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The clinical exercise physiology consortium (Dr Myers, Dr Ashley and Dr Froelicher) is located at five sites, three at the Palo Alto VA Medical Center (PAVAMC) and two at the Stanford University Campus: 1) Cardiology Department at the VA Hospital (PAVAMC, Bldg 101); 2) Exercise Training Unit (PAVAMC, Bldg 51); 3) Spinal Cord Rehabilitation Unit (PAVAMC, Bldg 6); 4) Stanford Sports Medicine Human Performance Laboratory (Arrellaga Recreation Bldg, 531 Galvez Ave, Stanford Campus), 5) Stanford Medical Center Exercise Testing Laboratory and Cardiomyopathy Clinic.
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- The Palo Alto VA Health Care System includes the Medical Center in Palo Alto (where three of our sites are located) and satellite clinics in Menlo Park, San Jose, Livermore, Monterey, Stockton, and Modesto, California. The Medical Center is a large combined medical and surgical, inpatient and outpatient VA facility. We are mainly located in the Cardiology Division on the second floor of Building 101. We have a large room with several computers dedicated for use by researchers and a combined exercise testing room divided by a movable partition with complete labs, one for clinical and the other for research testing. Our main offices are located there along with most of our supporting staff. Computer networking is readily available throughout the health care facility with direct access to VA computerized patient record data bases which the advisors use for epidemiologic research and medical record retrieval and review. The Cardiology Division includes rooms dedicated to Echocardiography, Cardiac Catheterization and ECG services. Cardiology clinics are also conducted on the first floor of Bldg 100. A regular educational lecture series is provided for a broad range of internal medicine and cardiology topics for Stanford students, residents and fellows who rotate through Cardiology.
- The Exercise Training Unit is a large room with multiple exercise training devices and ECG monitoring for up to 8 patients. It is on the first floor of Bldg 51 which is in the south corner of the VA grounds with large windows and ready access to grassy areas and walking paths.
- The Spinal Cord injury Research Laboratory is located in between our two facilities described above and is the site for ongoing VA Rehabilitation Research and Development funded projects involving exercise, risk reduction, and cardiovascular health in spinal cord injury. The VA has a large Spinal Cord Injury Center that provides patients for our studies.
- The Stanford Sports Medicine Human Performance Laboratory is used for evaluation of Stanford athletes, alumni and community cardiovascular testing, as well as research in human performance. It is associated with the Stanford Sports Medicine Clinic in the same building. Drs. Myers and Froelicher have provided Cardiology and Exercise Physiology consultation for over 10 years and are part of the Sports Medicine faculty. The lab has been recently opened and contains the latest equipment for the evaluation of athletes.
- Stanford Medical Center Exercise Laboratory is located in the Stanford Medical Center, a world renowned tertiary care center and School of Medicine. Stanford has been at the forefront of innovation in medicine since its inception. Stanford witnessed the birth of heart and lung transplantation and maintains a busy advanced heart failure service. As such, the exercise testing laboratory specializes in cardiopulmonary exercise testing for transplant evaluation and on going management of patients with cardiomyopathy and heart failure, as well as pulmonary hypertension. Stress echocardiography is combined with expired gas analysis to provide sophisticated integrated measurements in certain groups such as those with hypertrophic cardiomyopathy or those with ischemic cardiomyopathy. Servicing multiple scientific studies as well as the clinical population of Stanford and nearby centers, the lab interacts closely with other exercise physiology labs in the consortium.
Core Lab Functions
Statistical and Data Management Core Site
- We have provided data core site function for many multi-center medical studies including investigations of angiogenesis, myocardial laser vascularity and the evalustion of diagnostic techniques.\
Rest and exercise ECG data management
- We have a resting digital ECG data base of over 40,000 veterans with a 10 year follow up for death and a 10,000 patient exercise test data base (including 2000 patients with digitized ECG data stored at 500 samples/second).
Computerization of data gathering
- Including digitized or visual ECG data as well as web based clinical data entry.
Data analysis, reporting, biostatistical analysis and publications
- We have experience with FDA guidelines for drug and device evaluation and reports. We have even submitted a 510K
for EXTRA! Completed clinical, ECG and exercise core site projects include Gensia Pharmaceutical (arbutamine study), SciMed (PTCA catheter evaluation), transmyocardial and percutaneous laser revascularization and QUEXTA (VA multi-center study).
Hardware and Software Evaluation
- We have been involved in the development, prototyping and evaluation of medical devices.
Computerized ECG analysis and expired gas analysis
- Some of the medical companies that we have worked with include Burdick, Eisoate, HP, ORCA, Innovision, Medical Graphics, Mortara Instrument, Quinton (Cardioscience), Schiller and Siemens.
