R. Graham Barr, MD, DrPH

Board Certifications: 
Internal Medicine
Profile Headshot

Overview

Areas of Expertise / Conditions Treated

General Internal Medicine

Academic Appointments

  • Hamilton Southworth Professor of Medicine and Epidemiology

Administrative Titles

  • Chief, Division of General Medicine

Hospital Affiliations

  • NewYork-Presbyterian/Columbia

Languages

  • French
  • Spanish

Gender

  • Male

Location(s)

CUMC/Presbyterian Hospital and Vanderbilt Clinic
622 West 168th Street
New York, NY 10032
Primary

Insurance Accepted

Aetna

  • EPO
  • HMO
  • Medicare Managed Care
  • NY Signature
  • POS
  • PPO
  • Signature Administrators
  • Student Health

Cigna

  • EPO
  • Great West
  • HMO
  • POS
  • PPO

Empire Blue Cross Blue Shield

  • Blue Priority
  • EPO
  • HMO
  • Medicare (Mediblue)
  • NYP Employee Plan
  • Pathway (Exchange)
  • POS
  • PPO

Local 1199

  • Local 1199

MagnaCare

  • MagnaCare

Multiplan

  • Multiplan

Oxford Health Plans

  • Freedom
  • Liberty
  • Medicare Managed Care

UnitedHealthcare

  • Columbia University Employee Plan
  • Compass (Exchange)
  • EPO
  • Essential Plan
  • HMO
  • Medicaid (Community Plan)
  • Medicare Managed Care
  • POS
  • PPO

*Please contact the provider’s office directly to verify that your particular insurance is accepted.

Credentials & Experience

Education & Training

  • McGill University Faculty of Medicine
  • Internship: New York University Medical Center
  • Residency: Columbia Presbyterian Medical Center, NY
  • Fellowship: Massachussetts General Hospital

Board Certifications

  • Internal Medicine

Honors & Awards

2001 Robert Wood Johnson Generalist Physician Faculty Scholar Award

2004 Irving Scholar Award, Irving Center for Clinical Research, Columbia University

2009 Harold and Golden Lamport Award for Excellence in Clinical Sciences Research

2014 John Loeb Award Invited Lecturer

Research

Dr. Barr’s research focuses on respiratory epidemiology with a focus on obstructive lung disease and emphysema. In particular, he is interested in a better understanding of the epidemiology and causes of these components of chronic lower respiratory disease using methods that integrate advanced imaging (predominantly computed tomography [CT] and magnetic resonance imaging [MRI]) with genomic, cellular and biomarker information in large cohorts. Currently, Dr. Barr is principal investigator for the Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study, a related genetic study, the MESA COPD Study, the Columbia University Field Center for SubPopulations and Intermediary Outcome Measures in COPD Study (SPIROMICS), the COPD Gene study and the MESA Air Pollution Study. He is also principal investigator for the Spirometry Reading Center for the Hispanic Community Health Study.

Grants

SPIROMICS II: BIOLOGICAL UNDERPINNINGS OF COPD HETEROGENEITY AND PROGRESSION (Federal Gov)

Sep 15 2017 - May 31 2022

SUBCLINICAL INTERSTITIAL LUNG DISEASE IN MESA AND FAR-ILD (Federal Gov)

May 1 2017 - Apr 30 2021

GENOMIC AND TRANSCRIPTOMIC ANALYSIS OF EMPHYSEMA AND SUBCLINICAL LLD (Federal Gov)

May 15 2016 - Apr 30 2021

CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN NON-SMOKERS (Federal Gov)

Jul 1 2016 - Mar 31 2021

DIABETES PREVENTION PROGRAM OUTCOMES STUDY (DPPOS) (Federal Gov)

Feb 1 2016 - Jan 31 2021

THE MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS AND AIR POLLUTION (MESA AIR): NEXT STAGE (Federal Gov)

Sep 1 2017 - Aug 31 2020

MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS (MESA) - FIELD CENTER (Federal Gov)

Aug 15 2015 - Aug 14 2020

SPIROMICS GIC SUPPORT (Federal Gov)

Aug 15 2018 - Jul 31 2019

ALBUMINURIA AND INCIDENT CHRONIC LUNG DISEASE EXACERBATIONS IN FIVE POPULATION-BASED COHORTS (Federal Gov)

Sep 15 2015 - Jun 30 2019

VENTILATION AND PULMONARY ENDOTHELIUM TOXICITIES (VAPE-TOX) OF E-CIGARETTES: A RANDOMIZED CROSSOVER PILOT STUDY (Federal Gov)

