Cardiology; Cardiovascular Disease; Internal Medicine
As director of the Division of Cardiology at the Buffalo VA Medical Center (Buffalo VAMC), I oversee cardiac care, education and research. My division is one of the most efficient across similar VA facilities: it provides the full spectrum of cardiovascular diagnostic and therapeutic services while maintaining outcomes that meet or exceed all nationally mandated standards. I see outpatients in my own clinic, and I see inpatients as well, including those admitted to the Intensive Care Unit (ICU). My practice focuses on coronary artery disease (CAD), congestive heart failure, atrial fibrillation and valvular abnormalities. I approach my patients by practicing both the art and science of medicine and spend ample time getting to know my patients and the social structures that surround them. I believe that the care of a patient is much more effective when the patient is treated as a person rather than a diagnosis. I truly enjoy my clinical sessions at the Buffalo VAMC where I meet new and returning veterans who share their stories with me. It is a privilege to care for each of these amazing individuals. The abundance of complex cases at the Buffalo VAMC, along with extensive longitudinal electronic health data, allows us to conduct clinical research to improve patient care. We physician-scientists at the Buffalo VAMC are increasing our focus on clinical research to complement the bench research performed at UB. My current research is studying the role of post-traumatic stress disorder (PTSD) in heart disease. While longitudinal studies indicate a role of PTSD on CAD prevalence and outcomes, its causative mechanism has been debated. My colleagues and I are looking at mental stress-induced myocardial ischemia (MSIMI) and how this differs in patients with PTSD. I am passionate about teaching and feel a strong responsibility to mentor the next generation of physicians. I trained as a Royal College of Physicians educator in order to become a better medical educator. To me, mentorship involves more than just teaching the facts of medicine. I emphasize interpersonal and communication skills with the fellows I train, in addition to traditional bedside teaching, because these patient-centered abilities are essential to being a good physician. I also help trainees navigate increasingly complex hospital and health care environments. The knowledge I share with them about the systems that are part of modern health care is also key to providing the best care to patients.
Cardiology; Cardiovascular Disease
I am a noninvasive cardiologist at the Buffalo VA Medical Center (VAMC). I care for patients with various cardiovascular diseases, including acute and stable coronary artery disease, congestive heart failure, cardiomyopathies, valvular heart disease and arrhythmias. My responsibilities are diverse and include attending on the cardiology consult service, covering medicine inpatient service, performing and teaching transesophageal echocardiograms (TEEs), interpreting echocardiograms and electrocardiograms (EKGs) in addition to electrical cardioversions, stress testing and Holter/event monitors interpretation. My clinical specialties are valvular heart disease, atrial arrhythmias and acute cardiac and coronary artery diseases. I continue to care for patients after they are discharged from the hospital, both in my clinic at the VAMC and via the telehealth clinic in the VAMC to various areas in Western New York. I am currently involved in research projects both as a site principal investigator (PI) and as a subprincipal investigator in collaboration with colleagues at the VAMC. One project is focused on the role of new anticoagulants (NOACs) in the management of myocardial injury after noncardiac surgery (MINS). The other project is comparing double vs. triple therapy, i.e., antiplatelet drugs and Coumadin vs. NOAC after coronary percutaneous intervention in patients with atrial fibrillation. I also serve as a member of the VAMC’s institutional review board (IRB), which reviews the ethical and scientific aspects of research projects. I am passionate about teaching and enjoy working closely with medical students and medicine residents during their rotations on both cardiology and medical consult services. I supervise and work with cardiology fellows during their clinics, inpatient consultation and noninvasive/echocardiogram rotations at the VAMC.
