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.