Cardiovascular Pathology

Cardiovascular Pathology

The Cardiovascular Pathology group, led by Dr. James Stone, provides all diagnostic services on cardiac and vascular samples, conducts research both independently and with many collaborators through its Cardiovascular Histology Core Facility, and maintains an active teaching program for residents in pathology and other services.

Faculty

• James R. Stone, MD, PhD - Subspecialty Head, Cardiovascular Pathology
• R. Neal Smith, MD, PhD
• Adam Fisch, MD, PhD

Clinical Program

The CV service provides clinical, teaching and research services in the area of CV pathology. Clinical specimens typically include myocardial biopsies (95% of which are obtained from patients following cardiac transplantation), explanted hearts, vascular specimens including biopsies for vasculitis, pericardial specimens, cardiac valves and cardiovascular devices. The CV service evaluates about 1,500 specimens per year and consults with other services on cardiovascular issues including vasculitis and amyloidosis. Special expertise exists in the area of myocardial biopsy evaluation, especially myocarditis and transplant rejection; these specimens (about 15-20 per week) require same-day interpretation on a routine basis directing and effecting the immediate treatment of patients.

Academic and Research Accomplishments

The unit is interested in elucidating the pathophysiologic mechanisms causing cardiovascular diseases. Dr. Stone's laboratory studies basic mechanisms related to atherogenesis, including the discovery of signaling pathways activated by endogenous levels of hydrogen peroxide in endothelial cells. Dr. Stone's group is also using proteomic approaches to understand why atherosclerosis only forms at particular sites in the human vasculature. Dr. Smith's work has focused on transplantation pathology and in particular on the mechanisms and diagnostic evaluation of cardiac humoral rejection. Dr. Tearney is employing novel real-time imaging modalities to image the human cardiac vasculature. Through the Cardiovascular Histology Core Facility, the CV service has numerous ongoing collaborative studies which include studies with the Center for Integration of Medicine and Innovative Technologies (CIMIT), the Center for Transplantation Biology, the vulnerable plaque program, the radiology department and cardiac surgical department. The core facility is equipped for histopathological, immunopathological, molecular and morphometric studies. The core facility is under the direction of Dr. James Stone.

Teaching and Educational Activities

The CV service is actively involved in teaching residents cardiovascular pathology and techniques of cardiac dissection. Regular sessions with pathology residents, cardiovascular fellows and cardiac surgical house officers provide structure-function correlation for these trainees. The CV service routinely participates in the monthly cardiac surgical M&M conference and the transplantation conference. Members of the CV service serve as lecturers and laboratory instructors for medical and graduate student courses at Harvard Medical School and the Massachusetts Institute of Technology.