Summer 2005

Working Independently and Working Together

Despite many advances in health care, heart and vascular disease remains a largely silent epidemic that continues to destroy the fabric of American life. Heart and vascular disease remains the number one cause of death and disability in the United States, representing more death and disability than that caused by all other diseases combined. This epidemic represents the greatest challenge to health care today.

One of the problems in heart and vascular health is that care is spread among various separate physician specialties that are narrow in focus, expensive and lack cohesiveness. Yet, at the same time, many advances in molecular biology, genetics and less invasive surgical technology have created the potential for powerful solutions to long-standing problems.

The vision for the UCSF Heart and Vascular Center is to lead the nation in the care of patients with heart and vascular disease by integrating a diseased-based clinical delivery system with a diseased-based research effort that spans the clinical and basic sciences. One essential component of the center is a multidisciplinary clinical care delivery system designed with both patient care and clinical research as core missions. Another core mission will be to pursue research that integrates clinical, translational and basic science in a program broadly related to understanding, preventing, diagnosing and treating heart and vascular disease.

First and foremost, we are trying to change the paradigm by which clinical care of heart and vascular disease is delivered in the U.S. We are trying to bind together the disparate subspecialties that traditionally provide clinical heart and vascular care, so that we can provide comprehensive treatment in a patient-centered manner. At the center, specialists and subspecialists in cardiology and cardiac and vascular surgery are bound together in a single clinical delivery team that integrates specialties at the disease level. For example, the heart failure group includes cardiologists as well as specialists in ventricular assist devices, heart failure and heart transplantation.

In addition to these specialists, UCSF Medical Center can boast of having one of the best risk factor assessment groups in the world, and internationally recognized lipid specialists who focus on heart and vascular disease. The Heart and Vascular Center's physicians have access to excellent facilities, including a new, state-of-the-art catheter lab for both coronary artery disease and cardiac electrophysiology.

The Engine Driving Treatment

Patients who have heart failure need integrated teams of specialists for optimum care. At the center, the physician groups use their expertise separately, but work together to provide interlocking care for both outpatients and inpatients. The analogy I like to use is that of an engine. Each cylinder works separately, but provides power by working with the others in an organized way.

In addition to providing improved care for heart patients, the heart center is organized around the principle that UCSF physicians need to form partnerships with patients and referring doctors. Part of this effort is employing skilled nurses and nurse practitioners who facilitate timely communication with referring doctors. One keystone of this effort is what we call the Gateway – an outpatient heart and vascular group dedicated to aggressive vascular risk factor assessment and disease treatment.

The central strength of the Heart and Vascular Center is its close relationship with the biomedical research community at UCSF's Cardiovascular Research Institute, led by Shaun Coughlin, M.D. Our patient and physician partners can depend on the fact that the most advanced molecular therapies and technological treatments, some of which were developed at UCSF, will always be available. The people who provide these treatments will most likely be some of the most skilled and experienced in the world with those procedures.

The mutually beneficial relationship between clinical and research groups at UCSF ensures that the latest knowledge will be translated as quickly as possible into safer, less expensive and more effective care of patients with heart and vascular disease. At the same time, through this unique integration, our research will be informed and nourished by the needs of our patients. This close dialogue is essential for the success of our clinical care and our research at the UCSF Heart and Vascular Center.

The cooperation between physicians and scientists at the center has been remarkable. We look to the future with confidence in the soundness of our vision to respond powerfully to the epidemic of death and disability caused by heart and vascular disease in the U.S.

Louis M. Messina, M.D.
Director, UCSF Heart and Vascular Center

Related Information

News Releases

New Director for Gladstone Institute
Deepak Srivastava, M.D., was named the new director of the Gladstone Institute of Cardiovascular Disease (GICD).

Researchers Identify Genes Linked to Lung Transplant Rejection
Researchers at the San Francisco VA Medical Center and UCSF have identified genes associated with lymphocytic bronchitis, which is thought to lead to obliterative bronchitis (OB), a common cause of long-term failure of transplanted lungs.