Podcasts about cardiovascular center

Hosts Mitsuaki Sawano, MD, Shun Kohsaka, MD, and Nobuhiro Ikemura, MD, welcome Masashi Amano, MD, from the National Cerebral and Cardiovascular Center in Japan, to discuss his recent article titled "Validation of Guideline Recommendation on Sudden Cardiac Death Prevention in Hypertrophic Cardiomyopathy," published in JACC: Heart Failure.Drawing from the REVEAL-HCM registry of 3,611 patients across 21 Japanese centers, the study evaluated how well U.S. and European guidelines for ICD implantation apply to Japanese patients with HCM. The findings revealed poor outcomes in end-stage HCM (EF

Take a virtual coffee break with the Medical College of Wisconsin and the Advancing a Healthier Wisconsin Endowment as we chat with Michael Widlansky, MD, MPH, Northwestern Mutual Professor of Cardiovascular Medicine, department of medicine and pharmacology, and director of the Cardiovascular Center at the Medical College of Wisconsin, about optimizing our endothelial cell function and why it's important.

Dr. Bouchard discusses "LIPOPROTEIN (a), A BIOMARKER FOR STROKE" with Dr. Leslie Cho, Director of the Cleveland Clinic's Women's Cardiovascular Center.Cardiovascular disease remains the leading cause of death and disability worldwide.Despite advances in lipid management, there remain significant risks of heart disease and stroke in patients treated with current therapies such as statin. 

