Podcasts about vascular center

Join Dr Ankur Kalra on Parallax as he explores the evolving landscape of precision medicine in cardiology with Dr Calum MacCrae, Vice Chair for Scientific Innovation at Brigham and Women's Heart and Vascular Center. Dr MacCrae reflects on how the promise of matching treatments to individual risk and disease mechanisms has evolved, from its roots in molecular medicine to today's data-driven aspirations, revealing why progress has lagged behind expectations. The discussion dissects the complexities of modern cardiology, challenging assumptions about therapeutic precision by examining barriers like incomplete disease understanding, flawed electronic health records, and the high cost of integrating biomarkers into practice. Listeners will value Dr MacCrae's incisive breakdown of precision medicine's ecosystem, and how innovations at each level could redefine treatment strategies. The episode delivers practical insights for clinicians, while posing critical questions about how systemic inertia and fragmented healthcare delivery can impede meaningful change.

Cutting-edge cardiac imaging is revolutionizing heart care, providing clearer, more precise diagnoses without invasive procedures. In this episode of Your Wellness Solution, host Scott Webb sits down with Dr. Peter Shaw and Dr. Vikas Veeranna—board-certified cardiologists at Elliot Heart and Vascular Center—to break down the latest advancements in MRI, CT, and PET scans. Discover how these state-of-the-art imaging technologies are transforming cardiovascular diagnosis, reducing risks, and personalizing treatment plans with incredible accuracy. Whether you're a patient or a provider, this conversation is packed with insights on how advanced imaging is shaping the future of heart health. ? Tune in now to Your Wellness Solution!

Audible Bleeding editor Wen (@WenKawaji) is joined by 3rd year medical student Nishi (@Nishi_Vootukuru), JVS editor Dr. Forbes (@TL_Forbes), and JVS-CIT associate editor Dr. Jimenez to discuss some of our favorite articles in the JVS family of journals. This episode hosts Dr. Trisha Roy (@trisharoymd), Dr. Judit Csore (@JuditCsore), and Dr. Maham Rahimi, the authors of the following papers.    Articles: Employing magnetic resonance histology for precision chronic limb-threatening ischemia treatment plan Biodesign: Engineering an aortic endograft explantation tool    Show Guests  Dr. Trisha Roy- Assistant professor of cardiovascular surgery at the Houston Methodist Debakey Heart and Vascular Center. Background of Material engineering, vascular imaging, research interest in peripheral vascular disease. Dr. Judit Csore-Radiologist and assistant lecturer at the Heart and Vascular Center of Semmelweis University, Budapest, Hungary. Her primary focus is on cardiovascular imaging and vascular MRI. She recently spent two years in the United States at Houston Methodist Hospital, where she had been collaborating with Dr. Trisha Roy since 2022 as a postdoctoral fellow, specializing in peripheral arterial disease imaging. Dr. Maham Rahimi-Associate professor in the department of cardiovascular surgery at Houston Methodist Hospital, His research interests include nanotechnology and Biomedical Engineering Follow us @audiblebleeding Learn more about us at  https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.

Audible Bleeding editor Wen (@WenKawaji) is joined by 3rd year medical student Nishi (@Nishi_Vootukuru), JVS editor Dr. Forbes (@TL_Forbes), and JVS-CIT associate editor Dr. Jimenez to discuss some of our favorite articles in the JVS family of journals. This episode hosts Dr. Trisha Roy, Dr. Judit Csore, and Dr. Maham Rahimi, the authors of the following papers.    Articles:   Employing magnetic resonance histology for precision chronic limb-threatening ischemia treatment plan Biodesign: Engineering an aortic endograft explantation tool    Show Guests  Dr. Trisha Roy- Assistant professor of cardiovascular surgery at the Houston Methodist Debakey Heart and Vascular Center. Background of Material engineering, vascular imaging, research interest in peripheral vascular disease. Dr. Judit Csore-Radiologist and assistant lecturer at the Heart and Vascular Center of Semmelweis University, Budapest, Hungary. Her primary focus is on cardiovascular imaging and vascular MRI. She recently spent two years in the United States at Houston Methodist Hospital, where she had been collaborating with Dr. Trisha Roy since 2022 as a postdoctoral fellow, specializing in peripheral arterial disease imaging. Dr. Maham Rahimi-Associate professor in the department of cardiovascular surgery at Houston Methodist Hospital, His research interests include nanotechnology and Biomedical Engineering Follow us @audiblebleeding Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.

What do your blood pressure numbers really mean? In this episode, Dr. Swapna Ahern, a cardiologist at Elliot Heart and Vascular Center, explains everything you need to know about blood pressure and interpreting those often mysterious-sounding numbers. Learn how high blood pressure silently impacts your heart, brain, and overall health, and discover simple tips to manage it.

In this episode Dr. Zanotti discusses the current role of pulmonary artery catheters in critical care medicine. He is joined by Dr. Steven Hollenberg a critical care and cardiology physician. Dr. Hollenberg is a professor of medicine at Emory University School of Medicine and director of cardiac intensive care at the Emory Heart & Vascular Center. Additional resources: Pulmonary Artery Catheter Use and Risk of In-hospital Death in Heart Failure Cardiogenic Shock. Kanwar MK, et al. J Card Fail. 2023 Sep;29(9):1234-1244: https://pubmed.ncbi.nlm.nih.gov/37187230/ Pulmonary Artery Catheter Use and Mortality in the Cardiac Intensive Care Unit. Bernard S Kadosh, et al. JACC Heart Failure 2023: https://pubmed.ncbi.nlm.nih.gov/37318422/ Complete Hemodynamic Profiling With Pulmonary Artery Catheters in Cardiogenic Shock Is Associated With Lower In-Hospital Mortality. A Reshad Garan, et al. JACC Heart Failure 2020: https://pubmed.ncbi.nlm.nih.gov/33121702/ Right Heart Catheterization in Cardiogenic Shock Is Associated With Improved Outcomes: Insights From the Nationwide Readmissions Database. Sagar Ranka, et al. J Am Heart Assoc 2021: https://pubmed.ncbi.nlm.nih.gov/34423652/ Books mentioned in this episode: I Contain Multitudes: The Microbes Within Us and a Grander View of Life. By Ed Yong: https://www.amazon.com/Contain-Multitudes-Microbes-Within-Grander/dp/0062368605/ref=sr_1_1?crid=1EVOY6OVQZ437&dib=eyJ2IjoiMSJ9.Na-UJShWq7ngsH9dxvSV2Q.Ob-k26_k01p5WzKzo4CWnsvD4Jjq9RU1krhQhmUi9u4&dib_tag=se&keywords=I+contain+platitudes&qid=1732299607&sprefix=i+contain+platitudes%2Caps%2C132&sr=8-1 Kind of Blue. Miles Davis: https://www.amazon.com/Kind-Blue-Vinyl-Miles-Davis/dp/B0041TM5OU/ref=sr_1_2?crid=E6F0PBPV33BG&dib=eyJ2IjoiMSJ9.4Kk2sCHn8DAOl9j_qadqsZPMVZPlOuKNXg9vv_NTPEYrl10vHYNIC5-wrGJeFpn9K8rSS8aspG9zhJHjAyDqiIUiC9VKvvHjzQsAGmr4wP9VWUPWumInjcS72CDmoaEYr3h2Uoiy8yt-YfYFHm7Y-6XoPecnwju8_zumwohrrhYWC0X6rR8Ui3Xhp6ILDU3sBNb50TJ6iq_fjataiHX7X6fBL1YnUo3X-uBcnQVfKtc.v-zGaYaLVvE7BGxS1c-2_Brbwsq1kAxVKEuxqsaBci8&dib_tag=se&keywords=Miles+Davis+Kind+of+Blue&qid=1732299762&sprefix=miles+davis+kind+of+blue%2Caps%2C139&sr=8-2 Brahms: Ein Deutsches Requiem. Sir Simon Rattle: https://www.amazon.com/Brahms-Ein-Deutsches-Requiem-German/dp/B000MTEDIE/ref=sr_1_5?crid=2UCHLINLHSETV&dib=eyJ2IjoiMSJ9.aDG2ZKyB5OnEgO3Z6_VOsNplIVSXmtXffLy2Jrylq4vgaRHEYDyBsz_4YG1fE_88IJxJ2ScnxhBvvDkVZjauoazwhTEMef0o_nJN25zUb_7oXFNkPMo_U4WBLhgK5njVOkm2ae67weI5roWsx-KbokunvjgAf-tXngA30o2xDQxh0-9y0kJbJRdKtVY63PcPv3yp9YdOrpgo2PO-gpspQsio7uJ-dgz5SY1vX1je3U4.aMm-IxbuxnZSIacaIBGZWc36GYliQP4r-9f9-SBq5tQ&dib_tag=se&keywords=Brahms+requiem&qid=1732299866&sprefix=brahms+requiem%2Caps%2C142&sr=8-5e

Hypotension and shock are both recognized as complications post-cardiac surgery. Some patients may develop more severe shock refractory to fluids and catecholamines. This response is also known as today's podcast episode, topic: vasoplegia after cardiac surgery. For this discussion, Dr. Zanotti is joined by Dr. Iqbal Ratnani, an intensivist who practices at the DeBakey Heart & Vascular Center and the Center for Critical Care at Houston Methodist Hospital. Dr. Ratnani is an Associate Professor of Clinical Anesthesiology & Critical Care for the Department of Anesthesiology and Critical Care at Weill Cornell Medical College. In addition, Dr. Ratnani is the Director of Critical Care Education at the Center for Critical Care. Additional resources: Vasoplegia: A Review. Igbal Ratnani, et al. Methodist DeBakey Cardiovascular Journal 2023: https://pubmed.ncbi.nlm.nih.gov/37547893/ Vasoplegic Syndrome after Cardiopulmonary Bypass in Cardiovascular Surgery: Pathophysiology and Management in Critical Care. Zied Ltaief, et al. Journal of Clinical Medicine 2022: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9658078/ Books mentioned in this episode: Marino's The ICU Book. By Paul Marino: https://bit.ly/3XmWPGA Every Deep-Drawn Breath. By Wes Ely: https://bit.ly/4cODkeq In Shock: My Journey from Death to Recovery to Redemption. By Rana Awdish: https://bit.ly/3Z4mC7z

Two devices for preventing blood clots are allowing many patients to stop taking blood thinners completely. The Amulet and the Watchman are both devices that allow doctors to perform left atrial appendage occlusion more safely than ever before. Tom McElderry, M.D., co-director of the Heart & Vascular Center, explains what has made these devices easier and faster to install, with complication rates well below 1%. He also discusses imaging technology that makes same-day procedures possible. Learn more about clinical trials related to these devices underway at UAB.

In this episode of The Brave Enough Show, Dr. Sasha Shillcutt and Dr. Roxana Mehran discuss:  Stress and the physiological risks that is places on our bodies  How to process and remove the daily stress from your body  How to decrease stress, anxiety and poor sleep as risk factors for cardiovascular disease  How to reinvent yourself as a woman physician  Roxana Mehran, MD, is an internationally renowned interventional cardiologist and clinical research expert in the field of cardiovascular disease. She leads a globally-respected academic research center focused on designing and implementing randomized clinical trials, outcomes research projects, and high impact academic publications. She has served as principal investigator for numerous global studies, developed risk scores for bleeding and acute kidney injury, participates regularly in developing clinical guidelines, and has authored >1,500 peer-reviewed articles. Dr. Mehran currently serving as a member of the American College of Cardiology (ACC) Board of Trustees. She is a founder and Chief Scientific Officer of the Cardiovascular Research Foundation (CRF). Dr. Mehran is named Director of the Women Heart and Vascular Center at Mount Sinai Fuster Heart Hospital, spearheading a new program that represents a collaboration across multiple disciplines and designed to meet the unique needs of women's cardiovascular health. She has been included for the past seven consecutive years in Clarivate Analytics:  “Most Cited Researchers – Top 1%” as well as “The World's Most Influential Scientific Minds” (Thomson Reuters).   Dr. Mehran has spoken and attended over 400 presentations, leading the Lancet Commission on Women's Cardiovascular Diseases, which has brought together leading researchers from around the world to identify and bridge gaps in scientific discovery, clinical trials, and care for women with cardiovascular disease.  She was recently named Director of the Women Heart and Vascular Center at Mount Sinai Heart, spearheading a new program that represents a collaboration across multiple disciplines and designed to meet the unique needs of women's cardiovascular health. In 2019, she founded Women as One, dedicated to advancing opportunities for women in medicine.  Dr Mehran is a recipient of several awards including the 2016 American College of Cardiology Bernadine Healy Leadership in CV disease award, the 2018 Nanette Wenger Award from Women's Heart for excellence in research and education, the 2019 Ellis Island Medal of Honor, and the 2019 ESC Silver Medal and Andreas Grüntzig Lecture plaque. In 2022, she received The Terry Ann Krulwich Physician-Scientist Alumni Award at Mount Sinai; the Linda Joy Pollin Heart Health Leadership Award from Cedar Sinai Medical Center; Doctor Honoris Causa Degree at Università della Svizzera Italiana; Women in Cardiology Mentoring Award from American Heart Association; and the Pulse-Setter Champion Award from The Cardiovascular Research Foundation. Lastly, in 2023, Dr. Mehran was awarded the Bahr Award of Excellence by the American College of Cardiology.  Women as One Quote:  “We all need coaches to help us understand that if you are doing your best, whatever you accomplish in life is enough.” - Dr. Mehran  “Every time you are escalating and climbing the ladder as a woman, you have the responsibility to lift others in the process.” - Dr. Mehran  Episode Links:  BE24 Conference Invite Sasha to Speak Season 12 Sponsor - The Coach Firm The Coach Firm is a women-owned business that certifies life coaches in our signature method that focuses on mindset, coaching tools, and emotional regulation. Follow Brave Enough:   WEBSITE | INSTAGRAM | FACEBOOK | TWITTER | LINKEDIN Join The Table, Brave Enough's community. The ONLY professional membership group that meets both the professional and personal needs of high-achieving women.

Audible Bleeding editor Wen (@WenKawaji) is joined by second year medical student Nishi (@Nishi_Vootukuru), 3rd year general surgery resident Sasank Kalipatnapu (@ksasank) from UMass Chan Medical School, JVS editor Dr. Forbes (@TL_Forbes) and JVS-CIT associate editor Dr. O'Banion (@limbsalvagedr) to discuss two great articles in the JVS family of journals regarding endovascular management of acute limb ischemia and ultrasound-based femoral artery calcification score. This episode hosts Dr. Thomas Maldonado (@TomMaldonadoMD) and Dr. Raul J. Guzman, the authors of the following papers:   Articles:   Safety and efficacy of mechanical aspiration thrombectomy at 30 days for patients with lower extremity acute limb ischemia by Dr. Maldonado and colleagues. An ultrasound-based femoral artery calcification score by Dr. Raul Guzman and colleagues.     Show Guests: Dr. Thomas Maldonado is the Schwartz - Buckley endowed professor of surgery in the Vascular Division at New York University Langone Medical Center in New York,  Co-Director of Center for Complex Aortic Disease Dr. Raul J. Guzman is the Donald Guthrie Professor of Vascular Surgery, Chief of Division of Vascular Surgery at Yale New Haven Hospital. He is also Surgeon-in-Chief of Vascular Surgery, Heart and Vascular Center for the Yale New Haven Health System. (raul.guzman@yale.edu)   Follow us @audiblebleeding Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.  

