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  • 1. CARDIOLOGY FELLOWSHIP AT THE UNIVERSITY OF COLORADO HEALTH SCIENCES CENTER The postgraduate program in cardiology at the University of Colorado Health Sciences Center is designed to accommodate the needs of physicians whose goals include a career in academic cardiology with emphasis on teaching and research and who require strong training clinical cardiology. The usual training period is four years with two years of research or specialized training. Each trainee will receive training in modern clinical techniques in adult cardiology including coronary care, electrocardiography, cardiac electrophysiology and pacemaker therapy, cardiac catheterization including interventional cardiology, echocardiography, exercise testing, cardiac transplantation, vascular medicine, and cardiac rehabilitation. In addition, trainees will be familiarized with recent developments in cardiovascular physiology, biochemistry, pharmacology, and molecular biology. The philosophy behind the clinical training program is to provide both a thorough, comprehensive exposure to modern cardiology consultant practice, and sufficient scientific background to allow graduates of the program to critically evaluate future developments in this rapidly changing clinical specialty. In addition, trainees will have an opportunity to participate in some of the new approaches to cardiovascular disease both from a clinical as well as basic scientific standpoint. Clinical rotations utilize the facilities of the 350-bed University of Colorado Hospital, the 512-bed Veterans Administration Medical Center, the 249-bed Denver Health Medical Center and the 400-bed Rose Medical Center. At University Hospital, all outpatient and noninvasive cardiology facilities have been centralized into a new state-of-the-art facility, the Temple Hoyne Buell Heart Center. Faculty supervision during clinical rotations is provided by groups of approximately 18 full-time staff members at University Hospital, 6 full-time staff at the VA Medical Center and 7 full-time staff at Denver Health Medical Center. These rotations allow trainees exposure to a wide variety of cardiac disorders in both private and nonprivate patients. In addition, there are several Ph.D. scientists in the Division that help provide an optimal research environment in which trainees can develop the necessary skills to pursue independent careers in cardiovascular research. Another major feature of the program is regular clinical, basic science, and research conferences as part of a core curriculum for the fellowship. For many years, the Division of Cardiology has enjoyed a reputation for excellence in the training of clinical cardiologists. Under the direction of Dr. Eugene Wolfel the Division of Cardiology offers a comprehensive clinical and research environment for excellent cardiovascular training. There is an active invasive cardiac electrophysiology laboratory staffed by Drs. Michael Reiter, Arthur Easley, and Patricia Kelly. The Heart Failure Treatment and Transplantation Program is an integral part of the clinical program at University Hospital. This integrated program headed by Dr. Michael Bristow with Dr. JoAnn Lindenfeld as the Director of Cardiac Transplantation and Dr. Brian Lowes as Director of Clinical Heart Failure provides an opportunity for the trainee to gain in-depth knowledge in the clinical area of heart failure. In addition, a close interaction with the Temple Hoyne Buell Cardiovascular Research Laboratories provides an opportunity to acquire additional skills in the basic science principles related to heart failure. Activities in the cardiac catheterization laboratory at University Hospital headed by Dr. John Messenger include a full range of diagnostic and therapeutic techniques in a state-of-the-art digital laboratory with extensive computer assisted cardiac analysis systems. In addition, there is an active program in the pharmacologic therapy of patients with significant pulmonary hypertension, as well as an Interventional Cardiology program which includes complicated multivessel angioplasty, atherectomy and brachytherapy, as well as clinical programs in valvuloplasty, ovale closure, alcohol septal ablation, percutaneous atrial septal defect and patent foramen closure and newer coronary interventional techniques. The active coronary care facilities at University Hospital and Denver Health Medical Center offer excellent experiences in acute cardiac care. The sophisticated exercise testing and noninvasive testing laboratories at University Hospital and Denver Health Medical Center, the newly established nuclear 1
