Biology of the Myocardial Vasculature.
Key Faculty: Jay M. Edelberg, MD, PhD (Associate Professor), Mun Hong, MD (Associate Professor)

Our present research program aims to identify the biological basis of the increased cardiovascular pathophysiology associated with advanced age in order to develop novel approaches to treat, and potentially prevent, cardiovascular disease in older persons.

Selected References

Edelberg JM, Lee SH, Kaur M, Tang L, Feirt NM, McCabe S, Bramwell O, Wong SC, Hong MK. Platelet-derived growth factor-AB limits the extent of myocardial infarction in a rat model: feasibility of restoring impaired angiogenic capacity in the aging heart. Circulation. 2002;105:608-13.

Cai D, Xaymardan M, Holm JM, Zheng J, Kizer JR, Edelberg JM. Age-associated impairment in TNF-α cardioprotection from myocardial infarction. American Journal of Physiology 2003;285:H463-H469.

Xaymardan M, Zheng J, Duignan I, Chin A, Holm JM, Ballard VLT, Edelberg JM. Senescent impairment in synergistic cytokine pathways that provide rapid cardioprotection in the rat heart. Journal of Experimental Medicine. 2004;199:797-804.

Application of Drug Eluting Stents and Other Technologies in the Treatment of Obstructive Coronary Artery Disease and Discovery of Novel Predictors of Outcomes.
Key Faculty: S. Chiu Wong, MD (Associate Professor), Geoffrey Bergman, MD (Associate Professor), Robert Minutello, MD (Assistant Professor), Manish Parkih, MD (Associate Professor)

Selected References

Wong SC, Hong MK, Ellis SG, Buchbinder M, Reisman M, DeLago A, Kellett M, Popma JJ, Russell ME, Mehran R, Moses JW, Stone GW. Influence of stent length to lesion length ratio on angiographic and clinical outcomes after implantation of bare metal and drug-eluting stents (the TAXUS-IV Study). Am J Cardiol. 2005;95(9):1043-8.

Weissman NJ, Koglin J, Cox DA, Hermiller J, O'Shaughnessy C, Mann JT, Turco M, Caputo R, Bergin P, Greenberg J, Kutcher M, Wong SC, Strickland W, Mooney M, Russell ME, Ellis SG, Stone GW. Polymer-based paclitaxel-eluting stents reduce in-stent neointimal tissue proliferation: a serial volumetric intravascular ultrasound analysis from the TAXUS-IV trial. J Am Coll Cardiol. 2005;45(8):1201-5.

Holmes DR Jr, Leon MB, Moses JW, Popma JJ, Cutlip D, Fitzgerald PJ, Brown C, Fischell T, Wong SC, Midei M, Snead D, Kuntz RE. Analysis of 1-year clinical outcomes in the SIRIUS trial: a randomized trial of a sirolimus-eluting stent versus a standard stent in patients at high risk for coronary restenosis. Circulation. 2004;109(5):634-40.

Treatment of Patients in Cardiogenic Shock.
Key Faculty: S. Chiu Wong, MD (Associate Professor)

One of the highest risk subgroup of patients that we are treating in the catheterization laboratories are patient who are in cardiogenic shock complicating a myocardial infarction.

Selected References

Wong SC, Sleeper LA, Monrad ES, Menegus MA, Palazzo A, Dzavik V, Jacobs A, Jiang X, Hochman JS; SHOCK Investigators. Absence of gender differences in clinical outcomes in patients with cardiogenic shock complicating acute myocardial infarction. A report from the SHOCK Trial Registry. J Am Coll Cardiol. 2001;38(5):1395-401.

Hochman JS, Sleeper LA, White HD, Dzavik V, Wong SC, Menon V, Webb JG, Steingart R, Picard MH, Menegus MA, Boland J, Sanborn T, Buller CE, Modur S, Forman R, Desvigne-Nickens P, Jacobs AK, Slater JN, LeJemtel TH; SHOCK Investigators. Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock. One-year survival following early revascularization for cardiogenic shock. JAMA. 2001;285(2):190-2.

Wong SC, Sanborn T, Sleeper LA, Webb JG, Pilchik R, Hart D, Mejnartowicz S, Antonelli TA, Lange R, French JK, Bergman G, LeJemtel T, Hochman JS.Angiographic findings and clinical correlates in patients with cardiogenic shock complicating acute myocardial infarction: a report from the SHOCK Trial Registry.

Evaluating and Identifying Predictors for Complications Associated with Percutaneous Coronary Interventions.
Key Faculty: S. Chiu Wong, MD (Associate Professor)

As part of on-going quality assurance to assess angioplasty results in the New York State Angioplasty Registry, procedural results of every single patient treated in NY State catheterization laboratories are entered into the database.

Selected References

Wong SC, Minutello RM, Hong MK. Neurological complications following percutaneous coronary interventions: A Report from the 200-2001 New York State Angioplasty Registry. Am J Cardiol. Manuscript accepted May 2005 (In Press)

Chou ET, Minutello RM, Parikh M, Bergman G, Chiu Wong S, Hong MK. Can we identify vulnerable patients at risk for ST-segment elevation myocardial infarction based on their clinical characteristics? Coron Artery Dis. 2004;15(8):467-9.

