In keeping with its mission to “advance knowledge and improve quality of life and health across Kentucky communities,” the University of Louisville established the Center for Cardiometabolic Science, home to the largest collective of cardiovascular researchers on campus. 

Cardiometabolic disease remains the leading cause of illness and death in Kentucky and across the nation. To confront this challenge, the Center brings together researchers from across disciplines to pioneer new understandings of heart health and combat disease through innovative methods. Central to this work is a guiding belief: the heart does not fail in isolation. Rather, it is shaped by a complex web of metabolism, inflammation and environmental stressors. 

Yet for decades, the "standard" understanding of these stressors was built almost exclusively on male models. Helen E. Collins, assistant professor of medicine within the center, is working to dismantle this "one-size-fits-all" approach. As head of the Collins Laboratory, a program located within the Center for Cardiometabolic Science, she has turned her scientific curiosity into an unbridled mission: to understand the fundamental mechanisms of female cardiovascular resilience and improve health outcomes.

Her interest in this specific field of study developed during her doctoral and postdoctoral training, when she began to notice a troubling pattern. “The foundational knowledge I was learning was almost entirely based on the male cardiovascular system,” Collins said. “As a woman and a mother, I found this lack of representation troubling, especially because women make up half of the population and cardiovascular disease is the leading cause of death in women.”

This lack of research on women’s hearts has resulted in delayed diagnoses, a lack of targeted therapies and a widespread ignorance of female-specific symptoms and risk factors. These gaps are particularly dangerous given the rising rates of maternal mortality and the prevalence of pregnancy-associated conditions, such as peripartum cardiomyopathy. As Collins puts it, the historical reliance on male-centric data has, quite frankly, “failed women.”

Supported by NIH R01 funding, the Collins Laboratory is investigating how the heart adapts during pregnancy, a unique and understudied period of cardiovascular stress and resilience. This research seeks to understand how changes in metabolism, including glucose and ketone bodies, influence the heart’s ability to grow during a healthy pregnancy and safely return to its pre-pregnancy state after birth.

Using advanced "multi-omics" and multidisciplinary approaches, Collins and her team are working to identify unique biomarkers that could eventually help clinicians detect at-risk women before life-threatening complications arise.

Looking ahead, the Collins Laboratory hopes to expand this work to better understand the impact of environmental factors (such as age, sleep and diet) on cardiovascular disease. By uncovering what makes the female heart resilient, Collins aims to pioneer a path toward stronger recovery and more personalized care for women.

For Collins, the work remains deeply personal. “As long as I am fortunate enough to have this platform as a women’s health researcher and to be a mother to a young daughter, I will be dedicated not only to advancing scientific knowledge in this area but also to women’s health education and awareness.”