Skip Navigation

Fellowship Research

Fellow Research Bios

  • Keva Garg, M.D.

    Research Topic: Global Health
    Track: Clinician Educator Track
    Mentors: Dr. David Spragg, Dr. Garima Sharma

    Cardiovascular disease is well established as the leading cause of global mortality disability. In places like sub-Saharan Africa, although there are high rates of atrial fibrillation and atrial flutter in both heart failure and rheumatic heart disease, rates of anti-coagulation remain largely heterogenous. It is imperative, that as leaders in both electrophysiology and cardiovascular disease care, that our center continues to make a local and global impact on care for these patients to close the health inequities.

    We will use Hopkins EMR data to query patients within the Hopkins system that carry the diagnosis of atrial fibrillation. Amongst this group we hope to identify those followed by Hopkins cardiology or Hopkins Internal Medicine. We will identify time from first diagnosis to time of referral to EP, ablation, cardioversion and or time to prescription of a rhythm control agent. We will also try and quantify rates of anticoagulation for these patients. This strategy reflects other datasets that have attempted to quantify similar health inequities. If possible, we will also identify outcomes including hospitalizations for atrial fibrillation and cardioembolic strokes. We will then analyze these to identify disparities in care based on age, race, gender, nationality, spoken language, and zip codes (as a surrogate for socio-economic status). The methods for this analysis will be finalized during the first two terms of her MPH as she obtains foundational knowledge for statistical analysis of this data.

    In order to continue to build a framework for how to impact local inequities and global cardiovascular care, Dr. Garg will be pursuing an MPH during this year. She will be concentrating in Humanitarian health and will complete a certificate in Global Health. She will continue her involvement in two global sites; she will travel abroad to Managua, Nicaragua during 4th term for a global EP trip as well as continue triweekly conferences with Ampath Kenya’s Cardiology division.
    headshot of Keva Garg
  • Esra Gucuk Ipek, M.D.

    Research Topic: The Impact of Diabetes Mellitus Duration on Left Atrial Function Using Strain Echocardiography
    Mentor: Dr. Erin Michos

    The prevalence of heart failure (HF) with preserved ejection fraction (HFpEF) has been increasing relative to HF with reduced ejection fraction, accounting for at least 3 million of the HF cases in the US in the last decade. Diabetes mellitus (DM) is one of the increasing comorbid conditions that is likely associated with increased prevalence of HFpEF. Left atrial (LA) dysfunction is a common finding in patients with HF.

    Increasing evidence suggests that LA dysfunction can precede other structural changes such as LA enlargement and clinical signs of HF. It is likely that early changes in LA structure precede overt changes such as dilated LA or increased filling pressures. However, the impact of DM duration on LA function and strain is unknown. Understanding the effect of DM duration on the cardiac structural and functional changes can identify high-risk patients with DM who may benefit from cardioprotective therapies to prevent incident HF.

    The primary aim of Dr. Gucuk Ipek's study is to understand the impact of cumulative exposure to DM on LA structure and function by using strain echocardiography. The secondary aim is to evaluate other echocardiographic parameters including diastolic function, LA and left ventricular structural changes and associations with DM duration.
    headshot of Esra Gucuk Ipek
  • Arune Gulati, M.D.

    Research Topic: A multidisciplinary approach to improving cardiogenic shock care: the JHH Cardiogenic SHOCK Team
    Track: Clinician Educator – Program Building/QI
    Mentors: Dr. Tom Metkus, Dr. Peter Johnston

    Cardiogenic shock (CS) is characterized by reduced cardiac output and systemic hypoperfusion leading to multi-organ failure and ultimately death. Despite recent advances in CS care, mortality has remained largely unchanged for the past several decades. Moreover, the incidence of CS is rising, likely due to improved chronic therapies for ischemic heart disease and heart failure as well as an aging patient population. A promising development in recent CS care has been the proliferation of percutaneously deployed mechanical circulatory support devices (MCS). These devices clearly improve perfusion but are used in the absence of randomized trial data and standardized head-to-head comparisons, leading to heterogeneity in CS care.