- Our group has extensive experience in symposium planning, implementation and
presentation. We specialize in issues of clinical exercise physiology, Cardiac
rehabilitation, exercise testing, and basic cardiology. Currently we have developed with Blaufuss Media an animated auscultation/physical
diagnosis lecture series and are hosting it on hand held devices.
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Euan Ashley, MD
Dr Ashley is Assistant Professor of Medicine at Stanford University and directs the Hypertrophic Cardiomyopathy Clinic.
He graduated in Physiology and Medicine from the University of Glasgow, Scotland, before completing his residency at the John Radcliffe Hospital in Oxford, England. He was awarded a prestigious Wellcome trust award to join the clinician-scientist PhD program in Molecular Cardiology at the University of Oxford.
He later moved to Stanford to work with Tom Quertermous as a Donald W Reynolds fellow. After completing Cardiology fellowship at Stanford University, he joined the faculty in 2006 as an Assistant Professor of Medicine.
His research is both mechanistic, currently focused on apelin-APJ signaling in heart failure, systems based, reflecting an integrative approach to high dimensional biology, and translational, with studies ranging from the development of novel genetic tools for cardiomyopathy to clinical studies in heart failure and exercise physiology.
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Jonathan Myers, PhD
Dr. Myers graduated from the University of California, Santa Barbara, and
performed graduate studies at San Diego State University and the University of
He has been performing research, teaching, and writing in regard to exercise
testing and training for over 20 years. His research interests have focused on the areas of cardiopulmonary exercise testing, execise training in chronic heart failiure, epidemiology related to exercise test response and physical activity patterns, and cardiovascular health in spinal cord injury. He has conducted more than 100 workshops and consulted with manufacturers across
the United States and Europe.
In conjunction with Dr. Froelicher, he has published extensively in the areas
of exercise physiology, exercise testing, and exercise training.
Together. they co-authored a leading textbook on exercise,
"Exercise and the Heart, Clinical Concepts".
He has authored or co-authored guidelines on exercise
testing and related topics for numerous organizations,
including the American Heart Association, American Thoracic Society, the American College of Sports Medicine, and the european working group on exercise physiology and rehailitation.
Presently, he manages day-to day research activities in the Cardiology department
at the Palo Alto Veterans Affairs Medical Center, and is coordinator for
the Cardiology exercise laboratory. He is a clinical associate professor of
medicine at Stanford University, and a consultant to the Stanford Sports
In addition to a variety of clinical, research, and teaching activities at
Stanford and the VA, he keeps himself busy performing statistical and database
In addition to consulting with US firms, he frequently consults with foreign
groups on data management and statistics. Over the years, he has been involved
with research groups from Switzerland, Germany, Norway, South America, Italy, Japan
and Canada, and published papers related to exercise testing and training with all of them.
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Victor Froelicher, MD
A graduate of the University of Pittsburgh Medical School in 1967, Victor F. Froelicher
obtained his internship and internal medicine training at Wilford Hall U.S. Air Force
Medical Center. He then pursued his fellowship in cardiology at the University of Alabama
at Birmingham with T.J. Reeves. While at the U.S. Air Force School of Aerospace Medicine,
Dr. Froelicher published numerous works related to exercise physiology and early
screening for coronary artery disease in healthy aviators.
His angiographic and follow up studies of aviators were critical to the understanding
of silent ischemia and the application of Baysian statistics and predictive modeling
to diagnostic tests.
After eleven years of service in the U.S. Air Force, he joined the faculty at
the University of California at San Diego. At UCSD he was the principal
investigator of the NIHLBI randomized trial of cardiac rehabilitation called PERFEXT(PERfusion PerFormance EXercise Trial.
In 1980, he was the co-founding editors for the Journal of Cardiopulmonary
Rehabilitation. From 1984 to 1992, Dr. Froelicher was Chief of Cardiology at
the Long Beach Veterans Affairs Medical Center and Assistant Chief at the University
of California, Irvine. At the Long Beach VA, he performed the largest outcomes study in the VA of
coronary artery disease. He was the co-principal investigator of a Veterans Affairs cooperative multicenter study of exercise testing and angiography called QUEXTA (QUantitative EXercise Testing and Angiography).
In addition to writing several textbooks, Dr. Froelicher has participated in developing
exercise testing guidelines for numerous organizations including the American
College of Cardiology, American Heart Association and the American College of
Sports Medicine. He has co-authored over 300 papers, serves on numerous editorial
boards and reviews for many of the major medical journals.
In 1995 he was chosen for the "Best Doctors in the U.S." book and since 1997
has been chosen as a "Best Doctor" in the "Pacific Region" and in Silicon Valley.
He is cardiologist to the Stanford athletes and participates in the
Stanford Sports medicine program. He has just entered his 35th year in Government service
More About Dr. Froelicher
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