James E. Lowe, MD

Professor of Surgery, Professor of Pathology

Department:
Surgery

Division:
Cardiovascular and Thoracic Surgery

Mailing Address:
DUMC 3954 Durham, NC 27710

Telephone:
919-684-3235

Office Telephone:
919-684-3235

Fax:
919-681-7524

Training:
MD, University of California, Los Angeles, David Geffen School of Medicine, 1973

Residency:
Cardiothoracic Surgery, Duke University Medical Center, 1973-1981

Clinical Interests:
Surgical ablation for atrial fibrillation, transmyocardial laser revascularization, myocardial revascularization and valve replacement, congenital coronary malformations, cardiac tumors

Research Interests:
RESEARCH ABSTRACT
Our laboratory is involved in both basic and applied research studies investigating the pathogenesis of reversible and irreversible myocardial ischemic injury. Basic studies performed in both isolated rat myocytes as well as in intact hearts have investigated the effects of fatty acid inhibitors on glucose utilization during ischemia. During the first few seconds of total ischemia, oxygen within blood cells in capillaries throughout the heart is available for the continuation of aerobic metabolism. However, with the cessation of aerobic metabolism, toxic metabolites such as acyl co-esters are formed and these compounds are injurious to the phospholipid component of sarcolemmal membranes. Our hypothesis is that membrane injury occurs early during reversible ischemia and some of the effects of reperfusion injury may be related to early membrane injury, independent of the formation of free radicals. Moreover, another potentially beneficial effect of inhibition of free fatty oxidation during the first few seconds of ischemia is a marked increase in myocyte glucose utilization. Myocytes and intact hearts subjected to inhibition of free fatty acid oxidation increased glucose oxidation three-fold and pyruvate oxidation two-fold. The addition of insulin to myocytes preincubated with fatty acid inhibitors did not further increase glucose transport. In addition to further elucidating the regulation of glucose utilization, fatty acid inhibitors theoretically may have beneficial effects in hearts subjected to ischemia.
Our major applied research project is designed to develop a totally implantable biventricular, non-blood contacting cardiac assist device which we have termed, "Direct Mechanical Ventricular Actuation" (DMVA). DMVA is a non-blood contacting method for circulatory support which can be used in the failing heart, asystolic heart and fibrillating heart. The technology utilizes a contoured cup which attaches itself to both ventricles through a small anterior thoracotomy via a continuous vacuum. Once attached, positive and negative pneumatic forces move a diaphragm within the assist cup to "actuate" the ventricles into respective systolic and diastolic configurations. Recent advances in support cup design and drive-line mechanics strongly suggest that the technology can be further developed to provide safe, effective and economical long-term circulatory support with numerous advantages over blood-contacting cardiac support devices.

Publications:
Tripp HF, Glower DD, Lowe JE, Wolfe WG. Comparison of port access to sternotomy in tricuspid or mitral/tricuspid operations. Heart Surg Forum. 2002;5(2):136-40.

Shemin RJ, Dziuban SW, Kaiser LR, Lowe JE, Nugent WC, Oz MC, Turney DA, Wallace JK. Thoracic surgery workforce: snapshot at the end of the twentieth century and implications for the new millennium. Ann Thorac Surg. 2002 Jun;73(6):2014-32.

Hughes GC, Biswas SS, Yin B, Baklanov DV, Annex BH, Coleman RE, DeGrado TR, Landolfo CK, Landolfo KP, Lowe JE. A comparison of mechanical and laser transmyocardial revascularization for induction of angiogenesis and arteriogenesis in chronically ischemic myocardium. J Am Coll Cardiol. 2002 Apr 3;39(7):1220-8.

Burfeind WR, Glower DD, Davis RD, Landolfo KP, Lowe JE, Wolfe WG. Mitral surgery after prior cardiac operation: port-access versus sternotomy or thoracotomy. Ann Thorac Surg. 2002 Oct;74(4):S1323-5.

Arimoto-Kobayashi S, Ando Y, Horai Y, Okamoto K, Hayatsu H, Lowe JE, Green MH. Mutation, DNA strand cleavage and nitric oxide formation caused by N-nitrosoproline with sunlight: a possible mechanism of UVA carcinogenicity. Carcinogenesis. 2002 Sep;23(9):1537-40.

Shimoi K, Okitsu A, Green MH, Lowe JE, Ohta T, Kaji K, Terato H, Ide H, Kinae N. Oxidative DNA damage induced by high glucose and its suppression in human umbilical vein endothelial cells. Mutat Res. 2001 Sep 1;480-481:371-8.

Hughes GC, Landolfo CK, Yin B, DeGrado TR, Coleman RE, Landolfo KP, Lowe JE. Is chronically dysfunctional yet viable myocardium distal to a severe coronary stenosis hypoperfused? Ann Thorac Surg. 2001 Jul;72(1):163-8.

Horvath KA, Aranki SF, Cohn LH, March RJ, Frazier OH, Kadipasaoglu KA, Boyce SW, Lytle BW, Landolfo KP, Lowe JE, Hattler B, Griffith BP, Lansing AM. Sustained angina relief 5 years after transmyocardial laser revascularization with a CO(2) laser. Circulation. 2001 Sep 18;104(12 Suppl 1):I81-4.

Domkowski PW, Biswas SS, Steenbergen C, Lowe JE. Histological evidence of angiogenesis 9 months after transmyocardial laser revascularization. Circulation. 2001 Jan 23;103(3):469-71.

Clingen PH, Berneburg M, Petit-Frère C, Woollons A, Lowe JE, Arlett CF, Green MH. Contrasting effects of an ultraviolet B and an ultraviolet A tanning lamp on interleukin-6, tumour necrosis factor-alpha and intercellular adhesion molecule-1 expression. Br J Dermatol. 2001 Jul;145(1):54-62.

Cen YY, Glower DD, Landolfo K, Lowe JE, Davis RD, Wolfe WG, Pieper C, Peterson B. Comparison of survival after mitral valve replacement with biologic and mechanical valves in 1139 patients. J Thorac Cardiovasc Surg. 2001 Sep;122(3):569-77.