Dr. Leslie W. Miller hasn't yet started his new job at USF Health. But his vision already is clear: turning Tampa into a major destination for patients seeking the latest procedures, drugs and devices to treat damaged hearts. • "I don't dream small," says Miller, who will lead a new, expanded department of cardiovascular sciences at USF Health. "I really want to see this as the dominant institution in the state with niches where we're a national leader."
Miller, 62, comes to USF from Washington Hospital Center and Georgetown University School of Medicine in Washington, D.C.
A researcher and clinician for 28 years, Miller specializes in the treatment of heart failure and the use of ventricular assist devices — mechanical heart pumps known as VADs — in heart transplant patients. At USF, Miller hopes to move cardiac research forward at a rapid clip, particularly in the use of stem cells to regrow damaged tissue, and personalized medicine based on a patient's gene profile.
"Heart disease is still the No. 1 killer of Americans,'' he said in an interview at USF on Monday. "By age 65, 10 percent of the population is afflicted with heart failure. We're going to take a very aggressive tack to have these new therapies ready for patients in a very short period of time.''
Miller's first day on the job is Sept. 15, but while in Tampa this week for meetings, he sat down with the Times to discuss his goals for the program he'll oversee and how it will benefit patients in the Tampa Bay area and beyond.
How will cardiac care at USF Health, Tampa General Hospital (USF's primary teaching affiliate) and in the Tampa Bay area change with your arrival?
To be sure, I'm joining a team. And I think it's going to be an amazing fit with all that's already going on here and the talented people who are here. My focus is going to be new research, new therapies. What will that mean to the people of Tampa Bay? It will start with conferences and educational opportunities for medical professionals; health fairs, lectures and events for the general public; training the best and the brightest in medicine to increase the quality of health care in the community. I plan to spend time each week visiting community cardiologists, seeing their most difficult heart failure patients and letting them know what USF has to offer. One of the new things that will be coming here is the Regenerative Medicine Institute. It really is part of what brought me here. Using stem cells to repair the heart — I'm really interested in putting them in the patient to regain heart function.
You'll be working with USF's Paul Sanberg, who has done a lot of research using stem cells for brain repair.
Yes, we really hit it off. His work with umbilical cord cells is very provocative because they don't require an embryo. Those umbilical cord cells have not been used in patients with heart failure. That's the cell I want to try to go after early on and try and put those in heart failure patients who are candidates for ventricular assist devices. At the time you put in the VAD, the chest is open, it takes us about five minutes to inject the stem cells. Then, when the donor heart is found we'll have the benefit of studying the heart we treated to find out how the stem cells reacted, what dose is most effective, what are the side effects. We've never been able to take the entire heart out of a patient and study it in total. So it will markedly advance the research.
How far away is that from happening here?
That will happen within the year, I hope. There will be a trial here with stem cells within the next six months, I'm pretty comfortable with that. Will it meet the potential that everybody hopes for? That we can use stem cells in diabetes and Parkinson's disease and Alzheimer's and really have local tissue regenerate? We think that the data thus far suggests that it's possible. And we will have a whole institute to try to understand how we get there. That's the goal.
What else can we expect to see?
Personalized medicine. We can now understand racial differences, gender differences, age differences and how you're likely to respond to heart failure medications. So we'll have your genomic profile and say, "Okay, you have this alteration, you probably wouldn't respond to that drug, you may respond to this drug.'' Or the ultimate is to be able to tell you, "You have a predisposition to diabetes or heart disease and we can decide how to intervene on that early.''
Sum it all up.
We'll have stem cell therapy, gene therapy, new drug therapies and other research drugs, four kinds of ventricular assist devices, we have a spectacular heart transplant program. So I don't think you can go anywhere in the country and get something that isn't going to be offered here. That's my real goal.
Irene Maher can be reached at [email protected]