Harvard Catalyst Program for Diversity Inclusion (PFDI) Faculty Fellowship

Diana Lopez, MD
Clinical Fellow (Starting at Instructor July 1, 2023), Brigham and Women’s Hospital

Mentor: Ron Blankstein, MD, FACC, FASNC, MSCCT, FASPC, Associate Director, Cardiovascular Imaging Program, Director, Cardiac Computed Tomography, Co-Director, Cardiovascular Imaging Training Program, Senior Physician, Preventive Cardiology, Brigham and Women’s Hospital; Professor of Medicine and Radiology, Harvard Medical School

Mentor: Marcelo F. Di Carli, MD, Chief, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Executive Director, Cardiovascular Imaging Program, Departments of Radiology and Medicine, Brigham and Women’s Hospital; Seltzer Family Professor of Radiology and Professor of Medicine, Harvard Medical School

Department Chair: John Keaney Jr, MD, Chief, Cardiovascular Medicine, Co-Executive Director, Heart and Vascular Center, Victor J. Dzau Professor of Medicine, Harvard Medical School

Project Title: “The Impact of PCSK9-Inhibition on Myocardial Flow Reserve (EMPOWER Study)”

Project Description: Diffuse non-obstructive atherosclerosis and coronary microcirculatory dysfunction (CMD) are prevalent in patients with cardiovascular disease and consistently identify patients at increased risk for adverse outcomes, even in the absence of obstructive CAD. These abnormalities throughout the coronary vasculature are closely inter-related manifestations of atherosclerosis that have been linked to systemic inflammation. Positron Emission Tomography (PET) myocardial flow reserve (MFR) is a robust and reproducible imaging biomarker that integrates the hemodynamic effects of atherosclerosis across the entire coronary circulation and has been shown to predict outcomes, including higher rates of cardiovascular (CV) death. PCSK9 inhibitors are powerful agents that promote epicardial plaque regression and reduce the risk of CV events, but studies are needed to evaluate their effect on the coronary microvasculature and their potential anti-inflammatory effect on atherosclerosis. The investigator-initiated mechanistic clinical trial, “The Impact of PCSK-9 Inhibition on Myocardial Flow Reserve (EMPOWER study)” will enroll 50 participants to assess whether PCSK-9 inhibition for 12 months with Evolocumab improves PET MFR, and if so whether this effect is independent of changes in epicardial plaque and partially mediated by a reduction in inflammation. The findings of this study will provide novel and important insights into the comprehensive effects of Evolocumab on tissue perfusion, endothelial function, and microvascular function in a high-risk population. As such, these data would serve to address a critical gap in the identification of medical therapies that improve microvascular function and can thus target the residual risk of future cardiac events in patients with stable CAD.

Biography: Diana M. Lopez, MD, MSc, is a Cardiologist at Brigham and Women’s Hospital (BWH) and an Instructor in Medicine at Harvard Medical School (HMS). She completed her undergraduate studies at Dartmouth College, medical school training at HMS, and post graduate internal medicine residency and cardiovascular medicine fellowship at BWH. She subsequently completed a postdoctoral NIH-T32 research fellowship in the BWH Cardiovascular Imaging Research Program and received her Master of Science in Epidemiology from the Harvard T.H. Chan School of Public Health. As a clinical general cardiologist, she sees Spanish-speaking patients at BWH and Brigham and Women's Faulkner Hospital. In addition, she is currently the Diversity, Equity, and Inclusion (DEI) Officer for the BWH Cardiovascular Medicine Fellowship program. Her research focuses on integrating cardiovascular imaging/testing to better phenotype, risk-stratify, and manage the full spectrum of ischemic heart diseases, with a specific interest nonobstructive coronary artery disease and coronary microvascular dysfunction.

Matthew Yuyun, MD, MPhil, PhD
Assistant Professor, VA Boston Healthcare System; Brigham and Women’s Hospital

Mentor: Scott Kinlay, MBBS, PhD, Chief of Cardiology, VA Boston Healthcare System; Associate Professor of Medicine, Brigham and Women’s Hospital

Mentor:  Jacob Joseph, MBBS, MD, Chief of Cardiology, VA Providence Healthcare System; Professor, Brown University

Mentor: Jagmeet Singh, MD, PhD, Professor of Medicine, Harvard Medical School

Department Chair: Paul Conlin, MD, Chief, Medical Service, VA Boston Healthcare System; Professor of Medicine, Brigham and Women’s Hospital

Project Title: “Cardiac Arrhythmias in Heart Failure with Preserved Ejection Fraction: The Burden and Impact on Cardiovascular Morbidity and Mortality.”

