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Duke Heart Week ending March 14th 2021

50th DCD Heart Transplant Performed at Duke Health

The Duke Heart Transplant team performed their 50th Donation after Circulatory Death (DCD) heart transplant late last weekend at Duke University Hospital. The device used in the transplant procedure is the Transmedics Organ Care System (OCS), a device that circulates warm, oxygenated blood through organs. The OCS Heart system has not yet been approved by the FDA; it is still under investigational use at approximately 18 sites in the U.S.

“We are really happy to be at the forefront of research and innovation in heart transplantation and to be able to get our patients access to high quality organs despite not being in one of the larger U.S. metropolitan areas – like Los Angeles or New York City — where there are more donors and a much larger population,” said Adam DeVore, medical director of Duke’s Heart Transplant Program. “This means we are able to offer transplant to patients in a variety of statuses here in Durham and give them access to high quality organs earlier.”

Earlier access to a heart transplant could mean a better outcome for the patient – the sicker they get, the longer and potentially more difficult the recovery time for many patients.

The Duke team is a leader both in DCD heart transplant volume as well as enrollment into the EXPAND trial and DCD trial, both of which are in Continued Access Protocol (CAP) status, according to DeVore. The Duke team was the first in the U.S. to transplant an adult heart via the DCD donor method in December 2019 as part of the DCD clinical trial.

“We have now done 50 successful DCD heart transplants in 16 months, proving that we can expand the donor pool and transplant a good heart faster into patients who need them to survive,” said Jacob Schroder, surgical director of Duke’s Heart Transplant Program. “[In the past] we’ve talked about heart transplant as a supply-limited endeavor; that there are not enough donors. We believe, with DCD, the future is going to be demand limited.

“This should hopefully open up eligibility for heart transplant so that people who were passed over because they weren’t the “perfect” or ideal candidate can be considered for this life-saving therapy.”

DeVore credits a strong team dedicated to getting patients the care they need. “The absolute elbow grease, work and sweat that goes into this is incredible. We would not have gotten here without the work of Carmelo Milano and Chet Patel; and we have surgeons – Ben Bryner, Milano and Jacob Schroder – as well as research and perfusion team members — flying all over the place to get access to organs that can save lives. We have figured out how to do this and how to do it well, and it has been deeply rewarding.”

Congratulations to our Heart Transplant and Advanced Heart Failure team members – we are so proud of the work you’re doing!

Book Review: “A Funny Thing Happened on the Way to Stockholm”

Having worked for Bob Lefkowitz, I was not surprised to hear he had created the autobiography, A Funny Thing Happened on the Way to Stockholm. Working with Randy Hall, Lefkowitz chronicles life events from childhood through to the present. I was not surprised because Lefkowitz is a superb story teller and it seemed natural, that at some point, he compile his many stories into a novel. I found the book to be captivating and humorous, and enjoyed it immensely (just as I have enjoyed listening to his many stories over the years). On one level, the book describes the many scientific discoveries in the world of receptor biology, which Lefkowitz accomplished as he progressed from the National Institutes of Health, through the Harvard system and finally to Duke University.

For example, he describes in detail his scientific activity during 1986 when, in a single year, nine different G-protein-coupled receptors and an important regulatory kinase were cloned and characterized. He credits luck and his research fellows frequently for the discoveries, yet it is apparent that his keen intellect, competitive spirit and tireless focus were the critical drivers. More generally, this is a walk through a very dynamic time for biochemical science in general, as the discovery of the structure of DNA and the genetic code enable a much more in-depth study of most processes. Indeed, the reader realizes that science does not reveal itself in a linear manner but rather in episodic periods of exponential growth — and Lefkowitz was very much at the center of one of the most productive periods. All of this culminates with his selection for the Nobel Prize in Chemistry in 2012. However, if the book were to only describe his scientific accomplishments and progressive ascent to the Nobel Prize, it would not be as interesting as it is.

For one thing, the book spends time discussing failures and frustrations that Lefkowitz experiences along the way. Some of these events relate to his scientific career, but many others are uniquely personal (and relevant to all of us). These sections are captivating as the reader does not expect to see this side of a Nobel Laureate. He gives the reader sound advice for dealing with life’s challenges. The Lefkowitz recipe for overcoming and persisting despite life challenges includes pragmatism, humor and reliance on strong friendships. Furthermore, the book is also a good read for future leaders. While his personal accomplishments are, of course, legendary, his ability to recruit, drive and develop young talent is an even a greater achievement. The book reveals many strategies to motivate and inspire greatness in others. These approaches are valuable for anyone developing a high performance team.

