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Researcher Spotlight: Jamieson Bourque, MD, Unexplained Chest Pain & High-Intensity Exercise

Jamieson Bourque, MD is a UVA Health cardiologist, researcher, professor of cardiovascular medicine, and medical director of our nuclear cardiology, stress, and echocardiographic labs. Bourque's research is currently focused on two areas:

  • Using exercise to find the diagnosis and prognosis of patients with unexplained chest pain
  • Applying predictive analytics to identify patients at risk for decompensation on acute care cardiology wards

One of his key interests is how high-intensity exercise can treat heart problems, helping patients improve their heart health through movement.

He also aims to further develop the understanding of coronary microvascular dysfunction using advanced noninvasive imaging techniques. This includes cardiac positron emission tomography (PET) and cardiovascular magnetic resonance imaging (MRI).

See Bourque's selected publications. Below, Bourque discusses his work and answers our Researcher Spotlight questions.

What are you working on right now?

I currently have two primary areas of research interest. I am examining the large percentage of patients with INOCA, chest pain without obstructive coronary artery disease, a group with poor quality of life. I am interested in the diagnosis of cardiovascular and pulmonary impairment and risk stratification in this population and the use of high-intensity exercise training to improve their symptoms and functional status. Within this population, I am interested in using advanced cardiovascular imaging techniques, including cardiac positron emission tomography and cardiac magnetic resonance imaging, to identify the high-risk subgroup with coronary microvascular dysfunction.

I am also collaborating with a colleague in the department of pediatrics to apply predictive analytics techniques to identify patients at risk for decompensation on the acute cardiovascular inpatient service and to examine strategies to predict safe discharge in high-risk groups such as those with congestive heart failure. We are interested in the application of continuous physiologic monitoring variables in predictive models and creating optimal implementation strategies for predictive analytics tools.

What are the most intriguing potential clinical applications of your work?

Most patients evaluated with symptoms concerning for obstructive coronary artery disease do not have significant blockages. And yet, this group has a high burden of symptoms and reduced functional status. Identifying alternative diagnoses, stratifying risk, and finding effective treatments can have an enormous impact in this large but often forgotten population. In particular, exercise can be a powerful method to characterize the degree of cardiovascular and pulmonary impairment and can serve as an effective therapy.

Predictive analytics, particularly in the era of growing artificial intelligence, can broaden clinicians’ ability to care for patients hospitalized for cardiovascular illnesses. I am particularly excited about applying this tool to identify safe discharge timing in groups with a high risk of readmission, such as those with congestive heart failure. Moreover, our work in implementation strategies will provide an effective toolkit as optimal predictive analytics models change with improving AI techniques.

What made you choose UVA Health as the place to do your research?

UVA Health has been a fantastic place for me to pursue my research interests. There is a strong spirit of collaboration here that allows investigators across disciplines to connect and create new productive lines of research inquiry, such as my highly successful collaboration in predictive analytics. The confluence of faculty with intense academic curiosity, research proficiency, and clinical expertise is unparalleled. Moreover, the support from patients and administration has been strong and has allowed me to work at the cutting edge of my skills and discipline.

What do you wish more people knew about your area of research?

I wish that more people knew the high burden and significant functional impact of INOCA, chest pain without obstructive coronary disease. This is a group that is often reassured and dismissed, yet have significant levels of ongoing symptoms, functional impairment, missed work, and high levels of cardiac anxiety. I wish that clinicians knew that most patients undergoing stress testing fall into this category, so this is a highly prevalent population in need of dedicated research.

How did you become interested in your area of research?

I became interested in my current areas of research through my work on advanced cardiovascular imaging techniques and concurrent stress exercise testing in patients with coronary artery disease and coronary microvascular dysfunction. Working with patients with ongoing symptoms and functional impairment convinced me that this group with INOCA need to be addressed directly and needs effective means to identify why they are symptomatic and how we can best treat them.

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