Cardiovascular Medicine

Dr. Peter Stone 's research interests focus on a variety of aspects concerning coronary artery disease, from understanding the basic and clinical vascular biology of atherosclerosis progression in animals and in man, to investigating new pharmacologic and device therapies for patients with acute and chronic coronary artery disease.

A major focus of his work has been to understand the hemodynamic influences on vascular biology responsible for the progression of coronary atherosclerosis in man, to develop in-vivo methodologies to enable the identification of the sites where coronary atherosclerosis and “vulnerable plaque” will progress, and to investigate the clinical benefits resulting from early identification of high-risk lesions. The ultimate goal of these investigations is to create a new paradigm for management of coronary artery disease, whereby individual high-risk coronary lesions will be identified early in their natural history by vascular profiling of local endothelial shear stress and patterns of vascular remodeling. Identification of these high-risk lesions would enable utilization of highly selective pre-emptive interventions to avert subsequent adverse cardiac events.  

He has also been pursuing clinical investigations of new anti-ischemic therapies for patients with coronary artery disease as well as investigating the use of ambulatory ECG (AECG or Holter) monitoring to evaluate transient episodes of ST-segment deviation.

Dr. Stone has been the Director of the AECG Core Laboratory for a number of multicenter clinical trials sponsored by the NHLBI or by industry. He has been investigating the significance of T-wave alternans during ischemic episodes identified from AECG monitoring.  These electrophysiologic phenomena may identify patients at increased risk of arrhythmic events associated with ischemia.  His AECG Laboratory is also evaluating the cardiac effects of air pollution on high-risk coronary patients using measures of heart rate variability and myocardial ischemia.

References:

Stone PH, Coskun AU, Kinlay S, Clark ME, Sonka M, Wahle A, Ilegbusi OJ, Yeghiazarians Y, Popma JJ, Orav J, Kuntz RE, Feldman CL. The Effect of Endothelial Shear Stress on the Progression of Coronary Artery Disease, Vascular Remodeling, and In-stent Restenosis in Man: An In-vivo 6-month Followup Study. Circulation 2003;108:438-444.

Stone PH, Lloyd-Jones DM, Kinlay S, Frei B, Carlson W, Rubenstein J, Andrews TC, Johnstone M, Sopko G, Cole H, Orav J, Selwyn AP, Creager MA, for the Vascular Basis Study Group. The effect of intensive lipid-lowering, with or without antioxidant vitamins, vs moderate lipid-lowering, on myocardial ischemia in patients with stable coronary artery disease. Circulation 2005;111:1747-1755.

Stone PH, Gratsiansky NA, Blokhin A, Huang I-Z, Meng L on behalf of the ERICA Investigators. Anti-anginal efficacy of ranolazine when added to treatment with amlodipine: The Efficacy of Ranolazine in Chronic Angina (ERICA) Trial. J Am Coll Cardiol 2006;48:566-75.

Chatzizisis YS, Jonas M, Coskun AU, Beigel R, Stone BV, Maynard C, Gerrity RG, Daley W, Rogers C, Edelman ER, Feldman CL, Stone PH. Prediction of the Localization of High-Risk Coronary Atherosclerotic Plaques on the Basis of Low Endothelial Shear Stress: An Intravascular Ultrasound and Histopathology Natural History Study. Circulation 2008;117:993-1002.