Current Research

Internships

Duke Center for Living Integrated Health Sciences Internship Program

Program Description: The Duke Center for Living provides internship opportunities for motivated students majoring in health science, exercise physiology, kinesiology, human physiology or cardiac rehabilitation who would like to gain experience working with clinical trials investigating the effects of exercise and/or dietary interventions on cardiovascular and metabolic outcomes. Interns will have the opportunity to become familiar with the function and operation of laboratory equipment used for subject testing and collection of physiological data while assisting with scheduling, data collection, data reduction, and data analysis. Specifically, interns will take an active role in cardiopulmonary exercise stress testing, echocardiograms, muscle strength and physical function testing, vascular reactivity/stiffness testing, body composition analysis, as well as the supervision of exercise interventions in a variety of populations.

Interns will be assigned a mentor to help coordinate their specific internship goals and responsibilities, and will report to this person for the duration of the internship.
Internships are approximately 15 weeks in duration and are available during the fall, spring and summer semesters.
All interns will be expected to work 40 hours per week.
A monthly stipend of $300 will be provided.

Eligibility Requirements: Preference will be given to students currently enrolled in a college or university exercise science program or related field; however, other interested candidates will be accepted when positions are available. Applicants with a GPA below 3.0 will not be considered. Excellent communication skills and a high level of professionalism are essential because patient/client interaction is a vital aspect of this program. Interns are expected to be highly motivated, organized, self-directed, and open to feedback in order to ensure a mutually beneficial internship experience.

Deadlines:

Summer: (May - August)

Application due by – March 1

Decision made by – March 15

Fall: (August/September - December)

Application due by - June 10

Decision made by - June 25

Winter/Spring: (January – April/May)

Application due by - October 15

Decision made by - November 1

Interested individuals should send a résumé and cover letter describing their background, academic standing/GPA, interests, and career goals along with contact information for three professional or academic references to Catherine Mikus, Ph.D. at catherine.mikus@duke.edu.

Research Projects

ARFI

Acoustic Radiation Force Imaging of Arteries

Gregg E. Trahey, PhD, Principal Investigator / Jason D. Allen PhD, Co-Investigator

We have developed a new method of imaging the mechanical properties of tissues based on very brief (<1ms) and localized applications of acoustic radiation force and the ultrasonic measurement of the associated tissues’ responses to that force. This technique is called Acoustic Radiation Force Impulse (ARFI) imaging. This has been tested previously within ex vivo and in vivo tissues and been shown to distinguish hard and soft atherosclerotic plaques from normal vessel wall. This study will develop a real time system and test it the popliteal and femoral vessels (ex vivo and in vivo) and related to the mechanical properties in healthy and diseased vessels.

AMNESTI Trial
Angiogenesis and Mechanisms of Exercise Training in Peripheral Arterial Disease
Brian Annex, MD, Principal Investigator
Supervised exercise study for subjects with peripheral arterial disease.
Contact: Leslie Kelly, Recruiter (919) 660-6739 mailto:leslie.kelly@duke.edu

To find out more about AMNESTI, go to http://www.dukehealth.org/HealthPortals/heart/news/8211

GENECARD

Study of the Genetics of Early Onset Coronary Artery Disease

William E. Kraus, MD, Principal Investigator

This is a study of the genetic factors that contribute to the development of cardiovascular disease in younger patients. The study enrolls people who develop heart disease at an early age; men by age 50, women by age 55 as well as their offspring or other family members. Only one interview; visit to Duke not required.

Contact: Elaine Dowdy, Study Coordinator (919) 660-6725, 1(866) 643-2785, mailto:dowdy002@duke.edu

To find out more about GENECARD, go to http://www.chg.duke.edu/patients/eocd.html,

For a list of study publications, see Publications.

HF ACTION Study
Heart Failure and A Controlled Trial Investigating Outcomes of Exercise Training
William E. Kraus, MD, Principal Investigator at Duke
This supervised exercise study is for subjects with NYHA Class II, III, and IV heart failure.
Contact: Leslie Kelly, Recruiter (919) 660-6739, mailto:leslie.kelly@duke.edu

To find out more about HF ACTION, go to www.hfaction.org.

HF ACTION CORE CPX Laboratory

William E. Kraus, MD Principal Investigator; Daniel R. Bensimhon, MD, Co-Investigator

This Core CPX Laboratory establishes a centralized collection and CPX interpretation facility for the parent, multi-center HF-ACTION trial.