Cardiology; Cardiovascular Disease; Clinical Cardiac Electrophysiology; Internal Medicine
An internationally recognized cardiovascular physician-scientist, Dr. Cain is a specialist in abnormal heart rhythms. He is board-certified in internal medicine, cardiovascular diseases and clinical cardiac electrophysiology and pacing. He is a fellow of the American College of Cardiology, the American Heart Association and the Heart Rhythm Society. A former associate editor of Circulation, Cain is a member of the editorial boards of the American Journal of Cardiology, the Journal of Cardiovascular Electrophysiology, Nature Clinical Practice Cardiovascular Medicine and Heart Rhythm. His NIH-supported research has focused on determining the mechanisms of life-threatening heart rhythm abnormalities that occur in heart attacks and other conditions that damage heart muscle cells. This information is being used to better characterize and more accurately localize the abnormal heart tissue responsible for these abnormal heart rhythms and to improve the identification of patients at increased risk for sudden cardiac death.
Cardiology; Cardiovascular Disease; Apoptosis and cell death; Cardiac pharmacology; Gene therapy; Genomics and proteomics; Molecular Basis of Disease; Stem Cells
As chief of the Division of Cardiovascular Medicine at UB, I am responsible for the clinical, teaching and research programs related to adult patients with heart disease. I care for patients at the UBMD Internal Medicine practice group in Amherst, the Gates Vascular Institute (GVI) of Buffalo General Medical Center (BGMC) and the Buffalo VA Medical Center (VAMC). My clinical areas of expertise are in diagnosing and caring for patients with coronary artery disease and heart failure. My research group conducts translational studies directed at advancing our mechanistic understanding of cardiac pathophysiology as well as developing new diagnostic and therapeutic approaches for the management of patients with chronic ischemic heart disease. Our ongoing areas of preclinical investigation apply proteomic approaches to identify intrinsic adaptive responses of the heart to ischemia and studies examining the ability of intracoronary stem cell therapies to stimulate endogenous cardiomyocyte proliferation and improve heart function. We also conduct basic and patient-oriented research to understand how reversible ischemia modifies the cellular composition and sympathetic innervation of the heart to help develop new approaches to identify patients at risk of sudden cardiac arrest from ventricular fibrillation. In addition to my laboratory investigation, I serve as the deputy director of the UB Clinical and Translational Research Center (CTRC) and the director of the UB Translational Imaging Center. The Translational Imaging Center offers researchers opportunities to perform multimodality research imaging using PET molecular imaging, high-field magnetic resonance imaging (MRI) and X-ray computed tomography (CT). Our overall goal is to use advanced cardiac imaging to translate new applications between the bench and bedside in order to identify new imaging biomarkers of pathophysiological processes such as chronic myocardial ischemia and cardiac arrhythmogenesis. I am engaged in the cardiology profession at national and international levels, including as former president of the Association of Professors of Cardiology.
Cardiovascular Disease; Critical Care Medicine; Molecular and Cellular Biology; Stem Cells
I care for patients with diagnoses across the spectrum of heart disease at the UBMD Internal Medicine practice group in Amherst NY, the Buffalo General Medical Center Heart and Lung Clinic, and the Cardiac Care Unit in the Buffalo General Medical Center (BGMC). My specialty is the diagnosis and treatment of congestive heart failure: I integrate information from multiple cardiac diagnostic studies to coordinate treatment for my patients with interventional cardiologists, heart rhythm specialists and heart surgeons. I am trained as an Advanced Heart Failure specialist and I am experienced in the treatment of patients with cardiac transplants and ventricular assist devices. In the Cardiac Care Unit I oversee patients with acute congestive heart failure, most often after myocardial infarction. In the outpatient clinics I manage medical and device therapy for heart failure and perform cardiopulmonary stress testing to identify patients who need advanced heart failure therapies including left ventricular assist devices or cardiac transplantation. I am involved in multi-center clinical trials in treatment of heart failure. I study the role of hematopoietic system and inflammation in repair of heart attacks and the failing heart via my own independent research, and in collaboration with pharmaceutical firms. I am a peer reviewer for several leading global journals in Cardiology, and review research grant applications for the NIH and American Heart Association. I teach and supervise Internal Medicine residents and Cardiology Fellows in all facets of my clinical practice: during inpatient hospital care in the Cardiac Care Unit, while interpreting cardiac imaging studies, and in my outpatient practice. I also teach and mentor young scientists involved in research.