Project Description: The worldwide burden of heart failure continues to grow with a global prevalence estimated at 64.3 million. Heart failure with preserved ejection fraction (HFpEF) represents approximately 50% of all heart failure patients, with a very poor median survival of 2 years and 5-year mortality of ~75%. The burden and impact of cardiac arrhythmias in HFpEF remains unknown but probably high. It is known that sudden cardiac death (SCD) accounts for 25-30% of total deaths in HFpEF patients, but the mechanism of SCD remains undetermined (?arrhythmic). Death and hospitalizations resulting from arrhythmias is a promising target for therapeutic interventions once the specific arrhythmic mechanisms are known. The overall objective of the proposed project is to determine the burden and impact of arrhythmias in HFpEF. The specific aims of the study project will be as follows: Aim 1: To determine the burden of arrhythmias in patients with HFpEF in comparison to patients without heart failure. I will compare prevalence and incidence of arrhythmias in veterans with HFpEF with a control group of veterans without heart failure. Aim 2: To determine the impact of cardiac arrhythmias on morbidity and mortality in HFpEF. I will determine the hazard ratios of these outcomes in HFpEF patients with arrhythmias compared to those without. Methods: This study will be conducted using a cohort study design in veterans ≥ 18 years of age with HFpEF (exposed group) and a matched control group without heart failure (unexposed group), derived from national VA databases in the time period 2006-2022.

Biography: Matthew F. Yuyun, MD, M.Phil, PhD is an Assistant Professor of Medicine at Harvard Medical School (HMS) and an attending Cardiac Electrophysiologist & General Cardiologist at VA Boston Healthcare System.  He is also an Adjunct Assistant Professor of Medicine at Boston University (BU) Chobanian & Avedisian School of Medicine.  After obtaining an MD degree in Cameroon, he subsequently received the prestigious Commonwealth Scholarship Award to undertake additional training at the University of Cambridge, United Kingdom, where he received both MPhil (Biostatistics & Epidemiology) and PhD (Cardiovascular Epidemiology) degrees. He remained in the UK to complete residency in Internal Medicine (Cambridge University Hospitals), and Cardiology Fellowship training (University Hospitals of Leicester), after which he worked as a consultant General Cardiologist at Milton Keynes University Hospital, England. He subsequently completed a Clinical Cardiac Electrophysiology Fellowship training at Lahey Hospital & Medical Center / Tufts University School of Medicine, Boston, USA. In 2022, he received “The Excellence in Clinical Teaching Award” from medical trainees of HMS and BU. He is a member of the IRB committee at VA Boston Healthcare System. His earlier research work was focused on risk factors and biomarkers of cardiovascular diseases. More recently, his research interests have crystalized on cardiac arrhythmias in heart failure and cardiac implantable electronic devices, as well as epidemiology of cardiovascular diseases in the developing world, especially in the context of arrhythmias in the wider Global Health.

Nathaniel Harnett, PhD
Assistant Professor, Harvard Medical School, McLean Hospital

Division Chief and Mentor: Kerry J. Ressler, MD, PhD, Chief, Division of Depression and Anxiety Disorders, Mclean Hospital; Professor of Psychiatry, Harvard Medical School

Project Title: "The Impacts of Structural Racism on Threat Neurobiology"

Project Description: The present project investigates the neurodevelopmental impacts of structural racism. Structural racism is woven into the fabric of American life and has potentially deleterious consequences for minoritized individuals. However, limited research to date has assessed how disproportionated exposure to racialized stressors contributes to race-related differences in neurobiology relevant to psychiatric disease. Failure to properly consider the moderating role of structural racism and how it may contribute to observed race-related differences in the brain will result in inequitable neurobiological models of psychiatric disease that can contribute to engrained racism in psychiatry. We will use multidimensional assessments of life stressors and multimodal neuroimaging data collected from longitudinal and cohort studies including the Adolescent Brain and Cognitive Development Study and datasets in the Human Connectome Project. Normative age models across brain function and structure metrics will be generated across the datasets after harmonization. Global indices of exposure to structural racism will be derived from participant self-report demographics and neighborhood characteristics. This multidisciplinary project incorporates multiple areas of investigation from neuroscience and psychiatric to development and racism-related stress. The outcome of the project will provide novel insight into the neurobiological consequences of structural racism across the lifespan.