Also, it is fascinating that a premier basic scientist would devote so much discussion to clinical medicine. Indeed, many sections of the book describe clinical care scenarios that Lefkowitz encountered, most of which occurred before he became focused on basic science. He even at times laments his career turning away from direct patient care. These sections are entertaining and reinforcing for those of us who have remained in the doldrums of patient care, and don’t dream much of the Nobel Prize. Furthermore, a great deal of discussion relates to his own health conditions and those of his parents. These sections are particularly interesting since we get to see health care from the patient perspective where anxiety and depression can compound physical ailment. In this reading, health care workers can appreciate that they are brokering a precious commodity. Perhaps this attention on health care is not surprising as these memoirs suggest that our health remains the greatest prize of all.” – Carmelo Milano, MD

A Funny Thing Happened on the Way to Stockholm, The Adrenaline Fueled Adventures of an Accidental Scientist by Robert Lefkowitz with Randy Hall was published in early February by Pegasus Books.


Murillo Awarded 2021 TSF Fellowship

Alejandro E. Murillo, one of our cardiothoracic surgery residents, has been named the 2021 recipient of the Thoracic Surgery Foundation’s (TSF) Resident Research Fellowship Award for his project, Identification of Protein Biomarkers to Predict Cardiac Allograft Dysfunction after Ex-Vivo Normothermic Perfusion Storage. The fellowship provides support of up to $30,000 per year for up to two years. Murillo is a member of Carmelo Milano’s research lab. The TSF is the charitable arm of The Society of Thoracic Surgeons.

Congratulations, Alejandro!


AHA Triangle Heart Ball, March 19

The American Heart Association’s Triangle Heart Ball will take place virtually on Friday, March 19 at 7:30 p.m. The annual fundraiser features a silent auction and the AHA “Open Your Heart Appeal.” Tickets are free, but registration (secured with a credit card) is required so that you can bid on auction items and/or make an open donation. The silent auction opens Tuesday, March 16 at 8 a.m. and closes Friday, March 19 at 9 p.m.

To register, please visit: https://event.gives/triangleheartball and make sure to list Duke Heart as your company. This event is sponsored locally by Duke Heart, UNC Health and LeithCars.com.


Reminder: Vote! Best Hospitals Survey Open Through 26th

How to Vote: Voting for U.S. News Best Hospitals is open in Doximity through March 26, 2021. To vote, physicians can visit Doximity.com or the survey page on Doximity.com. The survey will display until the physician votes or the survey closes.


COVID-19 Updates:

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


Upcoming Opportunities/Save the Date:


Cardiology Grand Rounds

Mar. 16: Advanced Cancer is also Heart Failure Syndrome:  Cardio-Oncology Including and Beyond Cardiotoxicity with Stefan Anker, Professor of (Tissue) Homeostasis in Cardiology & Metabolism at Charite Berlin. 7:15 a.m., Webex.

Mar. 23: If You Build It… (They) Will Come – Advanced Therapies in ACHD with Jonathan Menachem of Vanderbilt University Medical Center. 5 p.m., Webex.

March 30: TBD

April 6: Management of POTS with Camille Frazier-Mills. 5 p.m., Webex.

April 13: Advancing Gender Equity in Global Cardiovascular Health Outcomes with Zainab Samad of Aga Khan University. 7:15 a.m., Webex.

April 20: Spontaneous Coronary Artery Dissection with Esther (Soo Hyun) Kim of Vanderbilt University Medical Center. 5 p.m., Webex.

April 27: Cardio-Oncology: Moving Forward in 2021 with Daniel J. Lenihan, Director, Cardio-Oncology Center of Excellence, Washington University in St. Louis. 5 p.m., Webex.


Six-Part Mental Health Webinar Series Available Through April

Mar. 17: Understanding Adolescent Alcohol and Substance Use. 4-4:30 p.m. Hosted by the Department of Psychiatry & Behavioral Sciences and led by associate professor David Goldston, PhD. (Link below)

This is the third in a six-part webinar series, “Taking Care of Yourself and Your Loved Ones,” for all Duke University and Duke Health community members and their families. The 30-minute topical webinars provide practical expert advice on topics including emotional wellness, substance misuse, suicide prevention, and mental health for children, adolescents and teens.

The webinar series runs through April 27. Learn more, watch past webinars and join upcoming webinars:  http://bit.ly/DukeMHSeries.

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:

March 8 — Duke University Health System

Gaston Gazette

‘BUSINESS North Carolina’ ranks CaroMont Health as third best in the state


March 9 — Adrian Hernandez

Bloomberg Government

HEALTH CARE BRIEFING: Study Offers Look at How Vaccines Compare


March 9 — Brian Mac Grory (Neurology)

Cardiovascular Business

‘A cardiovascular problem disguised as an eye problem’: Why CRAO requires immediate treatment


March 9 — Jill Engel


CTSNet To Go Podcast Episode: Straight Talk With APPs: Current Hot Topics and Trends in Practice and CT Surgery


March 9 — Adrian Hernandez and Rob Califf

Bloomberg Law

Real-World Study to Offer Look at How Covid-19 Vaccines Stack Up


March 10 — Michael Pencina and DCRI

Medpage Today

Machine Learning Adds Little to MI Prognostication


Division of Cardiology Publications Indexed in PubMed March 4–10, 2021

Arshad V, Samad Z, Das J, Almas A, Rashid N, Virani SS, Bloomfield GS, Jafar TH, Ahmed B. Prescribing Patterns of Antihypertensive Medications in Low- and Middle-Income Countries: A Systematic Review. Asia Pac J Public Health 2021;33(1):14-22. PM: 33084371.

