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Duke Heart Pulse – Week Ending December 19th 2021

December 19, 2021 / Leave a comment

Chief’s message:

Dear Duke Heart Faculty, Staff, Fellows, Residents, and Community.

Duke Chapel decorated for the Christmas holidays.

As 2021 comes to an end, we take time to reflect on the amazing accomplishments, resiliency, and teamwork of our entire Duke Heart community. In another difficult year, we were again privileged to be able to provide healthcare to our community, to be able to lean on each other in challenging times, and to be able to celebrate joint successes. Importantly we cherish our ability to continue to be with each other through these difficult times, frequently centering on our mission to train the next generation of heart leaders while we work to discover and deliver heart health.

So, on behalf of the Duke Heart Leadership team, we offer our heartfelt wishes of joy and health to you and your loved ones. More than ever, we recognize life is precious and hope that the season brings you peace — happiness, and warmth that comes from shared moments spent with friends and family.

Happy Holidays and Best Wishes in the upcoming year!

Highlights of the week:

Pediatric Team Receives SVRF Funding

We learned this week that Andrew Landstrom, MD, PhD, and his colleagues have been awarded a 2021 Single Ventricle Research Fund award. The funding was announced publicly on Wednesday, Dec. 15 by Additional Ventures. Landstrom will receive $660,000 ($220K for three years) to study single ventricle heart disease in the laboratory; his project is titled, “Leveraging induced pluripotent stem cells to define the developmental drivers of hypoplastic left heart syndrome.” Landstrom will serve as principal investigator; Drs. Nick Andersen and Joe Turek will serve as co-investigators.

The grant is particularly notable because it represents the first major funding award for the Single Ventricle Care and Research Program (SVCRP) launched in 2019 and housed within Duke’s Pediatric and Congenital Heart Center. The SVCRP is dedicated to the care of children born with single ventricle heart disease and improving their survival and quality of life. Their multi-disciplinary team is dedicated to the longitudinal care of these patients, from fetal life through adulthood. The program is led by Nick Andersen, surgical director; Andrew McCrary, cardiology director, and Veera Allareddy, medical director.

Congratulations to all!!!

Lee Completes EP Fellowship; Will Return to Military Service

Joshua Lee, DO, a fellow in the Duke Clinical Cardiac Electrophysiology Fellowship program, is completing his training with us this month and then heading back to San Antonio, TX. There, he will complete his military service with the U.S. Army and put his new skillset to work caring for patients at Brooke Army Medical Center, a 400-bed hospital situated at Fort Sam Houston.

Lee joined the EP fellowship in July 2019, spending the bulk of his time at Duke training during the COVID-19 pandemic. He says he chose the Duke program in part based on overall reputation, but also because he had known a former Duke EP fellow serving in the U.S. Army who had raved about their training here.

“When I first came to interview, I immediately sensed the collegiality between the EP attendings, as well as between the fellows and the attendings,” Lee says. “I knew I’d pick up excellent skills and knowledge here, but I also felt that I’d be joining a supportive, encouraging team who would provide great mentorship.”

He says that beyond the supportive environment, one of the things that really stood out to him was the emphasis on the importance of teamwork.

“Patient care is not just about offering a knowledgeable team of physicians,” Lee states. “It’s a holistic partnership involving EP technicians, EP staff, cardiologists, surgeons and general medicine – it’s all about teamwork. This has really been emphasized during my years here at Duke and it’s very similar to my work in the Army where you have a core group of people working together. You really develop a strong bond with others on your team.”

Electrophysiology began to intrigue Lee while he was practicing as a general cardiologist in San Antonio. During that time, he encountered a cardiac sarcoid patient with a recurrent ventricular tachycardia (VT). An electrophysiologist on the team performed a procedure and afterward the patient was shown to have no signs of VT and felt a lot better.

“It’s amazing how procedures, skills and knowledge are always improving in the EP field,” adds Lee. “Medicine is lifelong learning. I now have some great tools and resources that I’ve picked up during my time here at Duke and I am excited to keep learning more.”

Lee has four more years of commitment to fulfill with the Army and is looking forward to assisting in the training of general cardiology fellows when he gets back to Brooke Army Medical Center.

“It is very bittersweet to leave Duke, and while I feel sad about that, I am so excited to move on to another adventure,” Lee says. “I am so thankful to the many people that I have worked with here, especially the small group of EP attendings who work with our fellowship program. Everyone has been so easy to work with and it has been really fun. I felt happy every day to be here.”

It’s clear that Lee made just as big an impact on the EP team as they did on him.

