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Cardiovascular Disease

There are many different forms of cardiovascular (heart) disease.  The most common cause of cardiovascular disease is narrowing or blockage of the coronary arteries, the blood vessels that supply blood to the heart itself.  This is called coronary artery disease and happens slowly over time.  Other kinds of heart problems may happen to the valves in the heart, or the heart may not pump well and cause heart failure.  Some people are born with cardiovascular disease.

Programs + Services


CardioVascular Center

Learn about the Cardiovascular Center at Tufts Medical Center, providing heart transplants and other treatments for patients with cardiac disease.
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Hypertrophic Cardiomyopathy Center

Explore the Hypertrophic Cardiomyopathy (HCM) Center at Tufts Medical Center in Boston which offers a full suite of cardiomyopathy treatment and diagnostic options.
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Changing the narrative on a once grim genetic cardiac disease

Cardiovascular specialists at Tufts MC are spreading the word that Hypertrophic Cardiomyopathy (HCM) is now a treatable disease compatible with normal longevity and good quality of life.
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Doctors + Care Team

Mark D. Iafrati, MD

Mark D. Iafrati, MD

Title(s): Chief, Vascular Surgery; Director, Vascular Center; Director, Center for Vascular, Wound Healing and Hyperbaric Medicine; Vascular Surgeon; Associate Professor, Tufts University School of Medicine
Department(s): Surgery, CardioVascular Center, Vascular Surgery
Appt. Phone: 617-636-5019
Fax #: 617-636-8003

Complex vascular surgery, vascular biology, endovascular surgery, venous surgery, complex wound care

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Hanna Ahmed, MD, MPH

Hanna Ahmed, MD, MPH

Title(s): Cardiologist; Assistant Professor, Tufts University School of Medicine
Department(s): Medicine, CardioVascular Center, Cardiology
Appt. Phone: 617-636-2273
Fax #: 617-636-5913

Clinical cardiology, cardiovascular imaging

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Research + Clinical Trials


A Phase 2 Open-label Pilot Study to Evaluate Efficacy, Pharmacokinetics, Pharmacodynamics, Safety, and Tolerability of MYK-461 in Subjects With Symptomatic Hypertrophic Cardiomyopathy and Left Ventricular Outflow Tract Obstruction

The purpose of this phase 2 open-label pilot study is to evaluate the efficacy, pharmacokinetics (PK), pharmacodynamics (PD), safety, and tolerability of MYK-461 in subjects with symptomatic HCM and LVOT obstruction aged 18-70 years.
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A Randomized Parallel-Group, Placebo-Controlled, Double-Blind, Event-Driven, Multi-Center Pivotal Phase III Clinical Outcome Trial of Efficacy and Safety of the Oral sGC Stimulator Vericiguat in Subjects With Heart Failure With Reduced Ejection Fraction (HFrEF) - VerICiguaT Global Study in Subjects With Heart Failure With Reduced Ejection Fraction (VICTORIA)

This is a randomized, placebo-controlled, parallel-group, multi-center, double-blind, event driven study of vericiguat (MK-1242) in participants with heart failure reduced ejection fraction (HFrEF). The primary hypothesis is vericiguat (MK-1242) is superior to placebo in increasing the time to first occurrence of the composite of cardiovascular (CV) death or heart failure (HF) hospitalization in participants with HFrEF.
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HeartMate PHP™ Coronary InterventionS in HIgh-Risk PatiEnts Using a Novel Percutaneous Left Ventricular Support Device (SHIELD II)

Prospective, randomized, multi-center, open-label trial of the HeartMate PHP at up to 60 sites in the US. Control device will be the Abiomed Impella® Recover® LP 2.5 Percutaneous Cardiac Support System.

Additionally, the study will include a nonrandomized roll-in phase at each site. Each site must first enroll and treat up to 3 patients in the nonrandomized roll-in phase before entering the randomized phase.

Assess the safety and efficacy of the HeartMate PHP in supporting patients with severe symptomatic coronary artery disease with diminished but stable cardiovascular function, who are undergoing elective or urgent high risk percutaneous coronary interventions (PCI) but are not candidates for coronary artery bypass graft (CABG) surgery.

Proposed Indications The HeartMate PHP System is a temporary (<6 hours) ventricular assist device indicated for use during high risk percutaneous coronary interventions (PCI) performed in elective or urgent,

hemodynamically stable patients with severe coronary artery disease and depressed left ventricular ejection fraction.  Nonrandomized Roll-In Phase: Up to 180 patients undergoing PCI per the Inclusion/Exclusion criteria; up to 3 roll-in patients per site.

