Current Research and Scholarly Interests
Dr. Witteles' research focuses on three major areas:
1) Cardiac toxicity of cancer therapies -- Studying optimal prevention and treatment strategies for patients who develop heart failure and other cardiac toxicity as a consequence of cancer therapies, as well as studies to better understand the mechanisms/patterns of toxicity for multiple chemotherapeutic agents.
2) Amyloidosis -- As Co-Director of the Stanford Amyloid Center, Dr. Witteles works with a team of investigators to explore novel therapies for amyloidosis and to better understand the mechanisms underlying the disease. This work ranges from clinical trials for multiple types of amyloidosis (AL, ATTR, AA), to defining the role of organ transplantation and pacemakers/defibrillators, to partnering with basic science labs to explore basic principles of pathogenesis.
3) Insulin resistant cardiomyopathy -- Translational research studies to better define the contribution that insulin resistant makes (as a primary contributor) to nonischemic dilated cardiomyopathy, including PET-imaging studies of myocardial glucose uptake.
Studies of physiology/mechanisms include:
1) Relationship of insulin resistance and nonischemic cardiomyopathy. Myocardial glucose metabolism is assessed with PET imaging before/after pharmacologic interventions.
2) Cardiac resynchronization: Exploration of optimal programming methods for timing intervals with biventricular pacing devices using echocardiography and thoracic impedance measurements.
Clinical trials/studies include:
1) Cancer-therapy related cardiotoxicity: Clinical trials to test novel screening and intervention methods to prevent cancer-therapy associated cardiotoxicity from multiple agents (anthracyclines, trastuzumab, tyrosine kinase inhibitors)
2) Cardiorenal syndrome: A large completed double-blind, randomized clinical trial evaluated the role of nesiritide in treating cardiorenal syndrome. Current ongoing trials include studies of a novel natriuretic-peptide (outpatient study) and an adenosine antagonist (inpatient study).
3) Amyloidosis: Clinical trials of novel therapies for amyloidosis