A central mission of the Division of Cardiovascular Medicine is to provide our fellows with opportunities to train in the full spectrum of research, from basic mechanistic studies to clinical trials.
Our Innovative Research Training Programs
We have recently enhanced this rich research training experience with the establishment of two innovative new programs: The Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology (under the direction of Dr. Bobby Yeh), and a novel Program in Personalized Genomics and Cardiometabolic Diseases (under the direction of Dr. Robert Gerszten). These new programs provide unique opportunities for the investigation of hospital-based outcomes research as well as precision and personalized medicine – from novel genomic techniques to “big data” analyses integrating clinical trials.
Mentors and Research Electives for First-Year Fellows
During the first year of research training, fellows are assigned faculty mentors who help them identify areas of interest and potential research preceptors. A new feature now allows for a research elective in the very first year of training, and includes one-on-one project brainstorming sessions with potential mentors and the division chief. In addition to the specific labs and programs outlined below, fellows have access to an almost limitless array of research opportunities in the broader BIDMC community, as well as through Harvard Medical School, Harvard University and other Boston-area biomedical institutions. We encourage thoughtful, interdisciplinary and/or inter-institutional training programs!
One of the Nation's First T-32 Training Programs
Catalyzing our research training is one of the first NHLBI-funded T32 training programs in the country. Unlike many other training programs, the BIDMCT32 program supports fellows across the entire spectrum of research endeavors, from basic research to population science. In 2015, Dr. Murray Mittleman, who also directs masters training at the Harvard School of Public Health, was appointed Director of the T32 Cardiology Research Training Grant and Dr. Maria Kontaridis was appointed Associate Director of the grant and Director of the Basic Cardiovascular Research program. Drs. Mittleman and Kontaridis work closely with Division Chief, Dr. Robert E. Gerszten, who previously led a T32 program at Harvard Medical School.
State of the Art Laboratory Facilities
Cardiovascular research faculty is housed in a state-of-the art laboratory facility in the Center for Life Science (CLS) building, one of the largest research buildings in Boston's Longwood Medical Area. Medical-center wide, BIDMC consistently ranks as a national leader among independent hospitals in National Institutes of Health (NIH) funding and, in total, research at BIDMC is a $200 million enterprise. Indeed, our cardiovascular programs herald an exciting period for biomedical research at BIDMC.
We invite you to explore our research programs. Please contact the leaders directly if a particular program piques your interest.
Personal Genomics and Cardiometabolic Disease
An investigative team lead by Dr. Robert Gerszten (right) focuses on the nexus of cardiac and metabolic diseases. This translational research program is a national leader in the use of metabolomics and proteomic technologies — and the integration of this information with human genetics — for the discovery of new biomarkers and pathways contributing to atherogenesis and its complications. The Gerszten team has identified novel biomarkers that single out individuals destined to develop diabetes and heart disease more than a decade before disease onset, with the goal of determining which of these patients might benefit from clinical interventions. The group’s highly interactive program collaborates with researchers from across a spectrum of institutions, including the Broad Institute, the Framingham Heart Study, the Jackson Heart Study, the Diabetes Prevention Program,and the TIMI Study Group.
The Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology
The first program of its kind in Boston, the Smith Center for Outcomes Research has been created to evaluate and transform the delivery of care for a range of cardiovascular conditions. Directed by Dr. Robert Yeh (right), a national leader in outcomes research who has led seminal studies in the fields of cardiovascular epidemiology, health policy evaluation and comparative effectiveness research, the Smith Center is working to validate the safety and benefits of new therapies and technologies for the treatment of heart disease. The Smith Center brings together clinicians and researchers to examine today’s most pressing challenges in cardiovascular care, including clinical effectiveness, cost, quality, ethics and public policy. Rising health care costs, expanding technological capabilities and increasing patient complexity all impact the cardiovascular care delivered in the United States today and research conducted in the Smith Center provides evidence-based insights with the potential to dramatically improve patient outcomes.
Institute for Prevention of Cardiovascular Disease
Dr. Murray Mittleman investigates both primary and secondary prevention of acute cardiovascular events. He is a leader in epidemiologic methods and is one of the co-developers of the case-crossover study design. His research interests span the application of this methodology to disciplines beyond cardiovascular disease. Dr. Mittleman's group is actively pursuing three lines of research:
- Triggers of acute cardiovascular events
- Clinical and behavioral determinants of prognosis following acute myocardial infarction
- Determinants and prognosis of premature acute coronary syndromes in women.