This episode features David Goldberg, Executive Vice President, Vandalia Health and President & CEO Mon Health System, Dr. Wissam Gharib, Interventional Cardiologist, Medical Director of Structural Heart and Catheterization Laboratories at Mon Health Heart & Vascular Center, and Dr. Jaschar Shakuri-Rad, Urologist and Robotic Surgeon, Medical Director of Robotic and Minimally Invasive Surgery, Mon Health Medical Center. Here, they discuss key insights into their backgrounds & organizations, what will propel Vandalia Health's growth in 2024, Dr. Gharib's role in paving the way for renal denervation in the United States, how robotics and surgery is curving care delivery and changing the lives of patients, and more.

Audible Bleeding editor Wen (@WenKawaji) is joined by second year medical student Nishi (@Nishi_Vootukuru), third year medical student Leana Dodge (@ldogbe4), JVS editor Dr. Forbes (@TL_Forbes) and JVS-VS associate editor Dr. Curci (@CurciAAA) to discuss two great articles in the JVS family of journals regarding Medicare reimbursement for complex endovascular aortic aneurysm repair and novel drug delivery method involving tissue factor targeting peptides in reducing vascular injury response. This episode hosts Dr.Brinster, Dr. Conte, and Dr. Kim, the authors of the following papers:   Articles:   Current Medicare reimbursement for complex endovascular aortic repair is inadequate based on results from a multi-institutional cost analysis by Brinster et al. Tissue factor targeting peptide enhances nanoparticle binding and delivery of a synthetic specialized pro-resolving lipid mediator to injured arteries by Dr. Levy et al.     Show Guests: Dr. Clayton Brinster:  Associate Professor of Surgery at University of Chicago, and Co-Director of Center for Aortic Diseases, Department of Vascular Surgery and Endovascular Therapy Dr. Michael Conte: E.J. Wylie Chair, professor and chief of the division of Vascular and Endovascular Surgery at UCSF. Co-Directot of Heart and Vascular Center, Co-Director of UCSF Center for Limb Preservation and Diabetic Foot. Dr. Alexander Kim: Vascular surgery fellow and research fellow at UCSF   Follow us @audiblebleeding Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.  

Dr. Mullins explains the imaging used to treat patients with Venous Disease(s), Peripheral Arterial Disease Management (PAD), Deep Vein, Superficial Veins, Embolization Therapies Page, and more on the WRAM Morning Show.

Join us on Life of Flow as we venture into cutting-edge medical innovation with Trisha Roy, a renowned expert in medical device approval. Discover how advanced imaging and ex vivo testing are becoming the gold standard for ensuring safe and effective medical devices. Trisha sheds light on the critical role of device approval in patient safety, explores advanced imaging's transformative applications, and highlights the advantages of ex vivo testing over traditional methods. Dive into real-world case studies showcasing the impact of these innovations on device approval, and glimpse into the future with discussions on AI integration and upcoming regulatory changes.About Dr. Roy:"I am devoted to saving the limbs and lives of patients with vascular disease. As a surgeon-scientist, I am committed to developing and using the most advanced imaging techniques to deliver care that is precisely tailored to the needs of each individual patient."Dr. Trisha Roy wants to transform the way we plan and perform endovascular procedures with novel imaging techniques. She is a materials engineer, vascular surgeon, wound care physician, and imaging scientist at the Houston Methodist Hospital DeBakey Heart & Vascular Center. She trained at the University of Toronto where she obtained her engineering degree and Doctor of Medicine (MD). She then obtained her PhD through the University of Toronto Vascular Surgeon-Scientist Training Program where she invented a new method to image occlusive peripheral arterial disease using MRI. This patented imaging technique is flow-independent, does not require exogenous contrast, and even has the ability to characterize the morphology and mechanical properties of peripheral arterial lesions.Dr. Roy is currently an endowed investigator in the Jerold B. Katz Academy of Translational Research. She has been internationally recognized for her research and won international awards including a Vanier scholarship as well as federal grants from the Canadian Institutes of Health Research. She also received a Heart & Stroke Lewar Centre of Excellence Innovation Grant to commercialize her work. After her PhD training, she developed an endovascular steering catheter (CathPilotTM) and co-founded a company with her lab members (Magellan Biomedical Inc.). Dr. Roy currently serves as the Director of Research and Development. Dr. Roy's clinical focus is limb salvage and she provides the full spectrum of peripheral arterial care including wound care, medical therapy, advanced endovascular treatments, and open surgery. Her ultimate goal is to save limbs and lives by delivering care that is precisely tailored to the needs of each individual patient.Follow Life of Flow on Instagram Follow Life of Flow on TwitterFollow Dr. Miguel Montero-Baker on Twitter

Ambulatory Surgery Centers (ASCs) are a great option for low-risk patients to receive diagnostic or therapeutic care outside of the traditional hospital setting. In this episode of “Heart to Heart,” Dr. Jimmy Smith talks about our on-site ASC: Advanced Heart and Vascular Center. The post Ambulatory Surgery Center Awareness Month first appeared on Advanced Cardiovascular Specialists.

This week Bobbi Conner talks with Dr. Thomas Di Salvo about lifestyle changes to reduce risk of congestive heart failure. Dr. Di Salvo is a Professor of Cardiology and he's the Director of the Heart and Vascular Center at MUSC.

An aging population, physician shortages, and industry fragmentation are making cardiology the “new darling” of private equity investment. The question is – can private equity coexist with the quadruple aim? On MedAxiom HeartTalk, host Melanie Lawson talks with Ann Honeycutt, executive director of Virginia Cardiovascular Specialists, Larry Sobal, CEO of Heart and Vascular Institute of Wisconsin, Dinesh Pubbi, MD, a founding member of First Coast Heart and Vascular Center, Rick Snyder, MD, FACC, an interventional cardiologist at HeartPlace Dallas, and Joe Sasson, executive vice president of Ventures at MedAxiom. They discuss the influx of private equity in cardiovascular healthcare and how one size does not fit all.Guest Bios:Ann E. Honeycutt, MSN, is the executive director of Virginia Cardiovascular Specialists (VCS), a private practice based in Richmond, VA. In her role, Ann has been actively involved in developing strong partnerships with local health systems and managed care organizations and has strived to ensure VCS remains a leader in the transformation of healthcare and clinical cardiology. She also serves as vice chair of MD Value Care, an ACO comprised of 90 primary care physicians and 350 specialists. Ann is also the only practice executive serving on the Richmond Academy of Medicine Board. She received a Master of Nursing, Community Health and Education from the University of Washington. Over the course of her nearly 40-year career, she has held various leadership roles in the areas of community health, home health care, acute care, ambulatory services and physician practice management. She has in-depth experience with financial management, strategic planning, business development, talent acquisition and leadership development.Larry Sobal, MBA, MHA, FACMPE - CEO of the Heart and Vascular Institute of Wisconsin in Appleton, WI. - Larry is an innovative, results-driven senior healthcare executive with a diverse background in medical group leadership, hospital leadership, and insurance. Effective communicator with the ability to engage others to create a vision for change and translate that into strategy by analyzing critical business requirements, identifying deficiencies and potential opportunities, and developing innovative solutions. Respected decision-maker who delivers value and trust through strong relationships with colleagues, physicians, staff, and the community. His areas of expertise include strategic planning and implementation, leadership and management, and operations improvement.Joe Sasson, PhD - executive vice president of Ventures and chief commercial officer, MedAxiom - Joe is a tenured member of the MedAxiom team and brings with him a wide variety of perspectives on healthcare operations and market access strategies. As chief commercial officer and executive vice president of Ventures at MedAxiom, Joe helps members access the technologies and solutions they need to effectively run their organizations and prepare for the future of value-based care. He currently works with companies spanning medtech, device, pharma, imaging, cath labs/ambulatory surgery centers (ASCs) and health IT to deliver economic value propositions and strategies to accelerate commercial growth. Joe has created and led programs and workgroups centering on EMR utilization and optimization, chronic care management, physician in-office dispensing of medications, CCTA, cath lab efficiency and more.Dinesh Pubbi, MD – Dr. Pubbi is a founding member of First Coast Heart & Vascular Center. He completed his electrophysiology fellowship at St. Luke's Medical Center in Milwaukee where he trained in the latest electrophysiology procedures and techniques including atrial fibrillation ablations, device implantations and complex ablations. Dr. Pubbi completed his internal medicine residency at Sinai Samaritan Medical Center in Milwaukee and worked as an Internist and Primary Care physician for several years before completing his cardiology fellowship at Aurora Health Care at ASMC and St. Luke's Hospital also in Milwaukee.Rick Snyder MD, FACC – Dr. Snyder is a board-certified interventional cardiologist at HeartPlace, serving adults and teens in and around Dallas, Texas. He holds three board certifications: interventional cardiology, advanced heart failure and transplantation, and cardiovascular disease.Dr. Snyder joined the team at HeartPlace in 1996 and opened the satellite office at Medical City that same year. Though he's trained as an interventionist, Dr. Snyder prides himself on providing the highest quality preventive care. He believes that risk factor modification through diet and exercise can significantly reduce the risk of potentially serious issues like a heart attack or a stroke.As a cardiologist, Dr. Snyder serves as an advocate for his patients. That advocacy extends to his work with legislative leaders at both the state and national levels. His work as a physician advocate allows Dr. Snyder to help a larger number of people.Currently, Dr. Snyder serves as the president of HeartPlace. He enjoys leading the organization and has plenty of past experience — he's served as staff president at Medical City Dallas Hospital as well as president of the Dallas County Medical Society.

Dr. Khurram Nasir, Division Chief of Cardiovascular Prevention and Wellness at Houston Methodist DeBakey Heart & Vascular Center, joins the podcast to discuss his background, top 3 biggest issues in cardiology today, how heart care will evolve over the next 18 months, and today's nerves and excitements.

Dr. Khurram Nasir, Division Chief of Cardiovascular Prevention and Wellness at Houston Methodist DeBakey Heart & Vascular Center, joins the podcast to discuss his background, top 3 biggest issues in cardiology today, how heart care will evolve over the next 18 months, and today's nerves and excitements.

Todd Stefan, MD,FACS, RPVI, Heart and Vascular Center of Evangelical, Evangelical Community Hospital, Lewisburg on vascular disease and their upcoming Talk with the Doc. We'll ask the basic questions about our arteries, veins, and capillaries. We'll discuss health vascular systems and disease, common symptoms of disease and treatments. Along the same vein, we'll ask how to take care of your vascular system, and how to live with vascular disease. (We'll promote the upcoming ‘Talk with the Doc' panel discussion Wednesday, April 12, 6pm, conference rooms at the Main Entrance to the hospital, with Dr. Stefan, Ben Keyser DO, and Rachel Carr PA-C. Call 570-768-3200.) 

Melanie Patel, DO, Cardiologist, Heart and Vascular Center of Evangelical, on women's heart health, how heart attacks are very different for women, what signs to look for and why-why-why women sometimes take much care of their families than themselves. We'll talk about her work with patients, the exchange of information, options for treatment, and if a woman has had a heart attack—how tough is it to get them back to full health. We'll talk about the upcoming Talk with the Doc event: Talk with Doc – Women's Heart Health – Tuesday, February 21, 2023 at 6 pm – At the Hospital, conference rooms in the main lobby – Call 570-768-3200 to reserve your spot – Totally FREE and full of great information from Dr. Patel and the other panelists.

Dr. Saquib Siddiqi, DO, MS, Cardiologist, Heart, and Vascular Center of Evangelical helps us continue our ‘Rock Red for Healthy Hearts' initiative with Evangelical Community Hospital in Lewisburg. We talk about signs that your heart may be in trouble, including your numbers; blood pressure, cholesterol, triglycerides, etc., what can you do to take control of heart health, how important is it to build a strong relationship with a primary care provider, when should you commit to seeing a cardiologist and how will a cardiologist work with you to manage heart issues.

The heart is the energy source of our entire body. It pumps blood rich in oxygen and nutrients to the rest of our body – to our brains, our hands and to all the vital organs. But if something happens to the heart, the rest of the body suffers. And when the heart breaks, it can be fatal. Gary Chan, DO, PhD, cardiologist at MercyOne Siouxland Heart and Vascular Center, helps explain symptoms of a broken heart and why time is critical.

Dr. José L. Navia is the Director of the Heart and Vascular Center at Cleveland Clinic Florida, Chairman of Cardiothoracic Surgery in Florida, and a Distinguished Chair in Heart and Vascular Research. Dr. Navia is also a Professor of Surgery at Cleveland Clinic Lerner College of Medicine and an internationally known cardiovascular and thoracic surgeon. With 30 patents to his name, Dr. Navia has made numerous advances in cardiovascular medicine. Today, Dr. Navia joins us on the Health Pulse podcast to speak on a particularly special past case of his, as well as his passion and drive for innovation.

Today, Gowri and our Holding Pressure team republish the Vascular and Endovascular Surgery Society (VESS) National Student-Run Vascular Surgery Interest Group (VSIG) Webinar on "Discover: Vascular Surgery."  This webinar originally occurred on November 10, 2022.  Featured Physician Speakers:  Gabriela Velazquez MD, FACS, RPVI; Associate Professor, Program Director Vascular and Endovascular Surgery Fellowship, Director Vascular Surgery Clerkship; Department of Vascular and Endovascular Surgery, Wake Forest University School of Medicine Todd Berland, MD, FACS, RPVI; Associate Professor of Surgery, Division of Vascular Surgery at NYU Grossman School of Medicine; Director, Outpatient Vascular Interventions NYU Langone Health Ravi Rajani, MD, FACS, DFSVS; Professor of Vascular Surgery, Assistant Dean for Medical Education, Emory University School of Medicine; Chief, Vascular and Endovascular Surgery, Co-Director, Grady Heart and Vascular Center, Grady Memorial Hospital VESS VSIG Team/Moderators Audible Bleeding Resources: Episodes geared towards medical students: Audible Bleeding (Holding Pressure)  Exam Prep Book: https://adam-mdmph.quarto.pub/vascular-surgery-exam-prep/ VESS VSIG Resources for Medical Students interested in Vascular Surgery:  VESS membership link: https://vesurgery.org/my-vess/why-join-vess Website: https://vesurgery.org/vess-vsig/ Email: vessvsig@gmail.com VESS VSIG Resources for Medical Students: publication date TBD; stay tuned for an updated link once published

This week Bobbi Conner talks with Dr. Thomas Di Salvo about lifestyle changes to reduce risk of congestive heart failure. Dr. Di Salvo is a Professor of Cardiology and he's the Director of the Heart and Vascular Center at MUSC.

