Researcher’s Profile

Emily J. Tsai, MD, FACC, FAHA

Overview: 

The Tsai laboratory studies cellular and molecular signaling of the failing heart, with the goal of developing novel therapies for heart failure that are synergistic with current guideline directed medical therapy.  Our team focuses on two major areas of research: 1) dysregulation of the nitric oxide biosensor soluble guanylyl cyclase and 2) the molecular mechanisms underlying right ventricular dysfunction and right ventricular failure.

Right ventricular dysfunction (RVD) independently confers increased morbidity and mortality amongst heart failure patients, irrespective of their left ventricular ejection fraction. Despite the high prevalence of RVD, current guideline-directed medical therapies for chronic heart failure do not address RVD. In fact, medical treatment of RV failure is entirely empiric and emphasizes volume management and hemodynamic support, none of which improves long-term survival. Already proven to be functionally beneficial in advanced pulmonary arterial hypertension patients, novel cGMP enhancing drugs hold great promise in chronic heart failure. Yet many cGMP modifying drugs have not benefited heart failure patients in clinical trials, perhaps because these drugs do not target the optimal pool of cardioprotective cGMP signaling. Moreover, their direct myocardial effects, particularly in the failing right ventricle, are incompletely understood.

My research focuses on understanding the regulation and function of intracellular compartments of cGMP as a way to target and potentiate cardioprotective signaling in the failing heart and importantly in the medically treated failing heart. Using both animal models of heart failure and myocardial tissue from end-stage heart failure patients, we have discovered novel mechanisms by which the nitric oxide (NO) biosensor soluble guanylyl cyclase (sGC) is dysregulated in the dysfunctional heart and further identified interventricular differences in NO/sGC/cGMP signaling in the heart with biventricular failure. As we gain more insight into these interventricular signaling differences, we expect to devise novel strategies for modifying cardiac cGMP signaling that will improve biventricular function of the failing heart. Our studies also aim to identify other molecular mechanisms unique to right ventricular dysfunction and gender-specific differences in RVD.

The ultimate goal of the Tsai lab is to discover novel approaches for the treatment of chronic heart failure, with an emphasis on preventing and reversing right ventricular failure.

About: 

Emily J. Tsai, MD, FACC, FAHA, is an Assistant Professor of Medicine in the Department of Medicine, Division of Cardiology. She is an attending physician in the Center for Advanced Cardiac Care at New York-Presbyterian Hospital at the Columbia University Irving Medical Center. Board-certified in Cardiovascular Medicine and Advanced Heart Failure and Transplant Cardiology, Dr. Tsai specializes in caring for heart failure patients who require, or have received, a ventricular assist device or heart transplant.

Dr. Tsai is a magna cum laude graduate in engineering sciences of Harvard College. She received her MD cum laude from Harvard Medical School in the Harvard-MIT Division of Health Sciences and Technology and completed her internal medicine residency training at the Hospital of the University of Pennsylvania and cardiology fellowship at The Johns Hopkins Hospital. While at Hopkins, Dr. Tsai focused her clinical training in advanced heart failure and transplant cardiology. Supported by a Ruth L. Kirschstein National Research Service Award, Dr. Tsai also completed post-doctoral basic cardiovascular research training at Johns Hopkins University in the laboratory of David A. Kass, MD, FAHA. After her post-doctoral fellowship, Dr. Tsai was recruited to Temple University School of Medicine as an assistant professor of medicine and physiology and a principal investigator in its Cardiovascular Research Center. In 2015, Dr. Tsai joined the faculty of Columbia University College of Physicians & Surgeons.

Dr. Tsai is a physician-scientist who focuses on the molecular mechanisms of heart failure, specifically the dysregulation of nitric oxide signaling within heart cells and the pathobiology of right ventricular dysfunction. A translational investigator, Dr. Tsai also analyzes biological samples of heart failure patients to direct mechanistic studies in animal models. The ultimate goal of the Tsai laboratory is to discover novel approaches for the treatment of chronic heart failure, with an emphesis on preventing and reversing right ventricular failure. The Tsai lab is also interested in gender differences in the molecular signaling of heart failure. Dr. Tsai has received national recognition for her research accomplishments. Her research awards include the 2017 American College of Cardiology Presidential Career Development Award, the inaugural 2016 M. Irene Ferrer Scholar Award, the 2015 Columbia University Provost's Grant for Junior Faculty Who Contribute to the Diversity Goals of the University, and the 2012 Jay N. Cohn New Investigator Award in Basic Science from the Heart Failure Society of America. Dr. Tsai has received numerous research grants including the NHLBI K08 Career Development Award, an NHLBI R03, and the AHA National Scientist Development Grant.

Dr. Tsai reviews grants for the American Heart Association and is an author of the 2013 ACCF/AHA Guideline for the Management of Heart Failure.