What are your research interests?
My research activities are focused on peripheral arterial disease (PAD), in which atherosclerosis occurs in the arteries that supply blood to the legs. PAD occurs most often in older adults and patients with diabetes. People who smoke are also at increased risk for PAD.
What made you pursue this type of research?
I came to Northwestern for my internship and residency training in internal medicine. Following my residency, I completed a fellowship in general internal medicine and stayed on as junior faculty. As a fellow, I began working on clinical research in vascular medicine, with Drs. Gary Martin, William Pearce, and Joe Feinglass. I continued this area of work as a junior faculty member, with mentoring from Drs. Philip Greenland and Kiang Liu in Northwestern’s Department of Preventive Medicine.
What are some of your current research projects?
I am currently principal investigator of several studies sponsored by the National Heart Lung and Blood Institute. These include observational studies and clinical trials. Our most recently funded observational study is using magnetic resonance imaging (MRI) to measure characteristics of atherosclerotic plaque in the superficial femoral arteries. We will determine how these characteristics relate to walking performance and decline in walking performance among patients with peripheral arterial disease. We will also identify clinical characteristics associated with changes in plaque features over time. In another observational study funded by the NHLBI my research team is using CT scan images to measure characteristics of patients’ calf muscle. We measure muscle area, muscle density, and the percent fat infiltration of calf muscle. These calf characteristics turn out to be associated with walking performance in patients with peripheral arterial disease.
I am also the principal investigator for several clinical trials supported by NHLBI. For example, in an exercise trial we are determining with resistance training of the lower extremities can reverse some of the muscle impairments we have previously described in patients with peripheral arterial disease, thereby improving walking performance in persons with peripheral arterial disease. Participants in this study are randomized into one of three groups. Group 1 exercises on a treadmill. Group 2 performs resistance training exercises, and Group 3 receives some educational sessions but no exercise. We are determining how these exercise interventions improve walking performance in patients with peripheral arterial disease, including those who are asymptomatic or who have atypical symptoms. In another ongoing clinical trial, we are looking at the role of telephone counseling in helping patients control their LDL levels. The telephone counseling is designed to activate patients to discuss their cholesterol treatments with their physician. If our telephone counseling intervention is effective, it could potentially help patients with peripheral arterial disease reduce their risk of heart disease and stroke.
What are some of the challenges you face?
Recruiting study participants is always a major challenge. It always requires more time and effort than originally anticipated.