Dr. Norman Alpert studies the chemo-mechanical basis for contraction in normal and hypertrophied heart muscle. The goal of these studies is to provide detailed knowledge of the molecular basis for heart muscle contraction in normal muscle and to be able to delineate the changes which occur in adaptive hypertrophy or heart failure. A major remaining unsolved problem in cardiovascular medicine is the high mortality that results when congestive heart failure is present. The strategies used involve understanding the natural history of the disease(s), including the development of myocardial hypertrophy and the transition from the hypertrophied compensated heart to the failing heart. The recent advances in molecular biology and cell biophysics provide incisive tools to shed light on the mechanisms involved.