Christopher M. Kramer


  • AB, Harvard College
  • MD, University of California, San Francisco
  • Residency, University of Pennsylvania School of Medicine
  • Fellowship, University of Pennsylvania

Primary Appointment

  • Professor, Medicine- Cardiovascular Medicine


Research Interest(s)

Cardiac magnetic resonance imaging, myocardial disease, atherosclerotic plaque imaging, peripheral arterial disease, hypertrophic cardiomyopathy

Research Description

Cardiovascular magnetic resonance imaging is a powerful new technology that promises to become a comprehensive imaging approach to heart disease. A major focus of our work is on developing clinical applications of cardiovascular MRI. Active clinical protocols include a multicenter study improving risk prediction in hypertrophic cardiomyopathy, developing a comprehensive MR exam for clinical trials in peripheral arterial disease including atherosclerotic plaque imaging and calf muscle perfusion and energetics at peak exercise, and assessing quantitative myocardial perfusion in microvascular coronary artery disease.

Other clinical studies include atherosclerotic plaque regression studies with PCSK9 inhibitors, quantitative myocardial functional imaging as a measure of dyssynchrony in heart failure, and T1 mapping of myocardial fibrosis in different myocardial disease states.

Selected Publications

  • Auger D, Bilchick K, Gonzalez J, Cui S, Holmes J, Kramer C, Salerno M, Epstein F. Imaging left-ventricular mechanical activation in heart failure patients using cine DENSE MRI: Validation and implications for cardiac resynchronization therapy. Journal of magnetic resonance imaging : JMRI. 2017;46(3): 887-896. PMID: 28067978 | PMCID: PMC5502204
  • Lopez D, Pan J, Pollak P, Clarke S, Kramer C, Yeager M, Salerno M. Multiparametric CMR imaging of infarct remodeling in a percutaneous reperfused Yucatan mini-pig model. NMR in biomedicine. 2017;30(5). PMID: 28164391 | PMCID: PMC5488275
  • Sengupta P, Kramer C, Narula J, Dilsizian V. The Potential of Clinical Phenotyping of Heart Failure With Imaging Biomarkers for Guiding Therapies: A Focused Update. JACC. Cardiovascular imaging. 2017;10(9): 1056-1071. PMID: 28882290
  • Yang Y, Zhao L, Chen X, Shaw P, Gonzalez J, Epstein F, Meyer C, Kramer C, Salerno M. Reduced field of view single-shot spiral perfusion imaging. Magnetic resonance in medicine. 2017. PMID: 28321908
  • Balfour P, Gonzalez J, Kramer C. Non-invasive assessment of low- and intermediate-risk patients with chest pain. Trends in cardiovascular medicine. 2016;27(3): 182-189. PMID: 27717538 | PMCID: PMC5346457
  • Chandrashekhar Y, Dilsizian V, Kramer C, Marwick T, Min J, Shaw L, Zoghbi W, Narula J. Implementing Multimodality Imaging in the Future. JACC. Cardiovascular imaging. 2016;9(2): 91-8. PMID: 26846936
  • Chow K, Yang Y, Shaw P, Kramer C, Salerno M. Robust free-breathing SASHA T1 mapping with high-contrast image registration. Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance. 2016;18(1): 47. PMID: 27535744 | PMCID: PMC4989502
  • Coleman G, Shaw P, Balfour P, Gonzalez J, Kramer C, Patel A, Salerno M. Prognostic Value of Myocardial Scarring on CMR in Patients With Cardiac Sarcoidosis. JACC. Cardiovascular imaging. 2016;10(4): 411-420. PMID: 27450877 | PMCID: PMC5237422