Cardiology; Cardiovascular Disease; Interventional Cardiology
I am an interventional and clinical cardiologist at the Buffalo VA Medical Center (Buffalo VAMC) after having been in private practice for over 25 years. The focus of my practice is the cardiac catheterization laboratory, though I also see outpatients in the cardiology clinic and perform inpatient clinical consultations in the hospital. I care for individuals with a spectrum of cardiovascular disease, including patients with stable coronary disease, acute coronary syndromes, valvular diseases and cardiomyopathies. I participated as a site investigator in over 100 multicenter clinical research trials. My particular research interests are in studies of lipid management and preventive cardiology, intravascular ultrasound and plaque regression, critical care pathway development and application and outcomes research in the treatment of acute coronary syndromes. My current research involvement includes studies on lipid therapy, novel congestive heart pharmacologic therapy and atrial fibrillation in cancer patients. I am also involved in a supportive role with a study of antibiotic therapy and the management of peripheral arterial disease. I enjoy teaching and have taught throughout my private practice career and continue at the VA. I teach cardiology fellows in the cardiac catheterization laboratory and in the cardiology clinic during initial cardiology consultations and follow-up outpatient care. I also teach fellows, medical residents and medical students during consultative rounds in the hospital.
Cardiology; Cardiovascular Disease; Regulation of metabolism
My clinical activities as a noninvasive cardiologist primarily take place at the Buffalo VA Medical Center (VAMC). My responsibilities include attending on the inpatient cardiology consultation service and interpreting echocardiograms, stress tests and electrocardiograms (EKGs). My research career initially focused on translational research using porcine models to investigate physiologic and metabolic adaptations that result from acute and chronic myocardial ischemia (chronically stunned and hibernating myocardium). These preclinical investigations have led to clinical research, including the recent completion of an NIH-sponsored clinical trial. This trial, on which I am the co-principal investigator with John M. Canty, Jr., MD, proved that the presence of sympathetically denervated myocardium quantified by positron emission tomography can predict the risk of sudden death in patients with ischemic cardiomyopathy. I am in the process of extending these findings to the clinical management of patients with implantable cardiac defibrillators. My work as a physician-scientist has included serving on numerous research-related oversight committees and as a peer reviewer for multiple national, regional and local committees. I have been funded by the National Institutes of Health (NIH), the Department of Veterans Affairs and the American Heart Association to conduct a variety of investigator-initiated research projects. Medical education is a critical component of my professional life. Nearly all of my clinical and research activities are performed in conjunction with the education of fellows in cardiovascular diseases, residents in internal medicine and medical students. I facilitate small group sessions for second-year medical students in Cardiovascular Physiology for which I have earned several commendations for teaching excellence; I am gratified to have participated in the education of hundreds of young physicians. I have also published dozens of abstracts and manuscripts with various levels of trainees, giving them the opportunity to grow as physician-scientists while at the same time advancing medical knowledge.