Why would doctors choose to spend time volunteering in another country and creating a nonprofit organization to save children's lives overseas?Dr. Tom Forsberg and Dr. Chad Hoyt are co-founders of Healing Hearts Vietnam. Dr. Forsberg is an emergency physician with Centra Health in Central Virginia.  He currently serves in four emergency departments throughout the region. Dr. Chad Hoyt specializes in advanced cardiovascular imaging and has been in partnership with Centra Health for the past sixteen years. He currently serves as the executive medical director of Centra's Heart & Vascular Center, a busy four-hospital system with seven office locations and forty clinical providers. For nearly a decade, Dr. Forsberg and Dr. Hoyt have shared their expertise with Vietnam. During their trips, they became aware of the great need for cardiac surgeries in children. Upon returning from Vietnam, Dr. Forsberg led the charge to form Healing Hearts Vietnam which was established in 2015. Today, Healing Heart Vietnam provides financial assistance to allow children with congenital heart disease to access life-saving surgeries.In this episode of "Heart to Heart with Anna," Dr. Tom Forsberg and Dr. Chad Hoyt share with Anna how they came to form a nonprofit organization to save the lives of children and adults in Vietnam with broken hearts. They share how certain devices have helped them identify who they can serve and how they can best help the people of Vietnam. They also share how people in the community can donate to their organization in a variety of ways.Links mentioned in the episode:Healing Hearts Vietnam websiteHealing Hearts Vietnam Facebook pageVietnamese Boat People episode with Amy M. LeVietnamese Boat People podcastPlease visit our Social Media and Podcast pages:Apple PodcastsFacebookInstagramMeWeTwitterYouTubeWebsiteAnna's Buzzsprout Affiliate Link (we both benefit if you sign up with Buzzsprout with my link - yay!) Support the show (https://www.patreon.com/HearttoHeart)

On this episode of We Talk Health, Dr. Tommy Miller of the West Tennessee Medical Group Heart and Vascular Center. Dr. Miller is an Interventional Cardiologist, and he is in today talking about ways to have a healthier heart and a healthier lifestyle all around.  How can people have a healthier heart? Do diet and exercise really matter? Do they work? All of these questions and more are answered! Tune in to learn more! If you have questions for Dr. Miller or would like to schedule an appointment with him, give him a call at 731-421-6510. If you'd like to check out the Mediterranean Diet that he discussed, click the link below: https://www.wth.org/blog/the-mediterranean-diet-heart-health-whats-the-connection/Hosts:Will KwasigrohSocial Media Coordinator Tommy Miller, MDInterventional Cardiology 

On this episode of We Talk Health, Jennifer Varner joins Will Kwasigroh and discusses accreditation, specifically the accreditation that the West Tennessee Heart and Vascular Center has earned over the last couple of years. What does it mean to be accredited? How did the WTHVC achieve accreditation? What does that mean for the community? All of these questions, and more, will be answered. Tune in to learn more!Hosts: Will KwasigrohSocial Media Coordinator Jennifer Varner, RN, MSNDirector of Clinical Quality   

Dr. Saquib Siddiqi, DO, MS, Cardiologist, Heart and Vascular Center of Evangelical, Medical Director, Cardiac Rehabilitation, Evangelical Community Hospital, is our latest guest as we ‘Rock Red for Healthy Hearts' with Evangelical Community Hospital. Today we ask—when and why would you see a cardiologist, how do you start a productive doctor/patient relationship with a cardiologist, why would your PCP suggest a cardiology appointment, what to expect, what will they do, what are they looking for, what kind of treatments, and what follow up. The thematic monthly goal during heart month; encourage people to establish productive, beneficial relationships with your PCP and heart doc.

Dr. Aaron Kaplan has several startups and many years of cardiology practice under his belt, and he is uniquely positioned to give a physician's perspective on the medical device startup space and how big ideas actually impact the clinic. As a practicing interventional cardiologist and Director of Clinical Research, Heart & Vascular Center, at Dartmouth-Hitchcock Medical Center, Kaplan is intimately aware of the challenges facing cardiology today and the needs facing both patients and their care providers. And as an entrepreneur and inventor, he's learned to maximize his role in the startup arena. “The role of the doc is not to design the device, but to define the problem,” Kaplan told Medtech Talk. Kaplan says he brings ideas to the table “that often violate one if not two of Newton's laws”, but he has learned to hand them over to creative engineers and others with diverse perspectives. While, as a physician, he alone answers for all the care decisions that were made for a patient, as an entrepreneur, he instead builds multidisciplinary teams with competencies that are divorced from medicine. One of the biggest differences between the two roles, Kaplan says, is that entrepreneurs must learn to accept failure. In speaking with Geoff Pardo, Kaplan employs a physician's traditional habit of postmortem assessment of one of his previous startups, candidly breaking down the problems in the market approach, the trial strategy, and the leadership structure—valuable lessons for him—and others—to apply to future projects.Dr. Kaplan is a practicing interventional/structural cardiologist and a medical device entrepreneur. Aaron supervises cardiology fellows and lectures regularly at the Tuck School. In addition, he directs the Clinician-MBA Scholars Program at Dartmouth. Prior to Dartmouth, he was Director of Interventional Cardiology at the Palo Alto VA/Stanford University. Dr. Kaplan has authored >75 peer-reviewed papers and serves on the Editorial Board of Cardiac Catheterization & Intervention and J Soc Cardiovascular Angiography & Interventions. Aaron is an active entrepreneur who has been on the founding team of a number of companies including Conformal Medical, Tryton Medical, LocalMed and Perclose (acquired by Abbott). Dr. Kaplan is on the Board of Cairn Surgical and was an Entrepreneur-In-Residence at Three Arch Partners. Aaron has authored 60 U.S. Patents and was inducted into the National Academy of Inventors (Class of 2015). He received a BS in Engineering Sciences (Cum Laude) from Tufts University, MD from Wake Forest University, medical training at Northwestern University and cardiology training at Stanford University.

This week we review a recent important work from Germany about the coronary perfusion in patients with HLHS and possible relations between this flow and clinical outcomes. What factors are associated with abnormalities in microvascular coronary flow in the HLHS patient? What anatomical substrate is more concerning for these sorts of problems? Are there factors that might be modifiable that could possibly improve outcomes due to coronary microvascular flow problems in the HLHS patient? How practically easy are CMR studies to assess microvascular coronary flow in the HLHS patient? These are amongst the questions posed this week to Professor Carsten Rickers of University Heart and Vascular Center at the University Hospital Hamburg-Eppendorf. DOI: 10.1161/CIRCIMAGING.121.012468

Angiogram and Angioplasty at the Vascular Center... --- Support this podcast: https://podcasters.spotify.com/pod/show/dialysisdiaries/support

On this episode of We Talk Health, Will Kwasigroh interviews Scott Sweat of the West Tennessee Healthcare Heart and Vascular Center about the TAVR Procedure. TAVR Stands for Transcatheter Aortic Valve Replacement and has quickly become a popular procedure when it comes to heart health. What is involved with the procedure? Who could benefit from it? How long does it last? All of these questions and more are answered here. Tune to learn! Hosts: Will KwasigrohSocial Media Coordinator Scott Sweat, RN Structural Heart Coordinator 

CardioNerds (Amit Goyal and Daniel Ambinder) join fellow lead, Dr. Giselle A. Suero-Abreu (FIT, Massachusets General Hospital), Dr. Isadora Sande Mathias (FIT, Houston Methodist and CardioNerds Academy Fellow), and Dr. Victor Nauffal (FIT, Brigham and Women's Hospital) for a discussion with Dr. William Zoghbi (Chair, Department of Cardiology, Houston Methodist Hospital, Methodist DeBakey Heart & Vascular Center, Past President, the American College of Cardiology) about international medical graduates in the cardiology workforce. This episode focuses on the narratives of international medical graduates (IMGs) who make important contributions to the US medical workforce and scientific innovation. Listen to the episode to learn the state of IMGs in the US physician workforce and the field of Cardiology, an overview of factors that influence IMG selection when applying to residency and fellowship training programs in the US, the impact of recent changes in licensing exams and immigration restrictions, and how to address challenges and support IMGs throughout their medical careers. Audio editing by CardioNerds Academy Intern, Dr. Leticia Helms. Claim free CME just for enjoying this episode! Disclosures: None Cardionerds Narratives in Cardiology PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll Subscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Show notes 1. What is the definition of an international medical graduate (IMGs)? International medical graduates (IMGs) are physicians who who graduated from a medical school outside the United States, regardless of nationality. This group of foreign-trained physicians include US-IMGs (US citizens) and non-US IMGs (non-US citizens). Nearly 80% of IMGs are born abroad [1]. In a paper senior authored by Dr. Zoghbi, IMGs in the US physician workforce are described as “the multicultural, multiethnic, open-minded, and plural fabric that has defined American medicine and contributed to its success over the years” [2]. 2. Why are IMGs important? IMGs are an integral part of the U.S. healthcare system. They constitute about 25% of the physician workforce and, since 2010, the number of IMGs in practice has grown by nearly 18% [1, 3]. IMGs play a critical role in addressing healthcare inequities across the US, comprising a significant proportion of physicians in high-need rural and underserved urban areas [1, 3, 4]. IMGs contribute to the diversity and cultural competence in the US physician workforce with 98% of them speaking two or more languages fluently. They help patients overcome linguistic and cultural barriers that can interfere with their care [5]. Learn more about Diversity and inclusion (Episode 95) and Latinx representation in cardiology  (Episode 129). Racial and ethnic concordance between physicians and their patients results in improved healthcare outcomes, and IMGs are essential in matching the needs of the increasingly diverse US population [6]. Many IMGs pursue the opportunity to train in the best academic programs in the US and return as leaders to serve their country. This becomes an avenue for international collaboration to help patients and contribute to research, innovation, and education. 3. What is the state of the IMG workforce in Cardiology? IMGs in cardiology serve as an important source of cardiac care in the United States. Data from the 2020 Physician Specialty Data Report from the Association of American Medical Colleges (AAMC) [7] showed that: Among active US physicians, IMGs comprise 31% of general cardiologists, 46% of interventional cardiologists, and 26% of pediatric cardiologists.Among ACGME trainees, IMGs constitute 38% of fellows in cardiovascular disease, 53% in interventional cardiology, and 20% in pediatric cardiology.Many IMGs have non-immigrant visas, including the J-1 Visitor Exchange visa,

CardioNerds Cardio-OB series co-chairs University of Texas Southwestern Cardiology Fellow, Dr. Sonia Shah (FIT, University of Texas Southwestern) and Dr. Natalie Stokes, (FIT, University of Pittsburgh) join  Dr. Nanette Wenger, Professor of Medicine in the Division of Cardiology at the Emory University School of Medicine and a consultant to the Emory Heart and Vascular Center and Dr. Sharonne Hayes, Professor of Internal Medicine and Cardiovascular Diseases and founder of the Women's Heart Clinic at Mayo Clinic for an in depth discussion about lifelong advocacy for women's cardiovascular health. Audio editing by CardioNerds Academy Intern, Dr. Leticia Helms. CardioNerds Cardio-Obstetrics Series PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Guest Profiles - Advocacy for Women's Cardiovascular Health Dr. Nanette Wenger Dr. Nanette Wenger is Professor of Medicine in the Division of Cardiology at the Emory University School of Medicine. Dr. Wenger received her medical degree from Harvard Medical School in 1954 as one of their first female graduates followed by training at Mount Sinai Hospital where she was the first female to be chief resident in the cardiology department. She is among the first physicians to focus on heart disease in women with an expertise in cardiac rehabilitation and geriatric medicine.Dr. Wenger has received numerous awards including the Distinguished Achievement Award from the Scientific Councils of the American Heart Association and its Women in Cardiology Mentoring Award, the James D. Bruce Memorial Award of the American College of Physicians for distinguished contributions in preventive medicine, the Gold Heart Award, the highest award of the American Heart Association, a Lifetime Achievement Award in 2009 and the Inaugural Bernadine Healy Leadership in Women's CV Disease Distinguished Award, American College of Cardiology. She chaired the U.S. National Heart, Lung, and Blood Institute Conference on Cardiovascular Health and Disease in Women, is a Past President of the Society of Geriatric Cardiology and is past Chair, Board of Directors of the Society for Women's Health Research. Dr. Wenger serves on the editorial boards of numerous professional journals and is a sought-after lecturer for issues related to heart disease in women, heart disease in the elderly, cardiac rehabilitation, coronary prevention, and contemporary cardiac care. She is listed in Best Doctors in America. Dr. Sharonne N. Hayes Sharonne N. Hayes, M.D., studies cardiovascular disease and prevention, with a focus on sex and gender differences and conditions that uniquely or predominantly affect women. With a clinical base in the Women's Heart Clinic, Dr. Hayes and her research team utilize novel recruitment methods, social media and online communities, DNA profiling, and sex-specific evaluations to better understand several cardiovascular conditions. A major area of focus is spontaneous coronary artery dissection (SCAD), an uncommon and under-recognized cause of acute coronary syndrome (heart attack) that occurs predominantly in young women. Dr. Hayes also studies the diagnosis and treatment of nonobstructive (microvascular) coronary artery disease and chest pain syndromes and the subsequent risk of arrhythmias and other cardiac conditions in women who have had hypertension, diabetes or preeclampsia during a pregnancy. With the Pericardial Disease Study Group, Dr. Hayes is assessing the optimal management of pericarditis. Additionally, Dr. Hayes is involved in several research initiatives aimed at addressing health equity and reducing health disparities. Through partnerships with national professional women- and minority-serving organizations, Dr. Hayes assesses barriers faced by women and minorities that prevent or deter them from participa...

This year marks the 75th Anniversary of the Society for Vascular Surgery. This year's Vascular Annual Meeting will also be a very welcome return to in-person meetings after the pandemic.  Sharif and Fanny chat with the co-Chairs of the Program Committee for the VAM, Dr. Andy Schanzer and Dr. Matt Eagleton, to give us a preview. Dr. Andres Schanzer is a Professor of Surgery and Chief of the Division of Vascular and Endovascular Surgery at the University of Massachusetts Memorial Medical Center and University of Massachusetts Medical School in Worcester, Massachusetts, with a secondary appointment as Professor of Quantitative Health Sciences.  He serves as the Director of the UMass Memorial Heart and Vascular Center and is the founding Director of the UMass Memorial Center for Complex Aortic Disease. He serves as the national principal investigator for the United States Fenestrated and Branched Endograft Research Consortium. This is his first year as co-Chair of the Program Committee for the Vascular Annual Meeting of the Society for Vascular Surgery. Dr. Matthew Eagleton is the chief of the Division of Vascular and Endovascular Surgery at Massachusetts General Hospital and co-director of the Fireman Vascular Center  leading a multi-disciplinary team interested in the management of vascular disease. Dr. Eagleton's clinical and research interests are focused on the pathobiology and endovascular treatment options for complex aortic disease. Dr. Eagleton has served in a variety of national organizations including the Vascular and Endovascular Surgical Society and the Society for Vascular Surgery. This year, he is completing his tenure as Chair of the Program Committee for the Vascular Annual Meeting of the Society for Vascular Surgery. Dr. Fanny Alie-Cusson is joining us today for her first interview as part of the Audible Bleeding family. She is an Assistant Professor of Vascular Surgery at the University of Pittsburgh Medical Center. Click here to register for VAM21 See the VAM21 program here What other topics would you like to hear about? Let us know more about you and what you think of our podcast through our Listener Survey or email us at AudibleBleeding@vascularsociety.org. Follow us on Twitter @audiblebleeding Learn more about us at https://www.audiblebleeding.com/about-1/ and #jointheconversation.