  • Eskandari M, Kramer C, Hecht H, Jaber W, Marwick T. Evidence Base for Quality Control Activities in Cardiovascular Imaging. JACC. Cardiovascular imaging. 2016;9(3): 294-305. PMID: 26965731
  • Hamirani Y, Fanous I, Kramer C, Wong A, Salerno M, Dillon P. Anthracycline- and trastuzumab-induced cardiotoxicity: a retrospective study. Medical oncology (Northwood, London, England). 2016;33(7): 82. PMID: 27334792 | PMCID: PMC5253226
  • Hoyt W, Dean P, Schneider D, Conaway M, Kramer C, Battle R. Coronary Artery Evaluation by Screening Echocardiogram in Intercollegiate Athletes. Medicine and science in sports and exercise. 2016. PMID: 27926615
  • Kraitchman D, Kramer C. Interventions in Complex Congenital Heart Disease: The Exciting Potential of Magnetic Resonance Imaging. JACC. Cardiovascular interventions. 2016;9(9): 971-2. PMID: 27085577
  • McDermott M, Kramer C, Tian L, Carr J, Guralnik J, Polonsky T, Carroll T, Kibbe M, Criqui M, Ferrucci L, Zhao L, Hippe D, Wilkins J, Xu D, Liao Y, McCarthy W, Yuan C. Plaque Composition in the Proximal Superficial Femoral Artery and Peripheral Artery Disease Events. JACC. Cardiovascular imaging. 2016;10(9): 1003-1012. PMID: 27838307
  • Naresh N, Butcher J, Lye R, Chen X, Isakson B, Gan L, Kramer C, Annex B, Epstein F. Cardiovascular magnetic resonance detects the progression of impaired myocardial perfusion reserve and increased left-ventricular mass in mice fed a high-fat diet. Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance. 2016;18(1): 53. PMID: 27609091 | PMCID: PMC5016874
  • Patel M, Mor-Avi V, Kawaji K, Nathan S, Kramer C, Lang R, Patel A. Role of Perfusion at Rest in the Diagnosis of Myocardial Infarction Using Vasodilator Stress Cardiovascular Magnetic Resonance. The American journal of cardiology. 2016;117(7): 1072-7. PMID: 26830261
  • Salerno M, Kramer C. Myocardial Extracellular Volume: Unifying Form and Function in Heart Failure With Preserved Ejection Fraction. Journal of the American College of Cardiology. 2016;67(15): 1826-8. PMID: 27081023
  • Cardiovascular imaging and outcomes--PROMISEs to keep. The New England journal of medicine. 2015;372(14): 1366-7. PMID: 25773508
  • Novel magnetic resonance imaging end points for physiologic studies in peripheral arterial disease: elegance versus practicality. Circulation. Cardiovascular imaging. 2015;8(4). PMID: 25873725 | PMCID: PMC4400834
  • Role of Cardiac MR Imaging in Cardiomyopathies. Journal of nuclear medicine : official publication, Society of Nuclear Medicine. 2015;56 39S-45S. PMID: 26033902 | PMCID: PMC4465292
  • Bilchick K, Mealor A, Gonzalez J, Norton P, Zhuo D, Mason P, Ferguson J, Malhotra R, Michael Mangrum J, Darby A, DiMarco J, Hagspiel K, Dent J, Kramer C, Stukenborg G, Salerno M. Effectiveness of integrating delayed computed tomography angiography imaging for left atrial appendage thrombus exclusion into the care of patients undergoing ablation of atrial fibrillation. Heart rhythm. 2015;13(1): 12-9. PMID: 26341605 | PMCID: PMC4858349
  • Feng X, Salerno M, Kramer C, Meyer C. Non-Cartesian balanced steady-state free precession pulse sequences for real-time cardiac MRI. Magnetic resonance in medicine. 2015;75(4): 1546-55. PMID: 25960254 | PMCID: PMC4637255