Cardiology; Cardiovascular Disease
My clinical practice focuses on all aspects of general cardiology. I work in areas from preventive cardiology, such as treatment of patients with resistant hypertension or high-risk complex dyslipidemia, to inpatient care of critically ill patients with acute coronary syndrome,congestive heart failure exacerbation or advanced valvular disorders. I have particular expertise in noninvasive imaging techniques and use multimodality cardiac imaging to aid the diagnosis and treatment of patients with complex cardiovascular diseases. I am involved in the structural heart program at the Gates Vascular Institute (GVI) and am well-versed in ultrasound-based imaging modality. This includes interpretation of basic transthoracic and transesophageal echocardiograms as well as “interventional echocardiography,” which provides intraprocedural transesophageal imaging support for transcatheter aortic valve replacement (TAVR), MitraClip valve repair and left atrial appendage occluder deployment. I also perform and interpret 12-lead electrocardiograms, 24-hour Holter monitors, event monitors, 24-hour ambulatory blood pressure monitors, cardiac nuclear stress testing, stress echocardiograms and cardiac computed tomography (CT) angiography. My expertise in the range of cardiac imaging modalities allows me to provide guidance to medical practitioners from different specialties in the appropriate use and application of each modality. My research focus spans both translational and clinical applications. Using a porcine model of ischemic heart disease, our team investigates cardiac autonomic regulation and remodeling, employing in-vitro protein analysis and whole animal PET imaging to identify sympathetic denervation and subsequent neuronal sprouting. This area of study has important implications in our understanding of the myocardial substrate that promotes vulnerability to electrical instability and sudden cardiac death. I am also conducting several clinical trials, including a Phase III PCSK9 inhibitor study to evaluate the clinical benefits of Evolucomab in high-risk populations (FOURIER trial, Amgen). I am also involved in a clinical trial using the repositionable Lotus valve system for transcatheter aortic valve replacement (REPRISE study, Boston Scientific). As a faculty member in the Division of Cardiovascular Medicine, I teach medical students, internal medicine residents and cardiology fellows. I facilitate small group discussions for second-year medical students as part of the cardiovascular physiology curriculum, and I serve as a clinic preceptor for third-year medical students in the outpatient cardiology clinic. I also conduct inpatient rounds with residents and fellows. In addition, I teach cardiology fellows in the performance and proper interpretation of cardiac imaging modalities such as echocardiograms and stress testing.
Cardiology; Cardiovascular Disease
I am a cardiologist with a subspecialty interest in heart failure and general cardiology. I am based at Buffalo General Medical Center (BGMC) and the Gates Vascular Institute (GVI), and I care for inpatients admitted to Cardiology Critical Care, Inpatient Cardiology and Inpatient Consultation. I have administrative duties that focus on the care of the cardiac patient at Kaleida Health: I help lead the collaborative efforts of over 50 cardiologists to improve the quality of patient care and patient outcomes. My research responsibility has included serving as a local principal investigator in multicenter clinical trials, and our site has contributed to a number of cardiology research programs over the past 25 years. Our current focus is in systolic and diastolic heart failure, as a collaborative effort with colleagues in internal medicine and cardiology. I am part of the teaching faculty in the Division of Cardiovascular Medicine, and I am the lead physician for the BGMC training site. In this role, I work with another attending cardiologist to provide oversight and guidance to a team of five cardiology fellows, residents and fourth-year medical students at the BGMC continuity clinic. I also help organize and lead annual continuing medical education conferences through the medical school’s Department of Medicine and through Kaleida Health.
Cardiovascular Disease; Diagnostic Radiology; Neuroradiology - Radiology; Radiological Physics; Vascular and Interventional Radiology; Vision science
I am an Assistant Professor with a dual appointment in the Biomedical Engineering Department and Neurosurgery. I am the director of the Endovascular Devices and Imaging lab at Canon (former Toshiba) Stroke and Vascular Research Center. My research career focuses on improvement of endovascular image guided interventions and encompasses three major components: medical imaging, computer programming and endovascular device development. The greatest breakthrough of my team in the last three years is the development of complex 3D printed (3DP) vascular patient specific phantoms based on 3D imaging. Using my previous experience in developing CT reconstruction algorithms and 3D data analysis, this step came naturally. We are using these phantoms to test devices and validate software such as CT-FRR, parametric imaging and material decomposition using spectral CT. The 3DP phantoms we develop are probably some of the most complex