Meet Bridget and learn more about Men's Health Awareness and Dr. Mark Mattos from Michigan Vascular Center Listen every week to find out what's happening in our area and what's coming up. Discover Flint Township features the Flint Township DDA, HAP, Financial Plus Credit Union, Shea Automotive and other Special Guests. This week our guests include Bridget Hollingsworth Stafford of HAP and we will shine the Guaranteed Rate Business Spotlight on Dr. Mark Mattos from Michigan Vascular Center. Stay Safe, Stay Healthy, Shop Local, Buy Local and Discover Flint Township!

Dr. Richard Schatz is research director of cardiovascular interventions at the Scripps Heart, Lung, and Vascular Center and director of gene and stem cell therapy. His work in coronary stents launched a revolution in the treatment of coronary artery disease; over 2 million stents are placed each year. His work has had an immeasurable impact on prolonging life and reducing healthcare costs.This episode covers a cardiologist's perspective on the carnivore and low-carb diets, how the role of randomized controlled trials has changed over time, what to do to stay heart healthy.We also discuss advice for being an inventor. This includes the importance of being first to file, building a daily inventing habit, and knowing the basics of patent law. Finally, we discuss the emotional impact of having influenced 100+ million people, why his design worked, and what it was like to engage with world leaders like Lee Kuan Yew and Mother Theresa. Help The Louis and Kyle Show:If you enjoyed this episode, please share it with a friend!If you want to reach out to us, please do so on Twitter: https://twitter.com/LouisKyleShowEmail us: LouisandKyleShow@gmail.com

Dr. Kalra is an interventional cardiologist and medical director of clinical research for regional cardiovascular medicine at the Cleveland Clinic, section head of cardiovascular research at Cleveland Clinic Akron General, a university professor at the Cleveland Clinic Lerner College of Medicine (Associate Professor) and NEOMED (Adjunct Associate Professor), and founder of the non-profit startup, makeadent.org. He is director of Barry J. Maron Hypertrophic Cardiomyopathy Center in New Delhi, India. He is also the host of the cardiology podcast show, Parallax. He has presented late-breaking science at national and international scientific cardiovascular meetings, and has published over 200 scientific manuscripts in various peer-reviewed journals. Educated at Indira Gandhi Medical College (Shimla, India), he completed medical and cardiology training at the All India Institute of Medical Sciences (New Delhi, India), Cooper University Hospital (Camden, NJ), and Hennepin County Medical Center and Minneapolis Heart Institute (Minneapolis, MN). He served as a clinical and research fellow in interventional cardiology at Beth Israel Deaconess Medical Center, and a clinical fellow in medicine at Harvard Medical School (Boston, MA). He then completed a year of advanced interventional and structural cardiology fellowship at Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital (Houston, TX). Dr. Kalra is board-certified in Internal Medicine, Cardiovascular Disease and Interventional Cardiology from the American Board of Internal Medicine, and a Diplomate in Adult Comprehensive Echocardiography from the National Board of Echocardiography. He is also certified in patient safety, healthcare quality, health informatics and leadership from Harvard Medical School's 1-year Safety, Quality, Informatics and Leadership certification program. He is currently pursuing a Master of Science program in Health Economics, Outcomes and Management in Cardiovascular Sciences at the London School of Economics & Political Science in London, United Kingdom. He is also the author of the poetry book, "Ibadah" that was released on Amazon and Barnes & Noble, and launched in collaboration with Cleveland Clinic Arts and Medicine Institute on Valentine's Day, 2020. EHJ paper: https://academic.oup.com/eurheartj/article/38/23/1789/3867739 Non-profit startup, makeadent.org, and the poetry book, ibadahthebook.com

The Scope is dedicated to having open conversations about healthcare topics relevant to our patients and community. Whether you are trying to answer your own healthcare questions or want to be more informed when scheduling appointments for loved ones, this show is dedicated to helping you become more knowledgeable and involved. In this episode, Dr. Dmitry Familtsev, a Phelps Health cardiologist, answers questions about living a heart-healthy life. Please note that social distancing and hand hygiene guidelines were followed while filming this podcast. Resources: • Dmitry Familtsev, MD, PhD: https://phelpshealth.org/doctors/dmitry-familtsev-md-phd • Heart and Vascular Center: https://phelpshealth.org/conditions-treatments/heart-vascular-center You can connect with Phelps Health on the following platforms: • Website: https://phelpshealth.org • Facebook: https://facebook.com/PhelpsHealth1 • Instagram: https://www.instagram.com/phelpshealth1/ • LinkedIn: https://www.linkedin.com/company/14525428 • YouTube Channel: https://youtube.com/c/PhelpsHealth1 • Sound Cloud: https://soundcloud.com/user-550445603

February 17, 2021 - Dr Richard Timmons of the Heart and Vascular Center, Holy Family Memorial Hospital

February 17, 2021 - Dr Richard Timmons of the Heart and Vascular Center, Holy Family Memorial Hospital

February 17, 2021 - Dr Richard Timmons of the Heart and Vascular Center, Holy Family Memorial Hospital

According to the CDC, heart disease is the leading cause of death in the United States. In fact, 1 in every 4 deaths in the United States is caused by heart disease. To help keep you and your family healthy, all you need to do is remember your ABCS:Aspirin when appropriateBlood pressure controlCholesterol managementSmoking cessationLearn more about the ABCS for a healthy heart on our website.This episode's featured medical expert is Curtis Hoogendoorn, ARNP from MercyOne Siouxland Heart and Vascular Center. Send us your feedback or just say "hello" by emailing podcast@mercyhealth.com, or fill out the submission form at MercyOne.org/podcast Your Best Life – powered by MercyOne  

According to the CDC, heart disease is the leading cause of death in the United States. In fact, 1 in every 4 deaths in the United States is caused by heart disease. To help keep you and your family healthy, all you need to do is remember your ABCS:Aspirin when appropriateBlood pressure controlCholesterol managementSmoking cessationLearn more about the ABCS for a healthy heart on our website.This episode's featured medical expert is Curtis Hoogendoorn, ARNP from MercyOne Siouxland Heart and Vascular Center. Send us your feedback or just say "hello" by emailing podcast@mercyhealth.com, or fill out the submission form at MercyOne.org/podcast Your Best Life – powered by MercyOne  

Dr. Saquib Siddiqi, MS, DO, Cardiologist, Heart and Vascular Center of Evangelical Community Hospital, helps us kick-off Rock Red for Health Hearts month with Evangelical Community Hospital in Lewisburg.

Dr. Saquib Siddiqi, MS, DO, Cardiologist, Heart and Vascular Center of Evangelical Community Hospital, helps us kick-off Rock Red for Health Hearts month with Evangelical Community Hospital in Lewisburg.

Dr Mehra does not frame his experiences as failures or successes; he looks at all events with one question in mind: What can I learn from this? In this week’s episode Ankur’s guest is Dr Mandeep R Mehra, Medical Director of Brigham Heart and Vascular Center and Professor of Medicine at Harvard Medical School. Dr Mehra’s professional journey started in the Sevagaram Ashram in India where medicine and the Gandhian way of life were both instilled in him. His career in the US was prompted by a question posed by a neuroscientist, Sister Elizabeth Burns: “Have you ever thought about the scalability of your impact?” In this reflective and personal conversation Mandeep talks about the choices he made during his career and the people who shaped him. Ankur asks Mandeep about his editorship at the Journal of Heart and Lung Transplantation and Mandeep shares his thoughts on selecting priorities, and the importance of living in the present moment. How does Dr Mehra think about building opportunities? What were his formative experiences? How does he think about the role of mentorship in medicine? What is Dr Mehra’s message to our listeners? Questions and comments can be sent to “podcast@radciffe-group.com” and may be answered by Ankur in the next episode. Guest @MRMehraMD, hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO. Brought to you by Edwards: www.edwardstavr.com

Ijeoma Isiadinso, MD MPH FACC FASNC is a Board Certified Cardiologist at the Emory Heart and Vascular Center and Assistant Professor of Medicine (Cardiology) at Emory University School of Medicine. Dr. Isiadinso earned a dual degree in Medicine and Public Health during medical school. She joined the faculty at Emory University School of Medicine in 2010 after completing her Internal Medicine Residency and Cardiology Fellowship at Temple University Hospital. She is Board Certified in General Cardiology, Nuclear Cardiology, Echocardiography.She is clinical cardiologist in the Emory Center for Heart Disease Prevention. She is a dedicated educator and serves as the CME Course Co-Director for both the Emory Symposium on Coronary Atherosclerosis Prevention and Education (ESCAPE) Conference and the Annual Emory Women and Heart Disease Conference. Dr. Isiadinso served as the Director of the Emory Women's Heart Center at Decatur and Lithonia. She is passionate about preventing heart disease in women.Dr. Isiadinso's clinical research interest is focused on cardiovascular disease in patients with systemic inflammatory rheumatic diseases (specifically SLE and RA). For reasons that are not fully understood, this patient population is at increased risk for CVD and has a greater prevalence of traditional CV risk factors compared with the general population. Dr. Isiadinso's interest is to gain a better understanding of this increased risk through collaborative research projects and increase awareness among patients and clinicians through educational activities. Her clinical practice includes providing CVD screening, evaluation, and treatment of patients with inflammatory rheumatic diseases.This podcast is brought to you by Emory Lifestyle Medicine & Wellness. To learn more about our work, please visithttps://bit.ly/EmoryLM