  • Friedrich M, Bucciarelli-Ducci C, White J, Plein S, Moon J, Almeida A, Kramer C, Neubauer S, Pennell D, Petersen S, Kwong R, Ferrari V, Schulz-Menger J, Sakuma H, Schelbert E, Larose É, Eitel I, Carbone I, Taylor A, Young A, de Roos A, Nagel E. Simplifying cardiovascular magnetic resonance pulse sequence terminology. Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance. 2015;16 3960. PMID: 25551695 | PMCID: PMC4280685
  • Gonzalez J, Kramer C. Role of Imaging Techniques for Diagnosis, Prognosis and Management of Heart Failure Patients: Cardiac Magnetic Resonance. Current heart failure reports. 2015;12(4): 276-83. PMID: 26041670 | PMCID: PMC4496303
  • Gonzalez J, Lipinski M, Flors L, Shaw P, Kramer C, Salerno M. Meta-Analysis of Diagnostic Performance of Coronary Computed Tomography Angiography, Computed Tomography Perfusion, and Computed Tomography-Fractional Flow Reserve in Functional Myocardial Ischemia Assessment Versus Invasive Fractional Flow Reserve. The American journal of cardiology. 2015. PMID: 26347004 | PMCID: PMC4851492
  • Kramer C, Appelbaum E, Desai M, Desvigne-Nickens P, DiMarco J, Friedrich M, Geller N, Heckler S, Ho C, Jerosch-Herold M, Ivey E, Keleti J, Kim D, Kolm P, Kwong R, Maron M, Schulz-Menger J, Piechnik S, Watkins H, Weintraub W, Wu P, Neubauer S. Hypertrophic Cardiomyopathy Registry: The rationale and design of an international, observational study of hypertrophic cardiomyopathy. American heart journal. 2015;170(2): 223-30. PMID: 26299218 | PMCID: PMC4548277
  • Kramer C, Chandrashekhar Y, Narula J. Is it T1me for tissue characterization in myocarditis? JACC. Cardiovascular imaging. 2015;8(1): 115-7. PMID: 25592704
  • Kuruvilla S, Janardhanan R, Antkowiak P, Keeley E, Adenaw N, Brooks J, Epstein F, Kramer C, Salerno M. Increased extracellular volume and altered mechanics are associated with LVH in hypertensive heart disease, not hypertension alone. JACC. Cardiovascular imaging. 2015;8(2): 172-80. PMID: 25577446 | PMCID: PMC4418794
  • Lopez D, Pollak A, Meyer C, Epstein F, Zhao L, Pesch A, Jiji R, Kay J, DiMaria J, Christopher J, Kramer C. Arterial spin labeling perfusion cardiovascular magnetic resonance of the calf in peripheral arterial disease: cuff occlusion hyperemia vs exercise. Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance. 2015;17 23. PMID: 25890198 | PMCID: PMC4336689
  • Marinescu M, Löffler A, Ouellette M, Smith L, Kramer C, Bourque J. Coronary microvascular dysfunction, microvascular angina, and treatment strategies. JACC. Cardiovascular imaging. 2015;8(2): 210-20. PMID: 25677893 | PMCID: PMC4384521
  • Mehta B, Auger D, Gonzalez J, Workman V, Chen X, Chow K, Stump C, Mazimba S, Kennedy J, Gay E, Salerno M, Kramer C, Epstein F, Bilchick K. Detection of elevated right ventricular extracellular volume in pulmonary hypertension using Accelerated and Navigator-Gated Look-Locker Imaging for Cardiac T1 Estimation (ANGIE) cardiovascular magnetic resonance. Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance. 2015;17 110. PMID: 26692265 | PMCID: PMC4687111
  • Ramachandran R, Chen X, Kramer C, Epstein F, Bilchick K. Singular Value Decomposition Applied to Cardiac Strain from MR Imaging for Selection of Optimal Cardiac Resynchronization Therapy Candidates. Radiology. 2015;275(2): 413-20. PMID: 25581423 | PMCID: PMC4456179