This week, please join author Zdenka Pausova and Associate Editor Svati Shah as they discuss the article "Circulating Metabolome and White Matter Hyperintensities in Women and Men." Dr. Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. We're your cohosts. I'm Dr. Carolyn Lam, Associate Editor from the National Heart Center and Duke National University of Singapore. Dr. Greg Hundley: And I'm Dr. Greg Hundley, Associate Editor, Director of the Pauley Heart Center at VCU Health in Richmond, Virginia. Dr. Carolyn Lam: Greg, have you ever wondered what white matter hyperintensities in a brain are made of? Well, guess what? The feature discussion is going to give us a little clue. Believe it or not from the circulating metabolome, interesting, huh? Well, I'm going to keep you in suspense, as we first discuss other papers in the issue. And I want to go first, may I? Dr. Greg Hundley: Absolutely, but let's all grab a cup of coffee. Dr. Carolyn Lam: All right. You got yours. And here goes. This first paper reviews the results of endovascular aneurysm repair in patients from the Japanese Committee for Stent Graft Management registry, to determine the significance of persistent type II endoleak and the risk of late adverse events, including aneurysm sac enlargement. Dr. Greg Hundley: Ah, Carolyn, a very clinically relevant question. So what did this study show? Dr. Carolyn Lam: Of more than 17,000 patients who underwent endovascular aneurysm repair for abdominal aortic aneurysm from 2006 to 2015, 29% had persistent type II endoleak. The cumulative incidence rates of abdominal aortic aneurysm related mortality, rupture, sac enlargement, and reintervention were higher in patients with persistent type II endoleak. Specifically, the cumulative incidence rates of rupture and abdominal aortic aneurysm related mortality increased to 2% at 10 year follow up, which is dissimilar to the previously reported frequency of only about 1%. Cox regression analysis revealed older age, female sex, proximal neck diameter, and chronic kidney disease as independent, positive correlates of sac enlargement. Dr. Carolyn Lam: So these wonderful results are from Dr. Hitoshi Matsuda and colleagues from the National Cerebral and Cardiovascular Center in Osaka Japan, and really suggests that persistent type II endoleaks are not always benign. Dr. Greg Hundley: Beautiful summary, Carolyn. Well, my paper comes from the world of pre-clinical science. And Carolyn, in most eukaryotic cells, the mitochondrial DNA is uniparenterally transmitted and present in multiple copies derived from the clonal expansion of maternally inherited mitochondrial DNA. All copies are therefore, nearly identical or, as we would call homoplasmic. Dr. Greg Hundley: Now Carolyn, the presence of more than one mitochondrial DNA variant in the same cytoplasm can arise naturally or as a result from new medical technologies aimed at preventing mitochondrial genetic diseases and improving fertility. The latter is called divergent non-pathological mitochondrial DNA heteroplasmy, or DNPH. Dr. Greg Hundley: Now Carolyn, these investigators led by Professor Jose Enriquez from the Centro Nacional de Investigaciones Cardiovasculares hypothesized that DNPH is maladaptive and usually prevented by the cell. Dr. Carolyn Lam: Wow, that's really interesting, investigations from the world of preclinical science. What did the investigators find? Dr. Greg Hundley: Right, Carolyn. So, the investigative team engineered and characterized divergent non-pathological mitochondrial DNA heteroplasmy, or DNPH, as we've talked about before, mice throughout their lifespan. The authors found that DNPH impair mitochondrial function with profound consequences in critical tissues that did not resolve heteroplasmy, particularly within cardiac and skeletal muscle. Progressive metabolic stress in these tissues led to severe pathology results, including pulmonary hypertension and heart failure, skeletal muscle wasting, frailty, and premature death. And finally, Carolyn, symptom severity was strongly modulated by the nuclear context. Dr. Greg Hundley: So in conclusion, Carolyn, these findings suggest that medical interventions that could generate divergent non-pathological mitochondrial DNA heteroplasmy, or DNPH, so to address potential incompatibility between donor and recipient mitochondrial DNA. Dr. Carolyn Lam: Oh wow. That is fascinating. Well guess what? My next paper is also about mitochondria, but this time looking at the role of the mitochondrial calcium uniporter. So we know that calcium is a key regulator of energy metabolism and impaired calcium homostasis damages mitochondria, resulting in cardiomyocyte death, pathological hypertrophy, and heart failure. Dr. Carolyn Lam: This study by Dr. Wang from University of Washington and colleagues investigated the regulation and the role of the mitochondrial calcium uniporter in chronic stress induced pathological cardiac remodeling. In a series of elegant experiments in the mitochondrial calcium uniporter knockout or transgenic mice infused with isoproteronol, the authors found that the mitochondrial calcium uniporter is up regulated in the stressed heart to orchestrate mitochondria sarcoplasmic reticulum, and cytosolic calcium handling, preventing cytosolic calcium overload induced cardiomyocyte death. Dr. Carolyn Lam: Lack of mitochondrial calcium uniporter mediated mitochondrial calcium uptake is detrimental. Whereas, transgenic over expression is beneficial to the heart during chronic beta adrenergic stimulation. The nuclear translocation of calcium/ calmodulin kinase II delta beta via calcineurin mediated dephosphorylation of serine 332 activates CAMP response element binding protein to promote mitochondrial calcium uniporter gene expression in adult cardiomyocytes. Dr. Greg Hundley: Well, Carolyn, what's the take home here? What are the clinical implications? Dr. Carolyn Lam: Ah, thought you might ask. Well, this study indicates that enhancing mitochondrial calcium uptake could be a new approach to prevent chronic beta adrenergic stimulation induced heart remodeling. Targeting this cam kinase two delta beta KREB mitochondrial calcium uniporter pathway could be a therapeutic option for pathologic cardiac remodeling associated with chronic adrenergic stress. Dr. Greg Hundley: Excellent description, Carolyn, and thank you for walking us through that wonderful paper. Well, we've got some other papers in the issue and from the mail bag, Professor Lusis has a Research Letter entitled Identification of DNA Damage Repair Enzyme, ASK II as Causal for Heart Failure with Preserved Ejection Fraction. And Carolyn there's a cardiovascular case series from Professor Barrett entitled, “The Unrepairable Infant Mitral Valve, an Unexpected Case of Decompensated Heart Failure.” Dr. Carolyn Lam: Interesting. There's an exchange of letters between Doctors Matrougui and Wang regarding the article, “Integrated Stress Response Couples Mitochondrial Protein Translation with Oxidative Stress Control” and a Perspective piece by Dr. Fatkin on “Fishing for Links between Omega-3 Fatty Acids and Atrial Fibrillation.” Wow. Super cool. Greg, let's go on now to a feature discussion, shall we? Dr. Greg Hundley: You bet. Dr. Carolyn Lam: For our feature discussion today, we are talking about white matter hyperintensities. Now that's the most common brain imaging marker of small vessel disease. That may be known, but there's a lot more to it. For example, what are they made of? Well, you're going to so enjoy today's feature paper, and I'm so proud to have the corresponding author with us, Dr. Zdenka Pausova from Hospital for Sick Kids in Toronto, Canada, as well as our associate editor, Dr. Svati Shah from Duke University. So welcome ladies. And Zdenka, if I could start with, could you explain the rationale for your study and what you did?   