Molecular and Cellular Cardiology
The laboratory of Dr. Maria Kontaridis studies fundamental mechanisms underlying both congenital heart disease and end-stage heart failure, and the factors leading to abnormal heart development, aberrant molecular signaling and cardiac disease onset. The lab uses a myriad of tools and techniques including iPS, in vivo mouse model systems, biochemistry and molecular biology techniques. Kontaridis lab investigators gain valuable mechanistic and functional information in understanding the differential signaling pathways and developmental processes leading to cardiac disease. The lab has three main interests:
- Elucidation of the cardiomyogenic defects associated with Noonan Syndrome with Multiple Lentigines (NSML), an autosomal dominant congenital disorder primarily caused by unique mutations in the protein tyrosine phosphatase Shp2
- Understanding the functional role and mechanisms by which Shp2 activity is involved in the development of Systemic Lupus Erythematosus
- Elucidating the potential cardio-protective effects of the small G protein RhoA in the adult heart through identification of novel signaling pathways involved in cardiac pathogenesis
Dr. Peter Kang’s lab studies the molecular mechanisms of cardiac apoptosis and develops novel anti-apoptotic applications in cardiovascular diseases. One of these applications is the development of novel nanoparticle-based systems that are activated by hydrogen peroxide, the most abundant form of reactive oxygen species produced during reperfusion injury. These systems are designed to be used in cardiovascular therapeutics and bioimaging. The Kang lab is also investigating the molecular mechanisms of cardiac dysfunction associated with Vitamin D deficiency and examining the potential role of Vitamin D therapy in the treatment of heart failure. The lab, in collaboration with other investigators, recently identified novel VDR agonists and is studying these novel compounds for clinical applications.
Dr. Elad Anter is Director of the Cardiac Electrophysiology Laboratories and an internationally known expert in advanced therapies for atrial fibrillation and ventricular arrhythmias. He directrs the Electrophysiology Translational Research Program, dedicated to the development of new innovative ways to treat and manage arrhythmias, particularly in patients who have had prior unsuccessful procedures. His laboratory focuses on development of new technologies to improve ablative therapies for patients with arrhythmias. He currently serves as the principal investigator for several prospective randomized ventricular tachycardia ablation clinical trials.
Dr. Richard Verrier’s research focuses on neural, behavioral and environmental triggers of sudden cardiac death and arrhythmias. The laboratory specializes in computerized analysis of electrocardiographic markers, especially T-wave alternans, a beat-to-beat fluctuation in the area and form of the T-wave of the ECG. The lab demonstrated that T-wave alternans provides an index of vulnerability to life-threatening cardiac arrhythmias as well as a means to identify individuals at risk and to measure the efficacy of pharmacologic therapy. Current investigations include neural triggers of sudden death during ischemia, anger, REM sleep and exposure to environmental air particles.
Advanced Cardiovascular Imaging
Dr. Warren Manningis the Co-Director of the Cardiac Magnetic Resonance Imaging Center and Director of the Echocardiography Laborator. Former president of the Society for Cardiovascular Magnetic Resonance, Dr. Manning maintains many research interests, including cardiovascular applications of magnetic resonance (coronary MRI, valvular heart disease, subclinical atherosclerosis, atrial fibrosis in atrial fibrillation and pericarditis), as well as utilization of echocardiography for prognosis in valvular heart disease and appropriateness of echocardiographic referrals.
The laboratory of Dr. Reza Nezafat focuses on cardiovascular magnetic resonance imaging (CMR). Dr. Nezafat directs the Translational Cardiovascular Imaging Laboratory, which develops and clinically translates new CMR techniques with the goal of improving the care of patients with cardiovascular disease. His current clinical research focuses on cardiac arrhythmia, heart failure and cardiotoxicity. Dr. Nezafat teaches the CMR course at BIDMC and is involved in training fellows through the advanced cardiac imaging program.
Dr. Connie Tsao specializes in clinical cardiovascular imaging, including echocardiography and cardiovascular magnetic resonance (CMR). An investigator and co-director of the Echocardiography Laboratory in the Framingham Heart Study, Dr. Tsao’s research focuses on noninvasive assessment of cardiovascular structure and function and the epidemiology of subclinical cardiovascular disease, cardiac remodeling, vascular stiffness and heart failure. Current projects use CMR to investigate left ventricular function and myocardial characteristics and their relation to vascular stiffness in subgroups of heart failure patients; the effect of exercise on myocardial tissue characteristics and vascular flow patterns; and the detection and evaluation of myocardial fibrosis in preclinical tests of cardiovascular disease. Working with the Framingham Heart study, a large population study, Dr. Tsao’s research makes use of advanced imaging tools in echocardiography, CMR and computed tomography for the detection and prognostic evaluation of CVD.
Lipids and Atherosclerosis
The laboratory of Dr. Francine Welty investigates vascular injury, repair and remodeling, including the role of metabolic syndrome and insulin resistance — with their proinflammatory milieu — in the development of atherosclerosis. Her lab is also conducting an interventional study to prevent obesity, metabolic syndrome and type 2 diabetes in Kuwaiti children. In addition, her group is performing genome-wide association scans in the Amish population to search for genes for type 2 diabetes and blood pressure. In addition, kindreds with the apoB-67 mutation, which is a founder mutation in the Amish, are being extended to determine if the mutation predisposes to longevity and protects against cancer and atherosclerosis. Magnetic resonance imaging of the liver in these subjects will start soon to determine if a higher content of fat in the liver predisposes these subjects to insulin resistance and diabetes.
