In addition to our traditional 3-year Cardiovascular Disease Fellowship (https://residency-ncal.kaiserpermanente.org/fellowships/cardio/), we are pleased to offer a unique hybrid clinical-research training program which includes 2 years of rigorous clinical rotations at Kaiser Permanente San Francisco followed by a dedicated 2-year Delivery Science Fellowship offered in partnership with the regional Kaiser Permanente Division of Research and its Cardiovascular and Metabolic Conditions Research Section.
Division of Research
The Kaiser Permanente Northern California Division of Research (DOR) is a world class research institute embedded within our fully integrated and learning health care delivery system since 1961. There are more than 65 full-time investigators and >500 research support staff including project managers, programmer/analysts, research nurses, and research assistants. The DOR’s research portfolio spans the full spectrum of health and disease and includes >$150 million in annual funding through grants/contracts awarded by the National Institutes of Health (NIH), other federal agencies, private foundations, industry, and Kaiser Permanente. Projects include epidemiology, health services and outcomes research, implementation science, and clinical trials, with a total academic output >500 publications in 2022 alone.
Cardiovascular and Metabolic Conditions Research Section
Cardiovascular, renal, and metabolic conditions are a major research emphasis of the DOR, and this scientific section has a longstanding history of participating in groundbreaking research including the landmark NIH-sponsored, prospective Coronary Artery Risk Development in Young Adults (CARDIA) and the Chronic Renal Insufficiency Cohort (CRIC) studies, among many others. There are 8 faculty-level investigators in the section led by Dr. Alan S. Go (Associate Director, DOR) and including Dr. Andrew Ambrosy (Research Scientist I) and Dr. Ankeet S. Bhatt (Research Scientist I). Fellows have been involved in impactful research projects ranging from primordial prevention to end-stage heart disease and have a strong track record of presenting their findings at the annual KPNC CV Research Symposium and national scientific meetings and publishing their manuscripts in top tier peer-reviewed scientific journals. Section investigators also have a strong track record of mentoring and supporting trainees at different levels.
Delivery Science Fellowship Program
Investigators and fellows at the DOR partner directly with practicing clinicians and key stakeholders within Kaiser Permanente to do practice changing, operationally-oriented research aimed at improving quality of care and patient-centered outcomes. Fellows will have the unique opportunity to develop delivery science research and writing skills for presentations and publications while being mentored by experienced scientists in grant writing and other professional skill development. The 2-year, full-time program sponsored by The Permanente Medical Group includes a longitudinal experience with formal didactic and structured mentorship as well as a hands-on experience working directly with Drs. Go, Ambrosy, and Bhatt and other DOR investigators. There is also an opportunity to take advanced coursework in relevant methodological areas at nearby University of California campuses.
Applicants interested in this unique pathway are encouraged to express interest early so that they can meet with representatives from the Delivery Science Fellowship Program and DOR.
Manuscript Publications by Fellows
1: Ambrosy AP, Parikh RV, Sung SH, Tan TC, Narayanan A, Masson R, Lam PQ, Kheder K, Iwahashi A, Hardwick AB, Fitzpatrick JK, Avula HR, Selby VN, Ku IA, Shen X, Sanghera N, Cristino J, Go AS. Analysis of Worsening Heart Failure Events in an Integrated Health Care System. J Am Coll Cardiol. 2022 Jul 12;80(2):111-122. doi: 10.1016/j.jacc.2022.04.045. PMID: 35798445.
2: Tobler DL, Pruzansky AJ, Naderi S, Ambrosy AP, Slade JJ. Long-Term Cardiovascular Effects of COVID-19: Emerging Data Relevant to the Cardiovascular Clinician. Curr Atheroscler Rep. 2022 Jul;24(7):563-570. doi: 10.1007/s11883-022-01032-8. Epub 2022 May 4. PMID: 35507278; PMCID: PMC9065238.
3: Fitzpatrick JK, Ambrosy AP, Parikh RV, Tan TC, Bansal N, Go AS; CRIC Study Investigators,. Prognostic value of echocardiography for heart failure and death in adults with chronic kidney disease. Am Heart J. 2022 Jun;248:84-96. doi: 10.1016/j.ahj.2022.02.001. Epub 2022 Mar 10. PMID: 35278374; PMCID: PMC9064944.