Brezitski KD, Goff AW, DeBenedittis P, Karra R. A Roadmap to Heart Regeneration Through Conserved Mechanisms in Zebrafish and Mammals. Curr Cardiol Rep 2021;23(4):29. PM: 33655359.

Dong OM, Bates J, Chanfreau-Coffinier C, Naglich M, Kelley MJ, Meyer LJ, Icardi M, Vassy JL, Sriram P, Heise CW, Rivas S, Ribeiro M, Jacobitz R, Rozelle S, Chapman JG, Voora D. Veterans Affairs Pharmacogenomic Testing for Veterans (PHASER) clinical program. Pharmacogenomics 2021;22(3):137-144. PM: 33403869.

Fernandes F, Moreira CHV, Oliveira LC, Souza-Basqueira M, Ianni BM, Lorenzo CD, Ramires FJA, Nastari L, Cunha-Neto E, Ribeiro AL, Lopes RD, Keating SM, Sabino EC, Mady C. Galectin-3 Associated with Severe Forms and Long-term Mortality in Patients with Chagas Disease. Arq Bras Cardiol 2021;116(2):248-256. PM: 33656072.

Harrington RA, Ohman EM. Risk Stratification Science Goes to a New Level. JAMA Cardiol 2021;6(3):314-315. PM: 33295937.

Hartiala JA, Han Y, Jia Q, Hilser JR, Huang P, Gukasyan J, Schwartzman WS, Cai Z, Biswas S, Trégouët DA, Smith NL, Seldin M, Pan C, Mehrabian M, Lusis AJ, Bazeley P, Sun YV, Liu C, Quyyumi AA, Scholz M, Thiery J, Delgado GE, Kleber ME, März W, et al. Genome-wide analysis identifies novel susceptibility loci for myocardial infarction. Eur Heart J 2021;42(9):919-933. PM: 33532862.

Puffer ES, Healy EF, Green EP, Giusto AM, Kaiser BN, Patel P, Ayuku D. Family Functioning and Mental Health Changes Following a Family Therapy Intervention in Kenya: a Pilot Trial. J Child Fam Stud 2020;29(12):3493-3508. PM: 33664559.

Rosenberg P, Zhang H, Bryson VG, Wang C. SOCE in the cardiomyocyte: the secret is in the chambers. Pflugers Arch 2021;473(3):417-434. PM: 33638008.

Speakman JR, Yamada Y, Sagayama H, Berman ESF, Ainslie PN, Andersen LF, Anderson LJ, Arab L, Baddou I, Bedu-Addo K, Blaak EE, Blanc S, Bonomi AG, Bouten CVC, Bovet P, Buchowski MS, Butte NF, Camps SGJA, Close GL, Cooper JA, Creasy SA, Das SK, Cooper R, et al. A standard calculation methodology for human doubly labeled water studies. Cell Rep Med 2021;2(2):100203. PM: 33665639.

Tsai CF, Smith JS, Eiger DS, Martin K, Liu T, Smith RD, Shi T, Rajagopal S, Jacobs JM. Mass Spectrometry-Based Proteomics for Analysis of Hydrophilic Phosphopeptides. Methods Mol Biol 2021;2259:247-257. PM: 33687720.

Varma N, Cygankiewicz I, Turakhia M, Heidbuchel H, Hu Y, Chen LY, Couderc JP, Cronin EM, Estep JD, Grieten L, Lane DA, Mehra R, Page A, Passman R, Piccini J, Piotrowicz E, Piotrowicz R, Platonov PG, Ribeiro AL, Rich RE, Russo AM, Slotwiner D, Steinberg JS. 2021 ISHNE/ HRS/ EHRA/ APHRS collaborative statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals: From the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Society. Ann Noninvasive Electrocardiol 2021;26(2):e12795. PM: 33513268

Weissler EH, Gutierrez JA, Patel MR, Swaminathan RV. Successful Peripheral Vascular Intervention in Patients with High-risk Comorbidities or Lesion Characteristics. Curr Cardiol Rep 2021;23(4):32. PM: 33666765.

Zhang S, Breitner S, Cascio WE, Devlin RB, Neas LM, Ward-Caviness C, Diaz-Sanchez D, Kraus WE, Hauser ER, Schwartz J, Peters A, Schneider A. Association between short-term exposure to ambient fine particulate matter and myocardial injury in the CATHGEN cohort. Environ Pollut 2021;275:116663. PM: 33581627.


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