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Dr. Clark completed a 4-year MD/MPH program at the University of Texas Health Science Center in San Antonio. He subsequently completed all of his post-graduate training at Vanderbilt University Medical Center (VUMC), including Internal Medicine-Pediatrics, Adult Cardiology, and Adult Congenital Heart Disease (ACHD). Additionally, he served as Chief Fellow of the Vanderbilt Cardiovascular Medicine Fellowship, trained in multimodality cardiovascular imaging, and conducted clinical research during a two-year NIH-funded T32 research fellowship at VUMC.Prior to joining the Stanford ACHD faculty, he was appointed Instructor of Cardiovascular Medicine at Vanderbilt and read cardiac magnetic resonance (CMR) imaging as an attending for two years. He is appointed Assistant Professor of Medicine and Pediatrics at Stanford University School of Medicine. His academic and investigative interests focus on advanced cardiovascular imaging for ACHD patients, particularly the application of CMR in this population. During the COVID-19 pandemic, Dr. Clark pivoted his scholarly efforts to focus on studying the cardiovascular effects of COVID-19 with CMR. His current clinical investigations include understanding the CMR-derived diastolic patterns of Fontan physiology and the effect of cardiac rehabilitation on functional status among patients with Fontan failure.
Pharmacologic and therapeutic interventions for patients with Fontan failure are limited and poorly studied. Patient-reported outcome (PROs) metrics of quality of life (QOL) are crucial for aligning patient-centered goals regarding a meaningful improvement in their QOL and are currently underutilized in Fontan research. This proposal will address an urgent clinical need to better understand patient-reported outcome (PROs) metrics of quality of life (QOL), quantitative functional and frailty testing, and a direct comparison of two accessible, but underutilized therapeutic interventions among patients with failing Fontan physiology. A multicenter, randomized controlled trial (1:1) will test the central hypothesis that cardiac rehabilitation will result in improved peak VO2, frailty, and a validated, congenital heart disease-specific PROs (ACHD PROs) over a 12-week duration compared to PDE-5 inhibitor (Tadalafil).