PERFUSE Study Group
Interventional cardiologist Dr. Michael Gibson founded the PERFUSE study group in 1987. The PERFUSE academic research organization now has over 25 years of experience in leading and providing core laboratory services to support more than 110 international multi-center trials in cardiovascular disease. As an international leader in the development of secure informational portals for clinical trials, PERFUSE creates novel on-line “communities” to foster enrollment, drive physician and site engagement and enhance trial awareness. To build an academic community around a disease state, PERFUSE trials actively engage trial investigators as co-authors of textbook content on the medical education website WikiDoc.org, which was created by Dr. Gibson as “a living textbook” for medical education. Together with WikiPatient.org, a second medical education website created by Dr. Gibson, the two sites are viewed up to 2 million times daily.
Framingham Heart Study (FHS)
This National Heart Lung Blood Institute (NHLBI) sponsored project is the world's largest and longest running prospective cardiovascular disease epidemiology study. BIDMC cardiologist Dr. Connie Tsao helps to direct the Echo core lab at the FHS. New technologies have been introduced in recent years including M-mode, 2-D, and Doppler echocardiography, Holter monitoring for arrhythmia and ST segments, computerized 12-lead ECGs, ambulatory blood pressure measurements and carotid ultrasonography. Data from these are part of a correlated database that includes up to 40 years of information. Current research includes:
- Incidence, prevalence and prognosis of atrial fibrillation
- Exercise treadmill results as predictive of coronary disease
- Blood pressure response to exercise as predictive of left ventricular hypertrophy
- Arrhythmias on ambulatory ECG monitoring (impact of age and sex)
- Left ventricular mass and risk for sudden death
- Left ventricular mass and risk for stroke
- Determinants of diastolic left ventricular function
- Characterization of echo patterns in subjects with congestive heart failure
- Prevalence of ultrasound documented carotid disease in subjects with MI
- Differences in early and late death from coronary disease in men vs. women
Harvard Clinical Research Institute
Collaboration with biostatisticians, epidemiologists, decision and cost effectiveness analysts, and clinical trialists is available at the Harvard Clinical Research Institute (HCRI), an academic contract research organization specializing in the design and coordination of multicenter clinical trials as well as analysis of clinical research data from a wide variety of clinical disciplines (with special emphasis and expertise in cardiovascular diseases). A joint venture of Harvard Medical School, BIDMC and Partners Healthcare, HCRI has conducted over 100 national and international medical device, pharmaceutical and biological trials, many leading to FDA approval for novel therapies (including intravascular brachytherapy, drug-eluting stents and distal-embolic protection devices).
The institute is administered by Dr. Donald Cutlip andDr. Kalon Ho at BIDMC and Dr. Richard Kuntz at Brigham and Women's Hospital. Also active in HCRI is BIDMC interventional cardiologist Dr. C. Michael Gibson,Director of Core Services at the TIMI (Thrombolysis in Myocardial Infarction) Study Group. Dr. Peter Zimetbaum, Associate Chief of Cardiovascular Medicine at BIDMC, also works closely with the HCRI, with a focus on research of cardiac arrhythmias and arrhythmia monitoring for arrhythmia clinical trials, as does Dr. Alexei V. Shilkin, whose research focus includes 3-dimensional computerized analysis of electrocardiogram.
Harvard School of Public Health (HSPH)
Over a dozen fellows from the BIDMC Cardiovascular Division have participated in the Program for Training in Clinical Effectiveness at the Harvard School of Public Health during the last decade. Seven-week, intensive sessions designed for physicians are offered in July and August with introductory and advanced courses in epidemiology biostatistics, decision analysis, clinical trials, measurement techniques, outcomes analyses, quality improvement, and health services research. Fellows who wish to receive a master's degree (MSc or MPH) can do so by attending classes full-time during two summers and/or part-time during the academic year. A parallel, non-degree granting summer program is also available through the Summer Institute at the School of Public Health. BIDMC faculty member Dr. Murray Mittleman directs the MPH program at HSPH.
Harvard-Thorndike Electrophysiology Institute and Arrhythmia Service
Research studies include the basic science and clinical investigation of risk stratification for sudden cardiac death. The Institute has developed novel strategies such as T-wave alternans heterogeneity tests that allow simultaneous conduction and recovery to be assessed as a marker of risk. Other studies include epicardial and endocardial mapping to assess arrhythmogenic substrate, pericardial delivery of antiarrhythmic, anti-ischemic and angiogenic factors and prevention of sudden cardiac death in coronary artery disease with ablation techniques and substrate mapping. A collaboration with non-invasive imaging is developing cutting-edge imaging methods to define the electrophysiologic substrate of ventricular arrhythmia. The Institute's facilities include an animal laboratory for whole animal experimentation in arrhythmogenesis.