Heart failure and transplant specialist joins MCG
by Jennifer Hilliard
Dr. Chandra Kunavarapu, a heart failure and transplant specialist who recently completed an adult cardiovascular fellowship at the State University of New York, has joined MCG as an assistant professor of cardiology.
Dr. Kunavarapu will help MCG develop a cardiac transplant program. He has already established an inpatient advanced heart failure service, which includes two half-day clinics each week.
Dr. Kunavarapu has developed a comprehensive transplant evaluation program that includes cardiopulmonary stress testing, biopsy and right heart catheterization to detect abnormal blood flow. The primary goal of any heart failure service, he says, is to improve quality of care and quality of life. He plans to focus on targeted early care, state-of-the-art treatments of advanced heart failure and avoidance of repeat hospital admissions.
“The objective of this focused level of care is to identify patients with advanced weakening of the heart muscle at an early stage,” he says. “Once the appropriate risks have been identified, care can be tailored to that level of disease. Recent technological developments like left ventricular assist devices and biventricular pacing are becoming viable options for patients who, before, had only medications to manage a complex disease process.”
Dr. Kunavarapu’s research interests include pharmocogenomics to target drugs based on a genetic profile. “The underlying pathophysiology of heart failure involves the over-expression of molecules that are toxic to the heart and circulation,” he says. “The primary treatments are beta blockers and drugs that inhibit the production of angiotensin, a part of the blood that can constrict vessels and increase blood pressure.
“However, recent research has found that there may be a different response to those treatments in different ethnic groups, due to a genetic mutation in the pathways. This suggests that genetic information could predict which types and doses of medications would be most effective for heart failure patients. I think that in the future genotyping will be a routine lab test to guide treatment of heart failure patients.”
Dr. Kunavarapu also studies Doppler echocardiography, a technique to chart how blood moves within the cardiovascular system.
“Close attention to blood flow changes in the heart can give us a rough estimate of pressure inside the heart,” he says. “That information can be used to better guide day-to-day treatment.”
Dr. Kunavarapu completed a heart failure and transplant fellowship at Columbia University and New York Presbyterian Hospital. He is a graduate of Sidartha Medical College in Vijayawada, India, and completed an internal medicine residency at Interfaith Medical Center in Brooklyn, N.Y., including a year as chief medical resident, as well as a cardiology research fellowship at Columbia University.
His clinical interests include cardiomyopathy, valvular heart disease and pulmonary hypertension.