Background

Cardiologist Julie Brothers, MD, has one overarching ambition: to help children lead the healthiest lives possible.

She pursues that goal through two main avenues: as the director of CHOP’s Lipid Heart Clinic and as the medical director of its Coronary Anomaly Management Program.

In these roles, Dr. Brothers strives to prevent potentially life-threatening medical crises, both in the clinic and through clinical research.

“I want patients and their families to know that we truly care about their children and hope they have the best experience possible during their time at CHOP,” she says.

The Lipid Heart Clinic addresses dyslipidemia, or abnormal levels of fats (including cholesterol) in the blood. Dyslipidemia in children, which elevates the risk of heart disease later in life, is sometimes hereditary, but most often it results from lifestyle factors like diet and lack of physical activity.

“I am drawn to the patients with dyslipidemia,” Dr. Brothers says, “because there are many ways to work with kids and their families to get healthier, be it changing the diet, adding more physical activity and less screen time, or both.”

A promising area for dyslipidemia treatment, she says, is “teaching children and families the importance of choosing more whole, plant-based food and getting away from processed foods in helping reduce cardiovascular risk.”

Although most patients with dyslipidemia improve with lifestyle changes, children with inherited dyslipidemia may need medication as well.

In recent years, researchers have made significant advances in understanding the genetic basis of inherited dyslipidemia, and Dr. Brothers is enthusiastic about the prospects of improving treatments on the basis of this research: “I envision targeted medication for certain inherited lipid disorders based on the patient's genotype,” she says.

Coronary artery anomalies, the other focus of Dr. Brothers’ work, are considerably rarer than dyslipidemia.

Coronary arteries lead from the aorta (the large blood vessel that arises from the heart) and supply oxygen to the heart muscle. When these blood vessels are not located in their usual location on the aorta, it may lead to cardiovascular symptoms and may place the child at increased risk of sudden cardiac arrest, especially after vigorous exercise.

While some children with coronary artery anomalies experience symptoms such as chest pain, dizziness, palpitations or fainting, some patients have no symptoms and are diagnosed only when they undergo a diagnostic imaging procedure for some other reason.

Treatment of this condition is very challenging, as little is currently known about which factors increase the risk of sudden cardiac death in children with coronary artery anomalies. Dr. Brothers is actively researching this question.

“I am hopeful that we will be able to better determine which patients with certain coronary anomalies are at high risk for sudden cardiac arrest and which are at low risk. This would change the way we manage these patients,” she says. “I want to help figure this out and work with these families to allow their children to exercise safely.”

Education and Training

Medical School

MD - Yale University School of Medicine, New Haven, CT

Internship

Pediatrics - Oregon Health & Science University, Portland, OR

Residency

Pediatrics - Oregon Health & Science University, Portland, OR

Fellowship

Pediatric Cardiology - The Children's Hospital of Philadelphia, Philadelphia, PA

Board Certification

Pediatric Cardiology
Pediatrics

Titles and Academic Titles

Medical Director, Lipid Heart Clinic

Co-Medical Director, Preventive Cardiovascular Program

Medical Director, Coronary Anomaly Management Program

Associate Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania

Departments and Services

Research Interests

Pediatric exercise testing and cardiovascular disease prevention
Coronary artery anomalies

Publications

Papers

2021

Berger JH, Chen F, Faerber JA, O'Byrne ML, Brothers JA : Adherence with lipid screening guidelines in standard- and high-risk children and adolescents. Am Heart J 232: 39-46, Feb 2021.

2020

Jegatheeswaran A, Devlin PJ, Williams WG, Brothers JA, Jacobs ML, Lorber RO, Mertens L, Mery CM, DeCampli WM, Fleishman CE, Caldarone CA, Kirklin JK, Molossi S, McCrindle BW: Is Surgical Repair of Anomalous Aortic Origin of a Coronary Artery Benign? J Thorac Cardiovasc Surg 160: 757-71, Sep 2020.

Burstein DS, McBride MG, Min J, Paridon AA, Perelman S, Huffman EM, O'Malley S, Del Grosso J, Paridon SM, Brothers JA : Normative Values for Cardiopulmonary Exercise Stress Testing Using Ramp Cycle Ergometry in Children and Adolescents  J Pediatrics Sep 2020.