reported in literature. We created new tools for 3D mesh manipulation and workflow to build complex vascular trees, which maintain vessel down to 400 microns diameter. My team collaborates directly with 3D printing industry and engineers in academy, to optimize the 3DP materials and match tissue mechanical properties. As center of excellence for 3D printing, we contribute to identification of new clinical applications for the 3DP technology, 3DP material development, and testing, and software development. One of the challenges my team is tackling, is the 3D printing material and 3D design optimization to build structures with controlled mechanical properties. In the last two years, my research focused on how to use the 3D printing technology to create digital structures which can simulate mechanical properties of vascular tissue, vascular networks and arterial disease. My effort is directed toward developing methods to warp 3D structures and embed them within the arterial wall. The embedded structures could be printed with different materials to different mechanical properties. This approach will allow optimization of phantom physical properties which match those of the arteries. Thus, by combining the 3D design with the new polymers used for the 3D printing while maintaining the patient specific geometry, I plan to develop a vascular model which will behave and react identical as a human vessel, both healthy and diseased. On a secondary effort on 3DP, my team is involved in developing implantable devices; we are collaborating with metal printing industries in testing methods to develop 3DP patient specific devices. We are able to reproduce coronary stents, which match the physical size/geometry of those used in current practice. However, mechanical and corrosion aspects need more investigations. In this context, I believe that additive manufacturing can be another path towards personalized medicine, by allowing manufacturing of patient specific devices rather than one size fits all kind of approach used by current device manufacturers. Concerning my involvement in the scientific community, in the last two years, I became deeply involved with the effort to implement the new advances of 3D printing into a clinical setting. I have given presentations and symposiums at conferences such as RSNA where I emphasized the new additive manufacturing advances and the close relation with the 3D medical imaging. The new digital material technologies, the improved resolution and fast building time make this technology practical for the high pace workflow in the hospitals. As of now I am involved with Special Interest Group from RSNA for standardization of 3DP printing operations in hospitals and development of a DICOM standard associated with the workflow and manufacturing of 3D printed medical objects.
Cardiovascular Disease; Internal Medicine; Nephrology; Pathophysiology; Vascular and Interventional Radiology; Cardiac pharmacology
(1) Role of the sympathoadrenal system in hypertension, postural adaptation, and long-term cardiovascular adaptation (2) Control of regional and systemic blood flow during acute stress responses (3) Mechanisms of stress responses and vasoreactivity, both in vivo and in vitro, including metabolic interactions (4) Cardiovascular drug effects (5) Outcomes of drug therapies
Cardiovascular Disease; Cytoskeleton and cell motility; Molecular Basis of Disease; Molecular and Cellular Biology
My primary research interest is the behavior of endothelial cells, which form the inner lining of blood vessels and are key players in the remodeling events that occur during wound healing, aneurysm formation, tumor growth, and a wide variety of disease conditions. There are two questions about endothelial behavior that drive most of the research in my laboratory: (1) How does an endothelial cell migrate during wound healing and blood-vessel remodeling? We are particularly interested in the motor protein, myosin II, and how it exerts force within the cytoskeleton to push or pull the cell as it moves. In order to study the organization and movements of cytoskeletal proteins - and not just there biochemical properties - we use a variety of light microscopic methods to examine the dynamics and biochemistry of cytoskeletal proteins in living migrating endothelial cells. We also use conventional biochemical, genetic, and pharmacological manipulations to investigate the regulatory events that control myosin II behavior in situ. (2) How do endothelial cells sense and respond to their mechanical environment? Blood vessels remodel to accommodate long-term changes in blood flow. Certain flow environments can cause destructive remodeling that leads to cerebral aneurysms (local “ballooning” of vessels). Working with biomedical engineers in the laboratory of Dr. Hui Meng at the Toshiba Stroke Research Center, we use cell culture and whole animal systems to examine how endothelial cells respond to specific hemodynamic micro-environments in order to understand the mechanism and regulation of flow-induced remodeling, especially as it relates to cerebral aneurysms. A third interest is understanding the response of cultured endothelial cells to electrical fields, which have been shown to orient endothelial migration in vitro and to suppress edema in vivo by enhancing the endothelial permeability barrier.
