Each year we are blessed with some of the best and brightest fellows.  I am struck by the fearlessness of our cardiology fellows as they learn both the care of patients with heart disease but also ask questions and search for answers in how to better care for them.  As such, with increasing commitments, I have worked to engage our fellows to learn about their interests and lives.  One of the best ways that we have done that is by going to Duke Basketball games, a privilege that is not easy to come by.  It use to be that two cardiology fellows would have the chance (in the late 90’s early 2000’s) to carry the defibrillator to each game and sit behind the scorer’s table.  This was done with two EMT and two CCU nurses.  This was truly a ‘perk’ of the Duke Cardiology fellowship. However, with time and AEDs, that opportunity has changed.  So in an effort to keep the tradition going, I have been attending Duke games with various groups of fellows.  It has been fun to see the team, and more importantly learn outside the hospital how these young minds see the delivery and discovery to help improve heart health.  Inspiring and fun – something that hopefully describes Duke Cardiology. Here are some of our fellows before and after the Syracuse game (unfortunately an unexpected loss). 

Highlights of the week:

Islam “Izzy” Othman, MD to Join Duke Heart

We are excited to announce that Izzy Othman will be joining the Duke Heart Team to lead the care of patients with complex coronary artery disease and chronic total coronary occlusions.  Dr. Othman founded the complex coronary intervention and chronic total occlusion program at WakeMed in 2013.  Over the past 6 years, he has guided the program to regional and national recognition for exceptional safety standards and efficacy in complex coronary interventions.  A recipient of The Triangle Business Journal “40 under 40” award, Dr. Othman is a recognized leader in the field of complex coronary interventions directing cardiovascular symposia and serving as a national preceptor for complex coronary interventions including chronic total occlusions.  He has also served as medical director of interventional cardiology and director of cardiac cath labs in the WakeMed Health and Hospital system.  Dr. Othman will join the multi-disciplinary team at Duke that includes cardio-thoracic surgeons, interventional cardiologists, heart failure specialists, and general cardiologists that aim to improve decision-making regarding revascularization of patients with complex coronary artery disease.  Given his unique perspective as a healthcare leader within Wake County, he will also continue to help bridge the care for heart disease patients as part of the HeartCare Plus initiative by spending time seeing patients and performing procedures in Durham and Wake counties.

Dr. Othman is a native of Durham and completed his general cardiology and interventional cardiology fellowship at the Heart Institute at East Carolina University.  Please welcome Izzy when you see him.

AUGUSTUS Trial Results Accepted as ACC Late Breaker

Congratulations to Renato Lopes (trial PI), John Alexander (trial executive committee chair), Chris Granger (executive committee member) and the rest of the AUGUSTUS trial team! Their clinical trial findings have been accepted as a late-breaker for presentation at ACC.19; they’ll present their results on Sunday, March 17 in New Orleans.

Their submission, “An Open-label, 2 x 2 Factorial, Randomized Trial to Evaluate the Safety of Apixaban versus Vitamin K Antagonist and Aspirin versus Placebo in Patients with Atrial Fibrillation and Acute Coronary Syndrome and/or Percutaneous Coronary Intervention: Primary Results of the AUGUSTUS Trial,” was accepted into LBCT session 405: Joint American College of Cardiology/Journal of the American Medical Association Late-Breaking Clinical Trials.

This photo was taken during a dinner with AUGUSTUS trial team members from the Duke Clinical Research Institute and Bristol-Myers Squibb. Dukies shown here include Jerry Kirchner, John Alexander, Chris Granger, Liz Cook, Renato Lopes, Amit Vora and Gretchen Heizer. The others are from Bristol-Meyers Squibb, who, along with Pfizer, sponsored the trial. The team gathered on January 10 at Angus Barn to celebrate the unblinding of the AUGUSTUS results.

