Research Areas
- Hypercholesterolemia is a common problem post-transplant and contributes to the onset of post-transplant coronary vasculopathy, one of the largest impediments to long-term survival. My prospective randomized controlled study was able to demonstrate pravastatin had beneficial effects on post-transplant outcomes including cholesterol levels, the incidence of rejection causing hemodynamic compromise, one-year survival, and the incidence of coronary vasculopathy. On a molecular level, the study was also able to demonstrate a reduction in the cytotoxicity of natural killer cells as a result of pravastatin.
- In patients who have received a cardiac transplant, the denervated donor heart responds abnormally to exercise and exercise tolerance is reduced, resulting in poorer quality of life. In a controlled trial, I assessed the effects of training on the capacity for exercise early after cardiac transplantation. The results demonstrated significantly greater increases in peak oxygen consumption and workload, and ensured that the treatment (cardiac rehabilitation) was covered by insurance companies.
- Cardiac allograft vasculopathy (CAV) is a major impediment to long-term graft survival post transplant. Intravascular ultrasound (IVUS) is more sensitive than coronary angiography and detects intimal thickening (early CAV) in the coronary arteries of the donor heart. Our multicenter retrospective study demonstrated that progression of intimal thickening ≥0.5 mm in the first year after transplantation appeared to be a reliable surrogate marker for subsequent mortality, nonfatal major adverse cardiac events, and development of angiographic CAV through five years after heart transplantation.