2021 Eli Lilly & Company Impact Piece

With gratitude Thank you for creating the Ludeman Center Lilly Predoctoral Award. Bringing graduate students into women’s health research is a great way to set a strong foundation for a lifelong career in the field. Your generosity supported Danny Enge’s pre-doctoral work and sparked the formation of the CADENCE (Cardiac and vAscular DiseasE iN diabetes aCross the lifEspan) Research Group, which is a collaboration between adult and pediatric endocrinology, radiology, cardiology and bioengineering.

We are proud to report on Danny’s progress, and we thank you for supporting his research and education.

As you will see, your philanthropy is already making a difference, in both scientific discovery and inspiring future leaders in diabetes and women’s health research. We are truly grateful for our partnership.

Jane Reusch, MD Endocrinology, Diabetes and Metabolism

The first Ludeman Center Lilly Predoctoral Fellow Danny Enge, BS, our inaugural Lilly pre-doctoral fellow, is pursuing a PhD in bioengineering. The Lilly predoctoral fellowship enabled him to begin his training in advanced cardiac imaging and become engaged in a robust collaboration between endocrinology, the Ludeman Family Center for Women’s Health Research, radiology and bioengineering.

This year, Danny was published in the Journal of the American College of Cardiology, and he was a poster presenter at the American Diabetes Association (ADA) 80th Scientific Sessions, the Society for Cardiovascular Magnetic Resonance (SCMR) 2021 Scientific Sessions, and the ADA 81st Scientific Sessions. Thanks to his success, Danny was appointed to a prestigious departmental T32 award.

Danny’s mentors include Jane Reusch, MD, Alex Barker, PhD, Kendall Hunter, PhD, and Kristen Nadeau, MD.

Research and Progress Early detection and intervention are vital in combating type 2 diabetes (T2D), which can lead to excess cardiovascular (CV) mortality. Our group has identified preclinical cardiac dysfunction associated with decreased cardiorespiratory fitness and responsive to exercise intervention. As central arterial stiffness is a prognostic for progression to cardiovascular disease, we are investigating its quantification using novel cardiovascular magnetic resonance (CMR) imaging-derived measures.

Danny’s work leverages an ongoing study comparing BMI-similar patients with and without T2D, before and after a 90-day exercise program. His goal is to further develop advanced CMR measures of cardiovascular health and quantify the effects of uncomplicated T2D on cardiovascular physiology, as well as the adaptive response to aerobic exercise training.

So far, Danny’s research supports the following findings:

• Exercise training improved many, but not all, areas of cardiac function.

• In people with T2D, exercise training improved cardiac function: Left ventricle (LV) end-systolic volume (ESV) increased, end-diastolic volume (EDV) increased and decreased heart rate.

• In BMI-similar controls and people with T2D, exercise training decreased central arterial stiffness by 4D flow pulse wave velocity (PWV) with no change in carotid-femoral tonometry assessed PWV (SphygmoCor).

• Overweight participants with and without T2D had significant differences in stroke volume, cardiac output, ESV, EDV, 4D flow PWV compared to a lean age matched control cohort from another study.

• No significant difference was found between groups pre- or post-exercise intervention when measuring LV circumferential, longitudinal, and radial (3D) strain and strain rate.

• Danny started coding in Python for the training of an artificial intelligence network that will be able to automatically segment the aorta and pulmonary artery from 4D flow MRI through deep learning.

“The Ludeman Center Lilly Predoctoral Award has given me a unique viewpoint on how underrepresented sex differences have been in classic scientific research.

I hope to continue adding to this field after my training.”

Danny Enge

“We now have a team of leading edge cardiovascular imaging researchers with heightened awareness of women’s health disparities to support ongoing projects and to prepare young scientists for successful careers in women’s health, starting with Danny.”

Jane Reusch, MD

CADENCE Danny’s project was pivotal in creating a collaborative working group called the CADENCE (Cardiac and vAscular DiseasE iN diabetes aCross the lifEspan) Research Group. This group played a big role in recruiting an impressive junior faculty member, Erin England, PhD, MRI bioengineer and physicist, who further enhances our ability to conduct innovative research evaluating the cardiovascular system in women and men with and without diabetes.

Danny and the CADENCE team are developing novel cardiovascular magnetic resonance post-processing strategies and tools to detect preclinical cardiac and vascular function. Their findings will be of great importance for the prevention and early treatment of heart failure in diabetes.

Looking to the future The University of Colorado Anschutz Medical Campus diabetes research community and the Ludeman Family Center for Women’s Health Research have a shared mission to recruit and retain promising scientists in diabetes, cardiovascular disease and sex and gender research. The first Ludeman Center Lilly Predoctoral Award provided crucial support for one such up-and-coming scientist in diabetes research. In addition to the incredible results we’ve seen so far from Danny, his experience has shaped his goals for the future, and he plans to continue working in diabetes and women’s health research following his formal training.

Your support is transforming healthcare, between the research results we see now and the accomplishments we’ll undoubtedly see from Danny in the future. Given Danny’s success, we hope you’ll join us in supporting future brilliant minds in diabetes and sex differences research. Thank you for being our partner in philanthropy.