4: Wagner JR, Fitzpatrick JK, Yang J, Sung SH, Allen AR, Philip S, Granowitz C, Abrahamson D, Ambrosy AP, Go AS. Global assessment improves risk stratification for major adverse cardiac events across a wide range of triglyceride levels: Insights from the KP REACH study. Am J Prev Cardiol. 2022 Jan 29;9:100319. doi: 10.1016/j.ajpc.2022.100319. PMID: 35199077; PMCID: PMC8844399.
5: Ambrosy AP, Malik UI, Leong TK, Allen AR, Sung SH, Go AS; Healthy Eating as a Means for Active Living in Heart Failure (HEAL-HF) Study. Food security, diet quality, nutritional knowledge, and attitudes towards research in adults with heart failure during the COVID-19 pandemic. Clin Cardiol. 2022 Feb;45(2):180-188. doi: 10.1002/clc.23761. Epub 2022 Feb 2. PMID: 35106780; PMCID: PMC8860486.
6: Fitzpatrick JK, Yang J, Ambrosy AP, Cabrera C, Stefansson BV, Greasley PJ, Patel J, Tan TC, Go AS. Loop and thiazide diuretic use and risk of chronic kidney disease progression: a multicentre observational cohort study. BMJ Open. 2022 Jan 31;12(1):e048755. doi: 10.1136/bmjopen-2021-048755. PMID: 35105612; PMCID: PMC8808372.
7: Go AS, Reynolds K, Avula HR, Towner WJ, Hechter RC, Horberg MA, Vupputuri S, Leong TK, Leyden WA, Harrison TN, Lee KK, Sung SH, Silverberg MJ. Human Immunodeficiency Virus Infection and Variation in Heart Failure Risk by Age, Sex, and Ethnicity: The HIV HEART Study. Mayo Clin Proc. 2022 Mar;97(3):465-479. doi: 10.1016/j.mayocp.2021.10.004. Epub 2021 Dec 13. PMID: 34916054; PMCID: PMC9074114.
8: Ambrosy AP, Parikh RV, Sung SH, Narayanan A, Masson R, Lam PQ, Kheder K, Iwahashi A, Hardwick AB, Fitzpatrick JK, Avula HR, Selby VN, Shen X, Sanghera N, Cristino J, Go AS. A Natural Language Processing-Based Approach for Identifying Hospitalizations for Worsening Heart Failure Within an Integrated Health Care Delivery System. JAMA Netw Open. 2021 Nov 1;4(11):e2135152. doi: 10.1001/jamanetworkopen.2021.35152. PMID: 34807259; PMCID: PMC8609413.
9: Ambrosy AP, Yang J, Sung SH, Allen AR, Fitzpatrick JK, Rana JS, Wagner J, Philip S, Abrahamson D, Granowitz C, Go AS. Triglyceride Levels and Residual Risk of Atherosclerotic Cardiovascular Disease Events and Death in Adults Receiving Statin Therapy for Primary or Secondary Prevention: Insights From the KP REACH Study. J Am Heart Assoc. 2021 Oct 19;10(20):e020377. doi: 10.1161/JAHA.120.020377. Epub 2021 Oct 8. PMID: 34622663; PMCID: PMC8751901.
10: Feng KY, O’Connor CM, Clare R, Alhanti B, Piña IL, Kraus WE, Whellan DJ, Mentz RJ. Greater Pain Severity Is Associated with Worse Outcomes in Patients with Heart Failure. J Cardiovasc Transl Res. 2021 Oct;14(5):984-991. doi: 10.1007/s12265-021-10104-0. Epub 2021 Feb 9. PMID: 33564986.
11: Feng KY, Li J, Ianus J, de Zeeuw D, Fulcher GR, Pfeifer M, Matthews DR, Jardine MJ, Perkovic V, Neal B, Mahaffey KW. Reasons for hospitalizations in patients with type 2 diabetes in the CANVAS programme: A secondary analysis. Diabetes Obes Metab. 2021 Dec;23(12):2707-2715. doi: 10.1111/dom.14525. Epub 2021 Aug 23. PMID: 34402161.
12: Feng KY, Henricksen EJ, Wayda B, Moayedi Y, Lee R, Han J, Multani A, Yang W, Purewal S, Puing AG, Basina M, Teuteberg JJ, Khush KK. Impact of diabetes mellitus on clinical outcomes after heart transplantation. Clin Transplant. 2021 Nov;35(11):e14460. doi: 10.1111/ctr.14460. Epub 2021 Sep 12. PMID: 34390599.
