Since arriving at MGH in 1999 I have had the privilege of training in internal medicine and cardiology, teaching as a chief resident and as a cardiology attending, providing clinical care to patients with a broad range of cardiovascular diseases, and conducting research. As an investigator at MGH I have published over 80 manuscripts in fields ranging from the evaluation of novel therapies for heart failure to mechanisms of exercise intolerance in cardiovascular disease and metabolic response patterns to exercise. I am particularly interested in the role of the lung circulation and other extra-cardiac organs in mediating exercise intolerance in patients with heart failure. Through metabolic profiling of human plasma at rest and during exercise, in collaboration with the Broad Institute, our group has established metabolic signatures of cardiovascular disease states that may help to refine current phenotyping approaches. The cardiopulmonary exercise laboratory that I direct focuses on clinical evaluation of patients with shortness of breath of unclear etiology through comprehensive evaluations of each organ system's contribution to reduced functional capacity. Our laboratory also focuses on risk stratification in heart failure patients. As medical Director of Mechanical Circulatory Support and the Cardiology Intensive Care Unit I also have a strong interest in treatment of advanced heart failure and other critical illnesses.