Jegatheeswaran A, Devlin PJ, Williams WG, Brothers JA, Jacobs ML, DeCampli WM, Fleishman CE, Kirklin JK, Mertens L, Mery CM, Molossi S, Caldarone CA, Lorber RO, McCrindle BW.: Outcomes Following Anomalous Aortic Origin of a Coronary Artery Repair: A Congenital Heart Surgeons' Society Study. J Thorac Cardiovasc Surg April 2020 Notes: in press, online April 2020.

2019

Jegatheeswaran A, Devlin PJ, McCrindle BW, Williams WG, Jacobs ML, Blackstone EH, DeCampli WM, Caldarone CA, Gaynor JW, Kirklin JK, Lorber RO, Mery CM, St louis JD, Molossi S, Brothers, JA: Features associated with myocardial ischemia in anomalous aortic origin of a coronary artery: A Congenital Heart Surgeons' Society study. J Thorac Cardiovasc Surg Sept 2019.

Berger JH, Rome JJ, Brothers JA: Isolated single right coronary artery in a pediatric patient  World J Pediatr Congenit Heart Surg 10: 515-7, Jul 2019.

Lai K-C, Brothers JA, Stoller JZ : Severe hypertriglyceridemia associated with everolimus drug-eluting stentplacement in an infant. Cardiol Young Aprl 2019 Notes: doi: 10.1017/S1047951119000167.

2017

Meza JM, Elias M, Wilder T, O'Brien JE, Kim RW, Mavroudis C, Williams WG, Brothers J, Cohen M, McCrindle BW: Exercise restriction is not associated with increasing adiposity over time in patients with coronary arteries of anomalous aortic origin: a report from the CHSS AAOCA registry. Pediatr Cardiol Page: 1-7, May 2017 Notes: epub ahead of print doi: 10.1017/S104795111700066X.

Elias MD, Meza J, McCrindle BW, Brothers JA, Paridon S, Cohen MS: Impact of exercise restriction on patients with anomalous aortic origin of a coronary artery. World J Pediatr Congenit Heart Surg 8: 18-24, Jan 2017.

2016

Herrmann JL, Goldberg LA, Khan AM, Partington SL, Brothers JA, Mascio CE, Spray TL, Kim YY, Fuller S: A comparison of perioperative management of anomalous aortic origin of a coronary artery between an adult and pediatric cardiac center. World J Pediatr Congenit Heart Surg 7: 721-6, Nov 2016.

Sing AC, Tsaur S, Paridon SM, Brothers JA: Quality of life and exercise performance in unoperated anomalous aortic origin of the coronary artery. Cardiol Young 5: 1-10, Sep 2016.

Brothers JA, Kim TS, Fogel MA, Whitehead KK, Morisson TM, Paridon SM, Harris MA: Cardiac magnetic resonance imaging identifies stenosis, perfusion, and fibrosis preoperatively and postoperatively in children with anomalous coronary arteries. J Thorac Cardiovasc Surg 152: 205-10, July 2016.

2015

Lorber R, Srivastava S, Wilder TJ, McIntyre S, DeCampli WM, Williams WG, Frommelt P, Parness IA, Blackstone EH, Jacobs M, Mertens L, Brothers J, Herlon R, AAOCA Working Group of the Congenital Heart Surgeons Society. Anomalous Aortic Origin of Coronary Arteries in the Young: Echocardiographic Evaluation with Surgical Correlation. JACC Cardiovasc Imaging. 2015 Nov;8(11):1239-49. doi: 10.1016/j.jcmg.2015.04.027.

Brothers JA, Whitehead KK, Keller MS, Fogel MA, Paridon SM, Weinberg PM, Harris MA. Cardiac MR and CT Virtual Angioscopy Demonstrate Normal Coronary Ostial Morphology in Children with Anomalous Left Coronary Artery with Intraseptal Course. Am J Radiol. 204: W104-W109, Jan 2015.

2014

Wittlieb-Weber CA, Brothers JA: Coronary Artery Anomalies: Current Recognition and Treatment Strategies. Update on Recent Progress. Curr Cardiovasc Risk Rep. 8:395-398. July 2014.

Poynter JA, Bondarenko I, Austin EH, DeCampli WM, Jacobs JP, Ziemer G, Kirshbom PM, Tchervenkov CI, Karamlou T, Blackstone EH, Walters III HL, Gaynor W, Mery CM, Pearl J, Brothers JA, Caldarone CA, Jacobs ML, Mavroudis C, the Congenital Heart Surgeons' Society AAOCA Working Group. Repair of Anomalous Aortic Origin of a Coronary Artery in 113 Patients: A Congenital Heart Surgeons' Society Report. World J Pediatr Congenit Heart Surg. 2014 Oct;5(4):507-14. doi: 10.1177/2150135114540182.