  • 2. cardiology program at the University Hospital under the direction of Dr. Quaife and the research-oriented cardiovascular rehabilitation at University Hospital are also valuable aspects of the training program. An active echocardiography program at all three hospitals including exercise and pharmacologic stress echocardiography and transesophageal echo provides a good exposure to this aspect of noninvasive cardiology. The addition of Dr. William Hiatt, an internist specializing in Vascular Medicine, to the Division allows trainees to become knowledgeable in the area of peripheral and carotid vascular diseases. A very active program in Cardiovascular Outcomes Research, under the direction of Dr. John Rumsfeld at the Denver VA Hospital, provides the trainee an opportunity to develop knowledge and expertise in this growing area of research. Outcomes Research / Quality of Care is a strength of the entire Division, with multiple faculty focused in this area. Trainees with express interest in Outcomes Research will have the opportunity to pursue a Masters in Science Public Health or Ph.D. degree in Health Services Research through the Graduate School or Clinical Science Program at the University of Colorado Health Sciences Center. A major focus of the basic science research program in Cardiology is the study of adrenergic function in the failing heart under the direction of Dr. Bristow. This is a broad-based program including basic research as well as clinical trials of new therapy for heart failure patients with inotropic drugs and beta-blockers. Research in the area of endothelial cell function and reperfusion injury is being conducted under the direction of Lawrence D. Horwitz, M.D., the Director of Research in the Division of Cardiology. The effects of hypoxia on cardiac and pulmonary function, with studies extending from the molecular and cellular level to the intact animal or human subjects, are being investigated in the Cardiovascular Pulmonary Research Laboratory, under the direction of John V. Weil, M.D. Finally, the relationships between myocardial energy metabolism, ultrastructure, and contractile function are being investigated in intact animal models in the laboratory of Drs. Greg Schwartz and Cliff Greyson at the VA Medical Center. All these programs insure broad-based clinical and research training in the area of cardiovascular medicine and science. With renewal of our National Institutes of Health Research Training Grant we have the ability to fund five fellows in the areas of Heart Failure and Molecular Cardiology, Vascular Biology, and Health Services Research. This active investigative program also includes a didactic format in various aspects of basic science as well as statistical methods and scientific ethics. In addition, we have established an endowed fellowship in honor of Dr. S. Gilbert Blount, the first division head at the University of Colorado. This program allows one fellow per year to do clinical research as well as become involved in the teaching of cardiovascular medicine. Finally, the Cardiovascular Research Institute between our Division of Cardiology and the Department of Molecular, Cellular, and Developmental Biology (under the direction of Leslie Leinwand, Ph.D.) and the Department of Kinesiology (under the direction of Russell Moore, Ph.D.) at the University of Colorado in Boulder has broadened the scope of our research efforts and has increased the opportunities for fellows to become involved in basic research. Together, these new developments have solidified the research training in our program. Some of the major research programs in the Division of Cardiology include: 1. Studies of pharmacology, biochemistry, and molecular biology of adrenergic receptors in chronic congestive heart failure - Michael Bristow, M.D., Ph.D., David Port, Ph.D. 2. Clinical studies in congestive heart failure and cardiac transplantation - Michael Bristow, M.D., Ph.D., Brian Lowes, M.D., JoAnn Lindenfeld, M.D. 3. Hemodynamic evaluation of cardiac function, clinical studies with mitral valvuloplasty, clinical trials with new interventional techniques - John Carroll, M.D. 4. Studies of the pharmacology of the pulmonary circulation - John Reeves, M.D., Ivan McMurtry, Ph.D. 2
  • 3. 5. Studies of coronary endothelial damage due to reperfusion injury in animal models and tissue culture - Lawrence Horwitz, M.D., and Ivan McMurtry, Ph.D. 6. Studies of oxygen radical damage to the myocardium during ischemia and reperfusion - Lawrence Horwitz, M.D., and John Repine, M.D. 7. Study of molecular mechanisms of vascular smooth muscle proliferation - Lawrence Horwitz, M.D. 8. Studies of exercise responses and training in various cardiovascular systems - Eugene Wolfel, M.D. 9. Studies of high altitude physiology in normal man - John Reeves, M.D., Eugene Wolfel, M.D., and Bertron Groves, M.D. 10. Studies of mechanisms and treatment of arrhythmias - Michael Reiter, M.D., Ph.D. and Patricia Kelly, M.D. 11. Studies of vascular permeability in animal models and man as well as studies of hypoxic respiratory drive - John Weil, M.D. 12. Quality of life and outcomes in heart failure patients - Edward Havranek, M.D. 13. Studies on exercise responses in patients with peripheral vascular disease as well as studies in skeletal muscle metabolism and carnitive metabolism - William Hiatt, M.D., and Judy Regensteiner, Ph.D. 14. Studies of myocardial viability and perfusion - Robert Quaife, M.D. 15. The role of inflammatory cytokines in the genesis of heart failure - Carlin Long, M.D. 16. Studies of myocardial energy metabolism