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Duke Heart Week Ending April 25th 2021

Chief’s message: Spring Days

Spring days long days of sunlight are good for all of us.  It is notable in North Carolina that there is a yellow covering on all things – the season of pollen.  This week was notable for some more important announcements around change (see the announcement below around Dr. Fulkerson), continued teamwork by groups of faculty, fellows and staff in caring for our patients (see the photo from cath lab on Friday), and continue involvement in changing how we care for patients (ISHLT meeting 2021- lead by Joe Rogers).  We are blessed to at any given time at Duke Heart to be surrounded by great colleagues, partners, fellows, and staff, many of whom are shaping the field of cardiovascular medicine.   As we move through the ongoing change in healthcare, we will have trust and lean into working with each other to shape our future.  As I have often said, the people we get to work with make Duke Heart special.

Updates from the week:

Dr. Wiliam Fulkerson to Step Down from EVP of Duke Health December 21st  2021

Dr. Bill Fulkerson announced this week that he will be stepping down as the Executive Vice President of Duke Health system at the end of this year.  He noted that he will be continuing to support the health system, but wanted the next person who will be shaping our future to engage in this time of transition.

Dr. Eugene Washington provide the following statement around the tremendous impact Dr. Fulkerson has had on Duke Health.

“Dr. Fulkerson’s transition as EVP will be a great loss for Duke, but we will benefit from the fruits of his superb leadership for many years to come. When Dr. Fulkerson became the second EVP of the health system back in July 2010, he was already a seasoned leader, as well as an accomplished academician. He had served as Senior Vice President of Clinical Affairs for DUHS, CEO of Duke University Hospital, Vice President of DUHS, Chief Medical Officer for both DUHS and the Private Diagnostic Clinic (PDC), and Professor of Medicine in the Duke University School of Medicine. Throughout his leadership trajectory, Dr. Fulkerson has amassed a reputation of being an outstanding physician and administrator of integrity who cares deeply, is an award-winning teacher, has a passion for excellence, and is truly committed to championing DUHS to be the best in the industry.

As EVP over the past decade-plus, he has amply demonstrated his exceptional dedication and abilities as an executive administrator, a creator of innovative programs, a builder of state-of-the-art facilities, a respected colleague and mentor, and a collaborative broker of strategic partnerships across Duke Health, Duke University, Durham and beyond.

Dr. Fulkerson’s career has not only had a substantial positive impact on Duke, but also has improved hundreds of thousands of lives, in part due to the tremendous growth that DUHS has experienced under his leadership. Today, we are 24,000 people strong compared to approximately 15,000 when he started as EVP. Scores of individuals in DUHS have been recruited and have thrived under his tutelage. Our reach in touching lives has extended locally, regionally and nationally. The number of patients we cared for across Duke Health increased nearly 50% – from approximately 550,000 in 2010 to nearly 820,000 last year. Groundbreaking multidisciplinary, multisector programs and ventures have advanced and excelled with Dr. Fulkerson at the helm of DUHS. Our DUHS and broader Duke Health Clinical Enterprise footprint and facilities have also expanded impressively with Dr. Fulkerson as a driving force.

During this period of unprecedented growth, we continued to lead in the delivery of highest-quality, patient-centered care, deservedly receiving multiple professional accolades to affirm our high standards. DUHS’ financial performance has been stellar during Dr. Fulkerson’s EVP tenure, with revenue increasing 85% – from $2.1 billion in 2010 to $3.9 billion in 2020 and an average operating margin of approximately 8%. Importantly, DUHS’ success over this period has enabled $1.5 billion in support for our academic missions, principally the Duke University School of Medicine.”

We look forward to continuing to partner with Dr. Fulkerson and work with the Health system as we engage in our future state to discover deliver health to our community.


Shout-Out to Samsky

Together with Aimee Zaas, the Program Director of the Duke IM residency, and Sunil Rao, we want to give a HUGE thank you to Marc Samsky who covered the VA Cardiology Consult service for multiple days last week when a significant number of residents were out sick with food poisoning.

Thank you Marc!! – Anna Lisa Crowley

Nicely done, Marc!


Kudos to Loungani

We’re pleased to share the following note received last week by Anna Lisa Crowley – more great teamwork shown by cardiology fellow Rahul Loungani!

