Taylor, Angela M.

Angela M. Taylor

Angela M. Taylor

Primary Appointment

Assistant Professor, Medicine: Cardiovascular Medicine

Education

  • MD, Medicine, Medical University of South Carolina
  • BS, Biology, Charleston Southern University
  • MD, Medical College of South Carolina

Contact Information

can be followed noninvasively by CMR.  The hypothesis is that changes in microvascular function measured noninvasively with CMR will predict invasive measurements using CFR and that improvements in microvascular function will predict plaque stabilization and/or regression as measured by IVUS. 3.) To assess whether risk factors for coronary artery disease
Charlottesville, VA 22908
Telephone: 4-2581
Email: amt6b@virginia.edu
Website: the hypothesis is that risk factors for cardiovascular disease will predict disease burden on IVUS as well as CMR and CFR and that improvements in risk factors will predict improvements on invasive and noninvasive measurements. Project 2:  Mechanism of Acute Coronary Syndromes in Premenopausal Women Brief Description: The prevalence of cardiovascular disease and myocardial infarction is higher in men compared to women for every age group. Despite this

Research Interests

Diabetic cardiovascular disease - early diagnosis and prevention; Women's heart disease.

Research Description

Project 1:  Early Noninvasive Detection of Myocardial Microvascualr Dysfunction in Diabetes Brief Description: Type 2 Diabetes has become an epidemic in the United States. Cardiovascular disease is the most common cause of death in this population and is two to four fold higher than the general population. This increased risk is at least partially attributable to the high prevalence of the metabolic syndrome with its multiple coronary heart disease risk factors including central obesity, hypertension, glucose intolerance, chronic inflammation, and dyslipidemia. However, recent trials have demonstrated that traditional risk factors alone are not completely predictive of disease burden particularly early in the disease process prior to the development of flow-limiting coronary stenoses. Diagnosis and prevention of cardiovascular disease development has, thus, been elusive in this high risk population. It is not entirely clear which factors, known or novel, contribute the most in very early disease and which therapies may be most beneficial. It has been suggested that microvascular dysfunction, a composite of endothelial dysfunction, abnormal blood cell rheology, and abnormal blood viscosity, precedes the development of overt coronary stenoses and contributes to increased cardiovascular risk very early in disease development. Microvascular reactivity is affected by many aspects of the metabolic syndrome. Microvascular reactivity can be measured invasively at the time of cardiac catheterization by measuring myocardial blood flow and calculating the coronary flow reserve (CFR). Commonly used noninvasive tools may not be adequate to evaluate microvascular function in the heart at baseline or in response to therapy. The American Diabetes Association has recently released a consensus statement stating that better approaches are needed to screen for and identify coronary artery disease in patients with diabetes. Myocardial contrast echocardiography (MCE) and cardiac magnetic resonance imaging (CMR) provide noninvasive technology capable of directly measuring microvascular function within the heart. Our preliminary data with these modalities shows significantly reduced microvascular function in diabetes in the absence of significant coronary stenoses. Prior to development of stenoses in the coronary arteries, plaque accumulates via positive remodeling preserving the lumen. This can be detected invasively through the use of intravascular ultrasound (IVUS). Coronary CT is a potential noninvasive modality able to assess this early remodeling process, but it requires a substantial radiation dose and iodinated contrast dye. In addition, CT requires calcification to have occurred within the plaque, a finding believed to occur well into the life of the plaque. It is unclear how early plaque development is related to microvascular function and if stabilization or regression of plaque with available therapies improves microvascular function. The overall hypothesis is that CMR will predict invasive findings on CFR and IVUS providing a noninvasive mechanism to diagnose microvascular dysfunciton and thus early coronary disease. Secondary objectives will include demonstrating that CMR can be used to follow microvascular function noninvasively over time and that risk factors for the metabolic syndrome will predict disease burden using invasive and noninvasive meaasurements contrary to recent literature using standard noninvasive diagnostic methods. Such techniques may allow earlier noninvasive detection of disease as well as tailor treatment early in the disease process making prevention more cost effective. The specific aims of this proposal are as follows: 1.) To assess whether CMR will predict invasive findings with CFR and IVUS. The hypothesis is that MRI will predict findings on IVUS and CFR

Selected Publications