Lab Locations

 

The clinical exercise physiology consortium (Dr Myers, Dr Ashley and Dr Froelicher) is located at four sites, two at the Palo Alto VA Medical Center (PAVAMC) and two at the Stanford University Campus: 1) Cardiology Department at the VA Hospital (PAVAMC, Bldg 101); 2) Exercise Training Unit (PAVAMC, Bldg 51); 3) Stanford Sports Medicine Human Performance Laboratory (Arrellaga Recreation Bldg, 531 Galvez Ave, Stanford Campus), 4)  Stanford Medical Center Exercise Testing Laboratory and Inherited CV Diseases/Cardiomyopathy Clinic.  

  • The Palo Alto VA Health Care System includes the Medical Center in Palo Alto (where three of our sites are located) and satellite clinics in Menlo Park, San Jose, Livermore, Monterey, Stockton, and Modesto, California.  The Medical Center is a large combined medical and surgical, inpatient and outpatient VA facility.  We are mainly located in the Cardiology Division on the second floor of Building 101.  We have a large room with several computers dedicated for use by researchers and a combined exercise testing room divided by a movable partition with complete labs, one for clinical and the other for research testing.  Our main offices are located there along with most of our supporting staff. Computer networking is readily available throughout the health care facility with direct access to VA computerized patient record data bases which the advisors use for epidemiologic research and medical record retrieval and review. The Cardiology Division includes rooms dedicated to Echocardiography, Electrophysiology, Cardiac Catheterization and ECG services.  Cardiology clinics are also conducted on the first floor of Bldg 100.  A regular educational lecture series is provided for a broad range of internal medicine and cardiology topics for Stanford students, residents and fellows who rotate through Cardiology.
     
  • The Exercise Training Unit is a large room with multiple exercise training devices and ECG monitoring for up to 8 patients.  It is on the first floor of Bldg 51 which is in the south corner of the VA grounds with large windows and ready access to grassy areas and walking paths.
  • The Spinal Cord injury Research Laboratory is located in between our two facilities described above and is the site for ongoing VA Rehabilitation Research and Development funded projects involving exercise, risk reduction, and cardiovascular health in spinal cord injury.  The VA has a large Spinal Cord Injury Center that provides patients for our studies.
  • The Stanford Sports Medicine Human Performance Laboratory is used for evaluation of Stanford athletes, alumni and community cardiovascular testing, as well as research in human performance. It is associated with the Stanford Sports Medicine Clinic in the same building.  Drs. Myers and Froelicher have provided Cardiology and Exercise Physiology consultation for over 15 years and are part of the Sports Medicine faculty. 
  • Stanford Medical Center Exercise Laboratory is located in the Stanford Medical Center, a world renowned tertiary care center and School of Medicine. Stanford has been at the forefront of innovation in medicine since its inception. Stanford witnessed the birth of heart and lung transplantation and maintains a busy advanced heart failure service. As such, the exercise testing laboratory specializes in cardiopulmonary exercise testing for transplant evaluation and on going management of patients with cardiomyopathy and heart failure, as well as pulmonary hypertension. Stress echocardiography is combined with expired gas analysis to provide sophisticated integrated measurements in certain groups such as those with hypertrophic cardiomyopathy or those with ischemic cardiomyopathy. Servicing multiple scientific studies as well as the clinical population of Stanford and nearby centers, the lab interacts closely with other exercise physiology labs in the consortium.


Core Lab Functions

Statistical and Data Management Core Site
We have provided data core site function for many multi-center medical studies including investigations of angiogenesis, myocardial laser vascularity, exercise capacity using expired gases and the evaluation of diagnostic techniques.

Rest and exercise ECG data management
We have a resting digital ECG data base of over 40,000 veterans with a 10 year follow up for death and a 10,000 patient exercise test data base (including 2000 patients with digitized ECG data stored at 500 samples/second).

Data analysis, reporting, biostatistical analysis and publications
We have experience with FDA guidelines for drug and device evaluation and reports. We have even submitted a 510K for EXTRA! Completed clinical, ECG and exercise core site projects include Gensia Pharmaceutical (arbutamine study), SciMed (PTCA catheter evaluation), transmyocardial and percutaneous laser revascularization and QUEXTA (VA multi-center study).