Randomized Phase: Up to 425 patients undergoing PCI per the Inclusion/Exclusion criteria.

Data will be collected at baseline, during the PCI procedure, postprocedure, discharge, and 90 days post device removal.

All patients will have a follow-up visit at 90 days post-device removal.


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Transcatheter Aortic Valve Replacement to UNload the Left ventricle in patients with ADvanced heart failure: a randomized trial  (TAVR UNLOAD)

The TAVR UNLOAD trial is an international, multi-center, randomized, open-label, clinical trial comparing the safety and efficacy of Transcatheter Aortic Valve Replacement (TAVR) with the SAPIEN 3 Valve and optimized heart failure therapy ( OHFT ) versus OHFT in heart failure (HF) patients, with moderate aortic stenosis ( AS). OHFT is defined as guideline-directed medical therapy. It can be medication only or a combination of medical therapy and approved HF devices.

Clinical efficacy of TAVR is assessed after 1 year of follow-up in all 600 patients. All patients are followed for 2 years to evaluate the value of the study device in to treat patients with Heart Failure (HF) who have moderate aortic stenosis (AS). The Edwards SAPIEN 3 Valve has already been approved by the FDA for use in patients who require an aortic valve replacement due to severe aortic stenosis


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How Does Body Composition Change after Placement of a Left Ventricular Assist Device in Advanced Systolic Heart Failure?

Many patients with advanced heart failure describe loss of muscle mass and strength in their arms and legs. This process is known as ‘sarcopenia’ and has not been well studied in heart failure. In particular it is unknown whether the sarcopenia process can reverse after a heart failure patient receives a left ventricular assist device (LVAD, a surgically implanted heart pumpt). Therefore we are partnering with experts in nutrition and body composition at Tufts University to study changes in muscle mass, physical activity, food intake and metabolism in patients receiving an LVAD. Muscle mass is measured by two methods in the study, to help us determine which is the most accurate in heart failure patients: a dual-energy x-ray absorptiometry (DXA) scan and a non-radioactive isotope dilution technique. There are 3 study visits which each take a maximum of 4 hours, performed around the time of LVAD implant (30 days before to 21 days after), and at 3 months and 6 months after LVAD implantation.
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Entrestotm (LCZ696) In Advanced Heart Failure (LIFE Study) (HFN-LIFE)

The purpose of this study is to test whether EntrestoTM, a newly approved drug for heart failure that combines sacubitril and valsartan, improves symptoms and outcomes in persons with advanced heart failure in comparison to treatment with valsartan alone over 24 weeks. EntrestoTM has been studied in only a very small number of patients with advanced heart failure, like you. This study is beind done to obtain more information on the benefits and risks of EntrestoTM in patients with advanced heart failure. Both EntrestoTM and valsartan have previously been approved by the U.S. Food and Drug Administration (FDA)for people with heart failurea nd are available by prescription from a licensed medical doctor. Currently EntrestoTM is only available under the brand name EntrestoTM, there is no generic form of EntrestoTM. You do not have to take part in this study in order to receive EntrestoTM.
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A phase III randomised, double-blind trial to evaluate efficacy and safety of once daily empagliflozin 10 mg compared to placebo, in patients with chronic Heart Failure with preserved Ejection Fraction (HFpEF).

This is a prospective, multicenter, phase III randomized, double-blind trial to evaluate efficacy and safety of once daily empagliflozin 10 mg compared to placebo, in patients with chronic Heart Failure (HF) with preserved Ejection Fraction (HFpEF). The objective of this event-driven trial is to demonstrate superiority of empagliflozin 10 mg versus placebo in patients with symptomatic, chronic HF and preserved ejection fraction (LVEF > 40%) under stable treatment of HF symptoms. Empagliflozin is an orally available, potent, and selective inhibitor of the renal SGLT-2. Its selective inhibition reduces renal reabsorption of sodium and glucose. This leads to both increased urinary sodium and glucose excretion. While the urinary sodium excretion returns to normal within few days of empagliflozin administration, the effect on urinary glucose continues. The study treatment period will run for approximately 20- 38 months, until the required number of adjudicated primary events are reached. In Addition to the treatment period there is a 4-21 day screening period and a 30 day follow up visit.
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A phase III randomised, double-blind trial to evaluate efficacy and safety of once daily empagliflozin 10 mg compared to placebo, in patients with chronic Heart Failure with reduced Ejection Fraction (HFrEF).

