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Duke Heart Week ending July 17th 2020

Chief’s Note:
This weekend Representative John Lewis longtime congressman and civil rights leader died after a 6 month battle with cancer.  He rose from a farm upbringing in Alabama to become a leader of the civil rights movement most notably surviving a brutal beating by police during the 1965 march to Selma Alabama at the Edmund Pettus Bridge. He was a follower of Martin Luther King Jr. and participated in Freedom Riders challenging segregation with bus rides, lunch counter sit-ins, and was the youngest speaker at age 23 at the historic 1963 March on Washington.  His continuous and unwavering commitment to justice over 50 years lead to the Presidential Medal of Freedom in 2011. He embraced non-violence and forgiveness as a way of life even under tremendously trying circumstances, stating “we must never hate, the way of love is a better way.” He also advocated for speaking up when some thing was not right and “never be afraid to make some noise and get in good trouble, necessary trouble.”  John Lewis will be missed, and hopefully his actions and lessons will be remembered.

Navar Heading to UT Southwestern; Leaving Duke in September

Ann Marie Navar, MD, PhD, Associate Professor of Medicine in the Division of Cardiology, Associate Director for Outcomes Research with Duke Forge, and member of the Duke Clinical Research Institute, has accepted a faculty position with the UT Southwestern Medical Center (UTSW) in Dallas. She will serve as Associate Professor of Medicine in the Cardiology Division, and is joining their cardiovascular prevention team. Her last day at Duke will be Sept. 18.

A native Texan, Ann Marie was born and raised in Corpus Christi. After completing college at the University of Texas at Austin, she headed to Johns Hopkins Bloomberg School of Public Health where she obtained an MHS and later, a PhD in Global Disease Epidemiology and Control.

Navar has called Duke and Durham home since 2005, when she arrived for medical school at Duke. She completed medical school at Duke in 2009, and then went onto residency in Internal Medicine and Pediatrics. Ann Marie’s interest in cardiovascular disease began when she carried out research as a resident with Dr. Eric Peterson and Dr. Michael Pencina. She stayed at Duke for fellowship in cardiology, where she continued to focus on cardiovascular prevention research, with publications in many major journals including NEJM, JAMA, JACC and Circulation She was selected for the Greenfield award for outstanding research by a fellow in 2016, and successfully applied for a K award during her research year at the DCRI on her first attempt.

In four years on faculty, Navar has developed into nationally recognized expert in cardiovascular disease prevention. Her work has centered on using large databases to identify gaps in cardiovascular prevention, determine reasons for under-utilization, and explore ways to improve use of guideline based prevention therapies. She has become a frequently invited international speaker on real world data and cardiovascular prevention, served on numerous NHLBI working groups, and spoken before an FDA Advisory Committee. Currently, she is a board member of the American Society for Preventive Cardiology and an associate editor at JAMA-Cardiology. With a focus on innovation, Navar also served for the past four years on the American Heart Association’s Health Tech advisory group, chaired the Health Tech program at AHA’s Scientific Sessions, and served as DCRI’s Director of Innovation. In this role, she led a collaboration with Cerner that is now developing EHR-based tools for clinical research across a national network of health systems and creating new EHR-based datasets for clinical research. Recognizing this body of work, Navar was promoted to Associate Professor at Duke this past year.

Navar is especially grateful to her prevention research collaborators including: Eric Peterson, Michael Pencina, Neha Pagidipati, Mike Nanna, and Adam Nelson. “I owe them a lot of credit for my success, because they have all served as mentors, colleagues and mentees – everybody in every role at various times over the years. They’ve been the best part of working here, and I am so grateful to have had the chance to work with all of them.”

Ann Marie will also be remembered as a caring clinician and teacher. “I’ve had the opportunity to work with so many amazing people. I am so grateful for the nurses in the CCU who taught me the basics as an intern and showed me how to float an emergent temp wire as a fellow, the residents and fellows who supervised me as a medical student, the attendings I learned from in fellowship, and of course the amazing team of APPs that I get to work with when I am on the inpatient PAC service. But more than anything, I have had the best residents and fellow mentees I could have asked for.”

Outside the hospital, Ann Marie was notable for her infectious personality and initiator of fun and mischief. Despite not being able to throw a ball overhand, Ann Marie managed to be the longest serving player on the Duke Heart softball team, Number Needed to Harm. She will be remembered for her speed on the base pads, her ‘swinging bunt grand slam’ and her top-of-her-lungs cheering at for teammates. Simply put, she was the heart of the team.

Moving forward, Navar will be joining the faculty at UTSW working in cardiovascular prevention, and will have an Adjunct appointment in the Department of Population & Data Sciences. One strength of UTSW that was particularly appealing to Navar was the work the Department is conducting to improve population health at Parkland Hospital, which serves a diverse community in Dallas. “I’m excited to join a team that is already doing great things in implementation science and population health in the community, and I look forward to helping expand this work to cardiovascular prevention.”

Navar looks forward to closer collaboration with a number of other national experts in cardiovascular prevention at UTSW. “Fifteen years of connections at Duke are impossible to say good-bye to,” Navar says. “Instead, choose to see this as adding a new team to my group of collaborators. If there’s one thing COVID has taught us, it’s that we don’t have to be in the same room to work together. Regardless of where I am, I expect to remain closely connected to Duke for life.”

