Chris Gitter

Chris Gitter

Innovation Fund Intern

Hometown: Mendota Heights, MN
Education: University of Wisconsin (Madison, WI)
MD Mentor: Eric Fenstad
Staff Mentor: Sarah Dennis
Project: Pulmonary Hypertension with Severe Aortic Stenosis: Hemodynamic Characteristics Before and After TAVR

Chris Gitter is preparing for his senior year at the University of Wisconsin-Madison.  Originally from Mendota Heights, Minnesota, Chris is pursuing his bachelor’s degree in pharmacology and toxicology, with minors in global health, environmental studies, and leadership.  Chris is drawn to studying infectious diseases, immunizations and vaccinations, and he would like to incorporate these fields of study into his future medical career. 

Chris was exposed to the field of medicine through his parents, whose father is a nephrologist and mother is a pharmacist.  At 2 years old, Chris was diagnosed with Acute Lymphocytic Leukemia and underwent chemotherapy until the age of 5.  This sequence of events inspired Chris to pay-it-forward by pursuing a career in medicine with hopes of curing future patients.  Having previous experiences in a pharmaceutical sciences lab and a supplemental internship through Metro Urology, Chris is “looking forward to broadening my horizons this summer in cardiology, a field with which I am less familiar.”

Throughout the duration of his summer research internship, Chris will be mentored by Dr. Eric Fenstad and staff mentor Sarah Dennis.  This summer, Chris looks forward to all of the different shadowing opportunities available to gain a better understanding of clinical and surgical cardiology.  Chris will be contributing to the study– Pulmonary Hypertension with Severe Aortic Stenosis: Hemodynamic Characteristics Before and After TAVR.  This research is directed at studying pulmonary hypertension (PH) with severe aortic stenosis by looking at hemodynamic characteristics before and after transcatheter aortic valve replacement (TAVR).  This study aims to compare pre and post-TAVR pulmonary hypertension, estimate the prevalence of PH post-TAVR and compare one and two-year survival rates for patients with residual PH to those without PH post-TAVR. 

After this summer Chris will return to the University of Wisconsin-Madison, where he serves as a member of the Homecoming Committee.  Chris plans on taking the MCAT either at the end of this summer or next fall and plans on applying for medical school next summer.  During his gap year, Chris intends on continuing clinical research. 

Pulmonary Hypertension with Severe Aortic Stenosis: Hemodynamic Characteristics Before and After TAVR

Background: Pulmonary hypertension (PH) from aortic stenosis appears to affect 1- and 2-year outcomes and mortality following transcatheter aortic valve replacement (TAVR).  Many PH patients who undergo TAVR normalize right ventricular systolic pressure (RVSP), yet a subset of these patients continue with elevated RVSP.  Further evaluation of outcomes and hemodynamics post TAVR will aid in targeted pulmonary hypertension treatment.

Conclusions:

  • The clinical characterization of PH patients status pre- and post-TAVR has not been well categorized as of yet.
  • Residual PH status post-TAVR suggested via echo RVSP >50 mmHg was associated with worse 2-year survival (p=0.013, 42.8% vs 74.8%).
  • Elevated RVSP may indicate patients have significantly increased risk for heart failure-associated re-hospitalization (p=0.006, 39% vs 14%).
  • mPAP (p=0.034), PVR (p<0.001), and TPG (p=0.006) were associated with increased residual PH in patients post-TAVR.
  • In the PH group, only 1 was on PH-specific medications and only 4 had a post-TAVR RHC, the gold standard for PH diagnosis.
  • The patient group with residual PH is a high-risk population that behaves differently than patients that respond to TAVR with reduced RVSP.
    • For patients who do not normalize RVSP post-TAVR, further evaluation by a PH specialist with an RHC may be warranted for improved morbidity and mortality.
    • Whether these patients are appropriate for or will respond to PH-specific medications is yet to be determined.
  • Future studies may consider further investigation of the optimal medical therapy of these PH patients who retain residual PH via RVSP in Echo,