Posts by Gregory D. Lewis, MD
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Higher Peak Systolic BP on Exercise Testing May Not Indicate Adverse Vascular Function
Gregory D. Lewis, MD, Matthew Nayor, MD, MPH, and colleagues found in a study of 2,858 Framingham Heart Study participants that elevated peak systolic blood pressure on cardiopulmonary exercise testing can be due to a higher level of fitness and doesn't necessarily indicate higher risk of cardiovascular disease.
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Ex Vivo Perfusion and Transplantation of Hearts Donated After Circulatory Death Is Safe and Effective
Massachusetts General Hospital researchers found transplantation of hearts donated after circulatory death and preserved with a proprietary ex vivo warm perfusion system was safe and effective compared with control subjects who received hearts donated after brain death. The one-year survival rate was 97%.
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Blood Pressure Assessment During Exercise Testing Aids Risk Stratification of Patients With Heart Failure
Mayooran Namasivayam, MBBS, PhD, Gregory D. Lewis, MD, and colleagues demonstrated that lower proportionate pulse pressure during exercise testing of patients who have heart failure with preserved ejection fraction is associated with a 47% reduced risk of adverse cardiovascular outcomes.
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Clinical Challenge: Periodic Breathing in Cardiopulmonary Exercise Testing
Gregory D. Lewis, MD, and colleagues invite cardiologists and pulmonologists to test their knowledge about the implications of cyclic variations in graphical representations of cardiopulmonary exercise test results.
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Physical Activity Associated with Better Cardiovascular Fitness Regardless of Age, Health Status
Matthew Nayor, MD, MPH, and Gregory D. Lewis, MD, of the Cardiology Division, and colleagues demonstrate that all forms of physical activity help maintain cardiorespiratory fitness throughout life, regardless of one's age, sex, body mass index or cardiovascular disease status.
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Metabolic Cost of Exercise Initiation Higher in HFpEF
Ravi V. Shah, MD, and Gregory D. Lewis, MD, of the Corrigan Minehan Heart Center, and colleagues have defined a new measure, "internal work"—the metabolic cost of initiating movement—that may direct noncardiac therapy for exercise intolerance in patients who have heart failure with preserved ejection fraction.
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Clinical Diagnostic Tools May Misclassify HFpEF in Dyspnea Patients
Heart failure with preserved ejection fraction (HFpEF) can be challenging to diagnose, and recently risk scores have been developed to aid in diagnosis. For patients with chronic dyspnea, clinician-researchers in the Corrigan Minehan Heart Center sound a note of caution about using these scores including the HFA-PEFF algorithm and H2FPEF score to rule out HFpEF.
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Feasibility of a Viral Filter for Cardiopulmonary Exercise Testing During the COVID-19 Pandemic
A proof-of-principle study conducted by Massachusetts General Hospital researchers demonstrated the feasibility of using an electrostatic filter for cardiopulmonary exercise testing during COVID-19, finding that it preserved the ability to test oxygen exchange.
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Acute Exercise Dramatically Changes Metabolite Levels in Middle-aged Adults
Metabolic changes in response to cardiopulmonary exercise testing were part of pathways central to cardiometabolic health, cardiovascular disease and long-term outcome in middle-aged adults.
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Exercise Testing Can Unmask Abnormal Pulmonary Vascular Responses in Patients with Chronic Dyspnea
In a prospective study, exercise-induced pulmonary hypertension was associated with worse CV event–free survival even in the absence of pulmonary hypertension at rest.
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Hypertension and CVD Are Among Risk Factors for Severe COVID-19
Many patients in a cardiology practice are at risk of developing severe COVID-19 if they become infected with SARS-CoV-2, the new coronavirus.
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Cardiology Care During the COVID-19 Pandemic: Guidance for Treating Both Uninfected and Infected Patients
Routine use of ACE inhibitors and angiotensin II receptor blockers should be continued, but these drugs should not be started for patients who develop COVID-19.
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Different Definitions of HFpEF Have an Impact on Patient Outcomes
The various definitions of heart failure with preserved ejection fraction (HFpEF) miss up to 85% of patients with abnormal rest or exercise filling pressures, cardiologists at Massachusetts General Hospital have found. Better hemodynamic phenotyping is needed to target patients at highest risk.
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Prior Sternotomy Linked to Worse Survival After Cardiac Transplantation
A history of sternotomy is a risk factor for worse survival after cardiac transplantation, cardiac surgeons at Massachusetts General Hospital determined after reviewing nationwide data.
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Impaired RV Reserve Predicts Cardiac Outcomes in Congenital Heart Patients
Impaired Right Ventricular Exercise Reserve, Strongly Predicts Adverse Cardiac Outcomes In Adults with Congenital Right Heart Disease.
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Innovation Increases Availability of Hearts and Lungs for Transplant
Warm perfusion and careful selection of marginal organs allow Mass General transplant teams to save more lives.
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The Promise of Ventricular-Assist Devices (VADs)
VAD technology is continually improving. Mass General data indicates new VADs improve 5-year survival rates. Trials for the latest generation are under way.
Biography
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.
Cardiovascular Care at Mass General
At Mass General, our world-class physicians and nurses specialize in specific forms of both heart and vascular disease, and work closely together to offer leading treatments and preventive care for cardiovascular conditions.