Cardiology; Cardiovascular Disease; Cell growth, differentiation and development; Gene Expression; Molecular and Cellular Biology; Signal Transduction; Stem Cells
As a general cardiologist, I diagnose and treat a wide range of problems that affect the heart and blood vessels, including but not limited to coronary artery disease, valvular heart disease, heart failure, diseases of the myocardium and pericardium, cardiac arrhythmias, conduction disorders and syncope. I attend on the inpatient Coronary Care ICU (CCU), Cardiac Step-down Unit, and Cardiology Consult service at Buffalo General Medical Center as well as see patients in my outpatient clinic. In addition to treating pre-existing cardiac conditions, I also believe in strong preventive care and addressing modifiable risk factors for coronary disease. I take time to get to know my patients, and I talk with them about measures they can take to reduce their risk for cardiovascular disease and improve their health. As a clinician-scientist, I have a special interest in developing new stem cell based treatments for heart disease. My research is focused on understanding what stem cell secreted factors are responsible for improved heart function, what their targets are and how these can be modulated to develop new cell-free therapies that can help patients with a wide spectrum of coronary disease and heart failure. I welcome medical students, graduate students, residents and fellows to conduct research with me in my lab. As a native Buffalonian, I am honored to partner with the patients in our community to help improve their heart health and cardiac knowledge base. I am equally excited to be involved in shaping the next generation of physicians through the teaching I conduct at the medical student, resident and fellow level.
Cardiology; Cardiovascular Disease
I am a cardiologist with more than 30 years’ experience. The primary focus of my patient care is the diagnosis, treatment and prevention of coronary artery disease, arrhythmias, valvular heart disease, lipid abnormalities, heart failure and hypertension. My goal is to improve my patients’ quality of life. The UBMD cardiology practice allows me to provide my patients the full spectrum of cardiovascular services representing state-of-the-art therapy. In addition, I am able to take advantage of a wide range of clinical research studies conducted within UBMD Cardiology, which may prove to be unique options for my patients. Having these complete services and research studies available to me allows my patients to receive a level of care unparalleled in our community. I am intimately involved in educating the next generation of physicians through my teaching of medical students, residents and fellows. In 2015, the family medicine residents at Millard Fillmore Suburban Hospital recognized my commitment to medical education with an award for my specialty teaching.
Anesthesiology; Cardiovascular Disease; Cardiopulmonary physiology; Immunology
Special interest in academic medicine and active research in the kinetics of inflammatory responses in acute lung injury and myocardial ischemia reperfusion.
Cardiology; Cardiovascular Disease
As a general cardiologist, I care for patients with a spectrum of cardiovascular diseases, including acute and chronic manifestations of coronary artery disease, congestive heart failure, cardiomyopathies, valvular disorders, arrhythmias and aortic and pericardial diseases. I have expertise in the role of echocardiography and nuclear cardiac imaging for the evaluation of cardiac disorders, including transesophageal echocardiography (TEE), nuclear stress testing (myocardial perfusion imaging), viability imaging and multiple-gated acquisition scan (MUGA) studies for evaluation of cardiac function. I also perform stress testing, electrical cardioversions to manage arrhythmias and interpret electrocardiograms (EKGs). I care for inpatients in the critical care and cardiac monitoring units (telemetry) at the Buffalo General Medical Center (BGMC) and the Gates Vascular Institute (GVI), and I provide consultative services there as well. I continue to provide care for patients after they are discharged from the hospital, and I also provide outpatient consultations at the UBMD Internal Medicine office in Amherst. I care for patients with chronic cardiac conditions, evaluate patients with chest pain or shortness of breath and provide preventative cardiology services for patients with hypertension and hyperlipidemia. I am also part of a multidisciplinary team that cares for patients with sarcoidosis, an inflammatory condition that can affect the heart. My research interests are focused on clinical cardiac imaging. They include using single photon emission computed tomography (SPECT) to evaluate patients with mildly elevated biomarkers of cardiac injury and elucidate mechanisms of transient ischemic dilation of the left ventricle in patients without significant coronary artery disease. I also help supervise positron emission tomography (PET) studies at the UB Clinical and Translational Research Center (CTRC) in patients with ischemic heart disease, to better identify patients at risk of sudden cardiac death from ventricular arrhythmias. As program director for the fellowship in cardiovascular disease, I organize the fellowship didactic curriculum and case discussions. I mentor the fellows and coordinate their training to help them achieve their specific career goals, including their preparation for subspeciality training in interventional cardiology, electrophysiology, heart failure or advanced cardiac imaging. I also teach medical students and residents. I teach in the second-year medical student cardiovascular curriculum, and I coordinate and lead small-group case discussions for third- and fourth-year medical students. I also provide didactic teaching to residents.
