Cardiologist pumps new knowledge into understanding of heart science

By Susan Lassetter   Photograph by Megan Bean

Pulse racing, palms sweating, breath quickening—telltale signs of cardiac distress or excitement over meeting the leader of the free world? Ask Dr. Ervin Fox. He has experience with both.

A cardiologist at the University of Mississippi Medical Center, Fox is a leading researcher in the function and responses of the cardiovascular system. So, last year, when his heart started racing as he walked to shake the hand of President Barack Obama, he knew it was from excitement and not something more alarming.

“I never would have thought I’d have the chance to shake the president’s hand,” the Clarksdale, Miss., native said. “I was thinking ‘Wow, do I really deserve this?’ I was humbled and excited at the same time.”

This once-in-a-lifetime moment came during the 16th annual Presidential Early Career Awards for Scientists and Engineers. Fox was one of 96 honored at the event for contributions to the fields of science, technology, engineering and mathematics.

A 1989 biomedical engineering graduate, Fox was selected based on his work in understanding vascular function in African-Americans and how it relates to risk factors for heart disease and other cardiac ailments.

“This is a unique assessment to build a comprehensive characterization of vascular function in African-Americans,” Fox explained. “We want to find a baseline of this function, see if early assessment can reduce risk factors for cardiac diseases, and understand if there are genetic determinants involved.”
Vascular function refers to how small-, medium- and large-caliber vessels carry blood throughout the body. Fox’s particular interest lies with the endothelium, a thin layer of cells that lines the vessels and helps control the cardiovascular system. This lining also plays a role in inflammation; coagulopathy, a clotting disorder; and arteriosclerosis, the thickening and hardening of arteries—conditions that put a person at greater risk for cardiovascular disease.

Studies suggest that endothelium cells respond differently in African-Americans than they do in persons of European descent. This difference could explain why black populations record higher rates of cardiovascular disease and its risk factors.

“It’s unclear why these physiological differences exist, that’s why research into the biological markers is important,” Fox said. “By understanding why certain groups are predisposed to cardiovascular problems, we can, hopefully, find more effective ways to prevent and treat them.”

A report from the American Heart Association shows that among non-Hispanic blacks 20 years old and older, 44.4 percent of men and 48.9 percent of women have cardiovascular disease, the leading cause of death in those groups. Rates of heart attack and stroke are particularly high among middle-aged individuals.

“This is very detrimental to families and communities because those middle aged individuals are potentially at the peak of their productivity in terms of income generation and other support,” Fox said.

Insurance status, nutrition and other environmental factors are known to have an impact on a person’s predisposition to disease, but, by performing long-term studies of community-based groups, Fox also will be able to show what biological markers are involved.

Funded by the National Institutes of Health, his research is part of the Jackson Heart Study that focuses on African-American residents of Hinds, Rankin and Madison counties. By partnering with the study that began in 2001, he and his team can build on previously collected echocardiogram data to understand the cardiac structure and function of the group.

“It allows us to be a little more investigative. We can look at biological markers and whether or not certain pathways are playing roles in heart disease,” Fox explained.

Since opening the newly renovated Vascular Function Lab in April 2012, Fox has collected data on approximately 1,500 participants. With more than 3,000 left to go, the research is expected to run through 2016.

“We have a large cohort to work with and a wealth of information to process,” Fox said. “This means we are uniquely qualified to address the racial disparity in these diseases.”

Fox said it was an interest in robots, sparked by the new-at-the-time “Star Wars” movies, that first drew him to biomedical engineering. He admits it’s not the most logical leap, but it’s one that ultimately led him to the career he loves.

“I would tell people I wanted to be a doctor, just so they would leave me alone about choosing biological engineering, but, lo and behold, that’s what I did,” he said, with a chuckle. “My older brother especially gave me a hard time because he was in civil engineering and thought that was the best major around.”

The son of educators, Fox said he enjoys learning, so much so he was still taking classes in 2010. In addition to a bachelor’s, he holds a medical degree from the University of Mississippi Medical Center and a master’s in public health from Harvard University. Add two fellowships, a residency and a thriving career as an academic clinical-research cardiologist, and no one teases him anymore about the path he chose. In fact, his brother and the rest of the family traveled to Washington, D.C., to celebrate when Fox received his career achievement award.

“It was a fantastic experience and we really made the most of it as a family,” Fox said. “It meant a lot to share it with them because without their support, and the help and mentorship of many colleagues throughout my career, it wouldn’t have been possible.”

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