  • Suinesiaputra A, Bluemke D, Cowan B, Friedrich M, Kramer C, Kwong R, Plein S, Schulz-Menger J, Westenberg J, Young A, Nagel E. Quantification of LV function and mass by cardiovascular magnetic resonance: multi-center variability and consensus contours. Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance. 2015;17 63. PMID: 26215273 | PMCID: PMC4517503
  • Yang Y, Kramer C, Shaw P, Meyer C, Salerno M. First-pass myocardial perfusion imaging with whole-heart coverage using L1-SPIRiT accelerated variable density spiral trajectories. Magnetic resonance in medicine. 2015;76(5): 1375-1387. PMID: 26538511 | PMCID: PMC4860174
  • Bilchick K, Kuruvilla S, Hamirani Y, Ramachandran R, Clarke S, Parker K, Stukenborg G, Mason P, Ferguson J, Moorman J, Malhotra R, Mangrum J, Darby A, Dimarco J, Holmes J, Salerno M, Kramer C, Epstein F. Impact of mechanical activation, scar, and electrical timing on cardiac resynchronization therapy response and clinical outcomes. Journal of the American College of Cardiology. 2014;63(16): 1657-66. PMID: 24583155 | PMCID: PMC4427624
  • Fielden S, Mugler J, Hagspiel K, Norton P, Kramer C, Meyer C. Noncontrast peripheral MRA with spiral echo train imaging. Magnetic resonance in medicine : official journal of the Society of Magnetic Resonance in Medicine / Society of Magnetic Resonance in Medicine. 2014. PMID: 24753164
  • Hamirani Y, Kramer C. Cardiac MRI assessment of myocardial perfusion. Future cardiology. 2014;10(3): 349-58. PMID: 24976472 | PMCID: PMC4152773
  • Hamirani Y, Wong A, Kramer C, Salerno M. Effect of Microvascular Obstruction and Intramyocardial Hemorrhage by CMR on LV Remodeling and Outcomes After Myocardial Infarction: A Systematic Review and Meta-Analysis. JACC. Cardiovascular imaging. 2014;7(9): 940-952. PMID: 25212800
  • McDermott M, Carr J, Liu K, Kramer C, Yuan C, Tian L, Criqui M, Guralnik J, Ferrucci L, Zhao L, Xu D, Kibbe M, Berry J, Carroll T. Collateral vessel number, plaque burden, and functional decline in peripheral artery disease. Vascular medicine (London, England). 2014;19(4): 281-288. PMID: 25047855
  • Mieres J, Gulati M, Bairey Merz N, Berman D, Gerber T, Hayes S, Kramer C, Min J, Newby L, Nixon J, Srichai M, Pellikka P, Redberg R, Wenger N, Shaw L. Role of noninvasive testing in the clinical evaluation of women with suspected ischemic heart disease: a consensus statement from the American Heart Association. Circulation. 2014;130(4): 350-79. PMID: 25047587
  • Polonsky T, Liu K, Tian L, Carr J, Carroll T, Berry J, Criqui M, Ferrucci L, Guralnik J, Kibbe M, Kramer C, Li F, Xu D, Zhao X, Yuan C, McDermott M. High-risk plaque in the superficial femoral artery of people with peripheral artery disease: Prevalence and associated clinical characteristics. Atherosclerosis. 2014;237(1): 169-176. PMID: 25240112
  • Salerno M, Taylor A, Yang Y, Kuruvilla S, Ragosta M, Meyer C, Kramer C. Adenosine stress cardiovascular magnetic resonance with variable-density spiral pulse sequences accurately detects coronary artery disease: initial clinical evaluation. Circulation. Cardiovascular imaging. 2014;7(4): 639-46. PMID: 24759900 | PMCID: PMC4102611
  • de Haas H, Arbustini E, Fuster V, Kramer C, Narula J. Molecular imaging of the cardiac extracellular matrix. Circulation research. 2014;114(5): 903-15. PMID: 24577969
  • Brooks J, Kramer C, Salerno M. Markedly increased volume of distribution of gadolinium in cardiac amyloidosis demonstrated by T1 mapping. Journal of magnetic resonance imaging : JMRI. 2013;38(6): 1591-5. PMID: 23450747 | PMCID: PMC3855558
