Ascension Providence Hospital Cardiovascular Disease Research
Participation in research is required of all trainees. It is expected that each cardiovascular fellow will prepare a research project for presentation at a regional or national meeting and will submit at least one project for publication in a peer review journal. The Department of Research at Ascension Providence Hospital is in a position to offer technical facilities and monetary assistance (through research grants to staff members) to residents and trainees participating in clinical research. The Research Department acts as a complement to the medical teaching program and fulfills requirements for the unique individual research studies required in specialized medical fields. Elective rotations in research are offered during the 3rd year of training. This rotation is under Dr. Shukri David’s supervision.
Through research, practicing physicians are kept alert to problems outside of routine patient care and are stimulated to search for new medical knowledge and techniques.
The Research Department is under the direction of David Svinarich, Ph.D., Director of Patient Care Research. A newly constructed 10,000 sq ft facility was opened in June of 2001. The Research Department consists of the following divisions: Clinical Trials Unit, Research Laboratory, Teaching Laboratories.
Clinical Trials Unit
The Clinical Trials Unit has three experienced Research Nurses with expertise in conducting Phase I-IV clinical research studies. Services offered include assistance with regulatory documents, study coordination and data management. The Clinical Trials Unit has clinical research experience with the following sponsors and clinical research organizations:
Academic Pharmaceuticals Henry Ford Coordinating Center AstraZeneca IVT Bayer Corporation Medtronic Biotronik NIH Boston Scientific NHLBI Bristol-Myers Squibb Novartis Ciba-Geigy Paragon Cordis Parexel Covance Parke-Davis DCRI Pfizer Eli Lilly St. Jude Medical Genentech TherOx, Inc. Guidant Wyeth-Ayerst Pharmaceuticals
Since 2000, the Ascension Providence Hospital Sectin of Cardiology has participated in the following clinical research studies (sponosors are in parentheses):
- AFFIRM (NIH, NHLBI)
- PEACE (NIH, NHLBI)
- MOST (NIH, NHLBI)
- SCD-HeFT (NIH, NHLBI)
- VALIANT (NIH, NHLBI)
- RAMPART (Parke Davis)
- A double-blind comparison of the incidence of hypotension with two formulations of intravenous amiodarone: Cordarone IV vs amiodarone aqueous IV injection (Wyeth Ayerst)
- Acute evaluation of autocapture in Bachmann’s Bundle vs right atrial appendage using Affinity DR Device (St Jude Medical)
- PEACE: Prevention of events with angiotensin converting enzyme inhibitor therapy – Ancillary study (NIH, NHLBI)
- Evaulation of atrial arrhythmias utilizing the onset of electrogram capability of Discovery II and Ventak Prizm AICD (Guidant)
- Omapatrilat cardiovascular treatment assessment vs enalapril (OCTAVE) protocol CV-137-120 (Bristol-Myers Squibb Company)
- CONSERVE: Comparison on new stents for equivalency of reduction in vascular events (IVT)
- PainFree Rx II: Does pacing fast VT Reduce Shock Rx? (Medtronic)
- TACT: Tachos Atrial Conversion Therapy (Biotronik)
- The open evaluation comparing stent thrombosis rate of the BX Velocity Heparin Coated Stent and the BX Velocity Stent (Cordis)
- TENAX XR registry investigational plan (Biotronik)
- TherOx Aqueous Oxygen System -Acute Myocardial Infarction with Hyperoxemic Therapy (AMIHOT) Phase II Clinical Trial: A randomized, controlled, multicenter trial of aqueous oxygen infusion for 90-minutes post-primary PTCA/Stent Intervention in Acute MI (TherOx, Inc.)
