The Hospitals of the Emory System

Clinical fellows receive training at each of the four teaching hospitals within the Emory system: Emory University Hospital, Crawford W. Long Hospital of Emory University, Grady Memorial Hospital, and the Emory-affiliated Atlanta Veterans Affairs Medical Center. Each of these hospitals is staffed by full time Emory Medical School faculty members, and offers learning opportunities ranging from primary cardiology training to the state-of-the-art tertiary care. The combined clinical efforts of the four hospitals provide an outstanding environment for clinical training in Cardiology. These hospitals annually perform over 7000 cardiac catheterizations, 3,800 interventional procedures, 2,500 electrophysiology procedures, 3,000 open heart operations, and 35 adult cardiac transplants.

Emory University Hospital

Emory University Hospital is a tertiary care facility providing comprehensive training in all aspects of clinical cardiology. Rotations are available in consultative cardiology, heart failure and cardiac trans-plantation, clinical electrophysiology, nuclear cardiology, peripheral vascular disease, cardiac rehabilitation, and preventive cardiology. In addition, fellows rotate through both the echocardiography laboratory and the inpatient and outpatient cardiac catheterization laboratories.

The research opportunities at Emory University Hospital include basic cellular and molecular biology research, clinical epidemiology, echocardiography, and interventional cardiology. The vascular biology research group at Emory focuses on understanding the factors that regulate blood vessel tone, growth, and inflammation in normal and pathological states. Particular emphasis is placed on the regulation of vascular events by oxidative stress. This work overlaps extensively with work in animal laboratories using primate, porcine, rodent and canine models of coronary artery disease and atherosclerosis, and hypertension. Additional efforts in animal research in interventional cardiology revolve around the application of new technologies and approaches to mechanical revascularization. There is extensive collaboration between these cellular and molecular biology efforts and the animal model studies. Active programs in echocardiography research and clinical epidemiology are also in place at Emory University Hospital. Echocardiography research here focuses on new roles for transesophageal echocardiography and stress-echocardiography in clinical decision making. Efforts in clinical epidemiology make use of Emory's large and complete Cardiac Data Bank to study the clinical efficacy and cost effectiveness of cardiac procedures.

Veterans Affairs Medical Center

The clinical and research facilities at The Atlanta VA Medical Center are state-of-the-art with completely digital cardiac catheterization and echocardiography laboratories. Fellows rotate though the CCU and consult services in addition to the cath and echo laboratories. Comprehensive clinical electrophysiology services have recently been introduced to the Atlanta VA.
The research at the VA Medical Center encompasses clinical projects evaluating vacular function and endothelial reactivity in a variety of disease states. Investigator initiated projects include studies examining the role of the rennin angiotensin system in atherosclerosis, the potential anti-oxidant effects of novel beta-blockers, the physiologic effects of genetic polymorphisms of vascular oxidases, and the relationship between depression and vascular function. Faculty members at this facility have also participated in several multicenter clinical trials including V-HeFt III, Val-HeFT, CARP, COURAGE and PRAISE. Basic science studies focus on structure-function relationships of ion channels, mechanisms of ischemic preconditioning, and the development of novel technologies for the measurement of nitric oxide.

Grady Memorial Hospital

Grady Memorial Hospital is a large city hospital providing primary care to a significant segment of the population of the city of Atlanta. Fellows rotate through many rotations including the CCU, cardiac consultations, stress testing, echocardiography, and the cardiac catheterization laboratory. Some fellows also have their weekly outpatient cardiology clinics at Grady Memorial Hospital.

The principal investigators at Grady are interested in the clinical pathophsiology of congestive heart failure. There is also major effort in studying the importance of age and gender-related differences in the diagnosis and treatment of cardiovascular disease. Ongoing projects in the echocardiography laboratory are examining the role and cost-effectiveness of TEE in the diagnosis of endocarditis. The faculty also participate in multicenter and single center clinical trials.

Crawford W. Long Hospital

Rotations at Crawford W. Long Hospital provides fellows with a diverse clinical experience that encompasses all aspects of clinical cardiology. In addition to clinical experiences in the CCU and on consultative cardiology services, fellows rotate through the echocardiography, cardiac catheterization, nuclear cardiology, and clinical electrophysiology laboratories.

Clinical research at Crawford Long has included participation in a number of multicenter clinical trials, including the GUSTO, TIMI, and TAMI trials. The Carlyle Fraser Cardiovascular Laboratories, located at Crawford Long Hospital, study animal models of myocardial ischemia using nuclear and PET approaches for the diagnosis of myocardial ischemia. Studies are also underway that are attempting to define the pathophysiologic mechanisms of restenosis after placement of coronary stents. New efforts will focus on the
application of nuclear methods for the diagnosis of premorbid atherosclerotic cardiovascular disease.