Project 1: Iron Deficiency Cardiomyopathy
We have shown that iron deficiency is highly prevalent and underdiagnosed in U.S. adults. Our research has identified hepcidin and ferritin as upstream biomarkers of subclinical cardiac dysfunction as well as incident heart failure. We integrate large-scale epidemiologic data, proteomics, and Mendelian randomization to understand iron metabolism as a modifiable risk factor, with the goal of advancing early screening and intervention strategies.
Project 2: Inflammation & Inflammasome Activity in Cardio-Renal Disease
We investigate the role of inflammasome-mediated inflammation, including IL-1 and IL-6 signaling, in the development of chronic kidney disease-related cardiomyopathy and heart failure. Using proteomic profiling, mechanistic clinical trials, and population-based cohorts, we identify inflammatory pathways that may serve as therapeutic targets. Current work includes NIH-funded studies testing inflammasome-related biomarkers and the cardiac effects of targeted anti-inflammatory therapies.
Project 3: Omics-Driven Discovery of Heart Failure Mechanisms
Using high-throughput plasma proteomics and metabolomics, we identify proteins and metabolites linked to heart failure and adverse cardiac remodeling. These analyses reveal mechanistic pathways and candidate therapeutic targets. Findings inform precision risk prediction and the design of mechanistic studies.
Past Research
We have shown that intensive systolic blood pressure lowering primarily benefits patients with type 2 diabetes mellitus who have high cardiovascular risk profile and that these benefits are sustained for several years after discontinuation of the blood pressure lowering intervention. Our work also suggests that the cardiovascular benefits of intensive systolic blood pressure lowering can be achieved without an increased risk of end-stage kidney disease. We have proposed to measure blood pressure control using time in target range and have shown that time in target range predicts cardiovascular and kidney events independent of traditional risk factors. Ongoing clinical trials have implemented time in target range to guide blood pressure-lowering intervention (PMID 38988353, PMID 37479162).
Worsening heart failure is the leading cause of hospital admission among older adults and signifies accelerated deterioration of cardiac function. Across a series of studies, we have shown that intravenous loop diuretics, the primary treatment of volume overload in heart failure, can be administered in the ambulatory setting to achieve consistent diuretic effects without undue risk for acute kidney injury or electrolyte abnormalities. Furthermore, our data suggest that ambulatory management of worsening heart failure averts hospitalization over 180-day follow-up at an overall cost-savings to the institution. These data have contributed to a shift in decompensated heart failure management from the inpatient to the outpatient setting.