This is a prospective, multicenter, phase III randomized, double-blind trial to evaluate efficacy and safety of once daily empagliflozin 10 mg compared to placebo, in patients with chronic Heart Failure (HF) with reduced Ejection Fraction (HFrEF). The objective of this event-driven trial is to demonstrate superiority of empagliflozin 10 mg versus placebo in patients with symptomatic, chronic HF and preserved ejection fraction (LVEF ≤40%) under stable treatment of HF symptoms. Empagliflozin is an orally available, potent, and selective inhibitor of the renal SGLT-2. Its selective inhibition reduces renal reabsorption of sodium and glucose. This leads to both increased urinary sodium and glucose excretion. While the urinary sodium excretion returns to normal within few days of empagliflozin administration, the effect on urinary glucose continues. The study treatment period will run for approximately 20- 38 months, until the required number of adjudicated primary events are reached. In Addition to the treatment period there is a 4-21 day screening period and a 30 day follow up visit.
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Subcutaneous Furosemide in Acute Decompensated Heart Failure

The purpose of this study is to test if sending you home early from the hospital with a furosemide pump will improve your outcome after a heart failure admission. An investigational pump and drug combination - the sc2WearPump and Furosemide Injection Solution (SCP-101, made scPharmaceuticals), will be used to provide you with the drug you need and the study will also determine if this combination product is safe. "Investigational" means that the combination pump/drug is currently being tested in research studies and is not approved by the US Food and Drug Administration (FDA) for standard medical use. Furosemide is already approved by the FDA for the treatment of heart failure, but tihs study will test a furosemide injection given under the skin using a pump (sc2Wear Pump) applied to the belly.
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Dilated Cardiomyopathy Precision Medicine Study

The purpose of this study is to identify gene changes that cause DCM and gene differences that influence the development and severity of DCM. The genetic screening done for this study will be returned to the subject. These genetic studies may identify a change in a gene that has already been linked with DCM, a change in a gene not previously associated with DCM, or these studies may identify a gene or genes that affect the development and severity of the DCM. With this knowledge we hope to have a better understanding of how genes and gene changes cause DCM. We are collaborating with Dr. Ray Hershberger from The Ohio State University in the Dilated Cardiomyopathy (DCM) Precision Medicine Study, a family-based study aimed at enrolling individuals of European or African ancestry, and identifying the genes responsible for idiopathic DCM. Ours is one of several sites forming part of the DCM Consortium, a multi-institutional group established to conduct DCM research. This study requires one in person visit and a 10-15 minute phone call annually.
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Characterizing HIV-related Diastolic Dysfunction

This is a multicenter clinical trial of a cross section of HIV+ patients with and without diastolic dysfunction. Approximately 200 HAART-treated virally suppressed HIV+ subjects (100 HIV+/DD+ & 100 HIV+/DD-) will be enrolled. Currently only accepted patients who have HIV and Diastolic Dysfunction. This study will evaluate biomarkers, phenomapping, metabolomics, cMRI, and echocardiography to determined characteristics unique to this patient population.
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A Prospective, Multicenter, Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study to Assess the Efficacy and Safety of Macitentan in Patients with Pulmonary Hypertension after Left Ventricular Assist Device

This is a prospective, multicenter, double-blind, randomized, placebo-controlled, parallel-group study to assess the efficacy and safety of macitentan in patients with pulmonary hypertension (PH) after left ventricular assist device implantation. The purpose of this study is to evaluate the effect of the study drug, macitentan, on the properties and function of the heart and on the blood pressure in the pulmonary arteries and to find out more about the safety of the study drug in subjects with PH after LVAD implantation. Macitentan is a study drug that works by blocking the effect of a substance called endothelin, which is produced in increased amounts in patients with pulmonary hypertension. Endothelin causes blood vessels to narrow (constrict), and overgrowth of the muscle in the walls of the blood vessels in the lung occurs. By blocking the action of endothelin, macitentan may reduce the blood pressure in the lung and improve activity level and wellbeing.In this study, half of the subjects will receive study drug/macitentan, while the other half of subjects will receive a placebo (inactive substance or sugar pill). he treatment period will last for about 12 weeks, with a follow-up period of 30 days. In total, including the screening period and a 30-day safety follow-up at the end of the study, the study will last no longer than 5.5 months, with up to 6 planned visits.
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Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation (The COAPT)

This is a study to evaluate the safety and effectiveness of the MitraClip System for the treatment of moderate-to-severe or severe functional mitral regurgitation (FMR) in symptomatic heart failure subjects who are treated per standard of care and who have been determined by the site’s local heart team as not appropriate for mitral valve surgery. Eligible subjects will be randomized in a 1:1 ratio to the MitraClip device (Device group) or to no MitraClip device (Control group). Approximately 610 subjects will be randomized with approximately 305 subjects targeted to receive the study device.
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