Dr. Zdenka Pausova: Yeah. Thank you. Thank you for having me. Well, we were thinking that it is important to know what the metabolic variables that associate with white matter hyperintensities might be, simply because we know that there are other studies that have shown that whatever circulates in blood is in some way related to brain health. For example, different lipids associated with Alzheimer Disease, cognitive functioning and with structural properties of the brain. So we were wondering what the metabolics that are associated with white matter hyperintensities might be, simply because we would like to know a little bit more about the pathogenesis of the disease, because that's what metabolomic profiling can provide. And also if one can identify biomarkers that potentially could be used in the clinical setting. Dr. Carolyn Lam: Wow. Thank you. And Zdenka, this may be a very basic question, but we hear a lot about the metabolome and sometimes it's not very clear what metabolome profiling actually is. And could you just say a little bit about the technique and your study population and then your findings? Thanks. Dr. Zdenka Pausova: Yes. Sure. So we actually studied over 9,000 individuals from eight different population based studies and all of those individuals had metabolomic assays done with two main platforms. It's mass spectrometry and nuclear magnetic spectroscopy. Mostly these platforms are actually commercially available and altogether across all platforms, there were over 2,200 different metabolites. And from those we could study about 1200 that we had at least in two populations. And what the metabolites are, these are different metabolites of lipids, sugar, proteins, amino acids that people put on those platforms or that designers put on the platforms, in order to test some of their hypotheses, that they were actually these metabolites of interest for different sorts of diseases, including cardiovascular and cerebrovascular disease. Dr. Carolyn Lam: Wow. So this is really large scale, massive, big data, if I may, and if I'm not wrong, it's the first large scale study to identify circulating metabolomic measures associated with white matter hyperintensities. So could you please summarize the main findings? Dr. Zdenka Pausova: Well, overall we actually found that there were 416 metabolites that were nominally associated with white matter hyperintensities, but as it is in epidemiology, you have to correct for multiple comparisons. So when we did DR correction, there were only 30 variables associated with white matter hyperintensities. And when we wanted to check whether those associations are independent of the risk factors for white matter hyperintensities, such as hypertension, type two diabetes, smoking, obesity, we actually ended up with seven markers, seven metabolites that were significantly associated in the fully adjust model. Dr. Zdenka Pausova: And the main one was actually a derivative of amino acid hydroxyphenol that probably is a marker of ischemia in the brain. And what actually I am coming to is, and one of the main findings was, that many of those metabolites were associated with white matter hyperintensities in a sex specific manner. That is that they were detected in the pool sample, but essentially the signal came from only one of the sexes. And so this one that was the most significant was detected only in males essentially, and not really in females. Dr. Zdenka Pausova: And that I think is an interesting, one of the most interesting findings that we can expect that there are really sex specific pathways, biochemical pathways, that accompany white matter hyperintensities. Dr. Carolyn Lam: Wow. Zdenka, thank you so much. I have to bring Svati in right now to share some perspective, Svati, especially to put these findings into context, please. Dr. Svati Shah: Yes. Dr. Pausova, really wonderful paper. This is an incredible study, if you think about it. The largest scale study that really is trying to understand metabolic by biomarkers, but the biomarkers actually tell us about the potential biology of what's going on with these white matter hyperintensities. We know that these hyperintensities in the brain are associated with increased risk of stroke, increased risk of cognitive decline, but we don't really understand stand what the risk factors are. There's been some studies suggesting that there's genetic risk factors, but this is really the first large scale study to say, "Hey, what's in the blood that we can measure?" And just to be clear, these technologies are measuring these biomarkers that are very, very, very low levels in the blood, really granular snapshot of what's going on with the human being. Dr. Svati Shah: And by looking at these blood markers that the authors were able to find biomarkers that are associated with these brain abnormalities, but really highlighting some of the important biology as Dr. Pausova started to talk about. So I think what it gets us to is we get to have our cake and eat it too. We get to learn about biomarkers that might have clinical utility, but we also have discovered, they've discovered new biology that could lead to new therapies, for example, and a better understanding of the mechanisms of why some people develop these hyperintensities as they age. And some people do not. Dr. Carolyn Lam: Wow, Svati, you put that so eloquently and just to put it out there for everyone, that significant metabolite hydroxyphenol pyruvate explain 14% of the variants of white matter hyperintensity volumes in males. Whereas, the proportion of variants explained by hypertension is only 1% or type two diabetes is only 1 to 3%, or smoking is even less than 0.1%. So this is, as you said, Svati, it's a significant discovery as well. Zdenka, though, how do we apply this clinically? Dr. Zdenka Pausova: Well, it could be a marker that is measured in circulation and it is a marker that can be measured in blood and can indicate early stages of white matter hyperintensities. But I think before we get there, it would be of high value to actually carry out some longitudinal studies, because it would be really interesting to know if it is an early marker before the white matter hyperintensities extent is enlarged. And so that would one thing. But other than that, I think if that would be the case, we can just measure it in blood and see how predictable it is. Dr. Carolyn Lam: Can I ask what about the women? Did anything predict it in women? Dr. Zdenka Pausova: That's a good question. There was only actually one variable. To our surprise, only one variable that was significantly associated with white matter hyperintensities in women. And it is really surprising because the sample size was the same. The extent, the volume of white matter hyperintensities was quite similar. They were of similar age, similar adiposity. So there were no huge differences, yet we could not actually detect too many metabolized associated with white matter hyperintensities in women. Really surprising. And I don't have a good answer for it now. Dr. Carolyn Lam: Wow. Thank you. Svati, did you have further thoughts on the clinical applications and implications of these tremendous data? Dr. Svati Shah: Yeah. I think the ability to have a biomarker as Dr. Pausova nicely articulated that would potentially prevent people from having to get an MRI. And we would be able to identify people hopefully at an earlier stage in the process. In this lovely study, they were looking at biomarkers in people who already had the hyperintensities. I think the next step as Dr. Pausova outlined to be able to identify whether these predict high risk people who will develop them in the future and then try to target therapies. A potential advance in precision medicine in the neurologic space, that we could use this biomarker to say, "You need this particular medication." Dr. Svati Shah: Some of the biomarkers that Dr. Pausova's group discovered were actually just cholesterol measures. So maybe we need to be instituting more aggressive cholesterol therapies in these patients who are at high risk. I'm not saying we can do that yet, but these provocative results suggest that this could lead to a more personalized approach to high risk individuals who may have consequences and develop these white matter hyperintensities. Dr. Carolyn Lam: And Zdenka, did you have anything to add to that? Dr. Zdenka Pausova: Perhaps one interesting aspect of the study that I actually was nicely surprised at the end of the study that the markers, one could the different lipids or the different derivatives of amino acids, the literature provided actually a possible pathways, how those could be involved in the development of white matter hyperintensities. Some of them actually, we could possibly link to impairment of myelination of a neuronal axons, or actually the axons themselves could be the metabolized could reflect damage of those axons.     Dr. Zdenka Pausova: And also, one suspicious pathway or one pathway that is suspected to be big part of the development of white matter hyperintensities is the disruption of blood brain barrier and some of the markers could be actually linked to that vascular dysfunction. Dr. Carolyn Lam: Aw, that's wonderful. Thank you so much, Zdenka, for publishing this beautiful work with us in Circulation. And thank you, Svati, for taking this paper through and inviting this beautiful editorial. In fact, it quite summarizes our discussion. It's entitled, What Turns White Matter White? Metabolic Clues to the Origin of Age-Related White Matter Hyperintensities and it's by Dr. Eric Smith from University of Calgary and I invite everyone to read this. Dr. Carolyn Lam: So thank you once again for joining us today on Circulation on the Run. From Greg and I, it's been wonderful having you. Don't forget to join us again next week. Dr. Greg Hundley: This program is copyright of the American Heart Association 2022. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American Heart Association. For more, please visit ahajournals.org.