Biography: Dr. Harnett is an Assistant Neuroscientist at McLean Hospital and Instructor in Psychiatry Harvard Medical School. He received his Ph.D. in Psychology with a focus on Behavioral Neuroscience at the University of Alabama at Birmingham under the mentorship of David C. Knight, Ph.D. He received postdoctoral training in the Neurobiology of Fear Laboratory at McLean Hospital under the mentorship of Kerry J. Ressler, M.D./Ph.D. Dr. Harnett’s research is focused on understanding the neurobiological mechanisms that mediate susceptibility to trauma and stress related disorders. He uses multimodal neuroimaging, psychophysiology, and behavioral assessments to probe cognitive-affective function in individuals exposed to trauma to understand an individual’s potential to later develop posttraumatic stress disorder. In addition, he investigates how structural inequities produce differing neural responses to trauma and how these factors may reinforce racial disparities in mental health. Ultimately, the goal of his research is to develop predictive and preventative neuroscience-based techniques to reduce the prevalence of trauma and stress-related disorder​s. Dr. Harnett has received several awards and honors including a Ford Foundation Predoctoral Fellowship and was a DSPAN F99/K00 award. Dr. Harnett is a member of professional societies such as the International Society for Traumatic Stress Studies, the Society of Biological Psychiatry, and the Anxiety and Depression Association of America, and his work has been published in journals such as American Journal of Psychiatry, Neuropsychopharmacology, Biological Psychiatry, and NeuroImage. 

Michael Flores, PhD, MPH
Instructor, Harvard Medical School, Cambridge Health Alliance

Department Chair: Phillip Sung-En Wang, Dr.P.H, MD, Head of the Department of Psychiatry, Cambridge Health Alliance; Professor of Practice, Harvard Medical School

Mentor: Benjamin Le Cook, PhD, Associate Professor of Psychiatry, Cambridge Health Alliance

Project Title:  "Examining Racial/Ethnic Disparities in Opioid Treatment"

Project Description: Massachusetts (MA) is one of the top five states with the highest opioid-involved overdose rates. The shift to illicit opioid use has driven opioid-related mortality rates for Black and Latinx individuals to outpace that of White individuals. Despite the high opioid-involved mortality rates, few individuals with opioid use disorder (OUD) engage in evidence-based treatment, such as medication for OUD (MOUD, e.g., methadone, buprenorphine, and naltrexone); in fact, less than 10% receive any substance use treatment in MA. Our long-term goal is to understand how the opioid epidemic has impacted historically marginalized communities. Our overall objective is to examine MOUD access and opioid-related outcomes by race/ethnicity among MA residents using a comprehensive claims-based dataset. Our research objective aligns with the priorities of the MA Department of Public Health, who have partnered with us and granted access to the Public Health Data Warehouse, which we will analyze for this study. We aim to 1) estimate racial/ethnic trends (2011-2019) in OUD, MOUD initiation, MOUD retention, and MOUD availability; and 2) estimate racial/ethnic disparities in fatal/non-fatal opioid-related overdose and time to MOUD prescription. The study is informed by our long-standing collaborations with community partners, substance use specialist, and health services researchers. Our goal is to inform state policymakers, substance use treatment facilities, and clinicians on the extent to which OUD treatment availability and use is equitable across racial/ethnic groups using comprehensive claims-based MA data. Results can inform the allocation of limited resources and help improve opioid-related morbidity and mortality in the state of MA.

Biography: Michael Flores, Ph.D., M.P.H., is an Instructor in the Department of Psychiatry at Harvard Medical School (HMS) and a Research Scientist in the Health Equity Research Lab at Cambridge Health Alliance (CHA). His research employs rigorous analytic methods to inform policy development, allocation of limited resources, and to improve the health outcomes and care quality of racial/ethnic minorities with behavioral health disorders. Dr. Flores’ current research arc focuses on racial/ethnic minority populations and examines the social determinants of health as they relate to the opioid epidemic, the consequences of opioid use disorder, and ways to improve resource availability to reduce opioid-related morbidity and mortality. Dr. Flores completed a postdoctoral research fellowship at HMS/CHA, where he was awarded the Norman E. Zinberg Fellowship in Addiction Psychiatry Research from HMS. In recognition of his promise as an early-stage investigator, Dr. Flores was awarded a New Investigator Award from the National Institute on Drug Abuse and a Diversity Scholar Award from the American Society of Health Economists. He received his PhD in Health Services Research from Brown University.