I am cardiovascular specialist in the area of cardiomyopathy, chronic heart faiure, and pulmonary hypertension, focusing my clinical efforts in the more advanced stage of right and left heart failure syndromes. I am the current medical director of the mechanical circulatory support device program at the University of Pennsylvania and the clinical expertise that I bring to this program specifically involves phenotyping right ventricular function and right ventricular reserve in chronic heart failure. As a practitioner in various disease states causing pulmonary hypertension, I also have developed an expertise in characterizing right ventricular dysfunction due to RV-PA uncoupling in high pulmonary afterload syndrome (PAH).
In the area of advanced heart failure and Left ventricular assist device support (LVAD), I also bring a specialized program of myocardial recovery by optimizing the degree of mechanical unloading with a LVAD and maximizing the medical therapy that can be tolerated in an effort to drive the process of reverse myocardial remodeling to improve heart function. This is a highly specialized area in the field of advanced heart failure with only a handful of centers world-wide providing this therapeutic approach to their patients.
My role as an advanced heart failure clinician-scientist and director of the mechanical assist device program at Penn is to provide expertise in the area of myocardial failure in the more advanced stage of this syndrome. More recently I have been working on the emerging interface of metabolism and heart failure. The current focus of my research is the investigation of myocardial and systemic metabolism in the syndrome of chronic heart failure. Specifically, myocardial and systemic insulin resistance is being increasingly targeted as a mechanism of disease progression in chronic heart failure and the objectives as a translational researcher within my group have been to: 1. Understand the role of lipid and adipocytokine biology (leptin, adiponectin, resistin) in the emerging metabolic phenotype of heart failure; 2. Identify specific targets for improving myocardial energetics and whole-body metabolism in cardiomyopathic failure; and 3. Test the safety and efficacy through carefully designed pilot studies of “reversing” specific metabolic pathways which have been dysregulated in human heart failure. My collaborative network for this research currently includes the laboratories of Dr. Tim McGraw, Dr. Richard Shannon, Dr. Ken Margulies and Dr. Tom Cappola within my own group at Penn as well as the laboratory of Dr. Christian Schulze and Professor Ira Goldberg at Columbia University.
Prashanth Vallabhajosyula, MD, MS, Matthew Kramer, BS, Sofiane Lazar, BS, Fenton McCarthy, MD,Eduardo Rame, MD, Joyce Wald, MD, Wilson Szeto, MD, Matthew Williams, MD, Pavan Atluri, MD,
Nimesh Desai, MD, PhD, and Michael Acker, MD: Lower-extremity complications with femoral extracorporeal
life support. The Journal of Thoracic and Cardiovascular Surgery March 2016.
Bedi KC Jr, Snyder NW, Brandimarto J, Aziz M, Mesaros C, Worth AJ, Wang LL, Javaheri A, Blair IA, Margulies KB, Rame JE: Evidence for Intramyocardial Disruption of Lipid Metabolism and Increased Myocardial Ketone Utilization in Advanced Human Heart Failure. Circulation 133(8): 706-16, February 2016 Notes: Epub 2016 Jan 27.
Birati EY, Mathelier H, Molina M, Hanff TC, Mazurek JA, Atluri P, Acker MA, Rame JE, Margulies KB, Goldberg LR, Jessup M: Comparison of Causes of Death After Heart Transplantation in Patients With Left Ventricular Ejection Fractions ≤35% Versus >35. The American Journal of Cardiology S0002-9149(16): 30150-3, January 2016.
Burkhoff D, Maurer MS, Joseph S, Rogers JG, Birati Eo, Rame JE, Shah SJ: Reply: Is Pump the Answer to Heart Failure With Preserved Ejection Fraction? JACC Heart Fail 4(1): 93, January 2016.
Rame JE: Metabolic Staging in Human Heart Failure: Circulating Acylcarnitines and the Failing Heart's Energetic Signature. J Am Coll cardiol 67(3): 300-2, January 2016.
Stewart GC, Kittleson MM, Cowger JA, Johnson FL, Patel CB, Mountis MM, Patel PC, Rame JE, Testani J, Guglin ME, Teuteberg JJ, Stevenson LW: Who wants a left ventricular assist device for ambulatory heart failure? Early insights from the MEDAMACS screening pilot. J Heart Lung Transplant 34(12): 1630-3, December 2015 Notes: Epub 2015 Aug 4.
McCarthy FH, Kobrin D, Rame JE, Groeneveld PW, McDermott KM, Atluri P, Acker MA, Desai ND: Increasing Frequency of Left Ventricular Assist Device Exchanges in the United States. Annals of Thoracic Surgery 100(5): 1660-4; discussion 1665, November 2015 Notes: Epub 2015 Jul 21.
Bermudez CA, Rame JE: Reversible but risky: Pulmonary hypertension in advanced heart failure is the Achilles' heel of cardiac transplantation. J Thorac Cardiovasc Surg 150(5): 1362-3, November 2015 Notes: Epub 2015 Aug 6.
Rame JE, Birati EY: HeartWare Left Ventricular Assist Device Pump Thrombosis: A Shift Away From Ramp. JACC Heart Fail 3(11): 857-9, November 2015 Notes: Epub 2015 Oct 7.
Teuteberg JJ, MD, Slaughter MS, Rogers JG, McGee EC, Pagani FD, Gordon R, Rame E, Acker M, Kormos RL, Salerno C, Schleeter TP, Goldstein DJ, Shin J, Starling RC, Wozniak T, Malik AS, Silvestry S, Ewald GA, Jorde UP, Naka Y, Birks E, Najarian KB, Hathaway DR, Aaronson KD
: The HVAD Left Ventricular Assist Device: Risk Factors for Neurologic Events and Preventative Mitigation Strategies. JACC Heart Failure.
(eds.). 3(10): 818-28, October 2015.
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Last updated: 07/10/2016
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