Cardiovascular disease is the leading cause of death among women. Join experts Betul Hatipoglu MD, Professor of Medicine at CWRU School of Medicine, and Medical Director for Diabetes & Obesity Center at University Hospital Cleveland Medical Center, and Leslie Cho, MD, Professor of Medicine at Cleveland Clinic Lerner School of Medicine Case Western Reserve Medical School, Section Head of Preventive Cardiology & Rehabilitation, and Director of the Cleveland Clinic's Women's Cardiovascular Center, as they discuss common cardiovascular risk factors for women. Topics include, how to adequately assess lifetime risks for cardiovascular disease, risks from pregnancy, menopause, an autoimmune disease, and more.

Across all areas of study in health care and especially in recent years, African American patients and physicians have experienced racial inequity regarding telemedicine practices across the US.  However, a new pilot trial from the Perelman School of Medicine at the University of Pennsylvania suggested  subtle modifications in the methods of virtually engaging with Black patients that could be used to better communicate with populations affected by these inequities. Data from the trial showed that Black patients with cardiovascular disease covered under Medicaid and Medicare insurance are significantly more likely to share blood pressure measures with a clinician through text messages as opposed to a healthcare system online portal. Jennifer Lewy, MD, MPH, Director of the Penn Women's Cardiovascular Center, spoke of the motives behind this trial as well as the uptake and acceptability of a text-based model for at-home blood pressure monitoring when compared to online virtual patient portals among Black patients with Medicaid or Medicare.

Today's episode kicks off the month of February and Heart Awareness Month, and Amanda Daniels is my heart centered guest today. Diagnosed with heart disease at 18 and heart failure at 25,  Amanda has learned to thrive as a heart healer and heart warrior. A natural intuitive, Amanda helps others identify what she calls "heartquakes", adverse situations and circumstances that have shaped our experience of the world. - and can often lead to disease in the body. She has identified flight tools to help her clients live a more joyful, inspired and meaningful life, while listening to the voice within their heart.Amanda is a proud mom to three daughters, something she never imagined was possible. She shares her story with us and it is empowering and up lifting.  She co-founded the first  peer-led support group in Los Angeles for women living with heart disease and is on the Advisory Board at the ULCA Women's Cardiovascular Center, as well as a spokesperson for the American Heart Association. In addition, Amanda is a trained medicine woman and has studied at The Arthur Findlay Scool for the advancement of spirituality, psychic sciences and mediumship in Stanstead, England.You can find Amanda:https://www.flightoftheheart.com/Instagram: @flightoftheheart

Research has shown that women have low participation in clinical trials – especially when it comes to cardiovascular care. Dr. Leslie Cho, Director of the Women's Cardiovascular Center gives us some reasons this occurs, why it is important for women to increase their participation in trials, and where you can find information about clinical trials.

A Cleveland Clinic study found women remain underrepresented in cardiovascular clinical trials despite guidelines and legal requirements developed almost 30 years ago to ensure broader inclusivity, according to a report from the American College of Cardiology Cardiovascular Disease in Women Committee published today in the Journal of the American College of Cardiology. Heart disease is the number one killer of women, yet most clinical trials involving heart medications and medical devices typically skew male. This episode is an interview with Leslie Cho, MD, FACC, lead author of the study, a member of the ACC Cardiovascular Disease in Women Committee, and director of the Women's Cardiovascular Center and section head of preventive cardiology and cardiac rehabilitation at Cleveland Clinic. WEBSITES: clinicaltrials.gov  https://my.clevelandclinic.org/clinical-trials

Sulpizio Cardiovascular Center at UC San Diego Health marks 10 years of care. Explore patients' experiences and the center's impact on the community. From transforming cardiovascular medicine in San Diego to new collaborations, the last decade has led to tremendous success for cardiovascular medicine including the establishment of the Cardiovascular Institute. Series: "UC San Diego Health Talks" [Health and Medicine] [Show ID: 37275]

Sulpizio Cardiovascular Center at UC San Diego Health marks 10 years of care. Explore patients' experiences and the center's impact on the community. From transforming cardiovascular medicine in San Diego to new collaborations, the last decade has led to tremendous success for cardiovascular medicine including the establishment of the Cardiovascular Institute. Series: "UC San Diego Health Talks" [Health and Medicine] [Show ID: 37275]

Sulpizio Cardiovascular Center at UC San Diego Health marks 10 years of care. Explore patients' experiences and the center's impact on the community. From transforming cardiovascular medicine in San Diego to new collaborations, the last decade has led to tremendous success for cardiovascular medicine including the establishment of the Cardiovascular Institute. Series: "UC San Diego Health Talks" [Health and Medicine] [Show ID: 37275]

Sulpizio Cardiovascular Center at UC San Diego Health marks 10 years of care. Explore patients' experiences and the center's impact on the community. From transforming cardiovascular medicine in San Diego to new collaborations, the last decade has led to tremendous success for cardiovascular medicine including the establishment of the Cardiovascular Institute. Series: "UC San Diego Health Talks" [Health and Medicine] [Show ID: 37275]