Hardware and Software Evaluation
We have been involved in the development, prototyping and evaluation of medical devices.

Computerized ECG analysis and expired gas analysis
Some of the medical companies that we have worked with include Burdick, Eisoate, HP, ORCA, Innovision, Medical Graphics, Mortara Instrument, Quinton (Cardioscience), Schiller and Siemens.

Educational Services
Our group has extensive experience in symposium planning, implementation and presentation. We specialize in issues of clinical exercise physiology, Cardiac rehabilitation, exercise testing, and Cardiovascular aspects of Sportsmedicine. We use the Blaufuss Media animated auscultation/physical diagnosis lecture series.  Dr Ashley has initiated a Symposium on Athletic Sudden Death that will be held at Stanford every two years.


Euan Ashley, MD

Evan AshleyBorn and raised in Scotland, Euan Angus Ashley graduated with 1st class Honors in Physiology and Medicine from the University of Glasgow. He completed medical residency and a PhD in molecular cardiology at the University of Oxford before moving to Stanford University where he trained in cardiology and advanced heart failure joining the faculty in 2006. His group is focused on the application of genomics to medicine. In 2010, he led the team that carried out the first clinical interpretation of a human genome. The paper published in the Lancet was the focus of over 300 news stories, became one of the most cited articles in clinical medicine that year, and was featured in the Genome Exhibition at the Smithsonian in DC. The team extended the approach in 2011 to a family of four and now routinely apply genome sequencing to the diagnosis of patients at Stanford hospital where Dr. Ashley directs the Clinical Genome Service and the Center for Inherited Cardiovascular Disease. In 2013, Dr. Ashley was recognized by the White House Office of Science and Technology Policy for his contributions to Personalized Medicine. In 2014, Dr. Ashley became co-chair of the steering committee for the NIH Undiagnosed Diseases Network. Dr. Ashley is a recipient of the National Innovation Award from the American Heart Association (AHA) and a National Institutes of Health (NIH) Director’s New Innovator Award. He is a member of the AHA Council on Functional Genomics, and the Institute of Medicine (IOM) of the National Academy of Sciences Roundtable on Translating Genomic-Based Research for Health. He is a peer reviewer for the NIH and the AHA as well as journals including Nature, the New England Journal of Medicine, the Lancet and the Journal of Clinical Investigation. He is co-founder of Personalis Inc, a genome scale genetic diagnostics company.

Father to three young Americans, in his ‘spare’ time, he tries to understand American football, plays the saxophone, and conducts research on the health benefits of single malt Scotch whisky.

Current Research and Scholarly Interests:

The Ashley lab is focused on the application of genomics to medicine. We develop methods for the interpretation of whole genome sequencing data to improve diagnosis of genetic disease and to personalize the practice of medicine. We love big data questions and are obsessed with systems approaches to biology especially analysis of network graphs. The wet bench is where we test causality of key genes and investigate the biology of network modules. It is also the focus of our translational efforts. Therapeutic development is a near term goal and several of our discoveries are the focus of patents or are being actively pursued by pharmaceutical and biotechnology partners.



Jonathan Myers, PhD

Dr. Myers is a Health Research Scientist at the Palo Alto Veterans Affairs Health Care System, where he directs the Exercise Research Laboratory, and where he has worked since 1992. He graduated from the University of California, Santa Barbara, and performed graduate studies at San Diego State University and the University of Southern California. He is a Clinical Professor of Medicine at Stanford University, and a Research Career Scientist Award recipient through the Veterans Affairs Rehabilitation Research and Development (VA RR&D) Program. His 30-year body of research has focused on clinical applications of exercise testing and training in patients with chronic heart failure, physical activity and cardiovascular health, and the epidemiology of exercise test responses and physical activity patterns. He coordinates the Veterans Exercise Testing Study (VETS), a an ongoing, prospective evaluation of veteran subjects referred for exercise testing for clinical reasons, designed to address exercise test, clinical, and lifestyle factors and their association with health outcomes. He is presently principal investigator on projects funded by the National Institutes of Health and the VA RR&D.