and its relation to ventricular function in intact animal models – Greg Schwartz, M.D., Ph.D. 17. Studies investigating the mechanisms of right ventricular failure in pressure overload, using intact animal models – Cliff Greyson, M.D. Research experience is also available in several laboratories which collaborate closely with the Division of Cardiology faculty including Dr. Robert Murphy (pharmacology of leukotrienes), Dr. Kathryn Horwitz (steroid hormones and the cardiovascular system), Dr. John Repine (oxygen radical-mediated tissue injury), and Dr. Robert Schrier (salt and water metabolism in edematous states), as well as other investigators in the Cardiopulmonary Research Laboratory, the Hepato-Biliary Center and the Atherosclerosis Center. The presence of a Biomedical Research Building has facilitated collaborative research opportunities with other members of an outstanding Department of Medicine. In the area of clinical research there are strong programs in various areas of clinical cardiology at all three major teaching institutions. Every attempt is made to further the research development of trainees in Cardiology in order to prepare them for a career in academic cardiology. Please go to the ERAS web site at www.aamc.org/eras to apply to our program. Interviews will be held in March and April, 2006 and are by invitation only. The Cardiology Fellowship Program at the University of Colorado Health Sciences Center participates in the Subspecialty Fellowship Matching Program. 3
  • 4. Current full-time faculty members include: Professors: Michael R. Bristow, M.D., Ph.D. Division of Cardiology University of Colorado Health Sciences Center Eugene E. Wolfel, M.D. Interim Head, Division of Cardiology University of Colorado Health Sciences Center Gregory G. Schwartz, M.D., Ph.D. Chief, Cardiology Denver VA Medical Center John D. Carroll, M.D. Chief of Cardiology Director, Cardiac Catheterization Laboratory University of Colorado Hospital Bertron M. Groves, M.D. Cardiac Catheterization Laboratory - Pulmonary Hypertension Program University of Colorado Hospital Karl Hammermeister, M.D. Cardiology Clinical Professor Colorado Health Outcomes Program Edward P. Havranek, M.D. Staff Cardiologist Denver Health Medical Center Lawrence D. Horwitz, M.D. Division of Cardiology University of Colorado Health Sciences Center JoAnn Lindenfeld, M.D. Director of the Heart Transplant Program University of Colorado Hospital Carlin S. Long, M.D. Chief, Cardiology Denver Health Medical Center Ivan F. McMurtry, Ph.D. Director, Smooth Muscle Physiology Laboratory University of Colorado Health Sciences Center 4
  • 5. S. Gilbert Blount, M.D. Professor Emeritus, Division of Cardiology University of Colorado Health Sciences Center Michael J. Reiter, M.D., Ph.D. Electrophysiology Laboratory University of Colorado Hospital John Weil, M.D. Director, Cardiovascular Pulmonary Research Laboratory University of Colorado Health Sciences Center Phillip S. Wolf, M.D. Division of Cardiology University of Colorado Health Sciences Center William Hiatt, M.D. Director of Vascular Medicine Section Co-Medical Director, Cardiovascular Rehabilitation Unit University of Colorado Hospital Associate Professors: Clifford Greyson, M.D. Staff Cardiologist Denver VA Medical Center Brack G. Hattler, M.D. Staff Cardiologist Denver VA Medical Center Lawrence J. Hergott, M.D. Division of Cardiology University of Colorado Health Sciences Center Joseph D. Kay, M.D. Division of Cardiology University of Colorado Health Sciences Center Brian D. Lowes, M.D. Director, Heart Failure Program University of Colorado Hospital Luisa Mestroni, M.D. Division of Cardiology University of Colorado Health Sciences Center 5
  • 6. J. David Port, Ph.D. Division of Cardiology University of Colorado Health Sciences Center Robert A. Quaife, M.D. Division of Cardiology University of Colorado Health Sciences Center John S. Rumsfeld, M.D., Ph.D. Staff Cardiologist Denver VA Medical Center Ernesto E. Salcedo, M.D. Director, Echocardiography Program University of Colorado Health Sciences Center Howard D. Weinberger, M.D. Director, Cardiology Fellowship Training Program University of Colorado Health Sciences Center Assistant Professors: P. Michael Ho, M.D. Staff Cardiologist Denver VA Medical Center Patricia Kelly, M.D. Staff Electrophysiologist University of Colorado Hospital Frederick A. Masoudi, M.D. Staff Cardiologist Denver Health Medical Center John C. Messenger, M.D. Director, Cardiac Catheterization Laboratory University of Colorado Hospital Lorna Moore, Ph.D. Cardiovascular Pulmonary Research Laboratory University of Colorado Health Sciences Center Matthew Taylor, MD Human Genetics Program University of Colorado Health Sciences Center William Baker, M.D. Staff Cardiologist 6
  • 7. Denver Health Medical Center Eugenia P. Carroll, M.D. Staff Cardiologist University of Colorado Hospital Simon F. Shakar, M.D. Staff Cardiologist Denver VA Medical Center/University of Colorado Hospital Mori J. Krantz, M.D. Staff Cardiologist Denver Health Medical Center Laurent Lewkowiez, M.D. Staff Cardiologist Denver Health Medical Center 7