As a cardiologist at Northwestern Medicine and an associate professor at Northwestern University Feinberg School of Medicine, Matthew Feinstein, MD, MSc, investigates the role of inflammation in cardiovascular disease. He has particular interest in HIV, given the role heightened inflammation plays in the high burden of heart disease for people living with HIV (PLWH). His research specific to HIV and heart disease is supported by two R01 grants with initial funding from the Third Coast Center for AIDS Research (TC CFAR).

Immunologic and clinical contributors to HIV-associated cardiovascular diseases
Nazari I, Feinstein MJ. 1 Feb 2024. Evolving mechanisms and presentations of cardiovascular disease in people with HIV: implications for management. Fig 1 – Immunologic and clinical contributors to HIV-associated cardiovascular diseases. Clinical Microbiology Reviews. 37: e00098-22. DOI: https://doi.org/10.1128/cmr.00098-22

PLWH have a 1.25-fold higher risk for myocardial infarction (heart attack) than the general population. One of Feinstein’s major research interests is the impact of myocardial infarction on PLWH. He co-leads an R01 on this research topic with Ivona Vasile-Pandrea, MD, PhD, professor in the microbiology and immunology program at the University of Pittsburgh. They are examining immune responses to myocardial infarction in HIV, based on Feinstein’s prior data showing that PLWH have significantly more heart muscle damage following myocardial infarction than the general population.

Another area of Feinstein’s research expertise is the study of heart failure with preserved ejection fraction (HFpEF) among PLWH. Individuals living with HIV have a 2-fold higher risk for heart failure than the general population, and rates of HFpEF are much higher for PLWH. With another R01, Feinstein is investigating clinical, immunologic, and inflammatory factors that lead to heart failure with HFpEF for PLWH.

“The clinical heterogeneity of heart failure presentations in individuals living with HIV has been even greater than I initially expected. This underscores the importance of understanding various mechanisms causing heart failure in people living with HIV,” said Feinstein. “These findings are significant to both inform care of individuals living with HIV who are at risk or who have heart failure, and also to inform different approaches for HFpEF screening, prevention, and therapy for PLWH.”

Matthew Feinstein

Feinstein was the recipient of a TC CFAR pilot award and an administrative supplement award, which was essential to generating preliminary data for both of his research grants.

“Almost all the preliminary and feasibility data for both grants came from these CFAR awards,” said Feinstein. “I’m immensely grateful and can say that both of the R01s would not have been possible without the CFAR’s support.”

Since the Center’s founding in 2015, Feinstein has collaborated with the TC CFAR on his cardiovascular disease and HIV research.

“It’s a wonderful and supportive Center and I have been so impressed and appreciative for the inclusion across specialties to ensure we are taking a multidisciplinary approach to enhancing the health and lifespan of people living with HIV,” Feinstein said.