring of talented professionals, such as a project manager, research coordinators, a statistician, and lab technician – all thanks to philanthropic funding.

“The impact of donor giving during the pandemic is going to help people for a long time.”

Dr. Jim Russell “I firmly believe that my role is to hire people smarter than me,” says Dr. Russell, “and then it gets better and better. We have made progress, we have made contributions to the understanding of Long COVID, and these projects have a life that’s continuing on.”

He adds, “The Foundation’s funding goes right to the core of the projects and how they run.”

The achievements he’s made with his team of scientists is a mark of his leadership, at the heart of his job.

2022 Donor Update

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Recruiting Top Talent for Heart and Lung Research

Thanks to support provided by the De Lazzari Chair in Heart Lung Innovation (HLI), the Centre has the resources to recruit and retain three exceptional scientists over the past year whose work will advance the treatment of heart and lung diseases that affect patients in British Columbia, Canada, and around the world.

Along with the multidisciplinary team under Dr. Don Sin, they will contribute their expertise to the rich research and clinical landscape at St. Paul’s, across British Columbia and Canada.

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Graeme Koelwyn Dr. Graeme Koelwyn joined the Centre for Heart and Lung Innovation (HLI) as a Principal Investigator last autumn.

The exercise physiologist’s research focuses on investigating how physical activity might mitigate a patient’s vulnerability to the onset or progression of diseases such as cancer, heart and lung disease. Through his work he hopes to share a greater understanding of who might benefit most from exercise, when it might be most beneficial, and the “dosage” or amount of exercise that could be most effective.

The Centre for Heart Lung Innovation at St. Paul’s Hospital is the ideal place to pursue his lab’s work, he says.

“At places like HLI where you have cross-disease expertise, you have the capacity to answer some of these complex and difficult questions,” he says. “The level of research here is very, very high. I’m just so excited to be able to do this work in Canada and with a team that’s highly collegial, and doing such strong science.”

Ying Wang

Ilker Hacihaliloglu

Dr. Ying Wang’s lab at HLI strives to locate biomarkers, or “warning signals” in cardiovascular tissue that could predict a patient’s susceptibility to cardiac disease.

The core of Dr. Hacihaliloglu’s research aims to develop Artificial Intelligence systems that can be applied to clinical problems. At the height of the pandemic, for instance, his research helped construct a new AI system that can identify patients who were infected by COVID-19 disease or regular pneumonia.

These biomarkers live on lesions, where diseased cells accumulate, creating a blocking of a blood vessel. This buildup narrows, blocking oxygen, and eventually ruptures, leading to heart attack and stroke.

With a patient’s specific biomarkers mapped out, Dr. Wang collaborates with pathologists and clinician-scientists who could then pinpoint the best preventive therapies or construct personalized treatment plans.

“We are the glue between patients, pathologists and clinicians,” she says.

Dr. Wang says she was attracted to the diversity of scientists and potential collaborators at HLI. She’s also enthusiastic about the quality of the cardiovascular tissue biobank available to St. Paul’s scientists, which gives them the protein and molecular information that is so useful in their work.

“With this kind of a diverse team, and with such different expertise, we can work together on the multiple steps that makes ‘bench to bedside’ research happen.”

The research he’ll pursue at HLI follows a similar path that involves the design of an AI-powered point of care ultrasound system. When read on a portable laptop or cell phone, the data can provide a wealth of information at “point-of care” or wherever the patient may be found (at a long-term residence, for example) to determine their susceptibility to lung disease or infection.

More advances in gathering health data for mobile device testing may allow clinicians to create a treatment plan geared to each patient’s needs and mindful of their history and vulnerabilities to disease. The system will allow the detection of the disease at an earlier stage, providing ways for more successful treatment options.

Dr. Hacihaliloglu looks forward to working on more commissions in BC, alongside HLI colleagues he sees as “highly-ranked, well-respected researchers.

“The access to great data makes HLI and UBC very attractive,” he says, “and there are so many opportunities to collaborate, which is what you really want as a researcher.”

2022 DONOR UPDATE

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Creating Better Care for Adults Living with Congenital Heart Disease in BC Your support brings specialized cardiology services to patients living in the Okanagan Over the last year, a cardiologist, an echocardiography technician, and a nurse from St. Paul’s Hospital supported 40 adults in the Okanagan with congenital heart disease to receive their specialized cardiology care in Kelowna rather than Vancouver. The support included echocardiograms, clinical exams, health education and development of treatment plans – everything they need to maintain their cardiac health close to their homes.

The Yasmin and Amir Virani Provincial Adult Congenital Heart Program (VPACH) piloted a joint project between St. Paul’s Hospital and Kelowna General Hospital. The pilot was such a success that plans are to continue twice a year, improving the patient experiences of about 200 adults living with adult congenital heart disease (ACHD) in the Okanagan.

Present from birth, congenital heart disease once held a high mortality rate in patients’ first year of life. Medical and surgical progress over the last 60 years now provides children a greater than 90 per cent chance of surviving into adulthood. These soaring survival rates led to a growing population of adults living with

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St. Paul’s and Kelowna General Hospital staff working together to deliver care to adult congenital patients living in the Interior.

congenital heart disease and who require the specialized health care offered by a specialized team of ACHD providers.

Today, the patients who require regular ACHD care number around 200, and the population is growing. Many reside in Kelowna and the surrounding area, a five-hour drive from the VPACH clinic in Vancouver. This presents obstacles for patients who need to report to jobs, school, tend family duties or who may suffer from financial barriers.

