Dr. Jonathan Moreno

2022

We are currently doing an inpatient clinical trial called FASTR 2, which is an inpatient diuretic titration protocol with the use of automation for patients in acute decompensated heart failure and volume overload. The goal of the trial is to rapidly find the right dose of diuretic (water pills) for patients who are admitted with volume overload. By continuously assessing urine output, the diuretic regimen is titrated to maximum response. In this way, patients are decongested and can discharge from the hospital “faster” than with standard of care.

We are in the process of starting a trial called GOURMET-HF (site PI – Dr. Javaheri, my partner here at VA), to assess the use of home based, nutritious meals for patients with HF.

Lastly, we are formulating a clinical trial to understand biomarkers and patient outcomes for patients that are suspected of, and newly diagnosed with cardiac amyloidosis (CA). CA is a deadly, and debilitating disease where abnormal proteins infiltrate heart, kidneys and nervous systems. We, at VA, are at the forefront of CA workup and management, and this multi-center clinical trial, led by STL VA will yield critical insight into new pathways of drug discovery for patients with CA. In addition, we will better be able to understand the early features that predict patients who might go on to develop CA.

As an academic medical center (with collaborations with both SLU and Wash U), we have an obligation to continue to push the science and move new discovery forward for clinical medicine. It is what separates us from the community. I firmly believe that cutting edge clinical care is NOT JUST what is currently available, but actively enrolling patients into new clinical trials that might yield benefit both to them, as well as patients that come after them. Research allows us to test hypotheses and questions that arise in the course of taking care of patients.

Participating in research allows us to be at the forefront of cutting edge science and medicine, and offer groundbreaking therapies to Veterans with heart failure and other cardiac diseases. In addition, it gives Veterans the opportunity to “give back” to science and medicine and potentially make a meaningful impact in the Veterans who come after them

I deeply enjoy finding patients with limited options who might benefit from therapies that are not clinically available. As a PI, it’s fascinating to interact with other scientists, come up with testable hypotheses, and implement a protocol to test these ideas. It also allows me to be a part of a dynamic team of physicians, scientists, and clinical coordinators with a shared mission to relieve cardiovascular disease burden for our patients.