AUGUSTUS, which launched in 2011, enrolled 4614 patients with atrial fibrillation and either an acute coronary syndrome or PCI. Patients were randomized in a 2 x 2 factorial design to apixaban or warfarin and aspirin or aspirin placebo. The primary outcome was bleeding. Death or hospitalization and ischemic events were secondary outcomes.

Well done!

Califf, Ginsburg at Keystone

Digital Health: From Science to Application was held January 21-25 in Keystone, CO. Geoff Ginsburg was one of the organizers for the conference which was convened by Keystone Symposia on Molecular and Cellular Biology. The event pulled together dozens of thought-leaders with strong interest in digital technologies and how they’re applied to human health. Presenters included Robert Califf, “Can we map the human health condition?” and several others with ties to Duke including Helen Eggers of NYU and Jason Langheier of Zipongo.

To learn more, please see https://bit.ly/2sPUcOw or, if you’re on Twitter, you can check out their conference feed at #KSdighealth.

Duke at STS in San Diego

Jill Engel and Brittany Zwischenberger each presented at the 55th annual meeting of The Society of Thoracic Surgeons this weekend in San Diego. Engel was a moderator for the Multidisciplinary Session and is on that work group for the STS. She also spoke about Advanced Practice Coverage Models. Zwischenberger presented on a Culture of Safety and shared the work Duke Heart is doing as part of Duke Heart Safe Choices. Shown with them in this photo is Peter Smith, chief, Duke Division of Cardiovascular and Thoracic Surgery.

Nice job!

Cory Miller, CICU Nurse Clinician, was recently honored with a Duke University Health System palliative care award. The Palliative Care team at Duke nominates a person or persons who have not only been an outstanding collaborator to their team, but who also practice palliative care principles in their daily work. “We thought Cory was an ideal candidate,” said Tony Galanos, professor of medicine in geriatrics. “She demonstrates compassionate care and advocacy; is a wonderful communicator, and she teaches house staff and other nurses in the CICU.”

We could not agree more! This is a very well-deserved honor.

John Ryder, a 25-year volunteer with Duke Heart, was honored with a Lifetime Achievement Award from Tom Owens, MD, president of Duke University Hospital, on January 17. Ryder helped start our patient support program in 1992, which helps patients and their families cope with the challenges of being a heart patient. Ryder has volunteered thousands of hours at Duke. He is also a heart attack survivor.

“It’s very fulfilling to help these patients feel better,” said Ryder. “I often see a veil of fear lifted from their faces when I joke with them. I tell them that at Duke, they’re seeing the best heart mechanics on the planet. And, that always brings a smile to their face.”

Ryder said that volunteering has been a personal blessing for him, and that he feels he has touched many lives.

Indeed, Ryder has been a blessing to us as well.

Feb. 18: Exercise is Medicine Across the Lifespan Colloquium

Keynote Speaker: William E. Kraus, Science Behind the 2018 U.S. Physical Activity Guidelines. 8 a.m. to Noon, Trent Semans Center, Great Hall. Free. Space is limited, please register at this link: https://duke.qualtrics.com/jfe/form/SV_dhGzI4aGIbdEqd7

Feb. 20: Duke Heart Safe Choices. Registration: https://bit.ly/2KaKdeu

July 2019: Genomic Medicine T32 Training Program: Two slots remaining!

The Duke Center for Applied Genomics and Precision Medicine has two slots remaining for their two-year Genomic Medicine T32 training program, which opens in July, for PhDs or MD fellows. This is a great opportunity! To learn more, please visit: https://bit.ly/2Mz9DDG

Heart Month Events

Feb. 1: Let your color be RED! 

On February 1st, Duke Heart will host a booth from 8:00 a.m. to 1:00 p.m. in front of the Duke Atrium Café (Duke North cafeteria) to celebrate National Wear Red Day for Women. We will provide red awareness ribbons (while supplies last), heart health information, heart trivia, a “selfie” station and the opportunity to register for door prizes. Join us as we educate and raise awareness regarding heart disease as the leading killer of women in the U.S.