  • Jiji R, Pollak A, Epstein F, Antkowiak P, Meyer C, Weltman A, Lopez D, Dimaria J, Hunter J, Christopher J, Kramer C. Reproducibility of rest and exercise stress contrast-enhanced calf perfusion magnetic resonance imaging in peripheral arterial disease. Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance. 2013;15 14. PMID: 23343398 | PMCID: PMC3562222
  • Kramer C, Barkhausen J, Flamm S, Kim R, Nagel E. Standardized cardiovascular magnetic resonance (CMR) protocols 2013 update. Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance. 2013;15 91. PMID: 24103764 | PMCID: PMC3851953
  • Kuruvilla S, Adenaw N, Katwal A, Lipinski M, Kramer C, Salerno M. Late gadolinium enhancement on cardiac magnetic resonance predicts adverse cardiovascular outcomes in nonischemic cardiomyopathy: a systematic review and meta-analysis. Circulation. Cardiovascular imaging. 2013;7(2): 250-8. PMID: 24363358 | PMCID: PMC4007583
  • Kuruvilla S, Kramer C. Coronary microvascular dysfunction in women: an overview of diagnostic strategies. Expert review of cardiovascular therapy. 2013;11(11): 1515-25. PMID: 24160578 | PMCID: PMC3909446
  • Lipinski M, McVey C, Berger J, Kramer C, Salerno M. Prognostic value of stress cardiac magnetic resonance imaging in patients with known or suspected coronary artery disease: a systematic review and meta-analysis. Journal of the American College of Cardiology. 2013;62(9): 826-38. PMID: 23727209 | PMCID: PMC3863376
  • Lopez D, Kramer C. Oxygenation and flow in the limbs: Novel methods to characterize peripheral artery disease. Current cardiovascular imaging reports. 2013;6(2): 150-157. PMID: 23504569 | PMCID: PMC3597748
  • Moyer C, Helm P, Clarke C, Budge L, Kramer C, Ferguson J, Norton P, Holmes J. Wall-motion based analysis of global and regional left atrial mechanics. IEEE transactions on medical imaging. 2013;32(10): 1765-76. PMID: 23708788
  • Salerno M, Kramer C. Advances in parametric mapping with CMR imaging. JACC. Cardiovascular imaging. 2013;6(7): 806-22. PMID: 23845576 | PMCID: PMC4073213
  • Salerno M, Sica C, Kramer C, Meyer C. Improved first-pass spiral myocardial perfusion imaging with variable density trajectories. Magnetic resonance in medicine : official journal of the Society of Magnetic Resonance in Medicine / Society of Magnetic Resonance in Medicine. 2013;70(5): 1369-79. PMID: 23280884 | PMCID: PMC3929110
  • Wolk M, Bailey S, Doherty J, Douglas P, Hendel R, Kramer C, Min J, Patel M, Rosenbaum L, Shaw L, Stainback R, Allen J. ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons. Journal of the American College of Cardiology. 2013;63(4): 380-406. PMID: 24355759
  • Bourque J, Schietinger B, Kennedy J, Pearce E, Christopher J, Taylor A, McNamara C, Kramer C. Usefulness of cardiovascular magnetic resonance imaging of the superficial femoral artery for screening patients with diabetes mellitus for atherosclerosis. The American journal of cardiology. 2012;110(1): 50-6. PMID: 22459304 | PMCID: PMC3377855
  • Budge L, Helms A, Salerno M, Kramer C, Epstein F, Bilchick K. MR cine DENSE dyssynchrony parameters for the evaluation of heart failure: comparison with myocardial tissue tagging. JACC. Cardiovascular imaging. 2012;5(8): 789-97. PMID: 22897992 | PMCID: PMC3680367
