Support teaching, research, and patient care.
Dr. Clark is a board-certified, fellowship-trained cardiologist with the Adult Congenital Heart Program at Stanford Health Care. He is also a clinical assistant professor with dual appointments in the Division of Cardiovascular Medicine, Department of Medicine and the Division of Cardiology, Department of Pediatrics at Stanford University School of Medicine. Dr. Clark specializes in the diagnosis and treatment of adult congenital heart disease (ACHD) and the management of congenital and acquired heart disease in children. His clinical focus involves the combined use of cardiac magnetic resonance (CMR) and other imaging techniques to evaluate patients with known or suspected cardiovascular disease. Dr. Clark’s extensive training and experience with these techniques include multiple fellowships in adult cardiology, cardiovascular imaging, and ACHD. Dr. Clark is currently a co-investigator on multiple research studies. During his fellowship, he received a training grant from the National Institutes of Health enabling evaluation of the ability of CMR to diagnose COVID-19-associated heart inflammation among college athletes. He currently uses CMR to assess heart transplant outcomes in donors positive for hepatitis C virus. Dr. Clark also received a research grant from the Adult Congenital Heart Disease Association supporting a randomized, controlled clinical trial of cardiac rehabilitation among patients with Fontan failure.Dr. Clark serves as a peer reviewer for multiple prestigious journals, including The New England Journal of Medicine, Circulation, Journal of the American College of Cardiology, and Journal of the American Heart Association (JAHA). He serves on the editorial board for both JAHA and Circulation: Cardiovascular Imaging. He is also a member of numerous professional medical societies, including the American College of Cardiology, the American Heart Association, and the Adult Congenital Heart Association.
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).