Jun 1 2016 - May 31 2019

MUCUS MICROSTRUCTURE AND OSMOTIC PRESSURE: BIOMARKERS FOR CB IN COPD (Federal Gov)

Sep 15 2015 - May 31 2019

LONG LIFE FAMILY STUDY: COLUMBIA UNIVERSITY (Federal Gov)

May 1 2014 - May 31 2019

HISPANIC COMMUNITY HEALTH STUDY - STUDY OF LATINOS (HCHS-SOL) - COORDINATING CENTER (Federal Gov)

Jun 1 2013 - May 31 2019

NOVEL QUANTITATIVE EMPHYSEMA SUBTYPES IN MESA AND SPIROMICS (Federal Gov)

Aug 1 2014 - Apr 30 2019

DEFINING THE ROLE OF EARLY PULMONARY VASCULAR DISEASE IN COPD (Federal Gov)

Apr 15 2015 - Mar 31 2019

PULMONARY MICROVASCULAR BLOOD FLOW AND COR PULMONALE PARVUS IN EMPHYSEMA/COPD (Federal Gov)

Feb 1 2014 - Jan 31 2019

SPIROMICS - AIR POLUTION STUDY (Federal Gov)

Feb 24 2014 - Oct 31 2018

(1 OF 2) GENETIC EPIDEMIOLOGY OF COPD (Federal Gov)

Aug 1 2017 - Jul 31 2018

SUBPOPULATIONS AND INTERMEDIATE OUTCOME MEASURES IN COPD STUDY (SPIROMICS BRIDGE) (Private)

Aug 1 2016 - Jul 31 2018

TARGETING PULMONARY PERFUSION IN 1- ANTITRYPSIN DEFICIENCY (Private)

Jul 1 2015 - Jun 30 2017

ALPHA-1 ANTITRYPSIN IN AFRICAN AMERICANS AND HISPANICS (Private)

Feb 1 2015 - Jan 31 2017

SUBPOPULATIONS AND INTERMEDIATE OUTCOME MEASURE IN COPD STUDY (SPIROMICS: CLINICAL CENTER) (Federal Gov)

Feb 1 2009 - Jul 31 2016

MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS (MESA)- FIELD CENTER (Federal Gov)

Jan 15 1999 - Aug 14 2015

DESIGN AND TESTING OF PRACTICAL TOOLS TO ID INDIVIDUALS AT HIGH RISK FOR COPD (Federal Gov)

Jun 1 2014 - Jul 31 2015

HDL CHOLESTEROL AND CHRONIC LOWER RESPIRATORY DISEASE EVENTS IN FIVE COHORTS (Federal Gov)

Sep 15 2013 - Jul 31 2015

DESIGN AND TESTING OF PRACTICAL TOOLS TO ID INDIVIDUALS AT HIGH RISK FOR COPD (Federal Gov)

Jun 1 2012 - Mar 31 2015

A LIFECOURSE APPROACH TO EMERGING HEALTH DISPARITIES IN A US BIRTH COHORT (LINK/COHN) (Federal Gov)

Sep 29 2008 - Aug 31 2014

GENETIC EPIDEMIOLOGY OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (Federal Gov)

Aug 1 2013 - Jul 31 2014

PROSPECTIVE STUDY OF ATHEROSCLEROSIS AND CLINICAL CARDIOVASCULAR DISEASE LONG TERM EXPOSURE TO AMBIENT... (Federal Gov)

Aug 1 2004 - Jul 31 2013

PHTHALATE EXPOSURE AND INNER CITY PEDIATRIC ASTHMA (Federal Gov)

Sep 15 2007 - Jun 30 2013

HISPANIC COMMUNITY HEALTH STUDY-COORDINATING CENTER (Federal Gov)

Oct 1 2007 - May 31 2013

GENOME-WIDE AND LINKAGE STUDY OF QUANTITATIVE EMPHYSEMA PHEN OTYPES (Federal Gov)

Sep 1 2009 - Aug 31 2012

GENETIC EPIDEMIOLOGY OF COPD (Federal Gov)

Sep 27 2007 - Jul 31 2012

PROSPECTIVE STUDY OF ATHEROSCLEROSIS AND CLINICAL CARDIOVASC ULAR DISEASES LONG TERM EXPOSURE TO AMBI (Federal Gov)

Aug 1 2004 - Jul 31 2012

SPATIAL INVESTIGATION OF SOURCES, COMPOSITION, AND CHRONIC H EALTH EFFECTS OF COARSE PARTICULATE MATTER IN THE MULTI-ETHN (Federal Gov)