“We are really grateful to have had Josh in our EP fellowship program during the trying and difficult times of the COVID pandemic,” said Jonathan Piccini, MD, associate professor of medicine and director of Duke Electrophysiology. “He has inspired all of us with his eternal optimism, refreshing smile, and the kindness he extends to everyone. He always goes the extra mile for every single one of his patients. We know the San Antonio area and military will be very fortunate to have Lt. Colonel Lee taking care of them and keeping their hearts in rhythm. We salute you Dr. Lee and thank you for your service to Duke, our country, and the US Armed Forces!”

Congratulations, Josh! We look forward to tracking your career and wish you all the best.

Duke Heart Network Welcomes Kotyra as new Senior Director

Duke Network Services is happy to introduce Lisa Kotyra, RN, MSBA, ACNP, as the new Senior Director of the Duke Heart Network.

Lisa comes to Duke Network Services after practicing in the Advanced Heart Failure Program at the University of Rochester Medical Center (URMC) as a Senior Nurse Practitioner and the Program Administrator. Lisa had been with Advanced Heart Failure since 2004 and has experience managing one of the largest VAD centers in the US (behind Duke). Additionally, Lisa’s role included oversight of both CMS and the Joint Commission regulatory processes for Advanced Heart Failure and VAD. Throughout her career, Lisa has cared for cardiovascular patients, including time spent as a nurse practitioner in the URMC Cardiothoracic ICU and in a private, community cardiology practice in both inpatient and outpatient roles. Lisa has been a longstanding member of the American Association of Critical Care Nurses (AACN) and the American College of Cardiology (ACC); most recently serving as the NY State representative for the national ACC CV Team.

Lisa received her Bachelor of Science in Nursing from State University of New York at Binghamton. She received her Masters of Science in Nursing (Acute Care NP Program/Critical Care) from the University of Rochester and her Masters of Science in Business Administration from the Simon Business School at the University of Rochester.

Lisa enjoys paddle boarding, hiking and traveling with family — perfect for our NC landscape. She is married with three children – one of whom is 26, and twins who are 19.

Please give her a warm welcome when you are able to do so!

Outing with Califf

Saturday, December 11, brought a fun outing with Rob Califf – Duke and UNC cardiologists Kristin Newby, Sid Smith (UNC), Magnus Ohman and Chris Granger spent the day out on the links helping to “prep” Califf for his FDA Commissioner Senate hearing, which was held on Tuesday, Dec. 14.

For more on the hearing, please visit: https://www.pbs.org/newshour/politics/watch-live-senate-hearing-on-the-nomination-of-robert-califf-as-commissioner-of-fda.

Ginsburg Celebrated, Pre-Departure for NIH

The team at Duke’s Center for Applied Genomics & Precision Medicine (CAGPM) gathered this week to honor Geoff Ginsburg in his final days as Center director. Ginsburg, a faculty member in our division of cardiology, is leaving Duke to take on the role of Chief Medical and Scientific Officer for the National Institutes of Health (NIH) All of Us Research Program starting next month. In a recent message to the CAGPM, he said, “Transitions are great opportunities for everyone. I am extremely confident in this team, in your future growth and successes, and that Duke CAGPM will continue to be at the forefront of genomics and precision medicine.”

We wish him all the best in his exciting new role and look forward to staying in touch!

Kudos to Ouyang

We received some terrific feedback from a patient recently on behalf of Wendy Chian Ouyang, one of our terrific nurse practitioners.

The patient’s note states: “Wen a gentle spirit, she is. Dr. Glower picked a great lady, caring, kind and a loving spirit. Super attentive.”

Thank you for the care and the compassion you show to all of the patients you provide care for, Wendy! We are very happy that you joined our team. – Diane Sauro, MSN, ANP, NEA-BC, Director-Advanced Practice, Duke Heart Center

Way to go, Wendy!

ICYMI: Final Tributes – Duke Univ & Health System Passings, 2021

We lost several members of our Duke Heart family in 2021. The University published a full list of all staff, faculty and retirees who passed away this past year, through November. To access that publication, please visit: https://bit.ly/3J3zBfB.

Happy Holidays & Reminder from the Pulse!

We wish each of you a calm, peaceful and joy-filled holiday season. Duke Heart Pulse will not be published on Dec. 26 or Jan. 2. We’ll be back on Sunday, Jan. 9. Be safe and healthy out there and we’ll see you in the New Year!