My housestaff and I responded to a nursing call that our patient had SVT. Rahul was walking by and saw the tachycardia and our interventions and stepped in to help. Over the next 1.5 hours, he hung out with us at bedside as we managed (the patient’s) arrhythmias. Ultimately he also helped us arrange transfer to the CCU. We were all at bedside until close to 8 pm.

“I really appreciate the way he saw an opportunity to help colleagues and a patient and jumped in, even if it wasn’t his responsibility. These little acts of kindness and professionalism always fill me with happiness.

“FYI- the patient did great and is coming back out of the CCU, so the story also has a good ending.” — Joanna Kipnes, MD

Great job, Rahul!


Esther Kim CGR SCAD Presentation

Cardiology Grand Rounds this past week was presented by Duke alumnae Dr. Esther Kim, who is Associate Professor of Medicine and Medical Director of the Vascular Labs at Vanderbilt University Medical Center. She is an expert in vascular medicine and her wonderful presentation focused on spontaneous coronary artery dissection (SCAD), with particular attention to the recognition and treatment of SCAD events, as well as the links between SCAD and other systemic diseases like fibromuscular dysplasia. To see the recorded presentation of her CGR presentation, please visit: https://bit.ly/2QRDQ73.  Shown here is a screenshot of her take-home points.

Photo of the Week

A rare together at-work sighting of the Hernandez family! Photo of Adrian Hernandez and Tracy DeWald courtesy of Jon Piccini.

Triangle Go Red Luncheon – Registration Open

The American Heart Association’s 2021 Triangle Go Red for Women Luncheon digital celebration will be held on May 14th from 11:30 a.m. – 1 p.m. Join us as we celebrate the impact of Go Red for Women in the Triangle, learn tips to structure self-care into your day, participate in a series of health and wellness breakout sessions, and hear from inspiring survivors who are “Living Fierce” and not letting cardiovascular disease stand in their way. Registration is free and open to all. If interested, please visit https://events.bizzabo.com/301164.


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

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.

April 29: A Special celebration of Joe Rogers with Duke faculty, alumni & friends. 5 p.m., Zoom.


Upcoming (Virtual) 2021 Duke Heart CME

We have dates set for two upcoming virtual symposia; registration is not yet available.

October 8: Duke Advanced Heart Failure Symposium. Course director is Richa Agarwal

November 5:  13th Annual NC Research Triangle Pulmonary Hypertension Symposium. Course directors are Terry Fortin and Jimmy Ford (UNC).


Final Mental Health Webinar in Series

Apr. 27: Mental Health in Children of Color. Noon-12:30 p.m. Led by Erikka Dzirasa, MD, MPH, consulting associate in Psychiatry & Behavioral Sciences (Link below).

This is the final webinar of a six-part 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:

April 13 — Harry Severance


The COVID-19 Vaccine and Reopening the World: What might it look like?


April 15 — TransPop, MURDOCK Study mentioned

WBTV.com (Charlotte, NC)

Duke CTSI launches kidney disease study in Kannapolis for people with African ancestry


April 20 — William Kraus


Genius Little Ways You Can Move More Every Single Day


May 2021 issue — John Alexander

Scientific American

COVID Has Pushed Medical Research into Remote Trials, Benefiting Patients and Scientists


Division of Cardiology Publications Indexed in PubMed April 15-21, 2021

Birati EY, Najjar SS, Tedford RJ, Houston BA, Shore S, Vorovich E, Atluri P, Urgo K, Molina M, Chambers S, Escobar N, Hsich E, Estep JD, Alexander KM, Teuteberg JJ, Chaudhry SP, Ravichandran A, DeVore AD, Margulies KB, Hanff TC, Zimmer R, Kilic A, Wald JW. Characteristics and Outcomes of COVID-19 in Patients on Left Ventricular Assist Device Support. Circ Heart Fail 2021;14:e007957. PM: 33813838.

Blumer V, Mentz RJ, Sun JL, Butler J, Metra M, Voors AA, Hernandez AF, O’Connor CM, Greene SJ. Prognostic Role of Prior Heart Failure Hospitalization Among Patients Hospitalized for Worsening Chronic Heart Failure. Circ Heart Fail 2021;14:e007871. PM: 33775110.