Aug 1 2008 - Feb 28 2012

FISH OIL INTAKE, BIOMARKERS AND CHANGE IN LUNG FUNCTION (Federal Gov)

Apr 1 2004 - Mar 31 2011

INFLAMMATORY MARKERS AND ASTHMA (Private)

Jul 1 2001 - Jun 30 2006

Selected Publications

I have had an interest in using novel imaging modalities to understand cardiopulmonary interactions. We have found that subclinical emphysema is associated with large reductions in left ventricular (LV) filling with resultant reductions in cardiac output and LV mass but increased LV mass/end-diastolic volume, which may be mistaken clinically for LV diastolic dysfunction. Paradoxically, we have found that gas trapping/hyperinflation is associated with increased LV mass, likely due to increased LV afterload due to intrathoracic pressure swings.  Furthermore, we have found that the predominant change in the right ventricular (RV) in COPD is shrinkage, not hypertrophy, which may relate to RV diastolic dysfunction or impaired venous return. Hence, new imaging approaches are allowing redefinition of some on the classic teaching of cardiopulmonary interactions and suggesting new diagnostic and therapeutic approaches.

1.Barr RG, Bluemke DA, Ahmed FS, Carr JJ, Enright PL, Hoffman EA, Jiang R, Kawut SM, Kronmal RA, Lima JA, Shahar E, Smith LJ, Watson KE.  Percent emphysema, airflow obstruction and impaired left ventricular filling. New Engl J Med, 2010;362:217-27. PMID: 20089972. PMC2887729 

2.Smith BM, Kawut SM, Bluemke DA, Basner RC, Gomes AS, Hoffman E, Kalhan R, Lima JAC, Liu C-Y, Michos ED, Prince MR, Rabbani L, Rabinowitz D, Shimbo D, Shea S, Barr RG. Pulmonary hyperinflation and left ventricular mass. Circulation. 2013;127:1503-11, 1511e1-6. PMID:  23493320. PMC4018203

3.Kawut SM, Poor HD, Parikh MA, Hueper K, Smith BM, Bluemke DA, Lima JA, Prince MR, Hoffman EA, Austin, JHM, Vogel-Claussen J, Barr RG.  Cor pulmonale parvus in chronic obstructive pulmonary disease and emphysema. The MESA COPD Study. J Am Coll Cardiol. 2014;64:2000-9. PMID: 25440095  PMC4347835

An area of interest has been the significance of pulmonary emphysema and airway disease among patients who do not have COPD on spirometry.  We have an increasing number of papers showing that patients with ‘non-obstructive pulmonary emphysema’ have reduced exercise tolerance, increased dyspnea and increased mortality whereas those with airway disease and increased symptoms and exacerbations. These findings expand the spectrum of chronic lung disease, suggest that emphysema is a distinct clinical entity from COPD and has different risk factors compared to COPD.

1.Oelsner EC, Hoffman EA, Folsom AR, Carr JJ, Enright PL, Kawut SM, Kronmal R, Lederer D, Lima JAC, Lovasi GS, Shea S, Barr RG.  Association of emphysema-like lung on cardiac computed tomography and mortality in persons without airflow obstruction: the Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study. Ann Intern Med 2014;161:863-73. PMID: 25506855 PMC4347817

2.McAllister DA, Ahmed FS, Austin JH, Henschke CI, Keller BM, Lemeshow A, Reeves AP, Mesia-Vela S, Pearson GD, Shiau MC, Schwartz JE, Yankelevitz DF, Barr RG. Emphysema predicts hospitalisation and incident airflow obstruction among older smokers: a prospective cohort study.  PLoS One. 2014;9:e93221. PMID: 24699215. PMC3974731

3.Oelsner EC, Lima JA, Kawut SM, Burkart KM, Enright PL, Ahmed FS, Barr RG. Non-invasive tests for the diagnostic evaluation of dyspnea among outpatients: the Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study. Am J Med. 2014; pii: S0002-9343:00898-5. PMID: 25447621 PMC4346168.

4.Woodruff PG, Barr RG, Bleecker E, Christenson SA, Couper D, Curtis JL, Gouskova NA, Hansel NN, Hoffman EA, Kanner RE, Kleerup E, Lazarus SC, Martinez FJ, Paine R 3rd, Rennard S, Tashkin DP, Han MK; SPIROMICS Research Group. Clinical Significance of Symptoms in Smokers with Preserved Pulmonary Function. N Engl J Med. 2016;374:1811-21. PMID: 27168432

Given the lack of medical therapies for emphysema, we have been examining the endothelial hypothesis of emphysema and have been, along with others, resuscitating this early but discarded hypothesis on the role of the vasculature in the pathogenesis of emphysema. We have demonstrating endothelial changes in humans using cellular, functional and protein biomarkers, and developed imaging endpoints for trials targeting the pulmonary vasculature in emphysema. 

