Of Hearts and Minds

Anna Klar’s effort to understand the relationship between chronic heart failure and brain blood flow lands her the opportunity to showcase her work at an annual UW System science symposium.

By Katharine Tyllo
Photograph by Alex André

Anna Klar portrait

Anna Klar’s story is a familiar one to nursing students: She came to UW–Madison thinking she wanted to be a physician. And like many students interested in medical school, she became a certified nursing assistant to log required patient practice hours. But as she worked and learned how different providers interacted with patients and each other, she came to a new realization: What she really wanted to do was be a nurse.

“I like the patient advocacy. I like the bedside,” Klar says. “You’re really able to not only get to know your patients on a personal level and advocate for what they want personally, but you’re also constantly assessing your patients.”

Before Klar was formally admitted into the School of Nursing, she took Assistant Professor Lisa Bratzke’s undergraduate elective, Community Supports for People with Dementia. Bratzke, who focuses on the cognitive functioning of older adults with heart disease, was immediately impressed by Klar’s work ethic and offered her a position in her lab.

“Anna was just really amazing, one of those standout students in that class,” Bratzke says.

Klar has worked closely with Bratzke ever since. As a nursing honors student, Klar was able to pursue her own research. She chose to study how individuals with the same diagnosis of congestive heart failure (CHF) may experience very different symptoms. For example, one patient may report symptoms of breathlessness or fatigue more so than another even though clinically—in terms of test results and charted assessments—their heart failure looks essentially the same with similar lab results and standard assessments.

To understand why, Klar focuses not on the heart but on the brain. Her goal is to determine how the blood flow to different lobes affects which symptoms patients experience and how severe those symptoms are.

Klar uses a relatively new and rare neuroimaging technology called PC-VIPR, which is currently available only at UW–Madison and Vanderbilt. PC-VIPR is unique because it allows providers to see blood flow going through vessels without the use of a contrast agent. This is critical for Klar’s study, because many of her patients also have kidney issues that preclude the use of a contrast dye. Without PC-VIPR, Klar would not be able to include patients with kidney issues in her study, which would prevent her from eventually exploring how kidney disease affects chronic heart failure symptoms.

And it is that kind of complexity that drew Klar to the patient population she studies. Since many older adults deal with multiple health issues at one time, understanding what is wrong and how to help them becomes a more challenging puzzle. Klar likes the challenge of piecing all the factors together to get a clearer picture of what each patient needs.

Bratzke says that Klar’s research ultimately has the potential to influence how doctors and nurses manage chronic heart failure by using patient-specific information related to brain blood flow and to other health concerns to determine treatment protocols and care.

Klar has had the opportunity to work with other faculty members, but she says she is particularly indebted to Bratzke for helping her identify and pursue her interests and chart a unique course for her research and education. Ultimately, Klar says, Bratzke’s influence made a big university like UW–Madison feel more accessible and personal, and it led to invaluable learning experiences outside the classroom.

“Advocate for yourself and find a mentor who really cares because they will open a lot of doors for you,” Klar says. “Lisa really grounded me and also facilitated a lot of opportunities for me.”

Equally impressed with Klar, Bratzke nominated the senior for Research in the Rotunda. The annual symposium features the undergraduate research from UW System students, and Klar is one of six UW–Madison students presenting her work at the Capitol on April 17. “Anna’s pretty humble, and she’s a pretty bright kid,” Bratzke says. “She’s got some really cool ideas and she stays back hidden. She deserves to stand out.”