LVAD Study

Skeletal Muscle Plasticity Following LVAD Support

Brian H. Annex, MD, Principal Investigator

This is a study to establish that alterations in central hemodynamics are sufficient to induce changes in peripheral skeletal muscle in patients with CHF. The study aims to establish the extent, type, and time course, of peripheral skeletal muscle plasticity pre-LVAD to 9-weeks post-LVAD support. The study will examine potential circulating mediators before, and at serial time points after LVAD placement. Investigators will examine changes in rectus abdominus muscle from pre-LVAD to heart transplantation, using selected measures and compare those to changes in leg muscle over a comparable time period.

Contact: Brian Duscha, Study Coordinator, dusch001@mc.duke.edu

STRRIDE-PD

Studies of a Targeted Risk Reduction Intervention Through Defined Exercise in Pre-Diabetics: STRRIDE-PD
The purpose of this study is to evaluate the effects of different amounts and intensities of aerobic exercise, when compared to the combination of an aerobic exercise plus diet lifestyle intervention, on measures of glucose control in sedentary, overweight adults with pre-diabetes.
Eligibility Requirements
Participants must:
    -Be between 45 and 75 years old
    -Have a body mass index > 25.0 - < 35.4 kg/m2
    -Have fasting glucose > 100 - < 125 mg/dL
    -Exercise less than one day per week
Participants must not:
    -Smoke
    -Be dieting
    -Have any prior diagnosis of diabetes or heart disease
    -Be pregnant or intend to become pregnant
    -Have any allergy to xylocaine (numbing medicine)
    -Be taking confounding medications
    -Have a history of hypertension
    -Be unwilling to exercise at least twice per week at the Duke Center for Living Health and Fitness Center during research study staff supervised times
For more information, contact Leslie Kelly at 919-681-9000 or leslie.kelly@duke.edu.

Protocols in Development

CHANGES: Cardiovascular Health Assessment in a Nested Gene Environment Study

William E. Kraus, MD, Principal Investigator

This study will be a multi-center clinical study of the interaction of lifestyle (exercise and nutrition), pharmacological therapy (probably a three-arm component) and genetics on responses to physiologic components of the metabolic syndrome in 600 sibling pairs with clinically diagnosed metabolic syndrome and atherogenic dyslipidemia.

Does NO mediate clinical anti-VEGF vascular effects

Herbert I. Hurwitz, MD, Principal Investigator / Jason D. Allen PhD, Co-Investigator

The aims of this proposal are to use several novel approaches and the unique clinical setting of anti-VEGF therapy to evaluate the clinical effects of anti-VEGF treatment on several known VEGF/NO dependent processes. These include regulation of blood pressure, endothelial cell vasoreactivity, wound angiogenesis, and platelet function. A second aim is to determine if these effects are mediated by nitric oxide.

Effect of Hyperbaric Oxygen on Glycemic Control in Diabetics

John Freiberger, MD, Principal Investigator / Jason D. Allen PhD, Co-Investigator

Hyperbaric oxygen (HBO) is an accepted treatment of lower extremity wounds in both type 1 and type 2 diabetics. HBO for diabetic lower extremity wounds meets the requirements for an American Heart Association Class I treatment (definitely recommended) based on statistically significant positive randomized controlled trials. Although current theory cites oxidant signaling and neovascularization as the primary mechanism for HBO’s effect, we believe HBO may also improve wound healing by improving glycemic control and diseased vessels.

The GENECARD Offspring Study

William E. Kraus, MD, Principal Investigator

This is a project to follow-up the initial families in the GENECARD families, a collection of 920 nuclear families with early onset cardiovascular disease. This collection has already been used in a successful study to identify genomic linkage regions associated with early onset CVD. Through this work the investigators believe novel genetic factors and gene-environmental interactions will be identified and that targeted preventive strategies and treatment strategies will be more possible.

SCCOR in Peripheral Vascular Disease

Brian H. Annex, MD, Principal Investigator

The goals of this study will be to gain better understanding of the mechanisms underlying exercise limitations and exercise responsiveness in individuals with diabetes mellitus and peripheral arterial disease. The Aims are: 1) to establish the baseline vascular abnormalities present in patients with PAD; 2) establish the ability of selected vascular markers to predict peak VO2 in PAD; 3) establish the ability of exercise training to modify vascular abnormalities in PAD; and 4) examine the gender specificity of the previous findings.