Douglas L. Mann, MD, leader, scholar and innovator in HF therapeutics

Mann’s research into the molecular level of HF continues to broaden and improve understanding of the disease.

When Douglas L. Mann, MD, is not working to further his understanding of the failing heart, he keeps his own going by incorporating a daily dose of music, art and exercise.

Mann is the Lewin Chair and professor of medicine, cell biology and physiology, division of cardiology, at the Washington University School of Medicine, St. Louis, and cardiologist in chief at Barnes Jewish Hospital, also in St. Louis. He received his medical degree from Temple University School of Medicine in Philadelphia and completed fellowships in clinical cardiology at the University of California, San Diego (UCSD), and Massachusetts General Hospital in Boston.

Douglas L. Mann, MD Lewin Chair and Professor of Medicine, Cell Biology and Physiology, Division of Cardiology, at the Washington University School of Medicine, St. Louis. Cardiologist in Chief at Barnes Jewish Hospital, St. Louis. Immediate Past President of the Heart Failure Society of America. Editor of Heart Failure: A Companion to Braunwald’s Heart Disease and a co-editor of Braunwald’s Heart Disease, 8th edition. Member of several organizations, including the American Society for Clinical Investigation and the International Society for Heart Failure Research. Member, HF and Transplantation section of Cardiology Today’s Editorial Board.

Currently, Mann is the immediate past president of the Heart Failure Society of America and is a member of several organizations, including the American Society for Clinical Investigation and the International Society for Heart Failure Research. Mann is also the editor of Heart Failure: A Companion to Braunwald’s Heart Disease and a co-editor of Braunwald’s Heart Disease, 8th edition. His research interests include molecular and cellular basis of HF, with emphasis on the role of inflammatory mediators in disease progression of the failing heart.

What do you enjoy doing when you’re not practicing medicine?

Being with my family or traveling. One of the most enjoyable things about traveling has been understanding other cultures. There is just so much to see, learn and do, and within the confines of medicine, it’s sometimes hard to do that. It’s extraordinary how much there is in the world that we don’t get to see as physicians. So I take every opportunity I can to travel.

If you hadn’t gone into cardiology or medicine, what would you have done?

I would have been a musician. However, I knew early on that I just didn’t have the talent to be outstanding musician. Of all the things that have been most exciting in my non-medical career, it’s always been music. But the problem is to make it, you have to be extraordinarily gifted, talented and lucky, and I was neither of those three. The good news is I still enjoy listening to music, although I no longer perform.

What would you consider one of your biggest successes in your specialty?

The contribution of neurohormones, including inflammatory mediators, to the pathogenesis of HF and the translation of that insight to the bedside to develop new therapies have been the most exciting part of my career. We’ve just witnessed such dramatic changes in the management of HF that are, in many cases, driven by understanding of the basic mechanisms. That has been enormously rewarding.

I have also been involved on some early work on adrenergic signaling, which translated into some insights regarding how beta-blockers work, and have been a part of work involving inflammatory cytokines. While the latter work hasn’t translated into therapies yet, it has improved understanding of the pathophysiology of HF.

What is the last book you read, art collection you saw and music you purchased? Why, and what did you think of it?

The last book I read was a series of short stories by David Foster Wallace, entitled A Supposedly Fun Thing I’ll Never Do Again. Foster was an enormously talented and funny writer with an amazing gift for language. One of the most amazing wordsmiths I’ve ever read.

Recently, I visited Chicago and went to the art museum there. They had an American collection exhibit with “American Gothic” by Grant Wood and "Nighthawks" by Edward Hopper. It was incredibly enjoyable to see a true classic American work of art in person.

And the last music I purchased was the soundtrack to the movie Inception by Hans Zimmer. It’s intended to be in the background, so it’s great music to write or work to, but it’s also fun music to listen to as well.

Whom do you most admire, and what would you ask that person if you had 5 minutes with him/her?

Medically, the person I most admire is Eugene Braunwald, MD. He has been a tremendous positive force in cardiology for 40 to 50 years, and he continues to drive the field. I’m now one of the editors for Heart Disease, which is the book he started, and it’s amazing that he still finds things that could be better with the book and ways to improve it. He remains a student of medicine to this day.

Usually, when I get a chance to talk to him, I’ll bring up new ideas and see what he thinks of them. He still gets excited by ideas and concepts and advancements in the field. For him to still be so intellectually alive at his age is wonderful and inspirational. It reminds me that remaining alive intellectually, always questioning things, not taking anything for granted and trying to move the field forward is what it’s all about.

What is the best advice you’ve ever received?

Mark Entman, MD, once told me, “Do what gets you out of bed in the morning.” To me, this means do what you like, what gives you meaning and empowers you. There’s a lot of stuff you hear, and a lot of people trying to tell you what to do professionally, but what’s most important is going after your own personal goals and setting your own personal agenda for things you find meaningful in your life.

Whom do you consider your mentors?

Jim Covell, MD, and John Ross, MD, both of the University of California San Diego; Mark Entman, MD, of the Baylor College of Medicine; and Andrew Schafer, MD, also of Baylor. These are the people who helped shape my life. They encouraged me all along the way and enabled me to stay focused on research and on academic medicine.

What kind of diet and exercise regimen do you have?

I try to adhere to the traditional American Heart Association diet, although I do like a glass of red wine with a piece of red meat on occasion. Regarding exercise, I do a combination of aerobic and light-weight training; I try to exercise as often as possible, usually between three and five times a week, depending on my schedule. Exercise just helps me to sleep and concentrate better. If you could bottle what exercise does in a pill form, you’d make a fortune.

What do you think will have the biggest influence on cardiology in the next 10 years?

A personalized approach is where I hope we get to in the field. One large area that may help to drive this is cardiac imaging; in particular, molecular imaging, which may help us to better define vulnerable plaque and better-tailor therapies. Another big area, which may still be more than 5 to 10 years off, is the area ‘omics,’ (ie, genomics, proteomics and metabolomics) and biomarkers. We already are having pharmacogenetic-driven approaches in certain things, but whether it could be broadened and extended is a major question. Also, the issue of biomarkers and the ability to better risk-stratify people and tailor therapies based on biomarker profiles will be some of the other areas of major influence in the next 10 years.

What is your favorite travel destination?

Anywhere in Europe. The history is fantastic. My family came from Austria, and I enjoy learning about my roots any chance I get.

What is your favorite restaurant?

Danielle’s in New York. They’ve got innovative cuisine with a terrific wine list and a very elegant atmosphere. – by Brian Ellis