Presently, he manages day-to day research activities in the Cardiology Division at the Palo Alto Veterans Affairs Medical Center, and is coordinator for the Cardiology exercise laboratory. In addition to a variety of clinical, research, and teaching activities at Stanford and the VA, he keeps himself busy performing statistical and database management. He frequently consults with both US firms and foreign groups on data management and statistics. Over the years, he has been involved with research groups from Switzerland, Germany, Norway, South America, Italy, Japan and Canada, and published papers related to exercise testing and training with all of them. He is a former board member of the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), and a current member of numerous committees and writing groups related to exercise testing and rehabilitation, including the AACVPR, American Heart Association (AHA), American College of Sports Medicine (ACSM), American Thoracic Society, and the European Association for Cardiovascular Prevention and Rehabilitation. He was the 2007 recipient of the Michael L. Pollock Established Investigator Award through the AACVPR, and is a fellow of the AACVPR, ACSM, American College of Cardiology (ACC), and the AHA.


Victor Froelicher, MD

A graduate of the University of Pittsburgh Medical School in 1967, Victor F. Froelicher obtained his internship and internal medicine training at Wilford Hall U.S. Air Force Medical Center. He then pursued his fellowship in cardiology at the University of Alabama at Birmingham with T.J. Reeves. While at the U.S. Air Force School of Aerospace Medicine, Dr. Froelicher published numerous works related to exercise physiology and early screening for coronary artery disease in healthy aviators. His angiographic and follow up studies of aviators were critical to the understanding of silent ischemia and the application of Baysian statistics and predictive modeling to diagnostic tests. After eleven years of service in the U.S. Air Force, he joined the faculty at the University of California at San Diego. At UCSD he was the principal investigator of the NIHLBI randomized trial of cardiac rehabilitation called PERFEXT(PERfusion PerFormance EXercise Trial.

In 1980, he was the co-founding editor for the Journal of Cardiopulmonary Rehabilitation. From 1984 to 1992, Dr. Froelicher was Chief of Cardiology at the Long Beach Veterans Affairs Medical Center and Assistant Chief at the University of California, Irvine. At the Long Beach VA, he performed the largest outcomes study in the VA of coronary artery disease. He was the co-principal investigator of a Veterans Affairs cooperative multicenter study of exercise testing and angiography called QUEXTA (QUantitative EXercise Testing and Angiography).

In addition to writing several textbooks, Dr. Froelicher has participated in developing exercise testing guidelines for numerous organizations including the American College of Cardiology, American Heart Association and the American College of Sports Medicine. He has co-authored over 300 papers, serves on numerous editorial boards and reviews for many of the major medical journals.

In 1995 he was chosen for the "Best Doctors in the U.S." book and since 1997 has been chosen as a "Best Doctor" in the "Pacific Region" and in Silicon Valley.

Dr. Froelicher has been the major consultant to the “Stanford Sports Medicine Program” and participated in the pre-participation exam of all Stanford athletes and professional teams in their care.  Having “retired” from the Palo Alto VA Medical Center, he is currently the Director of the Stanford Sports Cardiology clinic.   He is also co-owner/founder and CMO of Cardeascreen, developers of hardware and software for ECG screening.

His amateur athletic experience includes lettering in collegiate Tennis, playing all intramural sports, running in innumerable slow 10 k’s and over 15 Marathons. His “fastest” marathon was the “Avenue of the Giants” in almost under 3 hours and last was the Boston Freedom Trail at 3.5 hours in 32 degree weather and 3 inches of rain.  He now daily cycles in the sun on bay trails by the water listening to audiobooks.

Current Research and Scholarly Interests:

  • Screening of athletes for sudden cardiac death
  • Computerized ECG and clinical data management
  • Exercise Physiology including expired gas analysis
  • The effect of chronic and acute exercise on the heart
  • Digital recording of biological signals; prognostic and diagnostic use of exercise testing
  • Development of Expert Medical System software and educational tools