Cardiologist Julie Brothers, MD, has one overarching ambition: to help children lead the healthiest lives possible.
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
MD - Yale University School of Medicine, New Haven, CT
Oregon Health & Science University, Portland, OR
Oregon Health & Science University, Portland, OR
The Children's Hospital of Philadelphia, Philadelphia, PA
American Board of PediatricsAmerican Board of Pediatrics/Pediatric Cardiology
Titles and Academic Titles
Director, Lipid Heart Clinic
Associate Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania
Departments and Services
Pediatric exercise testing and cardiovascular disease prevention
Coronary artery anomalies
Brothers JA, Paridon SM. The New AHA/ACC Guidelines for Competitive Sports Participation in Young Athletes With Anomalous Coronary Arteries: The Evolution of Change. World J Pediatr Congenit Heart Surg. 2016 Mar;7(2):241-4.
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.
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.
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.
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