- Evaluating the value of fluoroscopy in screening for coronary artery disease (Ascension Providence Hospital and Medical Centers)
- OAT: The occluded artery trial (NIH)
- Evaluation of the role of non-invasive hemodynamic monitoring in treatment of congestive heart failure (Ascension Providence Hospital and Medical Centers)
- Is cardiac monitoring post pacemaker placement necessary? A retrospective evaluation of trends in admitting post pacemaker placement patients to monitored unit versus non-monitored unit. (Ascension Providence Hospital and Medical Centers)
- Early ambulation following diagnostic coronary angiography using perclose closure of femoral arteriotomy (Ascension Providence Hospital and Medical Centers)
- Evaluation of doppler echocardiographic velocities in intra-aortic balloon pumping (DEVIAB) doppler correlates of left ventricular performance and prognostic implications of weaning (Ascension Providence Hospital and Medical Centers)
- Synergistic effects of risk factors for sudden cardiac death (SERF) study (Guidant)
- Does low androgen state correlate with more major adverse clinical events after coronary stenting? (Ascension Providence Hospital and Medical Centers)
- Feasibility of percutaneous suture closure for diagnostic electrophysiologic studies (SCEPS): Efficacy, safety and length of stay evaluation (Ascension Providence Hospital and Medical Centers)
- Pain FREE Rx II Expansion Study with GEM III AT ICD (Medtronic)
- The pacing energy margin verification via intracardiac electrogram study (Guidant)
- Optimal atrial lead placement for AF suppression (St Jude Medical)
- Optimization of atrial mode of pacing and AV interval in cardiac resynchronization therapy (CRT) using impedance cardiography and myocardial performance index (TEI index) (Ascension Providence Hospital and Medical Centers)
- The Clinical Trials Unit has an examination room and storage room for case report forms, records and investigational drug/device storage.
The Research Laboratory has a staff of two medical technologists with research experience. Two cell culture rooms are available for development of cell lines from tissue and the expansion of cell numbers for use in wound repair studies and/or bioengineering studies. A microbiology laboratory is available for specimen handling and set-up for cultures and other bioassays. It is equipped with a biosafety cabinet (Class II), incubator with CO2, and a microscope. This area also houses a general laboratory for specimen processing of blood and body fluids, extraction of nucleic acids (DNA and RNA), protein chemistries (protein quantitation, western blot), and immunohistochemistry. This area is equipped with a teaching microscope. There is a PCR and post PCR room for DNA and RNA detection and quantitation and a dark room for x-ray film processing.
The Teaching Laboratories consist of a microvascular laboratory and a gross anatomy laboratory, along with a skull-based surgery laboratory. The Medical Education department, with the help of the Biomedical Research department, holds an annual Resident Research Day where residents from various specialties present their research projects in a competition. All cardiovascular fellows are encouraged to participate. The resident award recipients from this competition then compete in the Southeast Michigan Center for Medical Education Research Forum (SEMCME). This Forum is also an annual event and the participants are from local area hospitals that are members of SEMCME.
The fellow who has a paper presentation accepted at a national or international meeting is provided funds to attend those meetings. Recent research publications are listed below:
- Brancheau D, Blanco J, Gholkar G, Patel B, Machado C. Cannabis induced asystole. J Electrocardiol. 2016 Jan-Feb;49(1):15-7. (PMID: 26520167)
- Chand G, Jhaj R, Sanam K, Sinha P, Alexander P. Pericardial salmonella with cardiac tamponade and ventricular wall rupture: A case report. Ann Med Surg (Lond). 2016 Mar 29;7:83-6. (PMID: 27141304)
- Patel B, Assaad M, Tolia S, Bajwa M, Zughaib M. Mild anemia as a possible cause of false positive stress echocardiography in non-obstructive coronary artery disease: A pathophysiologic hypothesis. Int J Cardiol. 2016 Jan15;203:525-6. (PMID: 26562536)