    The development of the multidisciplinary cardiogenic shock team has occurred in part to address the lack of standardization in modern CS care and to facilitate early recognition and interventions for CS patients. Shock teams are typically comprised of members from heart failure, critical care, and interventional cardiology as well as cardiac surgery. The team is organized around a central algorithm with an emphasis on the hemodynamic profiling of CS patients for tailored decision making. Excitingly, shock teams have led to dramatic improvements in CS outcomes at now multiple centers nationally.

    Over the past eighteen months, we have developed and implemented our own Cardiogenic SHOCK Team (CST) at JHH. However, true system-wide use of the CST remains limited, and its impact on practice patterns and short- and long-term outcomes for CS patients unknown. As part of the clinician educator pathway, Dr. Arune will be expanding visibility and usership across the entirety of JHMI, create a clinical research/quality improvement core to study practice patterns in CS and track outcomes, and expand the scope of CST care. Dr. Arune will also be attending the Armstrong Institute Patient Safety and Quality Leadership Academy. This unique nine-month program blends QI coursework with the structured implementation of an actual QI project.
    headshot of Arune Gulati
  • Mariam Meddeb, M.D.

    Research Topic: The adipose tissue and the risk of heart failure with preserved ejection fraction in obesity
    Mentors: Dr. David Kass and Dr. Chiadi Ndumele

    Obesity, particularly greater degrees of visceral adiposity (VAT), is an independent risk factor for heart failure with preserved ejection (HFpEF), an increasingly prevalent clinical syndrome. At the Johns Hopkins University (JHU) hospital, the HFpEF patient cohort predominantly has obesity, with a median body mass index (BMI) of 41kg. m-2. In this deeply phenotyped cohort, a subgroup of patients with the highest BMI (median BMI of 45 in this subgroup) was characterized by a distinct myocardial transcriptional signature and specific prognostic implications. Assessment of the sarcomeric function in skinned cardiomyocytes from patients with HFpEF demonstrated that the predominantly obesity-diabetes HFpEF phenotype is characterized by decreased tension compared with the predominantly hypertensive-hypertrophied phenotype. Contractility was strikingly depressed in the obesity-diabetes phenotype and maximum tension negatively correlated with BMI. Obesity is not only an independent risk factor for HFpEF but is also associated with a transcriptionally and functionally distinct HFpEF phenotype.

    The mechanisms underlying the progression to HFpEF in some patients with obesity, while others remain free of heart failure even at high levels of excess adiposity, are poorly understood. Similarly, the mechanisms underlying the unique transcriptional and sarcomeric functional signature in the HFpEF phenotype with predominantly obesity are largely unexplored. It is possible that the prominent endocrine effects of VAT may contribute to the predisposition of some patients with obesity to developing HFpEF.

    Dr. Meddeb hypothesizes that the VAT is inherently different in patients with obesity and HFpEF compared patients with obesity without HFpEF. She also hypothesizes that the sarcomeric dysfunction observed in HFpEF patients with obesity can be replicated in vitro offering a platform to study the effects of specific pathway manipulation to attenuate the hypothesized adipocyte-induced cardiac dysfunction.
    photo coming soon
  • Chang Kim, M.D., Ph.D.

    Research Topic: Dynamic risk prediction to guide digital health intervention following acute myocardial infarction
    Mentors: Dr. Seth Martin

    Early hospital readmissions following acute myocardial infarction (MI) are common (15-20% within 30 days), many of which may be preventable. Digital health intervention (DHI) has the potential to improve the quality and equity of healthcare delivery in this setting. In the MiCORE trial, an integrated self-management toolkit based on a smartphone app, smartwatch app, wireless blood pressure monitor, and backend data system reduced the rate of early readmissions by 52% while providing equitable access to study participants. Data obtained from wearable devices and risk prediction based on machine learning models may provide an effective solution to this scenario. Current cardiovascular risk assessment approaches capture risk factor magnitude, but not duration or variability, which have been shown to be independent predictors of adverse health outcomes. Limitations related to 1) data sparsity due to sporadic measurements and 2) low-capacity statistical models can be addressed with: 1) wearable devices that continuously monitor and store vital signs and 2) machine learning models that can properly utilize data generated by these devices. A dynamic risk calculator based on such data and model may be able to guide timely health interventions in the post-MI setting.