13: Mantri N, Lu M, Zaroff JG, Risch N, Hoffmann T, Oni-Orisan A, Lee C, Jorgenson E, Iribarren C. QT Interval Dynamics and Cardiovascular Outcomes: A Cohort Study in an Integrated Health Care Delivery System. J Am Heart Assoc. 2021 Oct 5;10(19):e018513. doi: 10.1161/JAHA.120.018513. Epub 2021 Sep 28. PMID: 34581201; PMCID: PMC8649135.
14: Mantri N, Lu M, Zaroff JG, Risch N, Hoffmann T, Oni-Orisan A, Lee C, Iribarren C. Torsade de pointes: A nested case-control study in an integrated healthcare delivery system. Ann Noninvasive Electrocardiol. 2022 Jan;27(1):e12888. doi: 10.1111/anec.12888. Epub 2021 Sep 21. PMID: 34547155; PMCID: PMC8739596.
15: Vafaei P, Naderi S, Ambrosy AP, Slade JJ. Implications of the Landmark ISCHEMIA Trial on the Initial Management of High-Risk Patients with Stable Ischemic Heart Disease. Curr Atheroscler Rep. 2021 Sep 1;23(11):70. doi: 10.1007/s11883-021-00970-z. PMID: 34468881.
16: Chen S, Merchant M, Mahrer KN, Ambrosy AP, Lundstrom RJ, Naderi S. Pregnancy Associated Spontaneous Coronary Artery Dissection: Clinical Characteristics, Outcomes, and Risk During Subsequent Pregnancy. J Invasive Cardiol. 2021 Jun;33(6):E457-E466. Epub 2021 May 14. PMID: 34001675.
17: Ambrosy AP, Malik UI, Thomas RC, Parikh RV, Tan TC, Goh CH, Selby VN, Solomon MD, Avula HR, Fitzpatrick JK, Skarbinski J, Philip S, Granowitz C, Bhatt DL, Go AS. Rationale and design of the pragmatic randomized trial of icosapent ethyl for high cardiovascular risk adults (MITIGATE). Am Heart J. 2021 May;235:54-64. doi: 10.1016/j.ahj.2021.01.018. Epub 2021 Jan 28. PMID: 33516752; PMCID: PMC7843090.
18: Malik UI, Ambrosy AP, Ku IA, Mishell JM, Kar S, Lim DS, Whisenant BK, Cohen DJ, Arnold SV, Kotinkaduwa LN, Lindenfeld J, Abraham WT, Mack MJ, Stone GW. Baseline Functional Capacity and Transcatheter Mitral Valve Repair in Heart Failure With Secondary Mitral Regurgitation. JACC Cardiovasc Interv. 2020 Oct 26;13(20):2331-2341. doi: 10.1016/j.jcin.2020.07.030. PMID: 33092707.
19: Ambrosy AP, Fitzpatrick JK, Fudim M. Hospitalizations for heart failure during the COVID-19 pandemic: making sense of the known knowns, known unknowns, and unknown unknowns. Eur J Heart Fail. 2020 Oct;22(10):1752-1754. doi: 10.1002/ejhf.1955. Epub 2020 Aug 4. PMID: 32946154.
20: Wagner J, Fitzpatrick J, Goldschlager N. VT or Not VT?: That Is the Question. Circulation. 2020 Aug 11;142(6):605-607. doi: 10.1161/CIRCULATIONAHA.120.047386. Epub 2020 Aug 10. PMID: 32776843.
21: Ambrosy AP, Fitzpatrick JK, Tabada GH, Gurwitz JH, Artz A, Schrier SL, Rao SV, Reynolds K, Smith DH, Peterson PN, Fortmann SP, Sung SH, Cohen HJ, Go AS; RBC HEART Investigators/PACTTE Consortium. A reduced transferrin saturation is independently associated with excess morbidity and mortality in older adults with heart failure and incident anemia. Int J Cardiol. 2020 Jun 15;309:95-99. doi: 10.1016/j.ijcard.2020.03.020. Epub 2020 Mar 12. PMID: 32201101.