If your team would like red ribbons delivered in time for Wear Red Day, please complete the form available through this link: https://duke.qualtrics.com/jfe/form/SV_6Ea625LsZjdBs3j

Feb. 14: Duke Heart at Cameron Indoor: It Takes a Team to Care for Your Heart

Joining Duke Heart at the Duke vs. VA Tech women’s basketball game. 7 p.m., Cameron Indoor Stadium, 115 Whitford Drive. We will offer free heart health risk-factor screenings, stroke education and wellness tips. Compression-only CPR education will also be available.

To receive a special discounted general admission ticket to the game, please visit https://tinyurl.com/y8zaxv4q and enter promo code: HEART.

Please consider volunteering. Duke Health staff members are needed to assist with our heart and stroke health risk-factor screenings from 6:00 p.m. until the end of the game.

To volunteer, please visit https://tinyurl.com/ToVolunteerTakesATeam

Feb. 23: Duke Heart Day at The Sutherland
Our special community outreach event for National Heart Month will be on February 23 at The Sutherland in Wake Forest, NC from 9:30 a.m. until 1:30 p.m.

For more information on any of our Heart Month events, please contact Leatrice Martin Short at 919-477-7611.

Upcoming Duke Heart sponsored CME Activities

March 2: 6th Annual Duke Valve Symposium, Trent Semans. Registration link forthcoming.

April 27: 6th Annual Duke Sports Cardiology & Sudden Death in Athletes Symposium, Washington Duke Inn. Registration link forthcoming.

September 7: 9th Annual Duke EP Summit, JB Duke Hotel. Registration link forthcoming.

September 21: 2nd Annual Duke Cardiology Symposium for APPs, JB Duke Hotel. Registration link forthcoming.

 

Duke Cardiology News, Updates, Reflections, and Accolades

Volume 107                                                                               January 20^th 2019

Chief’s message:

“Life’s most persistent and urgent question is, ‘What are you doing for others?’“ Dr. King once said to an audience in Montgomery, Alabama in 1957. On this weekend as we remember Dr. Martin Luther King, Jr., it is clear that the civil rights leader lived to help those most in need.  It is an important ethos that I see everyday in the Duke Heart work.  I am struck by the continued efforts among our faculty, staff, and colleagues in the care of people in our community and at the clinical places we work.  This includes serving at the food bank, book harvest, open access clinics, health fares, and many faith based community projects. As the month of February starts soon and we officially start “Heart Month,” I wanted to recognize the work of all of our Duke Heart Family.  We have much more to do to help our region become one of better health, but it is worth spending a moment reflecting this weekend on the service, support, and joy you all bring to lives in our communities.

Highlights of the week:

Wang Named Vice Chief for Clinical Services, Division of Cardiology

Andrew Wang, MD, professor of medicine in cardiology, has been named Vice Chief for Clinical Services in the Division of Cardiology. He replaces Chet Patel, who was recently named Vice Chair for Clinical Affairs in the Duke Department of Medicine. Wang’s term will begin at the end of this month.

Wang is director of the Duke Hypertrophic Cardiomyopathy Clinic and a highly respected structural heart disease specialist. He is an active researcher in the area of heart valve disease, including aortic and mitral valve conditions and is currently serving as principal investigator on a number of grants. He has held numerous teaching responsibilities throughout his tenure at Duke, including educational initiatives with the American College of Cardiology and American College of Physicians. Most recently, Wang served as program director of the Duke Cardiovascular Disease Fellowship Training Program from 2007-2018. He is a dedicated clinician and educator who has received numerous awards during his time at Duke, including the 2017 School of Medicine Master Clinician Teacher Award.

An author or co-author on more than 80 publications and 45 abstracts, he serves on the editorial board for American Heart Journal, and is a peer reviewer for more than 15 journals.