Desai NR, Sciria CT, Zhao X, Piccini JP, Turakhia MP, Matsouaka R, Fonarow GC, Lewis WR. Patterns of Care for Atrial Fibrillation Before, During, and at Discharge From Hospitalization: From the Get With The Guidelines-Atrial Fibrillation Registry. Circ Arrhythm Electrophysiol 2021;14:e009003. PM: 33724875.

Giarraputo J, Giamberardino S, Arvai S, Maichle S, Eckstein C, Newby LK, Gregory S. Profiling serum neurofilament light chain and glial fibrillary acidic protein in primary progressive multiple sclerosis. J Neuroimmunol 2021;354:577541. PM: 33725477.

Julien HM, Stebbins A, Vemulapalli S, Nathan AS, Eneanya ND, Groeneveld P, Fiorilli PN, Herrmann HC, Szeto WY, Desai ND, Anwaruddin S, Vora A, Shah B, Ng VG, Kumbhani DJ, Giri J. Incidence, Predictors, and Outcomes of Acute Kidney Injury in Patients Undergoing Transcatheter Aortic Valve Replacement: Insights From the Society of Thoracic Surgeons/American College of Cardiology National Cardiovascular Data Registry-Transcatheter Valve Therapy Registry. Circ Cardiovasc Interv 2021;14:e010032. PM: 33877860.

Kansal A, Green CL, Peterson ED, Newby LK, Wang TY, Sendak M, Balu S, Patel MR, Fanaroff AC. Electronic Health Record Integration of Predictive Analytics to Select High-Risk Stable Patients With Non-ST-Segment-Elevation Myocardial Infarction for Intensive Care Unit Admission. Circ Cardiovasc Qual Outcomes 2021;14:e007602. PM: 33757310.

Khan MS, Sreenivasan J, Lateef N, Abougergi MS, Greene SJ, Ahmad T, Anker SD, Fonarow GC, Butler J. Trends in 30- and 90-Day Readmission Rates for Heart Failure. Circ Heart Fail 2021;14:e008335. PM: 33866827.

Lee CL, Lee JW, Daniel AR, Holbrook M, Hasapis S, Wright AO, Brownstein J, Da Silva Campos L, Ma Y, Mao L, Abraham D, Badea CT, Kirsch DG. Characterization of cardiovascular injury in mice following partial-heart irradiation with clinically relevant dose and fractionation. Radiother Oncol 2021;157:155-162. PM: 33545252.

Lekavich CL, Allen JD, Bensimhon DR, Bateman LA, Slentz CA, Samsa GP, Kenjale AA, Duscha BD, Douglas PS, Kraus WE. Aerobic Versus Resistance Training Effects on Ventricular-Arterial Coupling and Vascular Function in the STRRIDE-AT/RT Trial. Front Cardiovasc Med 2021;8:638929. PM: 33869303.

Nguyen AH, Lefkowitz RJ. Signaling at the endosome: cryo-EM structure of a GPCR-G protein-beta-arrestin megacomplex. FEBS J 2021;288:2562-2569. PM: 33605032.

Sawant AC, Rizik DG, Rao SV, Pershad A. Algorithms for challenging scenarios encountered in transradial intervention. Indian Heart J 2021;73:149-155. PM: 33865510.

Shah AH, Puri R, Krasuski RA. Transcatheter Closure of Patent Foramen Ovale: Not Always an “Open or Shut” Case. Circulation 2021;143:1539-1541. PM: 33872078.

Sherwood MW, Gupta A, Vemulapalli S, Li Z, Piccini J, Harrison JK, Dai D, Vora AN, Mack MJ, Holmes DR, Rumsfeld JS, Cohen DJ, Thourani VH, Kirtane AJ, Peterson ED. Variation in Antithrombotic Therapy and Clinical Outcomes in Patients With Preexisting Atrial Fibrillation Undergoing Transcatheter Aortic Valve Replacement: Insights From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve. Circ Cardiovasc Interv 2021;14:e009963. PM: 33877866.

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 Rhythm. J Arrhythm 2021;37:271-319. PM: 33850572.

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