Spring 2019

Pioneering cardiac care

Rebecca Cogswell, M.D., explains how her father’s heart condition influenced her career in medicine

A rich history of world firsts anchor the current heart research of the University of Minnesota Medical School’s Rebecca Cogswell, M.D., and her colleagues. Cogswell, a University of Minnesota Health cardiologist, specializes in treating advanced heart failure and leads a research team that is shedding new light on it.

Rebecca Cogswell, M.D.

How did you decide on cardiology?

I knew I wanted to be a physician from age 18 or 19. I ended up in the field of advanced heart failure when my dad had significant heart failure. He was first sick when I was 5 years old and had a heart transplant when I was closer to medical school. 

You look at this now and think it would be obvious that I was going to be a cardiologist, but I didn’t necessarily view it that way. But when I was in residency taking care of cardiac patients, specifically those with heart failure, that’s where I felt the most comfortable and had the most passion. 

I think I bring to the field a lot of experience, and I’ve also been on the other side of it as a family member.

How do your clinical work and research intersect?

I take care of patients with very low heart function who are on their way to getting a mechanical pump or transplant, and I care for them afterward. Our goal is to get as many good years as possible out of the heart they were born with, so my role with patients might span many years. 

My involvement in clinical trials means I have a role in creating the new pumps that are coming forward. In 2015 we were part of a large clinical trial that brought the next generation of left ventricular assist devices into practice.

All of us, including the patients who had a device implanted for the very first time, are proud of our role in that. They’re pioneers.

How do you fund your research?

When I started my work here, I received a lump sum from a startup fund in the Department of Medicine’s cardiovascular division. That money came from donors, and it’s been instrumental to my work. I continue to apply for external funding—it takes money and resources to keep my team going.

What about your job do you find most satisfying?

I get to save lives—to be with people on their journey from diagnosis through chronic illness to getting better. It’s a gift.

Research with more muscle

Advanced heart failure inevitably progresses to the point where a patient cannot live without a heart transplant or mechanical pump. By then, patients’ skeletal muscle (above, at a cross-section)—the muscles connected to your bones that allow your body to move—has typically weakened, leading to weight loss, decreased mobility, and overall decline.

By analyzing information about the size of patients’ pectoralis muscles, Rebecca Cogswell, M.D., and her team discovered an interplay between outcomes and muscle wasting: skeletal muscle mass can help predict which patients are likely to do well after a transplant or pump placement and which ones are not—and, critically, when these procedures should be performed. They’ve found that the less wasting of the chest muscles, typically, the better the outcome.

Cogswell has now developed a tool based on this research that allows care teams to plug in data about a patient’s skeletal muscle mass to help predict his or her postsurgery outcome.