Wang earned his undergraduate and medical degrees from Duke University, and completed his internship and residency at Johns Hopkins in Baltimore, MD. He completed his fellowship at Duke, and joined our faculty in 1997.

His commitment to clinical care and clinical research, and his dedication to excellence in education will help strengthen the three priorities in our mission. Please welcome Andrew into this role as we work together toward improving clinical metrics, care access, and standardizing clinical pathways across our division. Congrats, Andrew!

Swamy Joins Duke Heart Team

We are pleased to introduce Rajiv Swamy, MD, FACC, as a new member of the Duke Heart faculty. Swamy officially joined our interventional cardiology faculty as an assistant professor of medicine on December 10; he will perform cardiac and vascular procedures at Duke University Hospital and at Central Carolina Hospital-Duke Lifepoint in Sanford, NC.

Most recently, Swamy worked in a busy academic cardiology and vascular practice at Allegheny Health Network in Pittsburgh, PA and held an academic faculty appointment at Temple University. In Pittsburgh, he worked on numerous committees to improve system processes within cardiology and he has a special interest in growing clinical programs that improve access and treatment choices to patients in community settings.

Swamy’s primary clinical focus is in the endovascular treatment of peripheral arterial disease and most notably in patients with critical limb ischemia. He hopes to use his experience and skills to help deliver greater treatment options and improved care to patients within Duke Health.

After completing his undergraduate degree at Duke University, Swamy earned his MD from the University of Chicago-Pritzker School of Medicine. He completed his internship, residency, chief medical residency and his fellowship in cardiovascular disease at the University of Chicago Medical Center. He then went on to complete his fellowship in interventional cardiology and peripheral interventions at New York University School of Medicine.

Rajiv and his wife, Richa Agarwal, MD, a faculty member in the advanced heart failure and transplant group at Duke, have two boys, Sohan (7) and Rahul (4). Their family is very excited to be in Durham and part of the Duke community and are looking forward to establishing deeper roots here.

Please offer a warm welcome to Rajiv when you see him!

Bloomfield Recognized by Circulation

The editors of Circulation, one of the journals published by the American Heart Association, have recognized Duke cardiologist and DCRI member Gerald Bloomfield as an Outstanding Reviewer for 2017-2018. In a letter, the editors Joseph Hill, MD, PhD; James de Lemos, MD, and Darren McGuire, MD, stated that “advances in biomedicine hinge critically on the vital, and often unrecognized, efforts of professionals such as Dr. Bloomfield who devote time, energy, and expertise to the evaluation of emerging science. We cannot publish outstanding – and reliable – content in Circulation were it not for these efforts. As this important work occurs largely behind the scenes, we are notifying you of our recognition of Dr. Bloomfield’s outstanding contribution to the fields of cardiovascular science and medicine.”

Congratulations, Jerry!

Keeping the Heart Young: Proposals to Invest in the Future of CV Research

We had the opportunity to hear from four finalist teams on Thursday evening as they presented their project proposals to compete for funding via the Translating Duke Health: Cardiovascular pillar, part of the Translating Duke Health Initiative. Representatives from each team presented and defended their proposals to translate and transform cardiovascular science at Duke and all did an incredible job. Presentations included:

Communities to Cells (C2C): Promoting Hypertension Resistance in Black Americans (PI: Ebony Eboulware, MD, MPH, Duke internal medicine)

A Population Health Approach to Early Precursors of Cardiovascular Disease: Establishment of the Research to Identify the Early Life Cardiometabolic Exposome (ResILienCE) Cohort (PI: Kevin Hill, MD, MS, Duke pediatrics)

Personalizing Cardiovascular Health: A population approach to promoting CVD resistance and resilience among individuals with obesity (PI: Neha Pagidipati, MD, Duke cardiology)

Cardiac Regeneration Therapy to Restore Ventricular Function (PI: Nenad Bursac, PhD, Duke cell biology and Pratt BME)

The event was held in the Great Hall of the Trent Semans Center. The TDH:CV steering committee will be meeting in the coming weeks to discuss the presentations and determine which teams will be awarded funding. Stay tuned for that announcement.