Sulpizio Cardiovascular Center at UC San Diego Health marks 10 years of care. Explore patients' experiences and the center's impact on the community. From transforming cardiovascular medicine in San Diego to new collaborations, the last decade has led to tremendous success for cardiovascular medicine including the establishment of the Cardiovascular Institute. Series: "UC San Diego Health Talks" [Health and Medicine] [Show ID: 37275]

The ACC CVD in Women Committee published a summary of recommendations for primary prevention of cardiovascular disease specific to women. Dr. Leslie Cho, Director of the Women’s Cardiovascular Center and Co-Section Head, Preventive Cardiology, discusses what clinicians should know about the updated guidelines. She addresses unique risk factors that pertain to women, as well as how traditional risk factors can be different for women in presentation and treatment.

New guidelines on primary prevention of cardiovascular disease in women were released in 2020, highlighting new risk factors special to women. Dr. Leslie Cho, Director of the Women’s Cardiovascular Center and Co-Section Head, Preventive Cardiology, talks about how your pregnancy or having auto-immune disease may be related to future heart disease. She also talks about the treatment of traditional risk factors in women.

The CardioNerds discuss Women's Cardiovascular Prevention with Dr. Leslie Cho, Interventional Cardiologist and Director of the Cleveland Clinic’s Women’s Cardiovascular Center. She is also Section Head of Preventive Cardiology and Rehabilitation in the Robert and Suzanne Tomsich Department of Cardiovascular Medicine at Cleveland Clinic. Amit, Dan and Carine take a deep dive into women's cardiovascular prevention and discuss the epidemiology, unique risk factors, different manifestations of CVD and treatment strategies to lower cardiovascular risk in women. Tune in as we discuss cases from the CardioNerds Women's Clinic to learn more! Take me to the Cardionerds Cardiovascular Prevention PageTake me to episode topics page Cardiac Consult PodcastTall Rounds Lectures Key Reference: Cho L, Davis M, Elgendy I, et al (2020) Summary of Updated Recommendations for Primary Prevention of Cardiovascular Disease in Women: JACC State-of-the-Art Review. J Am Coll Cardiol 75:2602–2618 We are truly honored to be producing the Cardionerds CVD Prevention Series in collaboration with the American Society for Preventive Cardiology! The ASPC is an incredible resource for learning, networking, and promoting the ideals of cardiovascular prevention! This series is kicked off by a message from Dr. Amit Khera, President of the American Society for Preventive Cardiology and President of the SouthWest Affiliate of the American Heart Association. Cardionerds Cardiovascular Prevention Series Dr. Leslie Cho is a professor of Medicine at Cleveland Clinic Lerner School of Medicine Case Western Reserve Medical School and serves as Director of the Cleveland Clinic’s Women’s Cardiovascular Center. She is also Section Head, Preventive Cardiology and Rehabilitation in the Robert and Suzanne Tomsich Department of Cardiovascular Medicine at Cleveland Clinic. Dr. Cho received her undergraduate degree in interdisciplinary studies from the University of California, Los Angeles, graduating cum laude. She received her medical degree from the University of Chicago Pritzker School of Medicine, and took her residency in internal medicine at the University of Washington Medical Center where she received the John Humphrey Award as Most Outstanding Internal Medicine Resident. Her clinical training continued when she accepted a fellowship in cardiology, followed by a fellowship in interventional cardiology and peripheral disease, both from Cleveland Clinic. Leslie Cho, MDAmit Goyal, MDCarine Hamo, MDDaniel Ambinder, MD

Dr. Leslie Cho,Director of the Women’s Cardiovascular Center and Co-Section Head, Preventive Cardiology talks about heart disease, the number one killer in women. She discusses symptoms of heart disease in women, the best diagnostic tests for women, and how women can prevent heart disease.

Dr. Leslie Cho,Director of the Women’s Cardiovascular Center and Co-Section Head, Preventive Cardiology discusses risk factors that clinicians can look for in women to prevent future heart disease (such as pregnancy associated cardiovascular risk factors, premature menopause, polycystic ovary syndrome, and autoimmune disease). Dr. Cho discusses research based and guideline directed strategies to initiate in patients with these risk factors.

Shon Dwyer is the Executive Director of University Hospital and the Frankel Cardiovascular Center at Michigan Medicine. Shon's path from registered nurse to hospital executive is highlighted. Listen and learn from Shon as she breaks down her extensive career path, highlights the moves she made and the reasons why, and shares with us valuable lessons she learned as she climbed the healthcare ladder. 

Dr. Leslie Cho, Section Head, Preventive Cardiology and Rehabilitation and Director of Women’s Cardiovascular Center answers questions about statin intolerance: How do you reduce risk of statin intolerance? What if you need a statin? Can you take herbals instead? What are the risks? How are patients monitored?