Brothers JA. Harris MA. Right Coronary Artery From Right Sinus of Valsalva and Ventricular Tachycardia. Ann Thorac Surg. 2014 Sep;98(3):1091-4. doi: 10.1016/j.athoracsur.2013.10.099.

Poynter JA, Williams WG, McIntyre S, Brothers JA, Jacobs ML, the Congenital Heart Surgeons Society AAOCA Working Group. Anomalous Aortic Origin of a Coronary Artery: A Report from the Congenital Heart Surgeons Society Registry. World J Pediatr Congenit Heart Surg. 2014 Jan 1;5(1):22-30. doi: 10.1177/2150135113516984.

2013

Wittlieb CA, Paridon SM, Gaynor JW, Spray TL, Weber DR, Brothers JA. Medium-term outcome after anomalous aortic origin of a coronary artery repair in a pediatric cohort. J Thorac Cardiovasc Surg. 2014 May;147(5):1580-6. doi: 10.1016/j.jtcvs.2013.07.022. Epub 2013 Aug 26.

Longmuir PE, Brothers JA, de Ferranti SD, Hayman LL, Van Hare GF, Matherne GP, Davis CK, Joy EA, McCrindle BW, American Heart Association Atherosclerosis, Hypertension and Obesity in Youth Committee of the Council on Cardiovascular Disease in the Young. Promotion of physical activity for children and adults with congenital heart disease: a scientific statement from the American Heart Association. Circulation. 2013 May 28;127(21):2147-59. doi: 10.1161/CIR.0b013e318293688f. Epub 2013 Apr 29.

2012

Brothers J, McBride M, Paridon A, Zhang X, Paridon S: Fatness is not a factor of fitness: analysis of cardiorespiratory data from healthy children over an eight year period. Cardiol Young 8: 1-7, Mar 2012.

2010

Brothers JA, Gaynor JW, Jacobs JP, Caldarone C, Jegatheeswaran A, Jacobs ML; Anomalous Coronary Artery Working Group: The registry of anomalous aortic origin of the coronary artery of the Congenital Heart Surgeons' Society. Cardiol Young 20 : S50-8, Dec 2010.

2009

Brothers JA, Gaynor JW, Paridon SM, Lorber R, Jacobs ML; Anomalous Coronary Artery Working Group of the Congenital Heart Surgeons' Society: Anomalous aortic origin of a coronary artery (AAOCA): understanding current management strategies in children and young Adults. Pediatr Cardiol 30: 911-21, Oct 2009.

Brothers JA, McBride MG,Marino BM, Tomlinson RS, Seliem MA, Pampaloni MH, Gaynor JW, Spray TL, Paridon SM: Exercise performance and quality of life following surgical repair of anomalous aortic origin of a coronary artery in the pediatric population. J Thorac Cardiovasc Surg 137: 380-4, Feb 2009.

2008

Brothers JA, Stephens P, Gaynor JW, Lorber R, Vricella L, Paridon SM: Anomalous aortic origin of a coronary artery with an interarterial course: should family screening be routine? J Am Coll Cardiol 51: 2062-4, May 2008.

2007

Brothers JA, McBride MG, Seliem MA, Marino BM, Tomlinson RS, Pampaloni MH, Gaynor JW, Spray TL, Paridon SM: Evaluation of myocardial ischemia following surgical repair of anomalous aortic origin of a coronary artery from the opposite sinus of Valsalva in a series of pediatric patients. J Am Coll Cardiol 50: 2078-82, Nov 2007.

2006

Davis JA, McBride MG, Chrisant MRK, Patil SM, Hanna BD, Paridon SM: Longitudinal assessment of cardiovascular performance after pediatric heart transplantation. J Heart Lung Transplant 25: 626-33, Jun 2006. Notes: Previously published under Davis, JA.

2002

Forsyth BWC, Davis JA, Freudigman KA, Katz KH, Zelterman D: Pregnancy and birth rates among HIV-infected women in the United States: the confounding effects of illicit drug use. AIDS 16: 471-9, Feb 2002. Notes: Previously published under Davis, JA.

2001

Davis JA, Cecchin F, Jones TK, Portman MA: Major coronary anomalies in a pediatric population: incidence and clinical importance. J Am Coll Cardiol 37: 593-7, Feb 2001. Notes: Previously published under Davis, JA.