    Dr. Kim will be building a risk prediction model that predicts risk of early readmission following acute MI. He will also be utilizing data from the MiCORE trial (Myocardial infarction, combined-device, recovery enhancement: IRB00099938), which contain baseline clinical characteristics and wearable device-generated heart rate, blood pressure, and physical activity data in the post-acute MI population, machine learning models will be trained to predict early readmission risk. Different risk intervals (e.g. 24 hours, 48 hours, 1 week, 2 weeks, 4 weeks) and model update frequency will be assessed for predictive accuracy and power.
    headshot of Chang Kim
  • Jana Lovell, M.D.

    Research Topic: Mechanistic analysis of the functional role of B cells within the cardio-splenic axis of chronic heart failure
    Mentors: Dr. Luigi Adamo

    Acute myocardial injury results in the robust activation of innate and adaptive immunological pathways. This acute physiologic inflammatory process is then followed by a period of resolution and tissue repair. However, if inflammation persists, it can become pathologic and contribute to adverse left ventricular remodeling and ultimately, heart failure. Despite growing understanding of the complex interplay between inflammation and cardiac function, clinical trials investigating immunomodulatory therapies in heart failure patients have largely yielded disappointing results. There is therefore an urgent need to identify novel and viable immunomodulatory therapeutic targets to prevent adverse cardiac remodeling.

    The cardio-splenic axis has been implicated as a critical component of the persistent inflammatory processes that follow myocardial ischemia. In murine models of acute myocardial infarction (MI), myocardial injury leads to splenic remodeling and multiple alterations in immune cell populations, including mobilization of monocytes from the spleen to the infarcted myocardium and expansion of dendritic cells and CD4+ and CD8+ T cells in the spleen. In mice with ischemic cardiomyopathy, splenectomy can reverse left ventricular remodeling with improvement in left ventricular (LV) systolic function and dilatation. Conversely, the transfer of splenocytes from mice with heart failure to naive mice results in adverse LV remodeling. In human patients that have experienced acute MI, increased splenic metabolic activity is also evident on positron-emission tomography imaging. These studies indicate that a persistent and pathological cardio-splenic axis contributes to the development of ischemic cardiomyopathy and chronic heart failure.

    B cells are the most prevalent splenic leukocyte in both rodents and humans. Prior studies have indicated that B cells are involved in adverse cardiac remodeling after acute myocardial injury and B cells can circulate between the myocardium and spleen. However, the role that B cells might play within the cardio-splenic axis of chronic heart failure has not been investigated. We have collected new preliminary data indicating that 1) the adoptive transfer of splenic B cells from mice previously exposed to MI into healthy recipients is sufficient to promote myocardial systolic dysfunction and 2) acute myocardial injury triggers persistent gene expression changes in myocardial and circulating B cells, consistent with activation of antigen processing and presentation.

    We hypothesize that acute myocardial injury triggers persistent activation of splenic B cells, which promote adverse cardiac remodeling within the cardio-splenic axis through MHC-II-mediated antigen presentation. Dr. Lovell is testing this hypothesis through characterizing the chronic changes induced by acute myocardial injury in splenic B cells, characterizing the functional role of B cells within the cardio-splenic axis and characterizing the functional role of B cell-mediated MHC-II restricted antigen presentation in the heart and the cardio-splenic axis.

    She expects that a mechanistic understanding of the role that B cells play within the cardio-splenic axis could lead to the identification of novel therapeutic targets to treat chronic heart failure.
    headshot of Jana Lovell
  • Martin Tibuakuu, M.D., M.P.H.