Inspire Cafe Podcast I had the honor of appearing on Kathy De La Torre's The Inspire Café podcast. She started the podcast to understand what makes a person resilient. She explains her motivation like this: I am fascinated with the stories of human resiliency…. What makes these people tick?  What became their turnaround, ah-hah moment or the trigger that caused them to pivot, shift their thinking and turn away from their dark moment and face the light?  The idea of people actually putting into practice of making lemonade out of their lemons, turning a negative into a positive, is remarkable. This week, I talk with Kathy in detail about my stroke, stroke in general, and why I started this show. It's the latest version of my origin story. I'm truly humbled to be on Kathy's show, especially when I look at the other folks she's interviewed. So after you listen to Strokecast, head on over to The Inspire Café in your favorite podcast app and listen to episode 69. News from ISC19 Neurologists, researchers, and other stroke professionals from around the world got to spend several days in tropical Hawaii in February to learn to more effective treat and prevent strokes at the International Stroke Conference 2019. And presumably to work on their tans and surfing skills in the off hours. A lot of research, reports and news came out of the conference or at least around it. Here are the 10 Topics Opioid epidemic fueling a rise in infection-related stroke AHA/ASA News Room Study Highlights: The opioid epidemic is fueling a steep rise in infection-related stroke hospitalizations. Injecting opioids, such as heroin, can introduce bacteria into the body which travels through the bloodstream to infect heart valves. Clumps of infected tissue can break off and travel to the brain, resulting in stroke. Safety Window for tPA Extended Up to 9 Hours for Ischemic Stroke Neurology Today "In the primary outcome measure, 37 percent of patients treated with tPA in the nine-hour window—including those with so-called "wake up" strokes—achieved a modified Rankin Scale (mRS) score of 0–1 at 90 days compared with 29 percent of patients who were treated with placebo in the Extending the Time for Thrombolysis in Emergency Neurological Deficits (EXTEND) trial (p=0.045), said Henry Ma, MD, PhD, director of physician training at Monash University in Melbourne, Australia. In the secondary outcome measure—achieving a mRS score of 0–2 at 90 days—the milestone was achieved by 51 percent of the patients treated with tPA compared with 43 percent of the patients on placebo therapy (p=0.022), Dr. Ma said in his late-breaker oral presentation. "EXTEND is the first positive thrombolysis trial in an extended time window using automated penumbral imaging," he said. "The current guideline for thrombolysis in acute ischemic stroke is less than 4.5 hours from stroke onset. But advanced imaging studies from our group and others suggest that the ischemic penumbra can exist up to 24 hours after onset and its salvage can lead to improved outcome." No Loss of Thrombectomy Benefit in Late Stroke With Transfer Medscape For patients with a large-vessel ischemic stroke in the late window who were found to have salvageable brain tissue on imaging, transfer from a primary stroke center to a thrombectomy-capable hospital did not affect the benefit of thrombectomy, latest results from the DEFUSE 3 trial show. Home-Based Telerehabilitation for Stroke Patients Is as Effective as the Clinic Neurology Today "In our presentation we showed that telerehabilitation is non-inferior to in-clinic rehabilitation and improves arm motor status," said Steven C. Cramer, MD, FAAN, professor of neurology, anatomy and neurobiology, and professor of physical medicine and rehabilitation at the University of California, Irvine. Cilostazol Prevents Recurrent Strokes in Japanese Study Neurology Today Dual antiplatelet therapy that includes cilostazol appears to reduce strokes in patients who have had a previous stroke and are at high risk of experiencing another, researchers reported here at the 2019 International Stroke Conference. In a late breaker presentation, Kazunori Toyoda, MD, PhD, deputy director general of the Hospital of the National Cerebral and Cardiovascular Center in Suita, Osaka, Japan, said that the combination of cilostazol plus either aspirin or clopidogrel was superior in preventing another stroke than either clopidogrel or aspirin alone. Flu-like Illness Linked to Stroke, Cervical Dissection Medscape Having an influenza-like illness (ILI) is associated with an increased risk of ischemic stroke on the order of 40%, regardless of sex, race, or geographical setting, new research suggests. "The study shows that influenza-like illness increases the risk of stroke, particularly in the first 30 days," study author Amelia Boehme, PhD, assistant professor, Epidemiology and Neurology, Columbia University, New York City, told Medscape Medical News. e-Cigarettes Linked to Increased Stroke, MI Risk Medscape Among more than 400,000 respondents older than 18 years from the 2016 Behavioral Risk Factor Surveillance System (BRFSS) survey, almost 66,800 reported having ever used e-cigarettes. Study results showed a 71% higher risk of experiencing a stroke, a 59% higher risk for an MI, and a 40% higher risk for angina or coronary heart disease (CHD) for the e-cigarette users compared with nonusers. Users also had twice the rate of smoking regular cigarettes. Marijuana, cocaine could play role in stroke increase among young adults AHA Website The vast majority of strokes occur in people over 65, but the number of younger adults having strokes is rising. New research suggests growth in illegal drug use could be playing a role. Past research has shown higher cardiovascular death rates for young adults who used cocaine or marijuana. But the new study, presented this week at the American Stroke Association's International Stroke Conference in Honolulu, investigates trends in illegal drug use among 18- to 54-year-olds who had a stroke. Researchers looked at 20 years of drug tests and self-reported data involving more than 2,200 young adults who had a stroke in greater Cincinnati and northern Kentucky. While alcohol and cigarette use in the stroke victims remained stable over the two-decade study period, drug use rose dramatically, from 4.4 percent in 1993-1994 to 30.3 percent in 2015. Countries with Dirty Air have more stroke deaths AHA/ASA Newsroom In a nationwide study, counties with dirtier air had higher rates of stroke deaths and shorter life expectancies, according to preliminary research to be presented in Honolulu at the American Stroke Association’s International Stroke Conference 2019, a world premier meeting for researchers and clinicians dedicated to the science and treatment of cerebrovascular disease. Researchers examined the average yearly levels air pollution (PM2.5) that contains fine inhalable particles. Produced by diesel engines and the burning of coal, biomass and kerosene, this type of air pollution has previously been shown to enter the circulatory system and harm health. Fluctuating blood pressure after stroke could mean higher risk of death AHA Website A new study, presented this week at the American Stroke Association's International Stroke Conference in Honolulu, delved deeper into the topic by researching whether increased blood pressure variability after a stroke is associated with risk of death. Researchers looked at data from 1,947 patients who had four to five blood pressure readings in the 24 hours after a stroke. After adjusting for various factors, they found that patients with more variation in their systolic blood pressure, the top number in the measurement, had a higher risk of death within 90 days. Dr. Adam de Havenon, the study's lead author, said the results reinforce the importance of blood pressure variability as a risk factor for poor outcomes after a stroke. Hack of the Week On the rare occasion I really clean the living room, I find random pills under the couch. The get there after making a run for it as I move them from prescription bottles to pill organizers. Bowl Cozys solve this problem for me. A bowl cozy is a curved lightly bowl shaped quilted piece of fabric. Their main use is for eating soup. You put your hot bowl of soup in it and then you can pick it up without burning your hands. You can find them on Amazon, Etsy, and at street fairs around the country. You can also finds patterns so you can make your own. When I fill my pill organizer, I start by pouring pills into a bowl cozy. Then I can put them in the organizer chambers one by one. Then I put the lefty overs back into the pill bottle and move on to the next med. And I don't lose pills anymore. Where do we go from here? Review the articles linked above for more details and to form your own analysis.  What do you think of this type of discussion? Let me know in the comments below. If you find this interesting, subscribe to Strokecast for free in your favorite podcast app. Don't get best…get better