This week’s episode includes author Mark Chan, editorialist Thomas Wang, and Associate Editor Wendy Post as they discuss the prioritization of candidates of post-myocardial infarction heart failure using plasma proteomics and single-cell transcriptomics. TRANSCRIPT BELOW: Dr Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. I'm Dr Carolyn Lam, associate editor from the National Heart Center and Duke National University of Singapore. Dr Greg Hundley: And I'm Greg Hundley, associate editor, director of the Pauley Heart Center at VCU Health in Richmond, Virginia. Well, Carolyn, this week's feature, really interesting, involving proteomics and single-cell transcriptomics, trying to identify how we could prioritize individuals after they've sustained myocardial infarction as to whether or not they'll develop heart failure. Lots to go over in that feature. But before we get to that, how about we grab a cup of coffee and start in with some of the other interesting papers in this issue? Dr Carolyn Lam: Absolutely. I've got my coffee and I have to tell you though, I am so excited about this feature, it comes from Singapore, but my first paper too is about transcriptomic profiling. But Greg, I have to ask you first, have you heard of the cardiac cellulome? Dr Greg Hundley: Oh my goodness, Carolyn. So you're starting the reverse-quiz strategy to help me. I have not heard of the cellulome. Help enlighten me. Dr Carolyn Lam: I just love that word. We've heard of all kinds of other omes, but this cellulome is something I've learned through today's paper. So the authors today who are Alexander Pinto from Baker Heart and Diabetes Institute and colleagues, they developed a novel cardiac single-cell transcriptomic strategy to characterize the cardiac cellulome. And that refers to the network of cells that forms the heart. The method was utilized to profile the cardiac cellular ecosystem in response to two weeks of angiotensin II as a pro-fibrotic stimulus. So what did they find? Well, they identified two previously undescribed cardiac fibroblasts populations that are the key drivers of fibrosis. Their names were Fibroblast-Cilp and Fibroblast-THBS4. Now, these do not correspond to smooth muscle actin-expressing myofibroblasts, which have been widely viewed as the primary drivers of fibrosis. So this is really novel. The cardiac cellular landscape was sexually dimorphic at the cell abundance and gene expression level, including cellular responses to angiotensin II induced tissue remodeling. So these data really provide insights into the cellular and molecular mechanisms that promote pathologic remodeling in the mammalian heart, and really highlight that early transcriptional changes precede chronic cardiac fibrosis. Dr Greg Hundley: Very nice, Carolyn. Well, let me switch to the clinical realm. And my first paper comes from Professor Holger Thiele from the Heart Center Leipzig at the University of Leipzig, and it's involving general versus local anesthesia with conscious sedation for patients undergoing TAVI procedures. So the study comes from the SOLVE-TAVI study, and it's a multi-center open-label 2x2 factorial randomized trial of 447 patients with aortic stenosis undergoing transfemoral TAVR, comparing conscious sedation versus general anesthesia. And the primary efficacy endpoint was powered for equivalence, and consisted of the composite of all-cause mortality, stroke, myocardial infarction, infection requiring antibiotic treatments, and acute kidney injury at 30 days. Dr Carolyn Lam: Wow, Greg, as I understand it, about half of patients today receive TAVI or TAVR with conscious sedation. So it's really an important question. So what did they find? Dr Greg Hundley: You're exactly right. So the composite end point occurred in 27% of the conscious sedation patients and 26% of the general anesthesia patients. Really equivalent. And this held true for each of those composite endpoints. In addition, there was a lower need for inotropes or vasopressors with conscious sedation, versus general anesthesia. Thus, these findings suggest that conscious sedation can safely be used for patients undergoing TAVR procedures. Dr Carolyn Lam: Very important clinical one, Greg. Well, I've got a clinical paper for you too. And this one, trying to answer the question, what's the optimal duration of dual anti-platelet therapy, or DAPT, after PCI with drug-eluting stents. A very familiar, perhaps, an important question. So these authors, led by Dr Deepak Bhatt from Brigham and Women's Hospital Heart and Vascular Center and Harvard Medical School, performed a systematic review and network meta-analysis of 24 randomized controlled trials comparing short-term DAPT, or less than six months, followed by aspirin or P2Y12 inhibitor monotherapy, versus mid-term DAPT, which was six months, versus 12 months DAPT, as well as an extended-term DAPT, which was more than a year after PCI with a drug-eluting stent. Dr Greg Hundley: So Dr Carolyn, three groups, what did they find? Dr Carolyn Lam: Compared to 12 months DAPT, short-term DAPT followed by P2Y12 inhibitor monotherapy reduced major bleeding after PCI with a drug-eluting stent, whereas extended-term DAPT reduce myocardial infarction at the expense of more bleeding events. Overall, the extended-term DAPT was associated with a higher risk of major bleeding compared with all other DAPT groups, except in patients with acute coronary syndrome. Dr Greg Hundley: So extended, more bleeding complications. So take me home on this, Carolyn, what is the final message here? Dr Carolyn Lam: Here's the message. Compared with 12-month DAPT, the net clinical benefit appears to favor short-term DAPT followed by P2Y12 inhibitor monotherapy instead of aspirin in select patients. Although, extended term DAPT has a role for patients who have a low bleeding risk, but a higher ischemic risk, such as those with acute coronary syndrome, thus a personalized approach appears to be warranted. Dr Greg Hundley: Very good. Well, I'm going to turn back to the world of basic science and discuss a paper related to pulmonary hypertension. And it comes from Dr Sébastien Bonnet from the University Laval. So Carolyn, the subcellular mechanisms that govern the transition from a compensated to a de-compensated right ventricle in patients with pulmonary hypertension remain poorly understood, and as a consequence, there are no clinically established treatments for RV failure and a paucity of clinically useful biomarkers. So this study investigated the long non-encoding RNAs, powerful regulators of cardiac development disease, in relation to adverse RV remodeling in pulmonary artery hypertension. Dr Carolyn Lam: So these LNK RNAs, I think that's what they're called, right? Long non-coding RNAs, what did they find? Dr Greg Hundley: This was another one of our really nice translational articles, because they combined results from both animals and human subjects. The authors demonstrated that the long non-coding RNA H19 is upregulated in decompensated right ventricles due to pulmonary hypertension, and the finding correlated with RV hypertrophy and fibrosis. Now, similar findings were observed in monocrotaline and pulmonary artery banded rats. The authors found that silencing H19 limits pathological RV hypertrophy, fibrosis, and capillary rarefaction, thus preserving RV function in those two models of pulmonary hypertension, both the monocrotaline and the pulmonary artery banded rats, without effecting pulmonary vascular remodeling. And finally, Carolyn, the authors found that circulating H19 levels in plasma of patients, discriminate pulmonary arterial hypertension patients from controls correlated with RV function and predicted long-term survival in two independent idiopathic pulmonary artery hypertension cohorts. Moreover, H19 levels delineated subgroups of patients with differential prognosis, when combined with NT-proBNP levels or the risk score proposed by both the Reveal and the 2015 European Pulmonary Hypertension Guidelines. So, in summary, these authors findings identify H19 as a potentially new therapeutic target to impede the development of maladaptive RV remodeling, and thus a promising biomarker as well of pulmonary arterial hypertension severity and prognosis. Dr Carolyn Lam: Oh, Greg, I love that. Not just the paper, but the way you explained it. Thanks so much. Well, let's dip into what else there is in today's issue, shall we? First, there's Global Rounds by Dr Yacoub entitled, Towards Meeting the Challenges of Improving Cardiovascular Health in Egypt. There's a research letter by Dr Cheng on imaging the sarcoplasmic reticulum calcium signaling in intact cardiac myocytes. There's another Research Letter by Dr Angiolillo on the pharmacodynamic and pharmacokinetic effects of a low maintenance dose ticagrelor regimen, versus standard dose clopidogrel, in patients with diabetes without prior major cardiovascular events, undergoing elective PCI. And this is the OPTIMUS-6 study. There's an On my Mind paper by Dr Santos on coronary artery calcification and familial hypercholesterolemia, and an ECG Challenge by Dr Liu, which is not your uncommon electrocardiographic findings, and really looking at Q waves with post-QRS deflections. I'll let you take a look. Dr Greg Hundley: Oh, wow, Carolyn. This issue is just jammed with really nice articles. I've got a research letter entitled, Long-Term Outcomes After Infective Endocarditis, Following Transcatheter Aortic Valve Replacement, and it's from Dr Josep Rodés-Cabau from Quebec Heart and Lung Institute. And then finally, a nice exchange of letters by Drs Rozenbaum, Kemner, and Parasuraman regarding the article Cost-Effectiveness of Tafamidis Therapy for Transthyretin Amyloid Cardiomyopathy, and there's a very nice response by Dr Kazi. Now we get to proceed on to that feature article. Dr Carolyn Lam: Yay! Let's go, Greg. Dr Greg Hundley: Well listeners, we are to our feature discussion. And today we have Dr Mark Chan from the National University of Singapore, our own associate editor, Dr Wendy Post from Johns Hopkins, and Dr Thomas Wang from the University of Texas Southwestern Medical Center. Well, Mark, we'll start with you. Could you explain to us some of your thinking behind how you formulated this study and what was the hypothesis that you wanted to address? Dr Mark Chan: The background, really, was to try to prioritize protein candidates in post myocardial infarction heart failure. We do know that there are several hundred candidates out there in the literature, but really, what we wanted to do was to try to enrich and select out what we thought would be the most biologically relevant proteins. And really, the hypothesis was that, by combining two very powerful unbiased discovery tools that have been developed in the last few years, we would be able to achieve this goal. The two tools, I think, Tommy would be very familiar with, because he's used plasma proteomics as well in a lot of his work. That's one of the unbiased discovery tools that we used. Measuring 1300 proteins in blast mine. Second two was a single-cell transcriptomics where we're able to look at RNA sequences, genome RNA sequences, at the individual cell level. So we first started off with cohorts of patients with acute myocardial infarction that were followed up for about five years for heart failure events, and we obtained plasma from these patients at about 30 days after myocardial infarction. So with the initial plasma proteomics, and found more than 200 candidates, actually very similar to what we actually see in the literature in terms of protein candidates predicting heart failure, in particular, post-MI heart failure. We then thought that what we really want to do is prioritize the most important proteins, and that's when we went onto single-cell transcriptomics. And we found a total of 83 protein candidates, which were directionally similar across the human plasma proteomics and the single-cell transcriptomic data across different models of ischemic heart failure. And six candidates are the ones that we are hoping to discuss a bit more about, the top six candidates, today, which I'm sure you'll ask me about very soon. Dr Greg Hundley: You've really led us into the next question. Tell us a little bit about the six candidates. Dr Mark Chan: The top six candidates to all of us are really familiar with NT-proB natriuretic peptide that's been around for decades, cardiac troponin, that's the second well-known, well-established candidate, and four other candidates that seem to be really emerging as potential targets in heart failure and ischemic cardiomyopathy. Angiopoietin-2, thrombospondin-2, latent-transforming growth factor binding protein 4, and a less commonly investigated protein, FSLT3, or follistatin-like related protein 2. The two candidates that are particularly interesting to me are angiopoietin-2 and thrombospondin-2 , and looking at a lot of Tommy Wang's work as well, we can see that these two candidates looking to be important future targets for biomarker discovery, validation, and maybe, potentially, druggable candidates to manage patients with post-MI heart failure and ischemic cardiomyopathy. Dr Greg Hundley: Wendy, coming to you as an associate editor and really an expert in genetic epidemiology, what intrigued you about this article? Especially I heard Mark discuss differentially expressed genetics and transcriptomics. What brought you to this article and what increased its relevance to you? Dr Wendy Post: We were very intrigued by both the importance of the problem that was being addressed, in that ischemic cardiomyopathy is a very common and major challenge that we all encounter as cardiologists, but also the unique approach that was used to handle a large amount of data. So with the plasma proteomic approach, which Mark described as the first step, you take thousands of data points and try to narrow it down, which he did, but still needed to narrow it down even more. And then use a complimentary, but different, approach to try to understand which of these hits, so to speak, maybe the ones that are important. And so using the single-cell transcriptomic approach, was able to narrow down to these six candidates. And then it was very reassuring that two of the six were what we would have hypothesized. So if you didn't find those, we'd worry that maybe something was wrong with your approach. So on the one hand, you'd say, "Well, we already knew that. So what are you telling us?" But it actually was proof, so to speak, that your approach was working, and that these other four novel candidates might turn out to be the next BNP. So that was really a few of the things that intrigued us about this paper. Dr Greg Hundley: So Tommy, as a practicing clinical cardiologist, and then also, really, as a clinician researcher, what do you see as relevant with Mark's work and also Wendy's description here for all of us that are seeing patients that has sustained myocardial infarction? Dr Thomas Wang: I think as Mark and Wendy have both nicely summarized, but I'll revisit, they're really two areas in which knowledge of these biomarkers could impact patient care down the road. One is an informative set of biomarkers to tell us which among the large number of patients with myocardial infarction might be destined to develop heart failure so that we can, as clinicians, ramp up our therapies, increase our vigilance, increase our monitoring, so that we might be able to intervene on that at a very early stage, or even before the heart failures develop. The second, which is potentially even more exciting, is the possibility that some of these biomarkers might be so informative of pathways leading to heart failure, that we could actually directly intervene on the pathways that are reflected by these biomarkers. So in other words, biomarkers would tell us not just biology, but about therapeutically effective strategies. And I think, as Mark has nicely emphasized, there are scores, if not hundreds, of biomarkers that have been looked at in this context, and there's no amount of resource in the world that allows investigators to pursue, in prospective clinical studies or experimental studies, all of these biomarkers. And so the real value of their study is to illustrate an approach for winnowing down this large number of biomarkers down to a smaller set, a much smaller set, that seem really worth pursuing in further study. Dr Greg Hundley: Well, with that lead in, Tommy and Mark and Wendy, maybe start with you, Mark, what do you see as the next step and this area of research moving forward? Dr Mark Chan: I think I need to sound a word of caution first with respect to the study itself. It is, at the end of the day, still a very descriptive study. Heavy in bioinformatic elucidation of targets. So careful mechanistic validation and further understanding of these highly prioritized targets will still be important. In terms of how we can potentially get these results closer to the post-MI heart failure patients, closer to the bedside, one concept that I think it's becoming increasingly apparent is that a lot of these bioactive proteins in circulating plasma are likely a part of the secretome. Part of what we call exosomes or micro-bubbles that are secreted by cells. And we do see the origin big cells in the single-cell studies as part of this paper. We do get an idea. A lot of these cells really are within the extracellular matrix, which is the substrate in which your cardiomyocytes are embedded. We think that enriching the plasma for the exosome fraction, which one of my colleagues is now working on, could be the best way to derive a more powerful tool for prognostication. To really determine with a high level of specificity, not just sensitivity, but highly specific to determine which patients end up with post-myocardial infarction heart failure. So enriching plasma for exosomes and potentially looking at the proteins within these exosomes, we've already started work on that. And so far, the results, compared to the proteins just measured in free plasma, seem to predict heart failure events a lot better when we come down to the exosome fraction. The other project, this is using exosomes to treat post-MI large animal models. So we have injected mesenchymal cell stem cell derived exosomes, and we've shown that they can reduce infarct size in large animal models, and also prevent some of the hemodynamic complications that result in heart failure. But really, trying to find which are the proteins actually are meaningfully preventing heart failure and reducing infarct size, I think that is also going to be part of the next steps. Dr Greg Hundley: Mark, thank you for that summary. Tommy, do you have anything to add to that? Dr Thomas Wang: I certainly agree with all that's been said. I would also emphasize that understanding the biology of some of these newer biomarkers and how they might link heart failure or active MI is going to be really important when we consider potential clinical applications. And so, further along the experimental line, I think animal models, mouse models, and other types of models, being which the biology and pathways we would manipulate it so that we can see whether these biomarkers truly do reflect etiologic pathways in heart failure would be valuable. Dr Greg Hundley: Thank you, Tommy. Well, listeners, we've had a great presentation from Dr Mark Chan, an excellent review by both Wendy Post and Tommy Wang, emphasizing how we are discovering new protein biomarkers using plasma proteomics for identification of those that may develop heart failure after myocardial infarction. And more to come in this area. We feel very privileged to have the opportunity to work with bright young investigators like this and present this work in Circulation For both Carolyn and myself, we wish you a great week and look forward to catching you next week on the Run. This program is copyright American Heart Association, 2020.

On August 30, 2020, our host Dr. Marianne Ritchie was joined by Dr. Tony Carabasi and Ms. Dawn Stensland for a discussion on vein disease & restoration.For over 20 years, Dr. Carabasi practiced at the prestigious Thomas Jefferson University Hospital and Medical school in Philadelphia, serving as Chief of Vascular Surgery for 16 years before opening his own private practice, Advanced Vein & Vascular Center, Inc, in 2007. In 2019, Dr. Carabasi partnered with the Center for Vein Restoration.Dawn is an Emmy award winning TV journalist, anchor and host. She is recognized for her work in cities across the country but is especially well loved in Philadelphia. She's in the Broadcast Pioneers Hall of Fame, named “Best of Philly” several times and she is currently the news anchor for “The Rich Zeoli Show” on WPHT.Each week we highlight the #RealChampions in your life! Your family, friends, or colleagues that go the extra mile to help others in their community. For this week, Your Real Champion was Sister Mary Scullion, the President and Executive Director of Project HOME, the country's most successful outreach for those who experience homelessness.

What Makes Vascular Center of Naples a Good Neighbor...It’s no stretch to say that Russell Becker, DO, a fellow-trained vascular surgeon practicing at Vascular Center of Naples in Naples, Florida, gets into things for the long run. Dr. Becker, who runs marathons in his free time, has experience and interest in all areas of vascular and endovascular surgery, including treatment of conditions like carotid artery disease, hemodialysis access creation and maintenance, and diseases of the veins.Beyond performing surgery, Dr. Becker is a well published author of vascular surgery literature. He has previously served as an investigator in numerous new and developing clinical device trials and has been a part of the clinical faculty in vascular surgery at Michigan State University College of Human Medicine in East Lansing, Michigan.Dr. Becker received his fellowship training in vascular and endovascular surgery at Wayne State University in Detroit. He is board-certified by the American Osteopathic Board of Surgery, he’s a fellow of the American College of Osteopathic Surgeons, and he retains active memberships with the Society for Vascular Surgery and the American Association for Vascular Surgery.After getting his undergrad degree at Michigan State, Dr. Becker received his medical degree from the Philadelphia College of Osteopathic Medicine. He later returned to Michigan State to complete his internship and residency in general surgery.Dr. Becker is married to Phan Anh Nguyen, a Naples area OB/GYN, and they have three children. When not in surgery or on the run, Dr. Becker enjoys spending time with his family.To learn more about Vascular Center of Naples, go to: https://www.vascularcenternaples.com/Vascular Center of Naples1875 Veterans Park Drive Suite 2203Naples, FL 34109Phone- 239-431-5884Support the show (https://goodneighborpodcast.com)

Dr. Anthony Burke, cardiologist with Tift Regional Heart and Vascular Center, joins us to provide insight into heart disease and women and how it may present differently than in men. Although heart disease may present differently in both genders, prevention for heart disease is still the same, and Dr. Burke also offers tips for prevention of heart disease.

Eric Broadwell, event director with GA 400 Century Ride, is in studio for this episode of Atlanta Real Estate Forum Radio. Joined by co-hosts Carol Morgan and Todd Schnick, Broadwell discusses the annual 100-mile bike race starting on GA 400 on today's Around Atlanta segment of Radio. Broadwell started his career as an aerospace engineer before moving on to IT and eventually landing in cycling advocacy. Broadwell and his kids raced bikes, and he quickly realized the interaction on the roads was not up to par with certain safety standards. This led Broadwell to go out into the community to educate and inform other cyclers on safety and fun! In addition to his work with cycling advocacy, Broadwell is also on the Board of Directors at Cobb EMC, a private pilot and works to flip houses and planes. A jack-of-all-trades, Broadwell is extremely active in several facets of the community! The GA 400 Century Ride is a 100-mile bike race starting with three miles on GA 400 and leading down Highway 9. The whole race only disrupts traffic for 30 minutes, allowing for the most convenience and safety for both cyclists and drivers. In recent years, the GA 400 Century Ride also took on an incredible charitable organization, Emory Heart and Vascular Center. This newly formed center is one of the many charities benefiting from the race. While the race is designed to be 100 miles upon completion, there are several alternative race routes for cyclists of all experience levels. The shortest race is nine miles and is named the “I Did it” ride. There are also 26, 44 and 60-mile options for varying skill levels. The race with the most participants is usually the 60-mile race. This event has been growing over the past 12 years and saw 1,600 participants in 2019. The organizers of GA 400 Century Ride expect over 2,000 participants in the 2020 race. In addition to the race, the event offers plenty of live music, free beer and free lunch. There will also be vendors all around the area to interact with. The event is set to take place on June 28 at 7:00 a.m. Anyone interested in signing up or participating in the event can visit www.GA400Century.com. You Can also listen to the full interview above for more information. Never miss an episode of Atlanta Real Estate Forum Radio! Subscribe to the podcast here. You can also get a recap of any past episodes on our Radio page. Georgia Residential Mortgage Licensee, License #22564. NMLS ID #6606. Subject to borrower and property qualifications. Not all applicants will qualify. New American Funding and GA 400 Century Ride are not associated. Click here to view the terms and conditions of products mentioned during the show. Corporate office 14511 Myford Rd., Suite 100, Tustin, CA 92780. Phone: (800) 450-2010. (April/2020) New American Funding is a family-owned mortgage lender with a servicing portfolio of over 123,000 loans for $30.4 billion, 198 branches, and about 3,100 employees. The company offers several niche loan products and has made Inc. 5000's list of Fastest-Growing Companies in America six times. It has a state-of-the-art career training facility and develops innovative technology, including the GoGo LO mobile application. For more information, visit www.branch.newamericanfunding.com/Atlanta. The Atlanta Real Estate Forum Radio “All About Real Estate” segment, presented by Denim Marketing, highlights the movers and shakers in the Atlanta real estate industry – the home builders, developers, Realtors and suppliers working to provide the American dream for Atlantans. For more information on how you can be featured as a guest, contact Denim Marketing at 770-383-3360 or fill out the Atlanta Real Estate Forum contact form. Subscribe to the Atlanta Real Estate Forum Radio podcast on iTunes, and if you like this week's show, be sure to rate it.