  • Green J, Berger J, Kramer C, Salerno M. Prognostic value of late gadolinium enhancement in clinical outcomes for hypertrophic cardiomyopathy. JACC. Cardiovascular imaging. 2012;5(4): 370-7. PMID: 22498326
  • Keeley E, Mehrad B, Janardhanan R, Salerno M, Hunter J, Burdick M, Field J, Strieter R, Kramer C. Elevated circulating fibrocyte levels in patients with hypertensive heart disease. Journal of hypertension. 2012. PMID: 22796709 | PMCID: PMC3643814
  • Naresh N, Xu Y, Klibanov A, Vandsburger M, Meyer C, Leor J, Kramer C, French B, Epstein F. Monocyte and/or macrophage infiltration of heart after myocardial infarction: MR imaging by using T1-shortening liposomes. Radiology. 2012;264(2): 428-35. PMID: 22723500 | PMCID: PMC3401349
  • Pollak A, Meyer C, Epstein F, Jiji R, Hunter J, Dimaria J, Christopher J, Kramer C. Arterial spin labeling MR imaging reproducibly measures peak-exercise calf muscle perfusion: a study in patients with peripheral arterial disease and healthy volunteers. JACC. Cardiovascular imaging. 2012;5(12): 1224-30. PMID: 23236972 | PMCID: PMC3531823
  • Pollak A, Norton P, Kramer C. Multimodality imaging of lower extremity peripheral arterial disease: current role and future directions. Circulation. Cardiovascular imaging. 2012;5(6): 797-807. PMID: 23169982 | PMCID: PMC3504350
  • Salerno M, Janardhanan R, Jiji R, Brooks J, Adenaw N, Mehta B, Yang Y, Antkowiak P, Kramer C, Epstein F. Comparison of methods for determining the partition coefficient of gadolinium in the myocardium using T(1) mapping. Journal of magnetic resonance imaging : JMRI. 2012. PMID: 23197434 | PMCID: PMC3899916
  • Tarroni G, Corsi C, Antkowiak P, Veronesi F, Kramer C, Epstein F, Walter J, Lamberti C, Lang R, Mor-Avi V, Patel A. Myocardial perfusion: near-automated evaluation from contrast-enhanced MR images obtained at rest and during vasodilator stress. Radiology. 2012;265(2): 576-83. PMID: 22893711 | PMCID: PMC3480816
  • West A, Anderson J, Epstein F, Meyer C, Hagspiel K, Berr S, Harthun N, Weltman A, Annex B, Kramer C. Percutaneous intervention in peripheral artery disease improves calf muscle phosphocreatine recovery kinetics: a pilot study. Vascular medicine (London, England). 2012;17(1): 3-9. PMID: 22363013 | PMCID: PMC3306608
  • West A, Anderson J, Meyer C, Epstein F, Wang H, Hagspiel K, Berr S, Harthun N, DiMaria J, Hunter J, Christopher J, Chew J, Winberry G, Kramer C. The effect of ezetimibe on peripheral arterial atherosclerosis depends upon statin use at baseline. Atherosclerosis. 2011;218(1): 156-62. PMID: 21570685 | PMCID: PMC3157540
  • Myocardial salvage determined by cardiac magnetic resonance is the most important prognostic imaging indicator in acute myocardial infarction. Current cardiology reports. 2010;13(1): 3-5. PMID: 20878369
  • Kramer C, Sinusas A, Sosnovik D, French B, Bengel F. Multimodality imaging of myocardial injury and remodeling. Journal of nuclear medicine : official publication, Society of Nuclear Medicine. 2010;51 107S-121S. PMID: 20395347 | PMCID: PMC3078824
  • Schietinger B, Brammer G, Wang H, Christopher J, Kwon K, Mangrum A, Mangrum J, Kramer C. Patterns of late gadolinium enhancement in chronic hemodialysis patients. JACC. Cardiovascular imaging. 2009;1(4): 450-6. PMID: 19356466 | PMCID: PMC2933143