Cardiology; Cardiovascular Disease; Internal Medicine; Radiology; Cardiopulmonary physiology; Autoimmunity; Cardiac pharmacology; Gene Expression; Immunology; Stem Cells
I am a cardiologist with specialized training in advanced cardiac imaging. I see outpatients at the Heart and Lung Center of Buffalo General Medicine Center (BGMC), and I care for inpatients through the cardiology consult and inpatient services at BGMC. As an advanced imaging cardiologist, I am responsible for developing and advancing the cardiac computed tomography (CT) and magnetic resonance imaging (MRI) programs at the Gates Vascular Institute (GVI) and providing these services to patients. These advanced, noninvasive imaging techniques allow physicians to perform in-depth, 3-D evaluation of the coronary tree, myocardium, heart valves, pericardium and great vessels. These imaging tools allow for the best possible diagnoses and care of patients. My research spans basic science, translational and clinical fields and combines the cross-discipline expertise on magnetic resonance (MR) technology with molecular biology. My overall goal is to study the consequences of ischemia-induced myocardial injury, with a focus on their therapeutic reversal. My research laboratory at UB’s Clinical and Translational Research Center (CTRC) is devoted to the development of novel time-and-tissue-targeted MRI methods for integrative understanding of cardiovascular pathophysiology in preclinical models. We have several interesting research projects, e.g., we have recently discovered that the presence of high-risk plaques in the carotid arteries predict future incidence of myocardial infarction and stroke. The results emphasize that the nature of atherosclerosis and the use of comprehensive non-invasive computed tomography angiography (CTA) will help identify patients who are at higher risk of developing ischemic stroke. These research results will help physicians employ early therapeutic strategies for these high-risk patients. I mentor medical students, residents and fellows both in clinical and research settings, and I precept cardiology fellows at the Heart and Lung Center at BGMC. In addition, I am deeply engaged in furthering the research and clinical education of our house staff. Our trainees have published their research in highly esteemed peer-reviewed journals, and many have routinely presented their work at national and international scientific conferences. I am committed to facilitating the career goals of my mentees while I continue to advance my own career as a clinician, researcher and mentor.
Cardiology; Cardiovascular Disease; Internal Medicine; Apoptosis and cell death; Cell Cycle; Cell growth, differentiation and development; Gene therapy; Stem Cells
I am a researcher with formal training and practice in both general and interventional cardiology. My research expertise is in coronary physiology and physiological studies in large animals with ischemic heart disease. Based on my background, my research is focused on therapeutic approaches to effect cardiac regeneration in large animals with acute and chronic ischemic heart disease. In my laboratory, I use a preclinical porcine model of hibernating myocardium with chronic left anterior descending (LAD) coronary artery occlusion and collateral-dependent myocardium or infarcted myocardium caused by coronary ischemia-reperfusion. I have addressed the problem with several different therapeutic approaches involved in gene therapy, pharmacological and stem cell therapies. We routinely perform physiological studies on these porcine models with quantitative analyses of myocardial morphometry and immune-histochemical analyses. The information we have collected in completed work demonstrates remarkable functional recovery and myocyte regeneration in the adult porcine heart. Intracoronary adenoviral gene transfer with fibroblast growth factor (FGF-5), the HMG-CoA inhibitor pravastatin and intracoronary mesenchymal stem cells (MSCs) all stimulate the proliferation of endogenous cardiac myocytes and, to some extent, generate new myocytes and vessels. Our current work is focused on understanding the regenerative capability of cardiosphere-derived cells (CDCs) originating from heart tissue in acute or chronic ischemic myocardium. The result of this work will play an important role in advancing the care of many patients with acute and chronic ischemic heart disease. In my laboratory, I mentor research fellows through their rotation. Fellows who work in my laboratory have the unique opportunity of being exposed to large animal experimentation and learning skills related to it--in physiology and coronary angiography, as well as computed tomography (CT) and magnetic resonance imaging (MRI) techniques. Under my supervision, fellows also may work on independent projects and learn about cell biology and molecular biology, with the chance to present at international meetings and to publish as an author in international journals.
