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Medical Director, Pediatric Heart Failure and Heart Transplant Programs
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As a child, Brian Feingold, MD suffered from frequent asthma attacks and spent a lot of time in emergency rooms. He vividly remembers a period when his asthma attacks were so frequent that he found himself in the ER 12 times in 14 days.
Those childhood experiences left their mark. His asthma now well controlled, Dr. Feingold recalls: “Being around physicians and other health care providers was what first got me interested in a career in medicine.”
As a student at the University of Pittsburgh School of Medicine, Dr. Feingold developed a special interest in heart function and particularly in congenital heart defects. Later, as a fellow in pediatric cardiology at UPMC Children's Hospital of Pittsburgh, he found his calling in the care of children with heart failure and those who had received heart transplants. It was because these patients have complex medical needs that he felt drawn to specialize in their care.
“You need to know a lot about medicine beyond cardiology to take care of patients with heart transplants,” he explains. “You have to take care of the whole patient.” In addition, because patients with heart transplants need ongoing follow-up care, he gets to know his patients over time as they grow into adolescents and young adults.
Dr. Feingold has served as Medical Director of Heart Failure and Heart Transplant Programs at Children’s since 2014. After graduating from medical school in 1999, he completed his internship and residency in pediatrics at the University of Massachusetts Memorial Medical Center in Worcester, MA. He returned to Pittsburgh to undertake fellowships in pediatric cardiology and pediatric cardiac transplantation and heart failure at Children’s.
Dr. Feingold holds a master of science degree in clinical research from the University of Pittsburgh, is board certified in pediatrics and pediatric cardiology by the American Board of Pediatrics, and is an author of more than 40 published journal articles. In addition, he is an internationally known expert in the care of children with Barth syndrome, an extremely rare condition in which a cardinal symptom is heart failure.
Barth syndrome is caused by a genetic defect that affects the mitochondria, structures inside cells whose job is to create the energy that cells – and in turn the organs of the body – need to function. In children with Barth syndrome, the mitochondria cannot make enough energy for healthy organ function. Affected children frequently have weak, enlarged hearts and weak muscles. Most children with Barth syndrome are at risk for frequent infections and below average in height and weight for their age.
The genetic defect that causes Barth syndrome is found on the X chromosome. The condition mostly affects boys, who have only one X chromosome, inherited from their mother. It is so rare that it has been described in only about 200 patients around the world. At Children’s, Dr. Feingold oversees the care of one of the largest cohorts of Barth syndrome patients in the world – a total of nine children.
Heart transplants are beginning to emerge as a potentially beneficial treatment for some patients with Barth syndrome, says Dr. Feingold. To date, two of the patients he follows at Children’s have received heart transplants and are doing well. He is currently working on a research project to determine how many Barth syndrome patients around the world have received heart transplants and how those patients have fared.
Dr. Feingold cautions that not every patient with Barth syndrome will need or will benefit from a heart transplant. Another goals of the research project is to identify factors that may make some Barth syndrome patients more likely than others to benefit from a heart transplant.
Children with a complex and extremely rare condition like Barth syndrome benefit from being cared for by a health care team that includes geneticists and other specialists as well as a cardiologist, says Dr. Feingold.
“Here at the Center for Rare Disease Therapy, we put a high value on working as a team,” he says. “And that contributes to ensuring that our Barth syndrome patients receive the highest standard of care.”