    Research Topic: Human-centered Design Framework for a Virtual Cardiac Prevention Clinic in Ghana/Africa
    Mentors: Dr. Seth Martin

    The global burden of cardiovascular morbidity and mortality is rising largely due to increasing heart disease incidence in low-to-middle income countries like Ghana. In 2019, stroke and ischemic heart disease (IHD) ranked in the top 10 causes of death in Ghana. Compared to 2009, there was a 25% increase in stroke-related deaths and a 38% increase in IHD deaths. Hypertension, obesity, and diabetes were ranked among the top 10 drivers of mortality and morbidity in Ghana. Ghana and many African countries have a high prevalence of smartphone usage that has created a robust and vast digital ecosystem where basic human services are currently delivered. Therefore, digital health innovations (DHI) have the potential to improve access, management, and ultimately improve cardiovascular health outcomes in these resource-limited settings. The mission of this project is to use a human-centered design (HCD) framework to develop a smartphone-based platform to offer Ghanaians the opportunity to undergo routine basic cardiovascular screenings, improve risk factors, attain ideal cardiovascular health status and reduce cardiovascular illnesses and deaths. HCD will enable us understand the end-user needs through user engagement in the design process.

    Dr. Tibuakuu will develop a digital health platform that reflects the needs of individuals from resource constraint settings. He will collaborate with expert designers from the Johns Hopkins Center for Health Equity who have extensive background in HCD methodology. He will summarize his findings and design methodology as a framework for digital health innovations in Africa. This will help guide other clinical investigators and health app developers to create engaging, equitable, and scalable digital health solutions in Africa.
    photo coming soon
  • Alison Wand, M.D.

    Research Topic: Investigating Challenges in Training in Echocardiography during Cardiology Fellowship
    Track: Clinician Educator Track
    Mentors: Dr. Jose Madrazo, Dr. Joshua Kiss, Dr. Sammy Zakaria

    Echocardiography is a foundational tool in the practice of cardiology. This widely available imaging modality allows for the complex evaluation of normal and pathologic cardiac anatomy, function, and hemodynamics. Furthermore, ongoing advancements in echocardiographic technology – including 3D and strain imaging – continue to expand its potential applications. Despite emphasis on obtaining proficiency in echocardiography during training and the detailed guidance regarding the scope of experiences needed to do so, the optimal approach to teaching the performance and interpretation of echocardiography to trainees is less clear. In general, this education has assumed an “apprenticeship model”, in which trainees learn interpretation directly from expert readers in a one-on-one setting. These encounters are supplemented by didactics, hands-on instruction from skilled echocardiographers or sonographers, simulation, clinical experiences, and self-study. However, there are few data regarding the effectiveness of each of these curricular components for teaching echocardiography in adult cardiology training programs. Furthermore, the assessment of proficiency remains challenging for training program leadership and trainees alike.

    Dr. Wand will develop an introductory written curriculum for first year cardiovascular fellows to use as a guide during Echocardiography rotations and assess implementation using pre- and post-implementation surveys. In addition she will develop and implement an objective structured clinical examination (OSCE) for cardiovascular fellows intending to achieve COCATS Level II or III competency prior to the completion of training.
    headshot of Alison Wand

cardiology fellowship - group of johns hopkins fellows

Past Silverman Award Winners

The Howard S. Silverman Award is an annual event in honor of Dr. Howard S. Silverman, a former Cardiology fellow and faculty member who died in 1996 from heart disease. The Silverman Awards is a research conference in which the 2nd year cardiovascular disease fellows present their research projects to the division. The faculty award the fellow whose project is the most original, creative and has the greatest scientific potential a monetary prize and certificate.

 
  • 2021-2022 Jana Lovell, M.D.
  • 2020-2021 Richard Carrick, M.D.
  • 2018-2019 Eunice Yang, M.D.
  • 2017-2018 Marios Arvanitis, M.D.
  • 2016-2017 Virginia Hahn, M.D.
  • 2015-2016 Thorsten Leucker, M.D.
  • 2014-2015 Steven Hsu, M.D.
  • 2013-2014 Libin Wang, M.D., Ph.D.
  • 2012-2013 Seth Martin, M.D.
  • 2011-2012 Grant Chow, M.D.
  • 2010-2011 Lincoln Shenje, M.D., Ph.D.
  • 2009-2010 Hiroshi Ashikaga, M.D., Ph.D.
  • 2008-2009 Chao-Wei Hwang, M.D., Ph.D.
  • 2007-2008 Dou (Alvin) Zhang, M.D., Ph.D.
  • 2006-2007Jacob Abraham, M.D.
  • 2005-2006 Henry Sun, M.D.
  • 2004-2005 Rich George, M.D.

