Associate Professor of Medicine in the Division of Cardiovascular Medicine
Specialty: Genetics of dilated cardiomyopathies and heart failure, heart failure
Fellowship: Cardiology, Duke University Medical Center, Durham, NC
Residency: Internal Medicine, Duke University Medical Center, Durham, NC
Medical Degree: Washington University School of Medicine, St. Louis
The opportunity to build a clinic dedicated to applying the latest breakthroughs in genetics to the treatment of patients with heart disease — this is one key reason Matthew Wolf, MD, joined the faculty at UVA. “Knowledge of the genetic causes of some forms of heart disease is growing all the time,” Wolf says. “I was attracted by UVA’s commitment to use that knowledge for the benefit of patients and their families.”
Another draw for Wolf was the UVA Robert M. Berne Cardiovascular Research Center. Wolf has long been interested in the genetics and signaling pathways that cause cardiomyopathies. At UVA, he saw an opportunity to advance his research by collaborating with distinguished scientists in fields such as imaging and biomedical engineering.
Wolf joined UVA in June 2015 after eight years serving on the faculty in the Division of Cardiology at Duke University. We spoke to him about the clinic, his research and more.
How have you found UVA so far?
This is a really wonderful place. There is a tremendous amount of collegiality and collaboration and a great willingness to work together, both in the clinical setting as well as in the research environment. That’s essential to providing excellent patient care and pushing the boundaries of science.
Talk about your vision for the cardiovascular genetics clinic.
The goal is to be able to take care of patients with cardiovascular diseases that run in families and evaluate these individuals and their family members for a genetic cause for their conditions. I see my role — with the assistance of Matt Thomas, our genetics counselor — as providing a consultative service for cardiologists and physicians in family practice or internal medicine, at UVA or elsewhere, who feel there may be a genetic cause for a patient’s heart condition. Importantly, we envision being a resource to assist providers, their patients and their patients’ families. We can perform genetic testing to determine if there is a genetic cause and offer counseling based on the information we gain, not only for the individual, but also for their family members. We can then work in concert with the referring physician to discuss genetic test results and develop a treatment plan.
What’s the value of this kind of information for a patient?
Let me give you an example. If you can identify a known genetic cause of a dilated cardiomyopathy before there is severe decline in cardiac function, you may be able to put the patient on medications that have been shown to positively impact heart function. We like to think that if we can start those medications earlier, we may be able to change the disease progression.
What are the principal genetic conditions that you screen for?
Physicians should send us patients with structural muscle conditions like hypertrophic cardiomyopathy (HCM) and dilated cardiomyopathies, arrhythmias like long QT syndrome, lipid issues like familial hypercholesterolemia, and collagen-vascular diseases like Marfan’s syndrome.
This seems to be the kind of practice where you care for the whole family, not just an individual patient.
If someone comes in with a heart condition, and we are able to identify a particular gene associated with this condition, it is important that we have first-degree relatives come in for a screening echocardiogram and, in some cases, a targeted genetic test to see if they have inherited the gene or not.
Are there clinical trials underway that might be of interest to your patients?
Yes, there are trials exploring new treatments for HCM, high lipids and heart failure among other issues.
What will be your research focus?
Our lab is interested in those genes that cause or modify the course of cardiomyopathies. The primary model system we use is based on fruit fly genetics. We use optical coherence tomography, which provides images with a resolution in the order of microns, to identify flies that have abnormalities in their heart chamber size or function and have identified a number of candidate genes that when mutated cause abnormalities. We are testing them in cell culture systems and in animal models.
At the same time, we are collaborating with researchers who study patients with HCM and who have identified a gene signature for the disease. In one set of studies, we took the human gene and put it in a fly, and the fly developed an abnormal cardiac phenotype. Our goal is to identify genes that affect heart function and determine if they represent potential targets for new therapies.
If you would like to arrange an on-site visit with Dr. Wolf or one of our other providers, please contact our Physician Relations team.