Richard L Verrier, PhD
Non Paid Employee
Cardiovascular Medicine
Contact Information
| Office: | RN-0301 |
| Phone: | 617-667-0730 |
| Fax: | 617-975-5270 |
| Email: | rverrier@bidmc.harvard.edu |
| Address: | 330 Brookline Ave; RN-0301
Boston, MA 02215 |
Advanced Degree And Training
| Year | Institution | Area or Rank |
| 1969 | University of Virginia | Cardiovascular Physiology |
| 1969 | University of Michigan | NIH post-doctoral fellow |
| 1971 | Harvard School of Public Health | Research Associate |
| 1974 | Harvard School of Public Health | Instructor |
| 1975 | Harvard School of Public Health | Asst Prof of Physiology |
| 1983 | Harvard School of Public Health | Assoc Prof of Physiology |
| 1988 | Georgetown University School of Medicine | Professor of Pharmacology |
| 1994 | Harvard Medical School | Assoc Prof of Medicine |
Research Lab Team Members
| Bruce Nearing PhD |
Major Research Theme
|
Our laboratory studies focus on major public health problem of sudden cardiac death, which claims more than 325,000 lives per year in the United States alone. The main challenges have been to elucidate the complex pathophysiologic factors involved and to develop novel approaches for identifying individuals at risk for this mode of demise, which occurs without prodromes in at least 30% of cases. We are exploring the translational utility and mechanisms of T-wave alternans, a beat-to-beat fluctuation in the magnitude of this waveform, to provide the missing information on patients' degree of cardiac electrical instabilty. We discovered in 1991 that this fundamental electrophysiologic phenomenon has the capacity to stratify risk for life-threatening arrhythmia. An extensive series of experiments revealed that T-wave alternans is able to track the influence of neural factors, myocardial ischemia, and other proarrhythmic influences. Conversely, physiologic and pharmacologic interventions that reduce the magnitude of alternans were found to be antiarrhythmic. These findings provided the essential scientific underpinnings for utilizing alternans as a marker of arrhythmic risk in human subjects. The critical next step was to develop the methodology for alternans testing to be compatible with routine ambulatory ECG monitoring and exercise stress testing in human subjects (Nearing and Verrier 2002). We demonstrated that T-wave alternans monitored on ambulatory ECG recordings is capable of identifying risk for arrhythmic events in the post-myocardial infarction period with odds ratios of 4 to 7 (Verrier et al 2003). The approach has been awarded seven United States patents and is licensed to GE Healthcare. Our alternans-testing software is FDA approved for both standard ambulatory electrocardiograms and routine exercise treadmill tests. More recent investigations have demonstrated the utility of T-wave alternans testing for screening low-risk populations for risk of cardiovascular mortality and sudden cardiac death (Nieminen et al, Eur Heart J 2007; Minkkinen et al J Cardiovasc Electrophysiol 2008). A second focus is the antifibrillatory potential of local cardiac drug delivery. We developed and tested in experimental animals a safe, rapid, and reliable means to access the normal pericardial space with a percutaneous catheter placed into the right atrium to pierce the appendage. This access route allows local treatment of coronary artery disease, myopathies, intractable atrial and ventricular arrhythmias, heart failure, cardiac infections, and other conditions, as it permits targeting of therapy to the heart and coronary vessels, with the major advantage of delivering high concentrations of compounds while minimizing adverse side effects of systemic drug administration. For example, experimental laboratory data indicate that administration of cells and growth factors for coronary vessels and heart muscle and agents to stabilize heart rhythm and dilate coronary vessels could prove to be uniquely effective when delivered into the pericardial space. We demonstrated in the porcine model that intrapericardial administration of the prototypical agent nitroglycerin protects against myocardial ischemia-induced ventricular arrhythmias including ventricular fibrillation (Kumar et al, J Am Coll Cardiol 2003;41:1831-1837) and determined that its efficacy is due to improved handling of intracellular calcium (Zhao et al, J Cardiovascular Pharmacol 2006;48:22-29). |
Publications
External Recognition
| Fellow of the American College of Cardiology Director, Cardiology Grand Rounds, Beth Israel Deaconess Medical Center Current editorial board member of Annals of Noninvasive Electrocardiology, Journal of Cardiovascular Electrophysiology, Heart Rhythm Journal, and Journal of Cardiovascular Pharmacology. Frequent reviewer for Circulation. Mentor of HMS and HST students who have received the Cadbury, Soma Weiss, and Resnick awards. |
Major Collaborative Activities
| 1. Collaboration with Dr. Mark Josephson, Chief of Cardiology, and Cardiology Fellow Dr. Kapil Kumar on clinical applications of T-wave alternans and other arrhythmia risk predictors in routine exercise treadmill testing and ambulatory ECGs. 2. Collaboration with Dr. Murray A. Mittleman, Director of Cardiovascular Epidemiology, and Dr. Andrew J. Burger, on T-wave alternans in the archived AECGs of the PRECEDENT trial of heart failure patients. 3. Collaboration with Dr. John J. Godleski and colleagues at Harvard School of Public Health in experimental studies of the cardiovascular effects of air pollution. 4. Collaboration with Dr. Peter H. Stone of Brigham & Women's Hospital on the effects of statin therapy on T-wave alternans. |
Investigator's Lab Web Site
| Research Lab URL | None listed |
| Harvard Catalyst Site: | Verrier Harvard Catalyst Web Site |