Abstracts

2018

Shiwani H, Brothers J, Villines TC, Liberthson RR, Blankstein R, Cheezum MK.  : Sudden Cardiac Death and Aborted Sudden Cardiac Death in Patients with Anomalous Aortic Origin of a Coronary Artery (AAOCA) from the Inappropriate Sinus of Valsalva: A Systematic Review of the Literature. American College of Cardiology Scientific Sessions 2018 March 2018.

Shiwani H, Brothers J, Villines T, Liberthson R, Blankstein R, Cheezum M : Sudden cardiac death and aborted sudden cardiac death in patients with anomalous aortic origin of a coronary artery (AAOCA) from the inappropriate sinus of Valsalva: A systematic review of the literature  J Am Coll Cardiol 71: A533, Mar 2018.

 

Books

Chapters

2021

Brothers JA & Gaynor JW: Surgery for Congenital Anomalies of the Coronary Arteries. Sabiston & Spencer Surgery of the Chest, 10th Edition. Frank W. Sellke, Pedro J. del Nido, and Scott J. Swanson (eds.). Elsevier, 2021.

2020

Brothers JA and Daniels SR: Management of Dyslipidemia in Children. Therapeutic Lipidology, Second Edition. Michael H. Davidson, MD, Peter P. Toth, MD, PhD, and Kevin C. Maki, PhD (eds.). SpringerNature, August 2020.

2019

Brothers JA and Daniels SR: Identification and Management of Children with Dyslipidemia. Lifestyle Medicine, 3rd Edition. J. Rippe (eds.). Taylor & Francis, Page: 919-933, June 2019 Notes: in press.

2018

Prout E, Panganiban J, Daniels SR, Brothers JA: Nutritional considerations for cardiometabolic health in childhood and adolescent obesity. Nutrition and Cardiometabolic Health. Bergeron, Bray, Krauss, Siri-Tarino (eds.). CRC Press, Taylor & Francis Group, 1: 149-172, 2018.

Brothers JA, Gaynor JWG: Coronary anomalies. Operative Cardiac Surgery, 6th ed. Thomas Spray, Michael Acker (eds.). NPM Ltd, Page: 687-97, August 2018 Notes: in press.

Brothers JA & Jacobs ML: Coronary artery anomalies. Critical Heart Disease in Infants and Children, ed 3. Ungerleider (eds.). Elsevier, June 2018 Notes: in press.

Brothers J: Chest pain with exercise. Cardiopulmonary Exercise Testing in Children and Adolescents. Rowland (eds.). Human Kinetics, Page: 167-174, Jan 2018.

Brothers J: Presyncope and syncope with exercise. Cardiopulmonary Exercise Testing in Children and Adolescents. Rowland (eds.). Human Kinetics, Page: 175-182, Jan 2018.

2015

Brothers JA, Gaynor JW: Surgery for congenital anomalies of the coronary arteries. Sabiston and Spencer's Surgery of the Chest, 9th edition. Selke, del Nido, & Swanson (eds.). Elsevier, Page: 2222-42, Sep 2015.

Brothers JA, Stephens P Jr, Paridon SM: Sports screening and participation. Moss and Adams'Heart Disease in Infants, Children, and Adolescents: Including the Fetus and Young Adult, 9th Edition. Allen, Driscoll, Shaddy, Feltes (eds.). Page: 261-86, Aug 2015.

2014

Brothers JA, Daniels SR: Special patient populations: children and adolescents. Clinical Lipidology, 2nd edition: a companion to Braunwald's Heart Disease. Christie M. Ballantyne (eds.). Elsevier, Page: 427-40, Nov 2014.

Brothers J, Gaynor JW: Congenital anomalies of the coronary arteries. The Johns Hopkins Manual of Cardiothoracic Surgery, 2nd edition. Stephen Yan, John Doty, and Luca Vricella (eds.). McGraw-Hill, Page: 1279-96, May 2014.

2013

Brothers JA, Gaynor JW: Coronary artery anomalies in children. Mastery of Cardiothoracic Surgery. LR Kaiser, IL Kron, TL Spray (eds.). Lippincott Williams & Wilkins, Page: 1055-73, Dec 2013.

Brothers JA, Stephens P, Paridon SM: Sports screening and participation. Moss and Adams' Heart Disease in Infants, Children, and Adolescents: Including the Fetus and Young Adult, 8th Edition. Hugh Allen, David Driscoll, Robert Shaddy, Timothy Feltes (eds.). Lippincott Williams & Wilkins, Page: 93-117, Jan 2013.