Minutello RM, Chou ET, Hong MK, Bergman G, Parikh M, Iacovone F, Wong SC. Impact of body mass index on in-hospital outcomes following percutaneous coronary intervention (report from the New York StateAngioplasty Registry). Am J Cardiol. 2004;93(10):1229-32.

Peripheral Vascular Disease.
Key Faculty: Ingrid Hriljac, MD (Assistant Professor)

It has recently been shown in the SHS that low and high values of the ankle brachial index (ABI) independently predict cardiovascular (CV) events and death, including cardiac events without direct connection to peripheral arteries, in individuals without clinically overt disease. We have now proven the hypothesis that low and high ABI would be associated with echocardiographic markers of preclinical CV disease in 3,084 SHS participants who were free of clinical CV disease at the time. These abnormalities may contribute to mediating the known associations of both low and high ABI with cardiac events that are not directly related to the peripheral arteries that contribute to generating the ABI. We also extend this analysis to the cerebral vasculature.

Selected References

Katz SD, Hryniewicz K, Hriljac I.Vascular endothelial dysfunction and mortality risk in patients with chronic heart failure. Circulation. 2005;111(3):310-4.

Hriljac I, Gustavson S, Olin JW. Images in vascular ultrasound: Stenosis of the innominate or left common carotid artery origin diagnosed on carotid ultrasound examination. Vasc Med. 2003;8(4):287-8.

Risk Factors for Cerebral Ischemia.
Key Faculty: Jorge Kizer, MD (Assistant Professor)

Research activities include the Thrombophilia In Cryptogenic stroKe (THICK) Study, with funding provided by a Patient-Oriented Career Development Award (K-23); analysis of population-based cohorts for which Cornell has participated as the Core Echocardiography Laboratory; and analyses of clinical data from the Echocardiography Laboratory on risk factors for cryptogenic stroke and embolic stroke in cancer. Training activities consist of coursework in genetic epidemiology at the Columbia School of Public Health and at the Southwest Foundation.

Selected References

Kizer JR, Silvestry FE, Kimmel SE, Kasner SE, Wiegers SE, Erwin MB, Schwalm SA, Viswanathan MN, Pollard JR, Keane MG, St John Sutton MG. Racial Differences in the Prevalence of Cardiac Sources of Embolism in Subjects with Unexplained Stroke or Transient Ischemic Attack Evaluated by Transesophageal Echocardiography. Am J Cardiol. 2002;90:395-400.

Kizer JR, Bella JN, Palmieri V, Liu JE, Best LG, Lee ET, Roman MJ, Devereux RB. Left Atrial Diameter as an Independent Predictor of First Clinical Cardiovascular Events in Middle-Aged and Elderly Adults: The Strong Heart Study. Am Heart J (in press.)

Kizer JR, Wiebers DO, Whisnant JP, Galloway JM, Welty TK, Lee ET, Best L, Resnick HE, Roman MJ, Devereux RB. Mitral Annular Calcification, Aortic-Valve Sclerosis and Incident Stroke in Adults Free of Clinical Cardiovascular Disease: The Strong Heart Study. Stroke (in process)

Epidemiologic Risk Factors for Cardiovascular Disease
Key Faculty: Jorge Kizer, MD (Assistant Professor).

Research activities include investigation of adipokines in the Cardiovascular Health Study, with funding from an AHA Clinically Applied Research Grant; evaluation of lipoprotein-associated phospholipase A2, with funding from Diadexus, in the Strong Heart Study (application pending); and the relative predictive value of albuminuria and glomerular filtration rate in the Strong Heart Study and the LIFE Study.

Selected References

Kizer JR, Zisman DA, Blumenthal NP, Kotloff RM, Kimmel SE, Strieter RM, Arcasoy SM, Ferrari VA, Hansen-Flaschen J. Association Between Pulmonary Fibrosis and Coronary Artery Disease. Arch Intern Med. 2004;164:551-556.

Premature vascular aging in chronic inflammatory diseases.
Key Faculty: Mary J. Roman, MD (Professor)

This area of research examines the impact of chronic inflammation, exemplified by SLE and rheumatoid arthritis, on vascular aging as manifest by preclinical atherosclerosis detected by carotid ultrasonography and vascular stiffening detected by applanation tonometry. These publications support the hypothesis that chronic inflammatory diseases are associated with premature vascular aging; analysis of longitudinal data is expected to provide strategies for interventional studies.

Selected References

Roman MJ, Shanker B-A, Davis A, Lockshin MD, Sammaritano L, Simantov R, Crow MK, Schwartz JE, Paget SA, Devereux RB, Salmon JE. Prevalence and correlates of accelerated atherosclerosis in systemic lupus erythematosus. N Engl J Med. 2003;349:2399-2406.

Roman MJ, Devereux RB, Schwartz JE, Lockshin MD, Paget SA, Davis A, Crow MK, Sammaritano L, Levine DM, Shankar B-A, Moeller E, Salmon JE. Arterial Stiffness in chronic inflammatory diseases. Hypertension. 2005;46:1-6.

Roman MJ, Moeller E, Davis A, Paget SA, Crow MK, Lockshin MD, Sammaritano L, Devereux RB, Schwartz JE, Levine DM, Salmon JE. Premature atherosclerosis in rheumatoid arthritis. Submitted for publication.