In Mark Sussman's lab at San Diego State University, a machine showing what looks like a sonogram that obstetricians use to image unborn babies in the womb instead shows the tiny heart of a mouse.

What is visible is actually a cross section of the heart that looks like a doughnut. The hollow center is the heart's chamber, the circle of tissue around it the walls of the animal's heart.

The heart is not in good shape. Lab technicians had tied the ascending aorta in the animal, akin to bending a kink in a hose, so that pressure built inside the heart.

The heart's response? It worked harder to pump blood through that kink, remodeling itself and eventually self-destructing.

Sussman and his colleagues had created a model for heart failure to see how the organ changes in the face of a cardiac infarction – a heart attack.

Helping to understand how the heart fails, and how to turn it around before it is too late, is the goal of Sussman's lab and that of his colleagues at SDSU's Heart Institute, one of several research enterprises at the university.

"Heart disease is the biggest killer in the United States ... but we now understand that unlike the dogma that was taught to us when we were going through school, that these aging processes are not insurmountable," Sussman said.

"There are ways of actually trying to get around it, and we may have finally hit upon the fountain of youth that everyone is looking for."

The challenges are enormous, but success could prove to be one of the most significant medical advances ever.

More than 930,000 people, men and women alike, died of cardiovascular disease in the United States in 2001 – nearly twice the number of Americans who died of cancer, the American Heart Association reported this month.

The ailment takes its toll on the economy. The cost of heart disease and stroke is projected to be $351 billion for 2003, according to the Centers For Disease Control and Prevention in Atlanta.

Sussman, who moved to SDSU last summer from Cincinnati's Children's Hospital and Research Foundation, is collaborating with heart researcher Piero Anversa at New York Medical College as part of a five-year, $10 million effort funded by the National Institutes of Health to explore how the heart ages and how to slow and even reverse that process.

The SDSU Heart Institute boasts several other prominent researchers.

Roger Sabbadini discovered molecules called sphingolipids that play an early role in the cascade of events that lead to rapid cell death during a heart attack.

The molecules can be detected in blood, so Sabbadini's group is developing a test that could provide an early warning of a heart attack. The diagnostic test could be available in two years, he said.

"That would be very important in an emergency room, for example, to distinguish people with heartburn from someone suffering from acute ischemia" – a loss of blood flow to the heart, Sabbadini said.

Roger Davis, besides studying the genetic basis for liver function, also studies how gene therapies can help prevent atherosclerosis – the accumulation of fatty deposits on the inside walls of arteries.

Sanford Bernstein, using fruit flies as models for human disease, explores cellular proteins called myosin heavy chain that drive the contraction of heart cells. Defects in these proteins can lead to abnormal heartbeats experienced by people with cardiovascular disease.

Sussman has shown in mouse studies that an enzyme called Akt boosts the activity of cardiac stem cells – the reserves of replacement cells that reside within the heart. By genetically engineering heart stem cells in mice to activate, or express, the Akt protein at higher levels than normal, he found that those stem cells helped protect the mice from heart failure.

"What we found was this mouse has an anti-aging phenotype, that is, the stem-cell population is expanded," Sussman said.

"Stem cells could potentially be the holy grail for . . . regenerating damaged cardiac tissue in the face of heart attack or heart failure."

Heart disease is partly caused by the aging of heart cells. While cardiac stem cells are believed to replenish the low level of heart cells that die throughout life, their ability to do that is believed to decline as people age.

"If we could . . . find a way to keep the heart cells perpetually going, it would allow you to get around that normal aging process that leads to heart failure and death," Sussman said.

At a time when the California State University system faces severe budget cuts, it might not appear to be the time for SDSU to invest in expensive projects. But SDSU administrators say research always has been a part of university life, despite CSU's tradition as a teaching institution.

"If faculty were standing on the sidelines, watching science play out and describing it as a third hand to the whole process, the teaching of science would be impoverished for our students," said Tom Scott, dean of SDSU's College of Sciences.

By summer, the university plans to break ground for a $13 million BioScience Center to house heart and other researchers. The center, scheduled to open sometime in 2006, is being funded with startup money by the San Diego State University Foundation.

The nonprofit group, whose budget for the 2003 fiscal year is $187.7 million, is designed in part to help manage research grants and invest in science research on campus. It also raises money to help recruit faculty members who cannot be supported with state funds.

"The board of directors has approved spending hundreds of thousands of dollars to recruit top biology research faculty," said Frea Sladek, the foundation's chief executive officer.

Clinical trials using cardiac stem cells in human heart patients could be less than three years away, Sussman said.

"Wouldn't it be great if instead of taking drugs for the rest of your life, they could take your cells and regenerate your heart and in six to nine months you'd be on your way?" Sussman said.

"That's hopefully where things are headed."