We will post information in Pulse regarding going-away celebrations as they are planned. Meanwhile, please join us in congratulating Ann Marie and wishing her continued success!


ICYMI: International Coordination Leads to first for Duke Health

Dr. Kishan Parikh, Silvia Macagno and her husband in early 2020 (before COVID-19).

Thanks to a talented team at Duke Raleigh Hospital (DRaH), a patient in the southern hemisphere is now receiving ongoing, life-changing care. Argentina’s Silvia Macagno is Duke University Health System’s first patient to receive a CardioMEMS implant and then be followed by international remote monitoring. This device measures and transmits changes in pulmonary artery pressure to signal worsening fluid retention in the lungs due to heart failure.

Macagno grew up with a heart malformation first diagnosed at the age of six resulting in a life dealing with heart failure, pulmonary hypertension and a series of surgeries. Her connection to DRaH came through Alex Barbagelata, MD, a cardiologist and adjunct professor in Duke’s Department of Medicine who practices in Argentina. (Barbagelata is an active DUCCS member.)

In December 2019, Macagno traveled to North Carolina where she was evaluated to be a candidate for pulmonary hypertension care, including the implantation of the CardioMEMS to remotely monitor and manage her pulmonary artery pressures. Kishan Parikh, MD, cardiologist and pulmonary hypertension specialist with Duke Health, led the effort.

“Fluctuations in these pressures can predict clinical changes. If we can act on this data, we can reduce heart failure complications,” said Parikh. “The information provided by the CardioMEMS device is like having data from a right heart catheterization procedure daily.”

The data from Macagno’s device is now transmitted to an online portal where Parikh monitors the readings, allowing him to work with Barbagelata to manage Macagno’s condition from Raleigh while she is at home in Argentina.

“This device helps bring care delivery from inside the hospital and clinic, to the patient’s home,” said Parikh. “It allows us to see trends, instead of just a snapshot every couple of months, so we can be proactive instead of reactive in our care of Ms. Macagno.”

This story appeared this week in Inside DukeHealth and in an earlier blog post for DRaH: https://bit.ly/3hlTDTX.

Nicely done!


Certificate of Excellence Awarded to 7100

Congratulations to the Duke University Hospital Unit 7100 team for their collaboration with EVS to ensure a clean environment for our patients and team. They received a Certificate of Excellence this week for having earned the Duke Hospital Highest Cleanliness Score (June, 2020) for their score of 91.7 under the HCHAPS metric “How Often Was Your Room and Bathroom Kept Clean.” Pictured here are some of our 7100 staff and leadership along with Elizabeth Webb, EVS Patient Experience Manager. Great job!!


ACLS/BLS Second Make-Up Course Held

The Duke Heart Leadership ACLS Instructor group, led by Dr. Kristen Newby, held their second faculty ACLS/BLS make-up session at DMP this week. The courses had been pushed out and required a new process due to new safety guidelines around COVID-19.

Shown here are Joe Rogers, Laura Dickerson and Jill Engel.

Thanks again to Cory Miller, Laura Dickerson, Heather McKinney, Mary Lindsay and Jill Engel for their efforts!


Duke Moments to Movement Series on Race and Social Injustice

A reminder that Duke is hosting an online series of panel conversations on race and social injustice, called Moments to Movement. The next panel, Black Women at Duke and in America, will take place on Thursday, July 23 at 1 p.m. A third is planned for August 13, called Clinicians on Race and Health Disparities. Information about registering and accessing the sessions have been shared via email. If you have not received an invitation and would like to attend the panels, please send a note to DUHSLeaders@duke.edu.

The first panel session included Duke Heart’s Brian Wofford as a panelist and is now available for viewing. Please visit: https://players.brightcove.net/5844457457001/default_default/index.html?videoId=6167555251001

For additional resources, please see the website for Duke’s Office for Institutional Equity. They have an extensive list of resources that may be of interest to you and others on your team. https://oie.duke.edu/resources-understanding-and-confronting-racism-and-its-impact.


DHTS: Email Services Update, July 24 & 25

REMINDER! DHTS is planning an email services update the weekend of July 24-25. Beginning at 11:59 p.m. on Friday, July 24, through 11:59 p.m. on Saturday, July 25, Duke University and Duke Health email services will be updated and access to email, MS Teams and other programs may be temporarily impacted during this time. A user’s email account and related Microsoft services may become temporarily unavailable anytime within the 24-hour window, however no individual user should be impacted for more than 4 hours.


COVID-19 Updates:

All the latest official DUHS information regarding coronavirus/COVID-19 response at the following locations:


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:

July 10 — Joseph Rogers

The News & Observer

There’s some good news buried in North Carolina’s rising COVID-19 hospitalization numbers


(Requires access to Duke Box)


July 10 — Jennifer Li, Sarah Armstrong and Asheley Skinner (Pediatrics, Population Health)


Early childhood overweight, obesity tied to high cardiometabolic syndrome risk



July 10 — Michael Nanna and Eric Peterson

tctMD/the heart beat

Black Patients in RCTs of PCI Show Worse Long-term Outcomes



July 16 — Guillaume Marquis-Gravel

MDEdge/Emergency Medicine

PCI or not, mortality climbs with post-ACS bleeding complications



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