A new report looks at the widespread impact of daylight saving time and how circadian disruptions affect every aspect of our sleep and health. We talk to lead author, Dr Miguel Meira e Cruz about the scientific consensus that's building about the harmful effects of DST. Episode Highlights 02:45 Introducing Dr Miguel Meira e Cruz 04:13 Recent proposals to abolish Daylight Saving Time (DST) 06:11 The origins and history of Daylight Saving Time 09:33 Sleep is only one of the many  functions affected by DST 11:27 How DST impacts on  sleep loss and circadian disruption 12:24 The difficulty of making associations between DST and sleep loss 13:45 Why sleep-related road traffic accidents are worse than drunk driving accidents 14:52 Does DST affect ethical decision making? 16:27 Why DST is not the same as jet-lag 20:14 The emerging field of circadian medicine 22:52 Chronopharmacology - the importance of taking medicines at the right time 25:10 Why permanent standard (winter) time is the appropriate time to maintain Last year, the European Union proposed putting a permanent end to Daylight Saving Time (DST), the twice yearly practice of changing the clocks in order to maximise the amount of daylight during longer winter evenings. But apart from the discussion around the economic advantages or disadvantages of DST, there's been little public debate, or enquiry into what's arguably a much more important factor - the widespread health impacts of disrupting our circadian clocks twice a year. The most obvious impact of DST is how it affects our sleep patterns. And indeed, studies have suggested many associations between fatigue related accidents and reduced cognitive functions around the time of the clocks changing. However, new research, in the field of circadian medicine is revealing that widespread circadian disruptions such as those caused by daylight saving time could be having a far wider impact on our health than previously thought. In this episode we speak to researcher and sleep scientist Professor Miguel Meira e Cruz about a new report he has co-authored which examines the many detrimental effects of daylight saving time on our circadian timing system. This Episode's Guest Dr Miguel Meira e Cruz Dr Miguel Meira e Cruz is an academic researcher, professor and coordinator of the postgraduate course in Chronobiology and Sleep Medicine at CESPU, Porto, Lisbon. He is an affiliate of the Pulmonary Function Laboratory of the Cardiovascular Center, University of Lisbon, where he coordinates the sleep unit.  Resources Website: http://miguelmeiracruz.com/me.html Link to study on DST impact: https://www.ejinme.com/article/S0953-6205(19)30013-5/abstract More Episodes

A new report looks at the widespread impact of daylight saving time and how circadian disruptions affect every aspect of our sleep and health. We talk to lead author, Dr Miguel Meira e Cruz about the scientific consensus that's building about the harmful effects of DST. Episode Highlights 02:45 Introducing Dr Miguel Meira e Cruz 04:13 Recent proposals to abolish Daylight Saving Time (DST) 06:11 The origins and history of Daylight Saving Time 09:33 Sleep is only one of the many  functions affected by DST 11:27 How DST impacts on  sleep loss and circadian disruption 12:24 The difficulty of making associations between DST and sleep loss 13:45 Why sleep-related road traffic accidents are worse than drunk driving accidents 14:52 Does DST affect ethical decision making? 16:27 Why DST is not the same as jet-lag 20:14 The emerging field of circadian medicine 22:52 Chronopharmacology - the importance of taking medicines at the right time 25:10 Why permanent standard (winter) time is the appropriate time to maintain Last year, the European Union proposed putting a permanent end to Daylight Saving Time (DST), the twice yearly practice of changing the clocks in order to maximise the amount of daylight during longer winter evenings. But apart from the discussion around the economic advantages or disadvantages of DST, there's been little public debate, or enquiry into what's arguably a much more important factor - the widespread health impacts of disrupting our circadian clocks twice a year. The most obvious impact of DST is how it affects our sleep patterns. And indeed, studies have suggested many associations between fatigue related accidents and reduced cognitive functions around the time of the clocks changing. However, new research, in the field of circadian medicine is revealing that widespread circadian disruptions such as those caused by daylight saving time could be having a far wider impact on our health than previously thought. In this episode we speak to researcher and sleep scientist Professor Miguel Meira e Cruz about a new report he has co-authored which examines the many detrimental effects of daylight saving time on our circadian timing system. This Episode's Guest Dr Miguel Meira e Cruz Dr Miguel Meira e Cruz is an academic researcher, professor and coordinator of the postgraduate course in Chronobiology and Sleep Medicine at CESPU, Porto, Lisbon. He is an affiliate of the Pulmonary Function Laboratory of the Cardiovascular Center, University of Lisbon, where he coordinates the sleep unit.  Resources Website: http://miguelmeiracruz.com/me.html Link to study on DST impact: https://www.ejinme.com/article/S0953-6205(19)30013-5/abstract More Episodes