- Perdoncin E, Seth M, Dixon S, Cannon L, Khandelwal A, Riba A, David S, Wohns D, Gurm H. The comparative efficacy of bivalirudin is markedly attenuated by use of radial access: insights from Blue Cross Blue Shield of Michigan Cardiovascular Consortium. Eur Heart J. 2016 Jun 21;37(24):1902-9. (PMID: 26377400)
- Brancheau D, Degheim G, Machado C. Timing for pacing after acquired conduction disease in the setting of endocarditis. Case Rep Cardiol. 2015;2015:471046. (PMID: 25628898)
- Brancheau D, Patel B, Zughaib M. Do cinnamon supplements cause acute hepatitis? Am J Case Rep. 2015 Apr 29;16:250-4. (PMID: 25923145)
- Hanson ID, David SW, Dixon SR, Metzger DC, Généreux P, Maehara A, Xu K, Stone GW. "Optimized" delivery of intracoronary supersaturated oxygen in acute anterior myocardial infarction: a feasibility and safety study. Catheter Cardiovasc Interv. 2015 Oct;86 Suppl 1:S51-7. (PMID: 25512256)
- Idris S, Degheim G, Ghalayini W, Larsen TR, Nejad D, David S. Home Telemedicine in Heart Failure: A Pilot Study of Integrated Telemonitoring and Virtual Provider Appointments. Rev Cardiovasc Med. 2015;16(2):156-62. (PMID: 26198562)
- Nasser M, Idris S, Marinelli K, Machado C. Flecainide-induced Torsades dePointes: Case Report and Review of Literature. Rev Cardiovasc Med. 2015;16(3):214-20. (PMID: 26451768)
- Sarsam S, Sidiqi I, Shah D, Zughaib M. Concomitant Wolff-Parkinson-White and Atrioventricular Nodal Reentrant Tachycardia: Which Pathway to Ablate? Am J Case Rep. 2015 Dec 11;16:872-5. (PMID: 26655223)
- Sidiqi I, Alexander P. Current advances in endovascular therapy for infrapopliteal artery disease. Rev Cardiovasc Med. 2015;16(1):36-50. (PMID: 25813795)
- Darda S, Zughaib ME, Alexander PB, Machado CE, David SW, Saba S. Cardiac sarcoidosis presenting as constrictive pericarditis. Tex Heart Inst J. 2014 Jun 1;41(3):319-23. (PMID: 24955053)
- Jain SK, Patel B, David W, Jazrawi A, Alexander P. Unloading of right ventricle and clinical improvement after ultrasound-accelerated thrombolysis in patients with submassive pulmonary embolism. Case Rep Med. 2014;2014:297951. (PMID: 25097552)
- Patel B, Assad D, Wiemann C, Zughaib M. Repeated use of albuterol inhaler as a potential cause of Takotsubo cardiomyopathy. Am J Case Rep. 2014 May 19;15:221-5. (PMID: 24855502)
- Pershad A, Fraij G, Massaro JM, David SW, Kleiman NS, Denktas AE, Wilson BH, Dixon SR, Ohman EM, Douglas PS, Moses JW, O'Neill WW. Comparison of the use of hemodynamic support in patients ≥80 years versus patients <80 years during high-risk percutaneous coronary interventions (from the Multicenter PROTECT II Randomized Study). Am J Cardiol. 2014 Sep 1;114(5):657-64. (PMID: 25037676)
- Roy D. Hameed A, Alper A, Williams F, Liddon V, Machado C. A comparative assessment of safety and cost for deep sedation in electrical cardioversion by anesthesiologist versus electrophysiologist. Presented by D. Roy at the 66th Annual Resident Research Day, April 25, 2002. Awarded 2nd Place Fellow Category.
- Z arghami J. Recurrent syncope (Clinical Vignette). Michigan Cardiology Fellows American College of Cardiology Society’s Clinical Vignette Competition, Henry Ford Hospital, August 25, 2001. Ron J. Vanden Belt Memorial Award Recipient.
- Zarghami J, Toukan K, Freih M, Al-Azzeh H, Machado C. Ou tpatient cardiac pacemaker implantation: No difference in outcome between postoperative admission to cardiac monitored bed versus non-monitored bed. Presented by J. Zarghami at the 67th Annual Resident Research Day, April 17, 2002. Awarded 2nd Place in the Fellows Category.
Specialized Courses and Meettings
Second and third year residents are given the opportunity to attend one of the major cardiology meetings, such as the annual meeting of the American Heart Association or the American College of Cardiology. In addition, senior residents are encouraged to attend the Michigan Chapter meeting of the American College of Cardiology and provide presentations for this meeting. Provisions are made for the attendance of specialized courses in order to obtain certification in specialized techniques or to add a qualification, such as echocardiography or electrocardiography.