Our Clinical Exercise Physiology Consortium 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 4); 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 two 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 25 years and are part of the Sports Medicine faculty.
The Stanford 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 ongoing 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, CPET, and Data Management Core Site
We have provided data core site function for many multi-center clinical studies including investigations of pharmaceutical interventions, angiogenesis, myocardial laser vascularity, exercise capacity using cardiopulmonary exercise testing and the evaluation of diagnostic techniques.
Rest and Exercise ECG Data Management
We have a resting digital ECG database of over 40,000 Veterans with a 10 year follow up for death and a 15,000 patient exercise test database (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 submitted a 510K for a program called Exercise Test Reporting Aid (EXTRA). We have completed clinical, ECG and exercise core site projects including Gensia Pharmaceuticals (arbutamine study), SciMed (PTCA catheter evaluation), transmyocardial and percutaneous laser revascularization, QUEXTA (VA multi-center study) and most recently several trials by multiple sponsors investigating pharmaceutical intervention in hypertrophic cardiomyopathy.
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 Instruments, Quinton (Cardioscience), Schiller, CosMed, Siemens and Cardiac Insight.
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 sports medicine. Dr. Ashley has initiated a Symposium on Athletic Sudden Death that is held at Stanford every two years.