22: Chen S, Ambrosy AP, Mahrer KN, Lundstrom RJ, Naderi S. Spontaneous Coronary Artery Dissection and Incident Ventricular Arrhythmias: Frequency, Clinical Characteristics, and Outcomes. JACC Cardiovasc Interv. 2020 Feb 24;13(4):539-541. doi: 10.1016/j.jcin.2019.10.041. PMID: 32081249.
23: Feng KY, Mahaffey KW. Cangrelor in clinical use. Future Cardiol. 2020 Mar;16(2):89-102. doi: 10.2217/fca-2019-0095. Epub 2020 Feb 18. Erratum in: Future Cardiol. 2020 Jul;16(4):351. PMID: 32067479.
24: Chen S, Merchant M, Mahrer KN, Lundstrom RJ, Naderi S, Goh AC. Spontaneous Coronary Artery Dissection: Clinical Characteristics, Management, and Outcomes in a Racially and Ethnically Diverse Community-Based Cohort. Perm J. 2019;23:18.278. doi: 10.7812/TPP/18.278. Epub 2019 Oct 11. PMID: 31926571; PMCID: PMC6836555.
25: Chen L, Mantri N, Eng ML, Wung W, Smith TWR, Stripe BR, Fan D, Boyd WD, Low RI, Rogers JH, Singh GD. Intraprocedural direct left atrial and wedge pressure correlation during transcatheter mitral valve repair: Results from a single center registry. Catheter Cardiovasc Interv. 2019 Jul 1;94(1):165-170. doi: 10.1002/ccd.28035. Epub 2018 Dec 27. PMID: 30588751.
26: Feng KY, Loungani RS, Rao VN, Patel CB, Khouri MG, Felker GM, DeVore AD. Best Practices for Prognostic Evaluation of a Patient With Transthyretin Amyloid Cardiomyopathy. JACC CardioOncol. 2019 Dec 17;1(2):273-279. doi: 10.1016/j.jaccao.2019.11.006. PMID: 34396189; PMCID: PMC8352120.
27: Fitzpatrick JK, Meyer CS, Schiller NB, Whooley MA, Mishra RK. Ventricular- Vascular Coupling at Rest and after Exercise Is Associated with Heart Failure Hospitalizations in Patients With Coronary Artery Disease. J Am Soc Echocardiogr. 2018 Nov;31(11):1212-1220.e3. doi: 10.1016/j.echo.2018.07.011. Epub 2018 Sep 8. PMID: 30205910.
28: Avula HR, Leong TK, Lee KK, Sung SH, Go AS. Long-Term Outcomes of Adults With Heart Failure by Left Ventricular Systolic Function Status. Am J Cardiol. 2018 Sep 15;122(6):1008-1016. doi: 10.1016/j.amjcard.2018.05.036. Epub 2018 Jun 21. PMID: 30057237; PMCID: PMC6740246.
29: Fitzpatrick JK, Goldschlager N. A case of narrow complex bigeminy, what is the underlying rhythm? J Electrocardiol. 2018 May-Jun;51(3):379-381. doi: 10.1016/j.jelectrocard.2018.03.005. Epub 2018 Mar 16. PMID: 29779527.
30: Fitzpatrick JK, Cohen BE, Rosenblatt A, Shaw RE, Schiller NB. Usefulness of Epicardial Area in the Short Axis to Identify Elevated Left Ventricular Mass in Men. Am J Cardiol. 2018 Jun 15;121(12):1639-1644. doi: 10.1016/j.amjcard.2018.02.058. Epub 2018 Mar 13. PMID: 29628127.
31: Fitzpatrick JK, Goldschlager N. The Clue Is in the U Wave: Torsades de Pointes Ventricular Tachycardia in a Hypokalemic Woman on Methadone. Ann Emerg Med. 2018 Apr;71(4):473-476. doi: 10.1016/j.annemergmed.2017.09.007. PMID: 29566890.
32: Fitzpatrick JK, Kohlwes J. Lime-Induced Phytophotodermatitis. J Gen Intern Med. 2018 Jun;33(6):975. doi: 10.1007/s11606-018-4315-z. Epub 2018 Jan 29. PMID: 29380219; PMCID: PMC5975144.
33: Avula HR, Rassi AN. The Current State of Left Main Percutaneous Coronary Intervention. Curr Atheroscler Rep. 2018 Jan 17;20(1):3. doi:10.1007/s11883-018-0705-2. PMID: 29344756.