1.Barr RG, Mesia Vela S, Austin JHM, Keller B, Reeves AP, Shimbo D, Stevenson L. Impaired flow-mediated dilatation of the brachial artery is associated with low pulmonary function & emphysema in ex-smokers. The EMCAP Study. Am J Respir Crit Care Med, 2007;176:1200-07. PMID: 17761614. PMC2176103 

2.Thomashow MA, Shimbo D, Parikh MA, Hoffman EA, Vogel-Claussen J, Hueper K, Fu J, Liu C-Y, Bluemke DA, Ventetuolo CE, Doyle MF, Barr RG. Endothelial microparticles in mild COPD and emphysema: the MESA COPD Study. Am J Respir Crit Care Med.  2013;188:60-8. PMID: 23600492. PMC3735242 

3.Ahmed FS; Xian-Cheng J; Schwartz JE; Hoffman EA; Yeboah J; Shea S; Burkart KM; Barr RG. Plasma sphingomyelin and longitudinal change in percent emphysema on computed tomography. The MESA Lung Study.  Biomarkers. 2014;19:207-13. PMID: 246489875.  PMC4088962

4.Hueper K, Vogel-Claussen J, Parikh MA, Austin JH, Bluemke DA, Carr J, Choi J, Goldstein TA, Gomes AS, Hoffman EA, Kawut SM, Lima J, Michos ED, Post WS, Po MJ, Prince MA, Liu K, Rabinowitz D, Skrok J, Smith BM, Watson K, Yin Y, Zambeli-Ljepovic AM, Barr RG. Pulmonary Microvascular Blood Flow in Mild Chronic Obstructive Pulmonary Disease and Emphysema. The MESA COPD Study.  Am J Respir Crit Care Med. 2015;192:570-8. PMID: 26067761

We are also examining the molecular predisposition to COPD and emphysema and personalised risk.

1.Manichaikul A, Hoffman EA, Smolonska J, Gao W, Cho MH, Baumhauer H, Budoff M, Austin JHM, Washko GR, Carr JJ, Kaufman JD, Pottinger T, Powell CA, Wijmenga C, Zanen P, Groen HJM, Postma DS, Wanner A, Rouhani FN, Brantly ML, Powell R, Smith BM, Rabinowitz D, Raffel LJ, Hinckley Stukovsky KD, Crapo JD, Beaty TH, Hokanson JE, Silverman EK, Dupuis J, O’Connor GT, Boezen HM, Rich SS, Barr RG. Genome-wide study of percent emphysema on CT in the general population: The MESA Lung/SHARe Study.  Am J Respir Crit Care Med. 2014;189:408-18. PMID: 24383474. PMC3977717

2.Burkart KM, Manichaikul A, Wilk JB, Ahmed FS, Burke GL, Enright, Hansel NH, Haynes D, Heckbert SR, Hoffman EA, Kaufman JD, Kurai J, Loehr L, London SJ, Meng Y, O’Connor GT, Oelsner E, Petrini P, Pottinger TD, Powell CA, Redline S, Rotter JI, Smith LJ, Soler Artigas M,  Tobin MD, Tsai MY, Watson K, White W, Young TR, Rich SS, Barr RG.   APOM and high-density lipoprotein are associated with lung function and percent emphysema.  Eur Respir J. 2014;43:1003-17.

3.Hancock DB, Eijgelsheim M, Wilk JB, Gharib SA, Loehr LR, Marciante KD, Franceschini N, van Durme YMTA, Chen T, Barr RG, Schabath MB, Couper DJ, Brusselle GG, Psaty BM,  van Duijn CM, Uitterlinden UG, Hofman A, Punjabi NM, Rivadeneira F, Morrison AC, Enright PL, North KE, Heckbert SR, Lumley T, Stricker BHC, O’Connor GT, London SJ. Meta-analyses of genome-wide association studies identify multiple loci associated with pulmonary function. Nat Genet, 2010;42;45-52. PMID: 20010835. PMC2832852

4.Loth DW… [Manichuikal A/Barr RG, First/Senior MESA authors] …London SJ. Genome-wide association analysis identifies six new loci associated with forced vital capacity. Nat Genet. 2014;46:669-77. PMID: 24929828. PMC4140093.