Emily Garner, RN, Dr. Eric Sievers, Clay Cox, RNFA and Steve Diamond discuss the recent announcement of the West Tennessee Heart and Vascular Center receiving a 3 Star Ranking by the Society of Thoracic Surgeons, how big of a deal this is for West Tennessee, and just what that means for our heart patients. Hosts: Dr. Eric Sievers, Cardiothoracic SurgeonEmily Garner, RN, Clinical ManagerClay Cox, RNFASteve Diamond, Clinical Manager

Most people have never heard of an abdominal aortic aneurysm (AAA), yet it accounted for nearly 10,000 deaths in the United States according to 2017 data from the CDC. Learn more about AAA from expert Dr. Ronald Fields, St. Mary cardiologist and medical director of St. Mary Heart & Vascular Center.

Listen to Josh's career path as he navigated his early career as an exercise physiologist in Texas, his multiple management positions in Indiana, his travels and experience in Abu Dhabi, to his current position at University of Colorado Health. Josh's path will leave you inspired and motivated to achieve more in your career.

Dr Carolyn Lam: Welcome to Circulation on the Run, Your Weekly Podcast Summary and Backstage Pass to The Journal and its Editors. I'm Dr Carolyn Lam, Associate Editor from the National Heart Centre and Duke National University of Singapore. Dr Greg Hundley: And I'm Dr Greg Hundley, Director of the Pauley Heart Center at VCU Health in Richmond, Virginia. Dr Carolyn Lam: Greg, this issue is full of super interesting papers, many of which were presented as late-breaking presentations at the American Heart Association, like the feature paper that sacubitril/valsartan across the spectrum of ejection fraction in heart failure, where this was really analyzed across the landmark PARADIGM and PARAGON trials. I'm sure everyone's looking forward to hearing about it, but before we talk about that, I want to share some more very interesting results from a very important trial, the REDUCE-IT trial. So, as some background, some trials have found that patients from the United States derive less benefit than patients enrolled outside the United States. And this was the reason that there was a pre-specified subgroup analysis of the REDUCE-IT trial, which really is the reduction of cardiovascular events with icosapent ethyl-intervention trial, and this analysis was conducted to determine the degree of benefit of icosapent ethyl in the United States. So, Greg, do you remember what the REDUCE-IT trial was about? Dr Greg Hundley: Well, Carolyn, I think REDUCE-IT randomized 8,179 statin-treated patients with triglycerides between 135 and 500 milligrams per deciliter and LDL cholesterol levels between 40 and 100 milligrams per deciliter and a history of atherosclerosis or diabetes to Icosapent Ethyl, four grams per day or placebo. And the primary endpoint, I believe, was cardiovascular death, nonfatal myocardial infarction, non-fatal stroke, coronary revascularization or hospitalization for unstable angina. Hah! Dr Carolyn Lam: Wow, Greg, you pass that quiz, like maybe you had a cheat sheet answer. Dr Greg Hundley: All right, Carolyn, tell us now what did REDUCE-IT USA find? Dr Carolyn Lam: This was from a corresponding author, Dr Deepak Bhatt, from Brigham and Women's Hospital Heart and Vascular Center, and his colleagues and they found that in the United States Icosapent Ethyl at four grams a day produced large and significant reductions in multiple ischemic endpoints including cardiovascular death, myocardial infarction, stroke, coronary revascularization, and hospitalization for unstable angina. Furthermore, REDUCE-IT US demonstrated that Icosapent Ethyl provided a statistically significant 30% relative risk reduction and a 2.6% absolute risk reduction in all-cause mortality. The risk benefit profile of Icosapent Ethyl was highly favorable with an overall safety and tolerability profile virtually identical to placebo. Dr Greg Hundley: Wow, Carolyn. So, this does have important implications for us in the US, very nice. Thank you for that lovely quiz. So, Carolyn, I'm going to switch now and talk about a paper from Roddy Walsh from Amsterdam in the Netherlands. In this study, the investigators defined the frequency of rare variation in 2,538 patients with dilated cardiomyopathy across protein-coding regions of 56 commonly tested genes and compared this to both 912 confirmed healthy controls and a reference population of 60,706 individuals to identify clinically interpretable genes robustly associated with dominant monogenetic dilated cardiomyopathy. Dr Carolyn Lam: Wow, wow. That's a huge study. So what did they find? Dr Greg Hundley: Okay, Carolyn. So overall rare variants in 12 genes potentially explain 17% of cases in the outpatient clinical cohort representing a broad range of adult patients with dilated cardiomyopathy and 26% of cases in the diagnostic referral cohort enriched in familial and early onset dilated cardiomyopathy. And so, practically speaking, by analyzing two dilated cardiomyopathy cohorts with distinctive patient profiles, the authors were able to comprehensively evaluate the genetic basis of dilated cardiomyopathy and identify variant classes that were particularly associated with early-onset disease. By restricting analyses to validated and interpretable genes and variant classes, the authors hoped in this study to increase the accuracy and reduce the uncertainty associated with genetic testing in dilated cardiomyopathy. Dr Carolyn Lam: Very nice, very practical information. Well, my next paper is, I have to admit a super favorite topic of mine, and that is sex differences in heart failure. Now as a reminder to everybody, women represent over half of patients with heart failure with heart failure preserved ejection fraction, and there are multiple effective drug and device therapies for HFrEF, or heart failure reduced ejection fraction, but none approved for HFpEF. Thus, there is a greater so-called failure therapeutic deficit in women compared to men. So, does the recently presented PARAGON trial provide answers? Dr Greg Hundley: Ah, Carolyn, you were involved in the PARAGON trial. Maybe tell us a little bit about that first to help us get oriented. Dr Carolyn Lam: I would love to. So PARAGON compared sacubitril/valsartan with valsartan in patients with HFpEF. The primary outcome was a composite of first and recurrent hospitalizations for heart failure and death from cardiovascular causes, and the trial overall narrowly missed this primary outcome. However, an intriguing result in PARAGON was a significant sex-by-treatment interaction. And this was explored further in the current pre-specified subgroup analysis of outcomes by sex, which was reported by John McMurray from University of Glasgow and his colleagues. Dr Greg Hundley: Ah, so I'm interested. What was this interaction? Dr Carolyn Lam: Ah, so here is how the interaction work. Now, remember this was multi-variably adjusted significant in a pre-specified large subgroup of PARAGON. And what we found was that as compared with valsartan, sacubitril/valsartan seem to reduce the risk of heart failure hospitalization more in women than in men. Now, while the possible sex-related modification of this effect of treatment has potential explanations, the current study really cannot provide a definitive mechanistic basis for this finding. Dr Greg Hundley: Very interesting. So, perhaps then, in heart failure preserved ejection fraction, sacubitril/valsartan could be very helpful in women. Dr Carolyn Lam: Yes, and perhaps especially those with each ejection fraction in the lower ejection fraction range. And that is coming up in our future discussions, so let's not preempt it. You got another paper, Greg? Dr Greg Hundley: Absolutely, Carolyn. My next paper is from Professor Irene Lang at the Medical University of Vienna, and it's related to microvascular disease and chronic thromboembolic pulmonary hypertension and hemodynamic phenotyping and histomorphometric assessments. So, Carolyn, pulmonary endarterectomy is the gold standard for treatment of patients with operable chronic thromboembolic pulmonary hypertension. However, persistent pulmonary hypertension after PEA or endarterectomy remains a major determinant of poor prognosis. Dr Carolyn Lam: Ah, so are there any possible solutions to this? Dr Greg Hundley: Well, Carolyn, today it is thought that a concomitant small vessel arteriography in addition to major pulmonary artery obstruction may play an important role in the development of persistent pulmonary hypertension and survival after pulmonary endarterectomy. One of the greatest unmet needs in the current preoperative evaluation is to assess the presence severity of small vessel arteriopathy. Dr Carolyn Lam: Huh, that makes a lot of sense. So what did the authors do? What they find? Dr Greg Hundley: Okay. Well, Carolyn, they had 90 patients with 49 of them receiving lung wedge biopsies for validation. So, in analyses incorporating receiver operating characteristic curves, pulmonary vascular resistance measures and larger arterial upstream resistance beds predicted persistent pulmonary hypertension after pulmonary endarterectomy, and certain values identified patients with poor prognosis after endarterectomy. Therefore, perhaps this form of analysis could be helpful in establishing prognosis in these patients and perhaps suitability for future interventions. Dr Carolyn Lam: Wow, very interesting. Well, we were saying this issue's full of very important papers, and that also includes research letters. There's a research letter by Dr Cannon talking about evaluating the effects of canagliflozin on cardiovascular and renal events in patients with type 2 diabetes and chronic kidney disease according to baseline HbA1c, including those with an HbA1c less than 7%. And these are very interesting results from the CREDENCE trial that was also presented at the American Heart Association. There's a research letter by Dr Jackevicius on the population impact of generic valsartan recall in Ontario, Canada, that really highlights the potential burden and risks associated with recalls of chronic oral medications used by large populations. And in Cardiology News, Bridget Kuehn talked about cardiovascular risk biomarkers, high-sensitivity cardiac troponin T and NT-proBNP and talked about how these two biomarkers may help clinicians stratify which patients may benefit the most from therapies for hypertension or diabetes. And this was according to a pair of studies presented, again, at the American Heart Association. Dr Greg Hundley: Well, Carolyn, that's quite a nice review. I've got just a couple more papers to discuss. There's a perspective piece from Dr Ben Levine and colleagues from UT Southwestern that discusses whether a simple physical exam and maneuvers could actually supplant tilt-table testing. He provides arguments as to whether we should continue with tilt-table testing given the high rate of false positives. And then lastly, from the Mailbag, Dr Shuyang Zhang from Peking Union Medical College Hospital and the Chinese Academy of Medical Sciences provides a letter to the editors regarding a prior publication on the clinical applicability of the awareness of androgen-deprivation therapy's effects on ventricular repolarization. And Dr Joe-Eli Salem from Vanderbilt University provides his response. Well, Carolyn, how about onto that feature? Dr Carolyn Lam: Let's go. Our feature discussion today is all about left ventricular ejection fraction. Ah, that measure we both love and hate in the world of heart failure, I think. And this paper is truly remarkable, in my opinion. It is the look at the effect of sacubitril/valsartan across the spectrum of left ventricular ejection fraction in the PARADIGM and PARAGON trials. And I'm just so pleased to have none other than the first and corresponding author, Dr Scott Solomon, from Brigham and Women's Hospital and Harvard Medical School, as well as our Senior Associate Editor, Dr Biykem Bozkurt, from Baylor College of Medicine as well. Scott, could you start by telling us about this analysis and why the opportunity to do such a special analysis in this paper? Dr Scott Solomon: This was a really fantastic opportunity because, as you know, we did these two trials, PARADIGM and PARAGON, not at the same time but essentially in series. PARADIGM was a trial of patients with heart failure reduced ejection fraction, so ejection fraction of 40%, and PARAGON was a study of patients with heart failure with preserved ejection fraction. And the interesting thing is that, with the exception of ejection fraction, the criteria for enrolling patients in these trial was virtually the same. In other words, we enrolled patients with signs and symptoms of heart failure, some elevation in natriuretic peptides, and we followed them. So it's really an extraordinary dataset of 13,195 patients in whom we can look at heart failure across that full spectrum of ejection fraction. We haven't been able to do this really since the CHARM study, which enrolled about 8,000 patients across the spectrum of ejection fraction. And it gave us an opportunity to look at a number of things including the effect of sacubitril/valsartan across that full spectrum of ejection fraction. Dr Carolyn Lam: Great. And, Scott, you want to tell us what you found? Dr Scott Solomon: When we pooled 13,195 patients, and by the way, this was a pre-specified analysis that we had decided to do prior to unblinding PARAGON. We see that if we put them all together, all these patients together, and just treat them as one group, we see that for every endpoint that we looked at, whether heart failure, hospitalization and cardiovascular death, cardiovascular death, all-cause mortality, whether we look at the time to first event endpoints or the total number of heart failure hospitalizations, we see a significant benefit in patients receiving sacubitril/valsartan compared to patients receiving either enalapril in the PARADIGM study or valsartan in the PARAGON study. Now, what we also saw though, and this is probably most important, is that there appears to be an attenuation of the treatment effect as ejection fraction rises. Now we know that patients with higher ejection fractions tend to have a lower frequency of these events such as heart failure, hospitalization and cardiovascular death. But we also see here that as ejection fraction goes up that the benefit of sacubitril/valsartan appears to wane, especially when you get over about 60, an ejection fraction of about 60%. We've looked at this in categorical ways and also looking at a continuous spline analysis throughout the entire spectrum. Dr Carolyn Lam: Yeah, I love that, and I just need to point every listener right now to figures 3 and 4 of your paper. I have a feeling we're going to be seeing these figures in a lot of talks and cited everywhere. Biykem, could I bring you in on this? What are the implications of something like this? Dr Biykem Bozkurt: The interesting findings from the pooled data are, first, support of what we had seen in PARADIGM, meaning the lower the EF, the more the benefit or the higher the benefits. And as we had seen in PARAGON, which did not show an improvement in the combined endpoint with treatment with sacubitril/valsartan in patients with heart failure with preserved ejection fraction. In the pooled analysis as the EF got higher, there didn't seem to be any benefit, but the interesting, perhaps group of patients that the pooled analysis allowed us to have a deeper dive into was heart failure with mid-range EF. And we can crudely perhaps define this as ejection fraction between 40 and 50%. And by certain analyses, which again this is in the post-hoc and also in a continuous analysis and a specific analysis and a cubic spline analysis, it appeared that the benefit extended into those individuals with mid-range ejection fraction. Again, we need to keep several points in consideration. One is ejection fraction can vary over time and is not a very precise measurement. There's definitely inter-reader as well as intra-reader variability and is not a good mayor of contractile performance. And we tend to actually have a significant amount of a specific infiltrative cardiomyopathies in that EF range, which tend to be excluded from usual clinical trials. And with that caveat, having kept this in mind, it's also important to recognize from cohorts and population-based studies, about 10 to 20% of our patients currently reside in that have HeFmrEF or heart failure with mid-range EF status. And thus the findings are intriguing, hypothesis generating and also encouraging that we may see perhaps benefits with RAS antagonism in individuals that do have LV systolic dysfunction. And probably, if this is persistent and a clear reflection of a phenotype that reflects itself as reduced ejection fraction, probably the patient may benefit. Again, these results may need to be supported by future studies, and also we need to keep in mind that infiltrative cardiomyopathies, such as amyloidosis or sarcoidosis or others, were not included in these studies. Dr Carolyn Lam: Thank you, Biykem. Go ahead, Scott. Dr Scott Solomon: Carolyn, I agree with many of Biykem's points. I think that this middle range, and you and I kind of coined that term, heart failure with mid-range injection fraction, a number of years ago. The problem, of course, is knowing where that range exactly is, and I think that some people believe it's 40 to 50%, but we know that these are very arbitrary cutoffs. The data from the pooled analysis in PARAGON, in particular, do suggest that the patients who have evidence of some degree of left ventricular dysfunction seem to benefit from sacubitril/valsartan. Now, this is not a completely novel finding because we saw that in patients who received candesartan in the CHARM study and in patients who received spironolactone in the TOPCAT trial that the greatest benefit was observed in the patients in that middle range of ejection fraction, again, below what we would normally consider the normal range. Normal might be 55% or 55% in men and women. And that gets me to the other thing that I think is really worth mentioning here, which is that we found that the range of benefits does vary by sex, so that women seem to derive greater benefit to a higher ejection fraction than men. We can see that here in figure 4, looking at these two curves that there really does appear to be a difference between men and women. Women overall derive greater benefit in the PARAGON study, it appeared than in men. So I think that the fact that there's biologic plausibility here that patients with cardiac function that is not normal seem to benefit from therapies that we know benefit patients with heart failure with reduced ejection fraction, that patients with ejection fraction that was in this middle range also do appear to benefit from sacubitril/valsartan as we think they did in other studies of other agents that we know work in patients with lower ejection fraction. Dr Carolyn Lam: Indeed, Scott. You've just pointed out my favorite figure of all, that figure 4. You know how I feel about sex differences and pointing them out. I would love to ask for Biykem's thoughts on it. But in the meantime, just to emphasize how important findings like these are because it makes us question the cutoffs that we use to define heart failure groups, makes us question is midrange more mildly reduced ejection fraction like we're also writing about. And I think really makes us question, for example, the 2016 ESC Guidelines that say that mid-range ejection fraction should be treated like preserved ejection fraction. Well, maybe this could be really game changing here in that we actually think now this group should be treated more like reduced ejection fraction. So, really, congrats on this incredible paper. Biykem, what do you think of those sex differences? I have to point out, I love your editorial, which everyone should read. Dr Biykem Bozkurt: It's very intriguing, very interesting point. The benefits from sacubitril/valsartan was interestingly similar for both sexes at lower EF levels. Women's benefit compared to men's benefit for low EF was comparable; they were not different. But women seem to confer a benefit at higher EF ranges and by this continuous analysis all the way up to the 50 to 60% range, which is very, very interesting. And as to what were the phenotypes of the women compared to men at that range, women were older, had more obesity, less CAD, and of course, at all ranges they usually tend to have a higher baseline EF. And, interestingly, even though we may state that maybe women may have more systolic dysfunction at higher EF quantification ranges or may have a different phenotype than men for HFpEF, maybe a more clear or pure heart failure phenotype, heart failure with preserved EF phenotype than men. The interesting things were the NT-proBNP levels were lower for women, though the symptoms were a little bit higher, and the benefit seemed to be higher even though the KCCQ scores were not different. So, even though we did have lesser sort of filling pressures for women and perhaps other surrogates for improvement did not seem to differ, and also biological metabolites, such as urinary cyclic GMP to creatine ratios, were not different in women. So, if we were to think of whether there were biological differences, whether there were differences in NT-proBNP levels or delta changes over time or the urinary cyclic GMP levels, they were not different in women versus men. So, we still have many other substrates for neprilysin. I mean there could be other substrates, such as adrenomedullin or bradykinin or substance P that may be differentially metabolized for women compared to men, and we don't have the data on those. But again, it's very interesting to see this upper scale of EF benefit being higher in women compared to men. So, we don't have any other either biological or other surrogate markers for benefit for women, either for the HFpEF or HFrEF being than different than men. Dr Carolyn Lam: Biykem, I just love the way you so carefully dissected that, and it's so reflected in that editorial that you and Justin Ezekowitz wrote entitled Substance and Substrate. So I'm going to make sure all readers look for it. We could go on forever. I mean I just was struck, that figure 4, also is really similar if we look at what normally ejection fraction is for women versus men with increasing age. We also see that women are supposed to have higher ejection fractions as they age compared to men at any age. So it's just intriguing to me, but you're right. I think hypothesis generating. Scott, I'm going to give you the last word. Dr Scott Solomon: I'm pretty confident that there are biologic differences between men and women. I just don't necessarily know what they are with respect to heart failure, preserved ejection fraction, but I think we're going to be spending a lot of time and effort trying to sort this out. We're pretty confident that the finding of a weighing of benefit with ejection fraction is a real one and that the benefit in this middle range is an important one to pay attention to because I agree with what you said, Carolyn. If we had been thinking about heart failure with reduced ejection fraction as something that went up to a higher level 25 years ago, we would probably have treated a lot more patients with therapies that we now know to benefit patients with heart failure with reduced ejection fraction. So, I think this data helps us rethink how we parse up heart failure and hopefully, ultimately will lead to changes how we treat patients. Dr Carolyn Lam: Well, listeners, you heard it right here on Circulation on the Run. Thank you so much, Scott and Biykem, for joining us, and don't forget to tune in again next week. Dr Greg Hundley: This program is copyright The American Heart Association 2020.  