“Our patient population is predominantly in their 20s to late 40s. So it’s a time in life that’s really busy,” says Karen LeComte, clinical nurse specialist for VPACH. She tells of one Kelowna mother of a developmentally disabled woman with congenital heart disease, who faced a $600 bill to stay in a Vancouver hotel for an appointment before the partnership clinic was launched.

The clinic in Kelowna is an excellent example of how donor generosity supports creative partnerships that improve the lives of patients.

Connecting Pharmacists with Heart Failure Patients Improves Health Outcomes Donor Support for Greg Moore Professorship leads to first clinic of its kind in Canada Led by Dr. Ricky Turgeon, PHARM-HF is an outpatient, telehealth-based heart function clinic that provides pharmacist co-management of heart failure medications, with the goal of improving the quality of life and survival of people with heart failure.

“For patients with heart failure, it is important for pharmacists to be involved from the beginning and at every step,” explained Dr. Turgeon, who was recruited to St. Paul’s in 2020 thanks to donor support in establishing the Greg Moore Professorship in Clinical & Community Cardiovascular Pharmacy. “Different pharmacists will play different roles throughout the heart failure journey.”

DR. RICKY TURGEON

Today, an increasing number of pharmacists are using their expertise to take more direct roles in patient care for conditions like heart failure, high blood pressure, and diabetes, including starting, changing, and stopping medications, ordering and monitoring bloodwork, and managing side effects.

Patients from anywhere in BC can be referred to PHARM-HF by a Providence Health Care cardiologist. During their first appointment at the clinic, the pharmacist and patient chat about the patient’s quality of life, treatment preferences and values, and medication options. Then, together, they make a plan.

Since its launch at the end of January 2021, PHARM-HF has been extremely well received by both patients and other members of the health care team, with a large increase in referrals since the summer. The growth in demand highlights the need for this sort of initiative within PHC and throughout BC. Dr. Turgeon’s team is now exploring opportunities to extend the reach of PHARM-HF via research and community partnerships.

Branko Dukic is one of the first patients cared for at the new PHARM-HF clinic, embedded within the Heart Function Clinic at St. Paul’s Hospital.

After discovering he had heart failure following an echocardiogram, Mr. Dukic was referred to the new Heart Function Clinic at St. Paul’s. He began having appointments with Dr. Turgeon every two weeks to discuss his prescription and alter his medications to drugs and dosages that would suit him better.

“My condition has significantly improved since the start of the year,” says Mr. Dukic. “Once I started treatment, my ability to walk began to improve. At the beginning, I could go maybe a couple of blocks before I had to stop because of chest pain and shortness of breath. But every week, I started to feel better. Any day now, I am expecting a call to schedule my heart bypass surgery.”

2022 DONOR UPDATE

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New Lab Equipment Doubles Our Capacity to Study Lung Disease Thanks to donor funding, the lab at the Centre for Heart Lung Innovation has the equipment it needs to improve patients’ quality of life With the addition of one more metabolic cart, known as the Parvo Medics True One, Dr. Jordan Guenette and his team can now double their capacity to collect data for critical studies exploring the roots of dyspnea, or persistent shortness of breath, as a symptom of Long COVID. In real time, the system helps the team analyze how frequently participants are breathing, the volume of their breath, the oxygen they consume, and how their heart functions.

Dr. Jordan Guenette supervises a student using the new metabolic cart.

“This is very advanced physiological equipment that will allow us to identify the physiology of why they’re experiencing this shortness of breath,” says Dr. Guenette.

The funding his HLI lab received from the Foundation donors has allowed him to leverage additional funds from the Canadian Institute of Health Research and the Canadian Lung Association.

Benefits of the new metabolic cart extend far beyond Long-COVID studies, he says. The original cart is used heavily for non-COVID research dealing with the mechanisms and management of breathlessness and exercise intolerance in adults with chronic obstructive pulmonary disease, cystic fibrosis, and interstitial lung disease, among other populations.

“We have such a high volume of testing to be done,” he adds, “there’s no way we’d be able to do it without this equipment.”

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Dr. Marc Deyell uses a new atrial fibrillation (AF) treatment system in the Peterson Cardiac Electrophysiology Lab at St. Paul’s Hospital.

ANOTHER “FIRST AND ONLY” AT ST. PAUL’S HOSPITAL Thanks to your support, game-changing technology is being used to treat people living with atrial fibrillation (AF) in a clinical trial at St. Paul’s Hospital. Dr. Marc Deyell, Director of Heart Rhythm Research at the Peterson Cardiac Electrophysiology Lab at Providence Health Care performed the first-in-BC ablation procedure using innovative technology developed by a team of clinician researchers, engineers, and scientists from Vancouver-based medical solutions company Kardium.

This new device, the Globe Mapping and Ablation System, can quickly map and diagnose the electrical disturbances in the heart and then rapidly treat them, all in real time.

Thank you.

Your support makes a difference in the lives of cardiac and respiratory patients from across BC. Please feel welcome to contact me if you have any questions, or to learn more about further opportunities to support St. Paul’s.

Teija Beck Director, Major Gifts Cell: 604.721.5998 tbeck1@providencehealth.bc.ca St. Paul’s Foundation 178-1081 Burrard Street Vancouver, BC V6Z 1Y6 St. Paul’s Foundation acknowledges with gratitude that it is located on the traditional, ancestral, and unceded territories of the Musqueam, Squamish, and Tsleil-Waututh Nations.

www.helpstpauls.com CHARITABLE REGISTRATION NUMBER: 11925 7939 RR0001