Dlabal Clinical Research Award

The Dlabal Clinical Research Award was established in 2019 by generous support from Dr. Paul Dlabal, a former Johns Hopkins School of Medicine graduate. The Dlabal Clinical Research Award is given annually to a fellow demonstrating originality and creativity in clinical research.

  • 2021-2022 Mariam Meddeb, M.D.
  • 2020-2021 Richard Vakil, M.D.
  • 2018-2019 Anum Minhas, M.D. M.H.S.
 

Timeline by Fellowship Year: Year 1

Fellowship YearGoalsSuggested Completion Date
First YearIdentify a career mentorNovember/December
Explore research opportunities and meet with potential research mentorsThroughout year
Mid-year check in with fellowship leadership to discuss progressNovember to January
Decide whether you are pursuing the early research trackDecember to March
Identify a clinical interest (prevention, imaging, HF, interventional, EP, etc.)June
 

Timeline by Fellowship Year: Year 2

Fellowship YearGoalsSuggested Completion Date
Second YearDiscuss research project with potential research mentorJuly to August
Select research mentorSeptember
Initial IDP completionNovember
Check in with fellowship leadership teamNovember to December
Apply for advanced training fellowship (if applicable)Interventional: December ERAS cycle (discuss with Dr. Hasan)
Formalize details of research plans, submit IRBDecember to March
Mentorship team meeting with Wendy, Steve or Thorsten includedApril
Present research plans at SilvermanMay
 

Timeline by Fellowship Year: Years 3-4

Fellowship YearGoalsSuggested Completion Date
Third/Fourth YearApply for advanced training or job

EP: July ERAS cycle

Heart Failure: July ERAS cycle Non-ACGME: congenital, imaging, critical care, prevention, women’s health

Jobs: July to September

Submit abstract for national meetingDeadlines vary
Present at Fellows Research ConferenceOctober to April
Complete/submit IDPNovember
Mentorship team meetingNovember
Prepare a research manuscript for publicationDecember to June
Submit abstract for Hopkins CV retreatSpring
Submit updated IDP, Research UpdateApril
 

Advanced Research Training

Optional Research Tracks

We offer flexibility in clinical and research training, allowing fellows to design their fellowship schedule individually as long as ACGME and COCATS requirements are satisfied.

Fellowship YearResearch Tracks
Year 112 month ACGME core clinical rotations
Year 212 month ACGME core clinical rotations
Year 23 month clinical/9 month research
Year 3Research
Year 33 month clinical/9 month research
Year 4Advanced Fellowship
Year 4Research
Year 46 month clinical/6 month research
 
 

Research as a Cardiology Fellow

 

Cardiovascular genomics | Marios Arvanitis, M.D.

Academic Success in Cardiology | Virginia Hahn, M.D.

Excessive O-GlcNAcylation causes cardiomyopathy | Priya Umapathi

Link Between Adverse Pregnancy Outcomes and Cardiovascular Disease | Anum Minhas

Pulseless Electrical Activity | Daniel Ambinder, M.D.

Myocardial Infarction, Recovery, Enhancement (MiCORE) Study

Clinical Educator Pathway: Global Health Focus | Keva Garg

 

Optional Clinical Educator Track

The goal of the optional clinical educator track is to become a leader as a clinician educator.

Fellowship YearGoals
Year 2Fellows would choose this track at end of the first half of their second year along with one to two mentors.
Year 3 and/or 4
Fellows would meet with their mentorship team at least twice a year.
Fellows would present at the Silverman conference their track and what they will be pursuing with goal of publishing their work as original research or review.
Fellows on the above tracks will be strongly encouraged to pursue coursework, present scholarly work (as related to a clinical program, quality improvement or education) at national meetings and demonstrate engagement in institutional and national societies.

Internal Award Opportunities

The Johns Hopkins Discovery Awards provide grant awards to cross-divisional teams, comprised of faculty and/or non-faculty members from at least two schools or affiliates of the university, who are poised to arrive at important discoveries or creative works.

 

Cardiology Fellowship Alumni

Our past cardiology fellows have made tremendous strides in the field of cardiovascular medicine. View the list of alumni that have entered into research and clinical care.

back to top button