Great job, everyone and thanks to all who attended!

Watts to Serve as Nurse Manager, DUH Invasive Labs, Effective Feb. 1

Duke Heart is pleased to announce that Elizabeth Watts, MSN, RN, will become Nurse Manager for the DUH Invasive Labs effective Friday, February 1. Elizabeth has served as Interim Nurse Manager for the DUH Invasive Labs since November 20, 2017.  Elizabeth joined the Duke Heart team in January, 2014 as a staff nurse in the Duke Electrophysiology (EP) Lab and became the EP Clinical Lead in December, 2015. During her time at Duke, Elizabeth has held a variety of leadership roles. She currently serves as Chair of the Invasive Labs Clinical Practice Committee (CPC); and is a member of Heart Core Safety, Heart Center Clinical Practice Council, and the EP Mentorship committee.

Elizabeth earned a Bachelor of Science in Health Services Management from East Carolina University (ECU) in 2007, a Bachelor of Science in Nursing from ECU in 2009 and a Master of Science in Nursing Education from ECU in 2013. She co-authored an article on EP education published in the February 2017 issue of EP Lab Digest (https://www.eplabdigest.com/articles/New-Approach-Electrophysiology-Education) and was a presenter at the 2017 Vizient Clinical Connections Summit.

Please join us in congratulating and welcoming Elizabeth to her new role.

 

DCMRC Completes Relocation; Now Fully Operational

The Duke Cardiovascular Magnetic Resonance Center (DCMRC) is pleased to announce it is fully operational in its new location within Duke Medical Pavilion (DMP) on the first floor near radiology. The DCMRC, under the leadership of its co-directors Drs. Raymond Kim and Robert Judd, is the largest dedicated cardiovascular MRI imaging (CMRI) center in the United States with more than 4,000 procedures performed per year. Drs. Kim and Judd are internationally recognized Gold Medal recipients from the Society of Cardiac Magnetic Resonance for their exceptional research and clinical work in the field of CMRI.

The DCMRC’s new location has three new Siemens MRI scanners; two 3.0 Tesla Siemens Vida scanners and the first North American installation of a 1.5 T Siemens Sola. The Sola will offer enhancements in hardware and software to provide imaging information with higher image resolution than previously possible at 1.5 T field strength. The DCMRC is also a Siemens showcase site which brings in physicians from all over America to see the cutting-edge work performed at Duke.

Commonly performed exams include: myocardial viability exam to assess for myocardial infarction and infiltrative disease, as well as accurate determination of left ventricular ejection fraction and structural heart disease; adenosine stress testing to assess for inducible myocardial ischemia; adult and pediatric congenital heart disease, and non-invasive 3-dimensional arterial angiography.

To schedule a cardiac or vascular MRI exam, please call the scheduling line at 919-668-6960. 

 

Cardiology Grand Rounds – updates

 

This week (Jan. 22) we welcome Paul Wischmeyer from our Critical Care Division who will speak on the role of nutrition in cardiac surgery and cardiac critical care: “Malnutrition is an Emergency in the Cardiology Patient: What Can You Do?” The meeting will begin at 7:15 a.m. in DN 2003.

 

Upcoming Cardiology Grand Rounds:

 

• 29: Kory Lavine, Washington University
• 5: Bridgette Christopher will be presenting her research from fellowship
• 12: Blair Grubb, University of Toledo
• 26: Rajesh Vedanthan, NYU (this will be a Global Health Conference)

Upcoming Events & Opportunities:

Feb. 1: Let your color be RED! 

