Phillip D. Levy, M.D., M.P.H., an assistant professor in the School of Medicine's Department of Emergency Medicine, has received a prestigious award that will assist him in continuing his work to identify preemptive signs of congestive heart failure.
Dr. Levy, who also serves as associate director of clinical research in the department, has been selected as a recipient of a Robert Wood Johnson Physician Faculty Scholar Award. The award, which includes a grant of $300,000 over three years, was one of 15 awarded. Sixty medical schools submitted applications for consideration.
"Dr. Levy is truly an exceptional faculty member, and the Robert Wood Johnson Foundation Physician Faculty Scholar Award is well-deserved," said Suzanne White, M.D., Chair of the Department of Emergency Medicine. "This accolade, along with his many other accomplishments, reflect his inner commitment to improve the prognosis and quality of life for patients at risk for heart failure through research."
Levy received the award for his research in screening asymptomatic hypertensive patients identified in the emergency department at DetroitReceiving Hospital for early cardiac dysfunction via echocardiography. The patients are randomized to two levels of blood pressure control: "usual," consistent with current guideline-based recommendations, and "aggressive," which seeks to lower blood pressure to optimal levels.
The project is an extension of his previous work, funded by the Blue Cross Blue Shield of Michigan Foundation in 2005, which sought to define the prevalence of early yet asymptomatic cardiac disease in the same patient population. Although Dr. Levy initially estimated a symptom prevalence of no more than 10 percent, the actual results discovered that 95 percent of patients screened showed evidence of disease through echocardiography. The work is in the final stages of analysis, said Dr. Levy, and the preliminary results will be presented at the Society of Academic Emergency Medicine Annual Meeting this month.
Dr. Levy believes his work will contribute significantly to the practice of medicine. "Heart failure is an issue of significant societal importance, imparting debilitating morbidity and progressive demise on those who are afflicted and tremendous financial burden on the healthcare system. Hypertension is the primary population attributable risk for development of heart failure, triggering a pressure-dependent continuum of structural cardiac damage that eventually culminates in overt disease. Detection of morphological changes in the heart prior to the onset of symptoms offers the opportunity to intercede in the process and, with appropriately aggressive therapy, potentially prevent clinically apparent heart failure."
The rates of the condition, Dr. Levy explained, are far greater among African-Americans compared to whites and Hispanics. Blood pressure control among African-Americans is much poorer, leading to premature onset of conditions such as heart failure.
"Despite the increased risk which blacks experience, few programs have been developed to target pre-clinical hypertensive cardiac disease detection or treatment in this specific population," Dr. Levy said. "Not surprisingly, predominantly black urban areas such as Detroit experience an excessive burden of hypertensive heart disease. Socio-economic factors contribute and increase reliance on emergency departments as a usual source of care."
Focused efforts in emergency departments could have "profound" downstream effects on disease prevention, said Dr. Levy, but this has yet to be investigated.
As he pursues his research, Dr. Levy will work with his primary mentor, John Flack, M.D., M.P.H., chair of the Department of Internal Medicine.
"Dr. Phil Levy is an outstanding faculty member, and is justly deserving of the Robert Wood Johnson Award," said Robert Zalenski, M.D., M.A., the Brooks F. Bock Professor of Emergency Medicine, director of the Division of Palliative Emergency Medicine at the School of Medicine and director of the Center to Advance Palliative-Care Excellence for Wayne State University. Dr. Zalenski served as a mentor to Dr. Levy. "His passion is to use the patients' visits to the Emergency Department for other problems to identify those who are succumbing to the effects of high blood pressure and heart failure and don't even know it. By screening them for heart damage with an echo at a point very much earlier in the disease (than they would normally be assessed), he may be able to prevent decades of disability and years of life lost to heart failure and kidney failure. A more worthy or innovative project you will not find in medicine today."
In 2006, Dr. Levy received a Faculty Research Excellence Award from the School of Medicine, and was named Distinguished Faculty Teacher of the Year by Wayne State and the Detroit Receiving Hospital Department of Emergency Medicine for 2002, 2003 and 2007. In 2004 he received the Medical Student Teaching Award from Wayne State University and in 2005 the WSU College Teaching Award. In 2003, he was awarded the Commander's Award for Excellence in Service from the Darnall Army Community Hospital in Fort Hood. And from 2005 to 2008, Dr. Levy has held a fellowship in the American College of Emergency Physicians.
"This project will have a profound effect on my career development, enabling development of further content expertise in my chosen area of focused research," said Dr. Levy. "The team of mentors that will be supporting my application offer unparalleled knowledge and, by way of this grant, I will be able to learn from them in a concentrated fashion. Of particular importance, this grant will provide specific data to help formulate the next phase of investigation for a planned National Institutes of Health R01 submission to track longitudinal outcomes associated with early cardiac dysfunction identified in asymptomatic hypertensive urban emergency department patients."