Meet Larisa Tereshchenko, M.D., Ph.D., assistant professor, cardiac electrophysiology, School of Medicine, Knight Cardiovascular Institute. She’s a new faculty member at OHSU, heading up a lab focused on prediction, prevention, and treatment of sudden cardiac death.
Where were you before coming to OHSU?
I was born and raised in Omsk, a small town in southwestern Siberia, where my parents were physicians. For me, there was no question but that I would go to medical school. At Omsk and Novosibirsk Medical School in the industrial city of Novosibirsk, Siberia, I studied math, science and engineering and got an M.D. Ph.D. degree, completed a clinical fellowship in cardiology and cardiac electrophysiology, and then worked as an assistant professor of medicine at Tyumen Medical School. My first mentor in cardiology died suddenly from ventricular fibrillation at age 51, which inspired me to focus on sudden cardiac death prediction and prevention. I look at the electrical side of things.
I came to the U.S. in 2004 as a visiting research associate at Washington University in St. Louis, and then became a postdoc in electrophysiology at Johns Hopkins in 2007. I conducted studies to build on the technology of implantable cardioverter defibrillators—to make these devices smarter and better able to predict and respond to irregular heartbeats. The same year I came to the U.S., in 2004, Hungarian soccer player, Miklos Feher, suffered sudden cardiac death during a game and died instantly. It’s a dramatic example of why we need to do this work. How can we predict how deaths like this happen? How can we tell if someone is at risk when they have none of the traditional markers of cardiac arrest? Much research has been done to trace cardiac arrest from its obvious origins: plaque buildup in the arteries, a history of stroke or heart attack, or genetics. But who’s at risk for sudden cardiac death in the general population? There’s no way to save them unless we know who’s at risk. In 2013, I received an R01 to look at who’s at risk for sudden cardiac death in the general population.
What brought you to OHSU?
I joined the Knight Cardiovascular Institute that same year to grow and expand my program in order to advance prediction, prevention and treatment of the cardiac arrhythmias. At the Knight Cardiovascular Institute, we work closely together with the clinical electrophysiology group under director Charles Henrikson, M.D. Close collaborations with Dr. Henrikson help us to work on clinically important questions and implement the results of our research findings in clinical practice, to improve patient care. I am working to identify the risk factors that lead to sudden cardiac death and underlying cardiac arrhythmias: ventricular arrhythmia, paroxysmal atrioventricular block, and atrial fibrillation.
What specific avenues of research are you exploring?
I am aiming to redesign the electrocardiogram analysis approach, developing a method to reveal and quantify unapparent ventricular conduction, variability in repolarization, and other electrical abnormalities. I am using non-invasive mapping to engineer models that display the body’s electrical activity, measure arrhythmia and ultimately identify predictors of cardiac arrest. We study the risk of arrhythmia in different groups of patients: heart failure patents, kidney failure patients on dialysis, and those who have rare diseases with a high risk of arrhythmias.
So far, our work has yielded two patent-pending inventions designed to measure and map electrical activity. We are looking at these measurements of heart function, overlapping them with other organ functions, to show more detail than an electrocardiogram ever could. We have three-dimensional bodies, so we should be looking for three-dimensional answers.
I am also conducting two ongoing clinical studies at OHSU that are actively enrolling patients. I am the principal investigator of a randomized controlled trial, called “aCRT ELSYNC,” which has the goal of determining the best treatment approach for heart failure patients. Another study is observational: we try to find the best way to record and analyze electrocardiograms to determine if subcutaneous defibrillators would be a suitable treatment option for those patients who might need it.
Also, recently I initiated and organized an electrophysiology patient council, a group of patients with cardiac arrhythmias who advise us how to conduct clinical research, which questions they consider important, and how they would like us to address those questions. This is a completely novel approach that put patients at the center of clinical research. The Patent-Centered Outcome Research Initiative (PCORI) inspired this revolutionary clinical research, and I am glad to be part of this effort.
Tell us something about your career that’s not on your CV?
I want to grow my team! I am looking for M.D.-Ph.D. students, postdocs, residents, cardiology and electrophysiology fellows, and, specifically, anyone with an electrical or biomedical engineering background. The work in my lab is translational research. Our lab-generated information is helping answer some very important clinical questions.
What do you like to do for fun?
I like to travel. This summer, I am going to Iceland to go snorkeling with my son. He’s an M.D.-Ph.D. student at the University Of Iowa Carver College Of Medicine.
Tereshchenko’s team’s paper –“Electrocardiographic Deep Terminal Negativity of the P Wave in V1and Risk of Sudden Cardiac Death: The Atherosclerosis Risk in Communities (ARIC) Study” – was published in the Journal of the American Heart Association in November 2014.