On February 1st, Duke Heart will host a booth from 8:00 a.m. to 1:00 p.m. in front of the Duke Atrium Café (Duke North cafeteria) to celebrate National Wear Red Day for Women. Each year, millions of Americans join together in the fight against heart disease in women by wearing red. This encourages awareness of the issue and provides a call to action to save more lives. We will provide red awareness ribbons (while supplies last), heart health information, heart trivia, a “selfie” station and the opportunity to register for door prizes. Join us as we educate and raise awareness regarding heart disease as the leading killer of women in the U.S.

If your team would like red ribbons delivered in time for Wear Red Day, please complete the form available through this link: https://duke.qualtrics.com/jfe/form/SV_6Ea625LsZjdBs3j

Feb. 14: Duke Heart at Cameron Indoor: It Takes a Team to Care for Your Heart

Make this Valentine’s Day extra special by joining Duke Heart at the Duke vs. VA Tech women’s basketball game. 7 p.m., Cameron Indoor Stadium, 115 Whitford Drive. Stop by our table on the Main Concourse to meet members of Duke’s Heart Team and learn how to care for your heart. We will offer free heart health risk-factor screenings, stroke education and wellness tips. Compression-only CPR education will also be available.

To receive a special discounted general admission ticket to the game, please visit https://tinyurl.com/y8zaxv4q and enter promo code: HEART.

Please consider volunteering. Duke Health staff members are needed to assist with our heart and stroke health risk-factor screenings from 6:00 p.m. until the end of the game.

To volunteer, please visit https://tinyurl.com/ToVolunteerTakesATeam

Feb. 23: Volunteers Needed for Duke Heart Day at The Sutherland
Our special community outreach event for National Heart Month will be on February 23 at The Sutherland in Wake Forest, NC from 9:30 a.m. until 1:30 p.m. Volunteers are needed to provide blood pressure screenings with BMI, weight, height and waist circumference measurements. We are also seeking support for event set-up, traffic control, registration, compression-only CPR training, and risk assessment education. Please complete the form below to confirm volunteer availability no later than January 23.

 

Designated times for volunteer duties are noted in this registration link:  https://duke.qualtrics.com/jfe/form/SV_aYmmkdoEO06y6Vf

For more information, please contact Leatrice Martin Short at 919-477-7611.

Have news to share?

If you have news to share with the Pulse readership, please contact Tracey Koepke, director of communications for Duke Heart at tracey.koepke@duke.edu. We would love to hear about your latest accomplishments, professional news, cool happenings, and any events or opportunities that may be of interest to our Duke Heart family. Please call with any questions: 919-681-2868. Feedback on Pulse is welcome and encouraged.

Duke Heart in the News:

January 14 — Christopher Granger

Medscape

AHA Initiative Boosts Quality of Care for STEMI

https://www.medscape.com/viewarticle/907591

 

January 14 — John Alexander

Medpage Today

Rivaroxaban Might Not Add Much to Post-CABG Prevention

https://www.medpagetoday.com/cardiology/prevention/77424

 

January 15 — Stephen Greene and G. Michael Felker

Healio/Cardiology Today

Improved medical therapy may lead to better outcomes in treating HFrEF

https://www.healio.com/cardiology/hf-transplantation/news/online/%7Bdad6878d-3edf-4387-b070-1963b52caf38%7D/improved-medical-therapy-may-lead-to-better-outcomes-in-treating-hfref

 

January 15 — general Duke mention/Blue Premier deal

WUNC.org

NC’s Largest Health Insurer Reaches Landmark Deal With Five Health Systems

http://www.wunc.org/post/ncs-largest-health-insurer-reaches-landmark-deal-five-health-systems

 

January 16 — general Duke mention/Blue Premier deal

NC Health News

BCBSNC, major hospitals say they’re coordinating to provide more “value-based” care

BCBSNC, major hospitals say they’re coordinating to provide more “value-based” care

 

January 16 — general Duke mention/Blue Premier deal

News & Observer

Blue Cross and 5 NC hospitals will now share patients medical data to slow cost increases

https://www.newsobserver.com/news/business/article224554225.html

 

Duke Heart Publications, week ending 01-20-2019

Shah R, Latham SB, Porta JM, Naz A, Matin K, Rao SV.  Bivalirudin with a post-procedure infusion versus heparin monotherapy for the prevention of stent thrombosis.  Catheter Cardiovasc Interv 2019.  Epub ahead of print.