Dr. Leslie Cho, Section Head, Preventive Cardiology and Rehabilitation and Director of Women’s Cardiovascular Center discusses tips for health care providers in treating statin intolerance. She covers common issues such as symptom management, medication choices, titration of meds, monitoring patients on statins, and the role of PCSK9 medications.

Medicine Grand Rounds December 8, 2017 Marvin A. Konstam, MD, FACC, FAHA Chief Physician Executive, the CardioVascular Center, Tufts Medical Center Professor of Medicine Tufts University School of Medicine

Recorded at the Cardiovascular Center, located across the street from the hospital, behind Papa John's.  In this episode Birdman chats with Dr. Yenhui Huang, MD, aka Dr. Bob, who is new to Summit Healthcare. Video @ https://youtu.be/5xWa9YFiK2I Summit Cardiovascular Services, 5171 Cub Lake Rd, Show Low, AZ 85901.  (928) 537-9944 About Yenhui Huang, MD : Yenhui Huang, MD, (aka Dr. Bob) is board-certified in Internal Medicine, Cardiology, Echocardiography and Nuclear Cardiology. He graduated from University of Witwatersrand in Johannesburg, South Africa and completed his internship,residency and fellowship through the University of Arizona in Tucson, Arizona.    “Dr. Bob” has always been fascinated with Cardiovascular Medicine. He loves the complexity of cardiology and the challenge of taking care of cardiology patients.  His practice philosophy is to stay current with the up-to-date cardiovascular treatments and treat all his patients as a member of his family. In his spare time he enjoys traveling.    What can you expect from a visit with Yenhui Huang, MD?  • A genuine interest in your cardiovascular needs. • Communication with your Primary Care Provider to assure continuity of care. • Ongoing, coordinated care for those with long term cardiovascular needs from our entire team of highly qualified staff.

Nazanin Moghbeli, a cardiologist near Philadelphia, founded and currently directs the Women’s Cardiovascular Center at Penn Medicine. She and her partner parent 3 young children. She also devotes time to her art - her abstract ink, gouache and graphite drawings on paper. the work grows out of a love of traditional calligraphy and reflect patterns and rhythms of music in Iran where she was born. She talks about how all the pieces fit together for her in a rich life. The website for her artwork is www.nmoghbeli.com.  

Are you heart healthy? Your national award-winning family radio talk show Let's Talk America with Host Shana Thornton will address heart healthiness with leading experts. Director of the Cleveland Clinic Women’s Cardiovascular Center, Dr. Leslie Cho, joins the show to share vital information. Pharmacist David Foreman also joins Shana to discuss lifestyle changes. Listen to this important segment with someone you love.     Please visit www.letstalkamericawithshanathornton.com. Thank you for tuning in.    #LTARadio #newstalk 

Alistair Lindsay interviews Anthony De Maria, director of the Cardiovascular Center at the UC San Diego medical school, and current Editor in Chief of JACCE.

Guest: Nazanin Moghbeli, MD, MPH Host: Lee Freedman, MD How can physicians assess and minimize the risk for women with existing heart disease prior to pregnancy? As many women are waiting longer to become pregnant, is the spectrum of cardiovascular disease among pregnant women changing as well? Dr. Nazanin Moghbeli, founder and director of the Women's Cardiovascular Center at Penn Medicine, joins host Dr. Lee Freedman to discuss ways to optimize outcomes for pregnant women with structural heart disease, as well as how to minimize the risks of complications that can arise during pregnancy for these patients. Dr. Moghbeli specifically talks about recommendations for women with peripartum cardiomyopathy, pulmonary hypertension, preeclampsia and congenital heart disease. Produced in Cooperation with

Host: Janet Wright, MD Guest: Karol Watson, MD, PhD When patients present with shortness of breath, physicians often face a quandary: Is it the heart or is it the lungs? What is the relationship between chronic obstructive pulmonary disease, or COPD, and cardiac function? Are patients with even subclinical emphysema at risk for showing reductions in cardiac output and left ventricular volume? Dr. Karol Watson, director of the Women's Cardiovascular Center, co-director of the program in preventative cardiology, and director for the Center for Cholesterol and Hypertension Management at the University of California Los Angeles, discusses recent findings about mild- to moderate-COPD and cardiac function, and how this new evidence should impact the way physicians diagnose and manage patients with shortness of breath. Dr. Janet Wright hosts. Produced in Cooperation with