In this episode we discuss, The intersection of technology & medicine? How  the medical field, and cardiology in particular has adapted to tech & AI advancements Case-studies revealing the effectiveness of AI techniquesWhether  medical systems need to change in order to optimize processes and provide better experiences & outcomes for their patientsHidden opportunities for entrepreneurs & healthcare practitioners The future of medicine in an AI worldResources: Books:Rebooting AI: Building Artificial Intelligence We Can Trust - Gary MarcusThe Patient Will See You Now: The Future of Medicine Is in Your Hands -  Eric Topol MDWays to follow along with Dr. Anuj, Twitter LinkedInWebsite 

Dr Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. 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 from the Pauley Heart Center in Richmond, Virginia, from VCU Health. Dr Carolyn Lam: You know what, Greg, I may have a hoarse voice today and I'm a little bit scratchy, but my goodness, I couldn't be more excited about this issue. It's the TCT issue. Dr Greg Hundley: Well Carolyn, I cannot wait to discuss with our listeners the feature article that compares Apixaban and a P2Y12 inhibitor without Aspirin, versus regimens with Aspirin in patients with AFib who have ACS, whether managed medically or with PCI, or also those undergoing elective PCI that experience regimens that include vitamin K antagonists, aspirin, or both, but more to come later. Carolyn, should I start with my first discussion article and we grab a cup of coffee? Dr Carolyn Lam: You bet, Greg. Dr Greg Hundley: So my first article is from Seung-Jung Park from the Asan Medical Center at the University of Ulsan College of Medicine. So Carolyn, here's our first quiz question. In terms of Ticagrelor, have studies been performed in those from Asia evaluating bleeding risk? Dr Carolyn Lam: You know, I have to admit, Greg, I'm not totally familiar with the literature, but I do know that it's a very important question for us practicing in Asia. We have a perception that the bleeding risk, especially intracranial bleeding, may be higher in Asians. Dr Greg Hundley: Absolutely. Well, in this multicenter trial, 800 Korean patients hospitalized for acute coronary syndromes with or without ST elevation, and intended for invasive management, were randomly assigned to receive in a one to one ratio, Ticagrelor with a 180 milligram loading dose, and then 90 milligrams twice daily, or Clopidogrel with a 600 milligram loading dose and 75 milligrams daily thereafter, and the primary safety outcome was clinically significant bleeding, which was a composite of major bleeding or minor bleeding according to the PLATO outcomes criteria at 12 months. Dr Carolyn Lam: Oh, so what did they find? Dr Greg Hundley: Well Carolyn, at 12 months, the incidence of clinically significant bleeding was higher in the Ticagrelor group than in the Clopidogrel group. So it was 11.7% versus 5.3, and that included major bleeding and fatal bleeding. They were also higher in the Ticagrelor group. The incidents of death from cardiovascular causes, myocardial infarction or stroke, was not significantly different between the Ticagrelor group and the Clopidogrel group, although there was a strong trend toward a higher incidence in the Ticagrelor group with a P value of 0.07. So consequently, Carolyn, these results identified safety concerns regarding bleeding complications of standard dose Ticagrelor in East Asian, Korean patients with acute coronary syndromes, and therefore large adequately powered randomized trials are needed to determine the optimal antithrombotic regimen in this patient population. Dr Carolyn Lam: Very important data for our patients, as is this next paper, which really examines the cost effectiveness of transcatheter mitral valve repair versus medical therapy in patients with heart failure and secondary mitral regurgitation. Now, these are results from the COAPT trial. As a reminder, the COAPT trial demonstrated that edge-to-edge transcatheter mitral valve repair using the MitraClip resulted in reduced mortality and heart failure hospitalizations and improved quality of life when compared with maximally tolerated guideline directed medical therapy in patients with heart failure and three to four plus secondary mitral regurgitation. In the current paper, first author Dr Baron from Lahey Hospital and Medical Center in Burlington, Massachusetts and St. Luke’s Mid America Heart Institute in Kansas City, as well as corresponding author Dr Cohen from University of Missouri, Kansas City, and their colleagues used data from the COAPT trial to perform a formal patient level economic analysis of the COAPT from the perspective of the US healthcare system, and they found that although the follow up costs were lower with the MitraClip compared with guideline directed medical therapy, and lower by more than $11,000 per patient. However, the cumulative two year costs remain higher by about $35,000 per patient with the transcatheter mitral valve repair, and this is all due to the upfront costs of the index procedure. Now when in trial survival, health, utilities, and costs were modeled over a lifetime horizon, transcatheter mitral valve repair was projected to increase life expectancy by 1.13 years, and quality adjusted life years, or QALYs, by 0.82 years at a cost of $45,648, yielding a lifetime incremental cost effectiveness ratio, or ICER, of $40,361 per life year gained, and $55,600 per QALY gained. Dr Greg Hundley: Very interesting. So how do we interpret these results for clinical practice? Dr Carolyn Lam: Ah, good question. So in order to place this in context, perhaps the most comparable case is the use of transcatheter aortic valve replacement, or TAVR. So based on the partner 1B trial, the ICER for TAVR, compared to medical therapy, was $61,889 per QALY gains. So this is very similar to what you just heard as the ICER for the transcatheter mitral valve repair. The cost effectiveness is also comparable for other commonly used treatments such as the implantable cardiac defibrillators for biventricular pacing, and was interestingly substantially more than the cost effectiveness of continuous flow LVADs, for example, and this is really discussed in a beautiful editorial by Dr Bonow, Mark, and O'Gara, and in this editorial, I think it's really important that they say the cost effectiveness projections really need to be placed in the context of continuing uncertainties regarding the interpretation of COAPT compared to that of the MITRA-FR trial, which reported no benefit of transcatheter mitral valve replacement compared to medical therapy, and so they warn that the current cost effectiveness analysis is not a carte blanche for interventional cardiologists to dramatically escalate their use of MitraClip procedure, and the data do support the thoughtful and deliberate use of this potentially life lengthening procedure in carefully selected patients and under very careful circumstances. You've got to read their editorial. Dr Greg Hundley: That sounds excellent, Carolyn. I really like that, putting that editorial that puts that data in perspective. Well, my next study really emanates from the ABSORB III trial, and it's from Dr Dean Kereiakes at the Christ Hospital Heart and Vascular Center. The manuscript addresses the long-term cardiovascular event rates among bioresorbable vascular scaffolds and drug eluting metallic stents. Dr Carolyn Lam: Greg, remind me, what were the results of the original ABSORB trial? Dr Greg Hundley: Right, Carolyn. So the ABSORB III trial demonstrated non-inferior rates of target lesion failure, cardiac death, target vessel myocardial infarction, or ischemia driven target lesion revascularization at one year with the bioresorbable vascular scaffolds compared with cobalt chromium everolimus-eluting stents, but between one year and three years, and therefore the cumulative to 3 year time point, the adverse event rates, particularly for target vessel myocardial infarction and scaffold thrombosis, were increased with this bioresorbable vascular scaffold. Dr Carolyn Lam: Ah, I see. Okay, so this current study evaluated the outcomes from three to five years beyond the implantation? Dr Greg Hundley: Exactly. So what this study did is they looked at an interval of time between three and five years out, and they found reductions in the relative hazards for the bioresorbable vascular scaffolds compared to the common coated stents, and that particularly occurred for target lesion failure, either cardiac death or target vessel MI or ischemia driven target revascularization when compared to the earlier zero to three year time period. So therefore Carolyn, the authors conclude that improved scaffold design and development techniques to mitigate that zero to three year bio resorbable vascular scaffold risk may enhance the late benefits that one sees in this three to five year time point, because of the complete bioresorption. Dr Carolyn Lam: So that's interesting Greg. Well, my next paper is kind of related. It is the first report of a randomized comparison between magnesium based bioresorbable scaffold and sirolimus-eluting stent in this clinical setting of STEMI with one year clinical and angiographic follow-up. So this study is from the Spanish group, Dr Sabaté and colleagues from the Interventional Cardiology Department and Cardiovascular Institute in Barcelona in Spain, and they found that at one year when compared to the sirolimus-eluting stent, the magnesium based bioresorbable scaffold demonstrated a higher capacity of vasal motor response to pharmacological agents, either endothelium, independent or dependent, at one year. However, the magnesium based bioresorbable scaffolds were also associated with a lower angiographic efficacy, a higher rate of target lesion revascularization, but without thrombotic safety concerns. Dr Greg Hundley: Wow, Carolyn, very interesting, and Dr Lorenz Räber and Yasushi Ueki wrote a very nice editorial on this whole topic of bioresorbable scaffolds, and they wonder about some of the unfulfilled prophecies. Great for our readers to put these two articles together. Now, how about in that mailbox, Carolyn? What have you got in there? Dr Carolyn Lam: First there's a research letter by Dr Kimura entitled Very Short Dual Antiplatelet Therapy After Drug-eluting Stent Implantation in Patients with High Bleeding Risk, and that's insights from the STOPDAPT-2 trial. There's another research letter by Dr Lopes entitled The Hospitalization Among Patients with Atrial Fibrillation and a Recent Acute Coronary Syndrome, or PCI, Treated with Apixaban or Aspirin, and that's insights from the AUGUSTUS trial. A very interesting perspective piece by Dr Rob Califf entitled The Balanced Dysfunction in the Health Care Ecosystem Harms Patients, a really, really interesting read, especially those working in the U.S. healthcare system. An ECG challenge deals with fast and slow, long and shorter. I would love to give you a clue to what it is. It's got to do with the atrial ventricular nodes, but I'll let you take a look and test yourself. There’re highlights from the TCT by Drs Giustino, Leon, and Greg Stone, and finally there's Highlights from the Circulation Family of Journals by Sara O'Brien. Dr Greg Hundley: Very nice, Carolyn. Well, I've got just a couple reviews. Richard Whitlock in a primer provides a nice historical review of anticoagulation for mechanical valves. How do we get here in anticoagulating this particular patient population? Next, Dr Mark Brzezinski from Brigham Women's Hospital in the Harvard Medical School in an on my mind piece provides very elegant figures, beautiful figures, demonstrating inadequate angiogenesis within the fibrous cap of atherosclerotic plaques, and indicates this could be a source or thought of as a contributing factor toward plaque rupture. What an issue, and I can't wait to get onto that featured discussion. Dr Carolyn Lam: For our featured discussion today, it is a super-hot topic, and a question that comes up again and again in clinical practice. What is the right antithrombotic therapy in patients with atrial fibrillation and acute coronary syndrome, not just those treated with PCI, but also in those treated medically? Well guess what? We're going to have answers right here. I'm so pleased to have with us Dr Renato Lopes, who's a corresponding author from Duke Clinical Research Institute and our associate editor, Dr Stefan James from Uppsala University in Sweden. Wow. Very, very important question here. Renato, could you just start by outlining what is the AUGUSTUS trial? Dr Renato Lopes: The AUGUSTUS trial was basically one of the four trials trying to give an answer, or help answering about the antithrombotic therapy in patients with anti fibrillation and/or NACS and/or PCI. So in other words, this combination of patients undergoing PCI who require antiplatelet therapy and also patients with AFib who requires anticoagulation therapy, and in summary, what the AUGUSTUS trial did was randomize patients to Apixaban versus VKA, or aspirin placebo in a double blind fashion, and this was a two by two factorial design. So these were basically the two questions that we wanted to answer. Is Apixaban better than VKA, and is it safe to drop aspirin from this treatment strategy? Remembering that everybody received a P2Y12 inhibitor for at least eight months. So this was basically the design of the AUGUSTUS trial, trying to answer two questions in the same study, a two by two factorial design. Dr Greg Hundley: Very, very nice. And Renato, if I could, I mean I said it in the intro, but may I make sure I got it right. This is the only trial in the field that included patients with ACS that was managed medically. So that's a very important group of patients that we still don't know what the best regimen is, is that right? Dr Renato Lopes: That is correct. The other trials, the PIONEER, the RE-DUAL PCI and the VPCI, they only included patients undergoing PCI, and when we designed the trial, we thought that it would be important to also include the whole spectrum of ACS, including not only the PCI treated patients, but also the medically managed patients. Dr Greg Hundley: Well, super. So could you tell us now what were the results? Dr Renato Lopes: So first, in terms of the breakdown, we found that the breakdown of the PCI, ACS versus elective PCI, was really nice. We had about 60% of the trial being ACS patients, and about 39%-40% elective PCI, and then within the PCI, I think that our results pretty much reflect practice in a lot of parts of the world, which was about 39% medically managed and about 61% PCI treated patients. So to begin with, I think a very nice breakdown that gives