Cardiology; Cardiovascular Disease; Stem Cells
My research program is focused on the investigation of mechanisms underlying functional and structural cardiac remodeling in heart disease, as well as novel therapeutic interventions to prevent or reverse left ventricular dysfunction caused by myocardial ischemia and hemodynamic overload. These studies generally utilize non-invasive advanced cardiovascular imaging techniques and invasive hemodynamic assessment to assess cardiac performance in vivo, along with ex vivo analysis of myocardial tissue to examine cellular and molecular mechanisms underlying observed changes in physiological function.
Cardiology; Cardiovascular Disease; Interventional Cardiology
As an interventional cardiologist, I perform a variety of invasive diagnostic and interventional cardiac catheterization procedures. My primary interests are in the diagnosis and treatment of acute coronary syndromes and interventional treatment of complex coronary lesions such as unprotected left main coronary artery interventions, bifurcating lesions and chronic total occlusions. Although my focus and passion have been interventional cardiology, I maintain an active interest and involvement in general cardiology and internal medicine and treat a variety of cardiovascular diseases, including congestive heart failure, valvular heart disease, arrhythmias and dyslipidemias. I practice at the Buffalo VA Medical Center (Buffalo VAMC) where I have been the chief of the cardiac catheterization laboratory since 1999. In addition to my responsibilities in the laboratory, my duties include attending on the cardiology consult service, covering the inpatient acute medicine service and interpreting a variety of non-invasive studies (e.g., stress tests, Holter and event monitor studies and EKGs). I enjoy teaching and working with medical students, residents and fellows as they progress through their hospital rotations on cardiology consults and weekend medicine service coverage. I also mentor, supervise and teach fellows in the cardiac catheterization laboratory and outpatient cardiology clinic.
Cardiology; Cardiovascular Disease; Interventional Cardiology; Endovascular Medicine; Vascular Medicine
I am an interventional cardiologist with UBMD Cardiovascular Medicine, with specialized training in echocardiography, nuclear cardiology and noninvasive vascular interpretation (RPVI). I see outpatients through the UBMD ambulatory practice at the Amherst Clinic, and I care for patients admitted to the Buffalo General Medical Center (BGMC) consultative service and BGMC’s Cardiac Care Unit (CCU). My interventional practice involves evaluating and caring for patients with coronary and structural heart diseases. I perform diagnostic coronary angiography, percutaneous coronary intervention (PCI), coronary atherectomy, percutaneous mechanical hemodynamic support, cardiac biopsy, patent foramen ovale (PFO)/atrial spetal defect (ASD) closure and transaortic valve replacement (TAVR). I also have a specialized focus on evaluating and managing patients with peripheral vascular disease, including noninvasive vascular testing and endovascular interventions. I see patients at the Gates Vascular Institute (GVI) where I perform diagnostic peripheral and carotid angiography and interventions for peripheral arterial diseases. These procedures include lower extremity arterial atherectomy, angioplasty and stenting, renal and mesenteric artery revascularization and subclavian intervention. I am active in research at the GVI by participating in a number clinical trials. One aims at protecting patients from renal damage during PCI (CARIN, Ischemix). Another involves an alternative procedure to perform TAVR for intermediate-risk patients with symptomatic aortic stenosis (SURTAVI, Medtronic). A third clinical trial addresses using intracoronary delivery of stem cells in patients postanterior myocardial infarction with ischemic left ventricular dysfunction (ALLSTAR, Capricor). As a faculty member at the University at Buffalo, I teach and mentor residents and fellows during their hospital rotations.