Secemsky EA, Ferro EG, Rao SV, Kirtane A, Tamez H, Zakroysky P, Wojdyla D, Bradley SM, Cohen DJ, Yeh RW. Association of Physician Variation in Use of Manual Aspiration Thrombectomy With Outcomes Following Primary Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction: The National Cardiovascular Data Registry CathPCI Registry. JAMA Cardiol 2019. Epub ahead of print.

Narayan SM, Wang PJ, Daubert JP.  New Concepts in Sudden Cardiac Arrest to Address an Intractable Epidemic: JACC State-of-the-Art Review.  J Am Coll Cardiol 2019;73(1):70-88.

Califf RM, Hamburg M, Henney JE, Kessler DA, McClellan M, von Eschenbach AC, Young F. Seven Former FDA Commissioners: The FDA Should Be An Independent Federal Agency.  Health Aff (Millwood) 2019;38(1):84-86.

Greene SJ, Butler J.  Primary Prevention of Heart Failure in Patients With Type 2 Diabetes Mellitus.  Circulation 2019;139(2):152-154.

Khan MA, Yang EY, Zhan Y, Judd RM, Chan W, Nabi F, Heitner JF, Kim RJ, Klem I, Nagueh SF, Shah DJ.  Association of left atrial volume index and all-cause mortality in patients referred for routine cardiovascular magnetic resonance: a multicenter study. J Cardiovasc Magn Reson. 2019;21(1):4.

Bratt A, Kim J, Pollie M, Beecy AN, Tehrani NH, Codella N, Perez-Johnston R, Palumbo MC, Alakbarli J, Colizza W, Drexler IR, Azevedo CF, Kim RJ, Devereux RB, Weinsaft JW.  Machine learning derived segmentation of phase velocity encoded cardiovascular magnetic resonance for fully automated aortic flow quantification.  J Cardiovasc Magn Reson 2019;21(1):1.

Warraich HJ, Taylor DH , Jr, Casarett DJ, Hasan M, Patel CB, Kamal AH, Harker M, Mentz RJ.  Hospice Care for Heart Failure: Challenges Faced by Hospice Staff in a Predominantly Rural Setting.  J Palliat Med 2019;22(1):7-8.

Diamantidis CJ, Davenport CA, Lunyera J, Bhavsar N, Scialla J, Hall R, Tyson C, Sims M, Strigo T, Powe NR, Boulware LE.  Low use of routine medical care among African Americans with high CKD risk: the Jackson Heart Study.  BMC Nephrol 2019;20(1):11.

Navar AM, Roe MT, White JA, Cannon CP, Lokhnygina Y, Newby LK, Giugliano RP, Tershakovec AM, Braunwald E, Califf RM, Blazing MA.  Medication Discontinuation in the IMPROVE-IT Trial.  Circ Cardiovasc Qual Outcomes. 2019;12(1):e005041.

Parikh KS, Sheng S, Hammill BG, Yancy CW, Fonarow GC, Hernandez AF, DeVore AD.  Characteristics of Acute Heart Failure Hospitalizations Based on Presenting Severity.  Circ Heart Fail 2019;12(1):e005171.

Johnston AL, Vemulapalli S, Gosch KL, Aronow HD, Abbott JD, Patel MR, Smolderen KG, Shishebor M, Spertus JA, Jones WS.  Ankle-brachial index in patients with intermittent claudication is a poor indicator of patient-centered and clinician-based evaluations of functional status.  J Vasc Surg 2019. Epub ahead of print.

Welcome to The Pulse where we share the Duke Heart News, Updates, Reflections and Accolades.