us power to look at these three separate groups: ACS medically managed, ACS PCI treated, and also elective PCI, which allows us to understand the whole spectrum of coronary disease in patients also with AFib, and in summary, what we showed for the primary endpoint, which was clinical major or relevant non-major bleeding. Let's start with the Apixaban versus VKA comparison, and we show that Apixaban was safer than VKA in all three groups, in the ACS medically managed, in the PCI treated patients, and also in the elective PCI patients. There was no significant direction for those three subgroups, although it was borderline 0.052, just showing maybe a little bit less pronounced results in the elective PCI group, but nonetheless, I would say that in general, very consistent, and in terms of Aspirin for the primary endpoint, also no difference, no interaction among those three groups. In other words, as we increase substantially the risk of bleeding about two folds in all the three groups, ACS medically managed, PCI treated patients, and elective PCI patients, with about again, two fold increase in bleeding compared to placebo. If we go to ischemic events, again, that's our hospitalization and other that are ischemic events. In terms of Apixaban versus VKA, the results were very consistent with the overall trial among these three groups, and in terms of as ACS versus placebo, the results also for the ischemic events were also similar among the three groups. So again, reassuring that the main results of the trial were very consistent, regardless how patients were managed in terms of the ACS, medically or through PCI, and also included in the elect PCI group. Dr Carolyn Lam: Thank you for explaining that so well. Stephan, I would love for you to take us under the hood. What were the editors thinking when we saw this paper, why we're highlighting it now, and what do you think are the implications? Dr Stefan James: The AUGUSTUS trial was unique in many aspects. I think Renato highlighted a few of them. As he told, there have been several similar trials without the other DOAX, factor 10A inhibitors and the dabigatran, but the AUGUSTUS trial was larger. It includes, as you mentioned previously, patients with ACS and medical management, and it also was designed as a two by two factorial design. So it actually asks two different questions and made two different randomizations, both anticoagulation with the two different agents, Warfarin versus Apixaban, but also Aspirin versus placebo, and so it's possible from this trial to understand more of the different aspects of treating patients, these complex patients with atrial fibrillation, NACS or PCI, and gave the study group and us an opportunity to better understand all these complexities. So with that, I'd like to turn to Renato and try to, with that background that I just outlaid, and you just try to make us understand what are the clinical implications of these aspects of the trial and the treatment of Apixaban and Aspirin in these patients? Dr Renato Lopes: I think we were in the area that we desperately needed randomized data, because basically until five years ago, the standard of care of treating these patients was the classic triple therapy with Aspirin, Clopidogrel, and Warfarin, and this was based on no randomized trials and all observational data, and we know how problematic this is, and this field has evolved tremendously almost year after year since the PIONEER trial, since the RE-DUAL trial, and this year, we had AUGUSTUS and ENTRUST and I think now, as Mike Gibson used to say, that we have about 2.8 million different combination of antithrombotic strategies to treat these patients because we have different anticoagulants, different anti-platelets, different doses, different durations, different types of stents, which makes it really impossible for physicians or for any guidelines to contemplate all these options. So we really needed a few trials to at least try to give a few options that are evidence based and not just based on low quality of data, and I think now, if you look at the Augustus results, and the totality of the data from all these trials, which now is about almost 11,000 patients all together, actually almost 12,000 patients all together. I think that what we know today is that yes, the initial period in hospital for some time it's important to use Aspirin. I think this is an important point to highlight, Stephan, that Aspirin still needs to be used for the acute treatment, and I would say at least for the first few initial days while patients are still in the hospital, but then by the time of discharge, which sometimes might be five days, six days, seven days, I think that now the totality of data show that it's reasonable to drop Aspirin for most patients. So based on the AUGUSTUS results, what we show is that if you're going to use anticoagulation as Apixaban at the dose that is approved for stroke preventions in atrial fibrillation, combined with a P2Y12 inhibitor without Aspirin after the initial period, you have the best outcomes in terms of lower rates of bleeding, lower rates of hospitalizations, and we don't have to pay a cost in terms of ischemic events when we actually drop Aspirin and keep only the NOAC, in this case was Apixaban, plus a P2Y12 inhibitor, which most of the time was Clopidogrel, and here with AUGUSTUS, we basically show that this is true for patients with AFib and ACS, irrespective of the management with medical managing, with medical therapy, or with PCI. So I think that's an additional piece that that is true irrespective of how we're going to treat your ACS patient, or if the patient basically underwent elective PCI, and I think we learned today that the classic treatment therapy of VKA plus Aspirin plus P2Y12 inhibitor, so in other words, the triple classic triple therapy should generally be avoided. Dr Stefan James: Thank you Renato. I think that that was a very complete answer in this complex arena. I'd like just to mention that of course the AUGUSTUS, as well as the other trials, have their limitations, as all trials. Although it was large, it was powered for safety, for bleeding events, and it was not powered for ischemic events. Having said that, we still want to look at ischemic events and clinical outcomes, and to what degree do you think we can do that? What conclusions can we draw from an ischemic point of view because of the fact that the trial was underpowered for that interpretation? Dr Renato Lopes: That is a great question, Stephan, and in fact, if we look at events like stent thrombosis, they are very rare, and if you really want to attack a significant difference between Aspirin versus placebo in patients having stent thrombosis, we're really going to need a trial with about 30-40,000 people, which would be not feasible and not doable. So we need to be cautious when we analyze those events in the power trial for ischemic events. Nonetheless, there was a signal, if you look at all trials, and even in the meta-analysis that we published recently, that dropping Aspirin probably increased the risk of ischemic events, not in a statistically significant fashion, but nonetheless, this trend exists. The signal exists. So probably keeping Aspirin, add some protection for ischemic events, primarily stent thrombosis and myocardial infarction. The problem is a tradeoff. The problem is that the cost of adding aspirin is too high. So now the question to us, Stephan, is to look further into our data and in the combined data sets that we're trying to work with the other authors and try to identify, okay, Aspirin really increased the risk of bleeding, but is there a group of patients who might benefit from a little bit longer Aspirin? So that's the first question. Who are those patients? May be complex PCI, maybe bifurcation lesions, maybe multiple lesions, multiple stents, and second, if we decide to give Aspirin longer, how much longer should we give? Because again, the cost is very high in terms of bad bleeds. So we are trying now to identify what is the trade off, and who most benefit from keeping Aspirin longer, and for how long in a way the cost might be worth it to pay in exchange of potentially save some ischemic events? And with that, we can further refine the treatment that I think I highlighted before. For most patients, I think what I said before is probably reasonable. We can drop Aspirin by the time of discharge after a few days, but for a few patients, for some patients, it might be wise to keep Aspirin a little bit longer, and we are trying now to identify first, who those patients are and second, form how much longer should we keep Aspirin, since the 40,000 patient trial is very unlikely to happen. Dr Stefan James: I like his interpretation, Renato, although I wanted to highlight that there are limitations, I think this trial is extremely informant for clinicians. We learned a lot how to treat these very complex patients with complex treatments. Dr Carolyn Lam: No, I couldn't have agreed more. I mean quoting Mike Gibson, 2.8 million combinations. Well, at least we've talked about some of them here and had a very clear take home message, although with the caveats that we were discussing. Thank you so much, Stefan and Renato. This was really a great discussion, and thank you audience for joining us today. You've been listening to Circulation on the Run. Don't forget to tune in again next week. This program is copyright American Heart Association 2019.  

Dr. Eric Velasquez, Robert W. Berliner Professor of Medicine (Cardiology); Chief, Cardiovascular Medicine; Chief, Cardiovascular Medicine, Yale New Haven Hospital; Physician-in-Chief, Heart and Vascular Center, Yale New Haven Health

Dr. Dan Jacoby, MD and Director of Comprehensive Heart Failure and Inherited Cardiomyopathy Programs at Heart and Vascular Center at Yale New Haven Hospital and Dr. Umer Darr, MD, cardiac surgeon and Chief of Cardiac Surgery at Heart and Vascular Center at Bridgeport Hospital were on Chaz & AJ in the morning Thursday, February 7 to discuss heart health and the importance of knowing your blood pressure and what happens if you do have high blood pressure. #smarthearts

Cardiologist Dr. Robert Winslow of Heart and Vascular Center at Bridgeport Hospital stopped by First Thing Fairfield County to, talk about atrial fibrillation and how to take care of yourself during Heart Month!

Guest: Thom W. Rooke, M.D. Host: Darryl S. Chutka, M.D. (@ChutkaMD) Varicose veins are common, and become more common with advance in age. Fortunately, in most cases they’re asymptomatic, but in some cases can cause symptoms and occasionally serious health problems. Today we’re joined by Dr. Thom Rooke, a vascular specialist at Mayo Clinic’s Vascular Center and specialist in peripheral artery disease, varicose veins, and sclerotherapy.Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.  

Transarterial-chemoembolization (TACE) has been a palliative treatment or bridging treatment for liver cancer, whether primary or metastatic. TACE is a combination of local delivery of chemotherapy and a procedure to block of the blood supply to the tumor and trap the chemotherapy in the tumor. Here to discuss the latest advances in trans-arterial chemoembolization of liver tumors (TACE) & radioembolization of liver tumors (Y90) is Dr Ahmed M. Kamel, he is the Chief, Interventional Radiology Co-Medical Director, Heart and Vascular Center at UAB Medicine.

John Cooke, chair of the Department of Cardiovascular Sciences at the Houston Methodist Research Institute and the director of the Center for Cardiovascular Regeneration in the Houston Methodist DeBakey Heart and Vascular Center in Houston, Texas is working to use science to rejuvenate aging cells.  More here: http://nationalpost.com/health/scientists-discover-method-to-rejuvenate-aging-human-cells/wcm/14c95c54-7c26-4c3a-8815-d1d8030fe901

Today’s guest is Patrick Jordan, the Chief Operating Officer for the Lahey Hospital & Medical Center, located in Burlington, Massachusetts, just outside of Boston. It encompasses an ambulatory care center serving more than 3,000 patients each day and a 317-bed hospital. It is a level II trauma center, and features several centers including the Cerebrovascular Disease Center and the Landsman Heart and Vascular Center. The first liver transplant in New England using an adult living donor was performed at Lahey and the system continues to support teaching and research in collaboration with Tufts University School of Medicine. In this podcast we explore Patrick’s career, a journey that begins with service as a ranger-qualified Army officer in the renowned 82nd Airborne Division and Special Operations Command Atlantic. We talk about how he transitioned from military service to hospital administration, starting as the manager of linen services for Massachusetts General Hospital, working his way up through logistics jobs, then transitioning to clinical operations, eventually holding the position of interim president for Newton-Wellesley Hospital before coming to present position at Lahey Hospital & Medical Center. Patrick has a great story, and he tells it with a lot of candor about his own successes and challenges. For more information, please go to our website, http://healthleaderforge.org

Peripheral artery disease (PAD) occurs over time, decreasing the blood supply to organs and limbs, primarily legs and feet. This circulation disorder occurs in blood vessels not found in the heart, but can affect blood flow to the heart. Ketul K. Chauhan, MD is here to explain why Florida Hospital is a Vascular Center of Excellence with experience in diagnosing and treating peripheral artery disease and other arterial conditions.

For patients with aortic aneurysms, symptoms often don’t begin until the aneurysm ruptures, which can be fatal for patients. Learn more about the risk factors and treatment options from a surgeon at the UVA Heart and Vascular Center who specializes in treating aortic aneurysms. Tagged under: Heart Health

Guest: Neil Stone, MD Host: Alan S. Brown, MD, FNLA Why is metabolic syndrome so important if it's not a disease? What have we learned from clinical trials about treating metabolic syndrome with lifestyle and/or drugs? And, what hurdles does the clinician face in trying to improve metabolic syndrome variables in the individual patient? Join Host Dr. Alan Brown as he welcomes Dr. Neil J Stone who will answer these questions and more. Dr. Stone is the Bonow Professor of Medicine at The Feinberg School of Medicine of Northwestern University and Distinguished Physician and Medical Director of the Vascular Center of the Bluhm Cardiovascular Institute of Northwestern Memorial Hospital in Chicago, Illinois.