2012

Parnell A, Dorfman A, Brothers J: Preventive cardiology. Pediatric Practice: Cardiology. Robert Shaddy, Marie Gleason, Jack Rychik (eds.). McGraw-Hill Publishing, Page: 289-314, Apr 2012.

2010

Brothers JA, Gaynor JW: Surgery for congenital anomalies of the coronary arteries. Sabiston and Spencer Surgery of the Chest, 8th Edition. Selke, del Nido, Swanson (eds.). Elsevier, 8: 1963-80, Sep 2010.

2008

Brothers JA, Daniels SR: When should children and adolescents be screened for dyslipidemia and how should they be treated? Clinical Challenges in Lipid Disorders. Toth PP, Sica DA (eds.). Atlas Medical Publishing, Oxford, Page: 61-74, July 2008.

Posters and Presentations

2019

Berger JH, Chen F, Faerber J, O'Byrne ML, Brothers JA : Poor Lipid Screening Rates In United States Children And Adolescents: A Call To Action For Pediatric Health Care Providers. American Heart Association Scientific Sessions 2019 Nov 2019 Notes: Poster presentation.

Jegatheeswaran A, Devlin PJ, Williams WG, Brothers JA, Jacobs ML, Lorber RO, Mertens L, Mery CM, DeCampli WM, Fleishman CE, Caldarone CA, Kirklin JK, Molossi S, McCrindle BW: Is Surgical Repair of Anomalous Aortic Origin of a Coronary Artery Benign? American Association for Thoracic Surgery May 2019 Notes: Accepted for Plenary session, oral presentation.

2018

Jegatheeswaran A, Devlin PJ, Williams WG, Brothers JA, Jacobs ML, Lorber RO, Mertens L, Mery CM, DeCampli W, Fleishman CE, Caldarone CA, Kirklin JA, Molossi S, McCrindle BW : Is Surgical Repair of Anomalous Aortic Origin of a Coronary Artery Benign? AATS 99th Annual Meeting May 2018 Notes: Podium presentation by A. Jegatheeswaran.

Jegatheeswaran A, Devlin P, Williams WG, McCrindle BW, Caldarone CA, DeCampli WM, Gaynor JW, Heinle JS, Jacobs ML, Kirklin JK, Lorber RO, St Louis JD, Brothers JA. : Surgical outcomes in AAOCA: Do the Benefits of Surgery Outweigh the Risks? American Association for Thoracic Surgery Annual Meeting May 2018 Notes: Accepted for Plenary Session Oral Presentation.

Awards and Honors

2010, Woman of the Week, 95.7 Ben FM
2007, American Heart Association Women in Cardiology Trainee Award for Excellence
2006, Fellowship Award for Outstanding Achievement in Research
2005, Outstanding Abstract/Poster for Clinical Research
2005-2007, NIH Institutional National Research Service Award Training Grant (T32HL07915)
2000, James Campbell Award for Highest Rank USMLE Boards
1999, Clyde A Swift Award for Outstanding Medical Student in Anesthesiology
1994, Mortar Board National Senior Honor Society
1994, Phi Beta Kappa Undergraduate Award
1994, Salutatorian, Class of 1994
1993, Pi Kappa Phi, Junior Year
1993, Phi Beta Kappa, Junior Year

Editorial and Academic Positions

Editorial Positions

2015-present, Peer reviewer, Circulation
2012-present, Peer Reviewer, American Heart Journal
2012-present, Peer reviewer, BMC Cardiovascular Disorders
2012-present, Peer Reviewer, Journal of Clinical Lipidology
2011-present, Peer reviewer, Archives of Pediatrics & Adolescent Medicine
2010-present, Peer Reviewer, JAMA
2010-present, Peer Reviewer, World Journal for Pediatric and Congenital Heart Surgery
2010-present, Peer reviewer, Cardiology in the Young
2008-present, Peer Reviewer, Pediatrics
2008-present, Peer Reviewer, Journal of Pediatrics

Leadership and Memberships

Memberships in Professional Organizations

International

2013-present, Congenital Heart Surgeons' Society

National

2016-present, Aegerion Pharmaceuticals, Consultant
2007-present, North American Society for Pediatric Exercise Medicine
2007-present, National Lipid Association
 - 2007-present, PedAL (Pediatric Atherosclerosis Prevention and Lipidology) Subgroup
2007-present, American Heart Association
2007-present, American College of Cardiology
 - 2016-present, 2017 Scientific Sessions (Abstract Reviewer: Congenital Heart Disease)
2003-present, American Heart Association