Q & A with Page Anderson, MD

Back to Dr. Anderson’s physician profile

Where did you receive your undergraduate and/or medical training?
I attended the University of California. Some years later it became UC of Berkeley.

How long have you been at Duke?
I have been at Duke since 1972.

Where did you work prior to coming to Duke?
I was a resident at Children's Hospital of Los Angeles

Have you received any awards or honors? Do you sit on any boards or journals?
I was the Chair of the NHLBI scientific review committee entitled Cardiovascular A for the meetings in 2000-2002. I have been the Chair of the Special Emphasis Panels for the NHLBI K08 awards in 2004 and 2005. I have chaired many other review groups for the NHLBI.

What are your board certifications and society memberships?
I am board certified in Pediatrics and Pediatric Cardiology. I am a Fellow of the American Academy of Pediatrics, a Fellow of the American College of Cardiology, and a member of the American Pediatric Society.

What led you into the field of pediatric cardiology/pediatric cardiac surgery?
I had an opportunity to be a fellow for six months in pediatric cardiology at the end of Medical School in January 1964. I had the opportunity to see how the field was rapidly changing and that the care of infants and children with heart problems was going to evolve to a point that we would better understand the disease processes and would be able to develop and apply new catheter based and surgically based approaches for their treatment.

What are your areas of sub-specialty and how have things changed since you entered the field?
I am a general pediatric cardiologist. I have had the opportunity to participate in clinical trials such as the application of indomethacin to close the ductus in the premature infant. I have had the opportunity to go from emergency cardiac catheterization and surgery to the use of prostaglandin infusions to maintain patency of the ductus arteriosus. We have gone from those emergent approaches to treat the critically sick neonate to echocardiographic diagnoses in utero, the planned delivery and care of the infant with complex heart disease, the stabilization of the infant in the PICU with prostaglandin infusion, and the use of cardiopulmonary bypass to cure or palliate the infant. We have gone from using hyperbaric chambers to perform surgery because cardiopulmonary bypass was not possible. Those open atrial septectomies had to be performed emergently because there was no catheter based atrial septostomies. The infants who underwent those open atrial septostomies returned to their room and not to a PICU. The changes continue to the great benefit of the patient and the family.

Are you involved with any clinical trials or research studies?
I am involved in the clinical trials that are supported by the NHLBI in the Pediatric Heart Disease Network. We have completed a Fontan Cross Sectional Study involving over 500 children ages six through 18 that have undergone a Fontan procedure. These data will provide the basis for developing pharmacological trials to improve the quality of life and the life span of these children. I have reviewed the pharmacological therapy of those children at the 7 participating PHN Centers and will present those data that underline the need for pharmacological trials at the annual American Heart Association National Meeting. We have completed the Kawasaki Disease Trial that assessed whether a pulse of steroids, in addition to standard of care therapy, would improve the outcome for these children. Those results will be presented at the annual American Heart Association National Meeting. We are presently carrying out four other clinical trials, the first of which is examining the outcome of atrioventricular septal defect surgery. The parents of those children who have significant mitral regurgitation at six months following surgery have the opportunity to enroll their child in a double blind placebo controlled randomized trial of the use of enalapril. Fortunately, none of the Duke patients have had moderate or worse mitral regurgitation.

We are carrying out a double blind placebo controlled randomized trial in infants with single ventricle physiology to test whether angiotensin converting enzyme inhibition will improve their outcome at 124 months of life measured by how they have grown, their height and weight.

Another trial is the Single Ventricle Reconstruction Trial that is testing which of the two commonly used palliative procedures for hypoplastic left heart syndrome has the best outcome as measured by death or transplantation at 12 months of life.

The final trial is examining the strength of the echo measurements made in children with cardiomyopathies.

What is the focus of your current research and how will your research contribute to the field of medicine?
My focus of research is in two areas:

1. Testing the significance of the four different forms of a contractile protein, cardiac troponin T, in heart function both in the normal and the failing heart. If we find there is an advantage of one over the other in the failing heart, the ultimate development of gene therapy would have a target molecule to be used in the patient with a failing heart.
2. The adult derived stem cell. We have found that cells from a line isolated from the liver of an adult rat transdifferentiate into cardiac myocytes in the adult heart. We have found that native cardiac myocytes signal to the stem cell to carry out this process through inducing calcium oscillations in the stem cell. We aim to elucidate the mechanisms so that they can be applied to the patient to enhance the homing of stem cells to the damaged heart and their transdifferentiation into cardiac myocytes that are integrated into the cardiac syncytium. We anticipate that such cells could be isolated from the patient and then given back after being amplified multifold to help repair the damaged heart.

What drew you to Duke and what do you enjoy most about your work?
I came to Duke because of the dynamic research program. I enjoy many aspects of my work including teaching, patient care and performing research.

Share a special story to explain more about your experience helping children with congenital heart disease.
There are too many to pick from, and time has made the details incorrect. How does it go? "Your dress was red." "No, it was blue."

What do you think sets Duke Pediatric Cardiology apart from other practices in the area?
The integrated team approach of a group of physicians who individually have great skills that are put together in such a manner that patients with complex or difficult problems are more likely to have an excellent outcome.

What are your personal hobbies or interests?
I like to play with my grandchildren in my garden.