Upcoming Events & Opportunities

Duke Well-Being Ambassador Virtual Course

January 11 – March 15: The Well-being Essentials for Learning Life-Balance (WELL-B) weekly webinar series begins January 11, 2022 at 3 p.m. EST. For only one hour a week for 10 weeks (with an optional 11^th week for sharing content with colleagues), healthcare workers can learn about the science and practice of well-being from Dr. Bryan Sexton, Dr. Carrie Adair, and Dr. Kyle Rehder. These strategies can enhance your well-being, and through sharing, the well-being of your co-workers. Available to all Duke Health employees and those outside of Duke as well. More information: bit.ly/dukewellb. Offered by the Duke Center for Healthcare Safety and Quality.

Duke Research Week 2022

January 31 – February 4: Registration is now open for Duke Research Week 2022. Join us virtually for a week-long celebration of research underway at Duke! There is an excellent lineup of faculty lectures, panel discussions, “flash talks” with graduate students, trainees and postdoctoral fellows, and guest presenters for the Robert J. Lefkowitz, MD, Distinguished Lecture and Daubechies Lecture. Check out the full agenda here: https://dukeresearchweek.vfairs.com/en/#distinguishedlectures

Save the Date: Wear Your Red

Friday, Feb. 4: National Wear Red Day. Seriously team, put this one on the calendar! It’s never too early to start thinking of what you can wear on National Wear Red Day — red running shoes? Heart socks? The perfect red top or sweater? A cool red tie? What about that AHA gear you picked up at the last in-person Sessions? Stock up, plan ahead and have plenty of attire to wear throughout heart month to help promote cardiovascular disease awareness — and YES — we would love to have individual and team photos to share in Pulse!!

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. Submissions by Noon, Wednesdays, to be considered for weekend inclusion. Note: Pulse is taking a break for the holidays (Dec. 26, Jan. 2). We’ll return on Jan. 9, 2022!

Duke Heart in the News:

December 13 — Manesh Patel

tctMD

World-wise: As In-Person Meetings Resume, Global Voices Hope to Be Heard

https://duke.is/g4tz7

December 14 — Stephen Greene

Medscape

Metformin Benefits Patients Hospitalized for Heart Failure

https://duke.is/w6c3p

December 15 — Svati Shah

Associated Press

$10 million invested to study long-term impact of COVID-19 on heart and brain health

https://duke.is/vdmnw

December 15 — Svati Shah

dicardiology.com

AHA Funds Research on Underlying Causes and Therapies for Cardiovascular Impacts of Long COVID

https://duke.is/ze76a

December 15 — Sunil Rao

Healio/Cardiology Today

DES systems to facilitate transradial PCI receive FDA approval

https://duke.is/mgxbq

December 15 — Rajesh Swaminathan

tctMD

Discharge Safe as Early as a Day After Primary PCI for STEMI

https://duke.is/85yyr

Duke Heart Pulse 12-12-2021

December 12, 2021 / Leave a comment

Highlights of the week:

Latest DUH Adult Cardiac Surgery Program STS Ratings

We learned this week that our Adult Cardiac Surgery program has earned 3-star quality ratings for all ranked categories from the Society of Thoracic Surgeons (STS). The 3-star ratings were earned for isolated coronary artery bypass grafting (CABG) procedures; isolated aortic valve replacement (AVR) surgery; for AVR + CABG, and for isolated mitral valve replacement and repair (MVRR) surgery.

The Duke University Hospital STS Risk Adjusted Harvest 3 report includes analyzed results for the 3-year period spanning July 2018 to June 2021.

The STS star rating system is one of the most sophisticated and highly regarded overall measures of quality in health care, rating the benchmarked outcomes of cardiothoracic surgery programs in the U.S. The star rating is calculated using a combination of quality measures for specific procedures performed by an STS Adult Cardiac Surgery Database (ACSD) participant.

Established in 1989 as an initiative for quality improvement and patient safety among cardiothoracic surgeons, the STS ACSD houses more than 6.5 million surgical records and gathers information from more than 3,800 participating physicians, including surgeons and anesthesiologists from more than 90 percent of groups that perform heart surgery in the U.S. The Database includes three other components: the Congenital Heart Surgery Database (CHSD), the General Thoracic Surgery Database (GTSD), and the mechanical circulatory support database (Intermacs). Duke has participated in the STS National Database since its inception.

This achievement is the result of the effort the entire Duke Heart team puts in every day — across the board – our nurses, residents, fellows, CT surgeons, anesthesiologists, ICU teams, cardiologists, pharmacy leaders, cardiac rehabilitation team and all those who support them. Congratulations!

CVRC Announces Annual Mandel Awards

The Duke Cardiovascular Research Center (CVRC) has recently announced their annual Mandel Awards. The Mandel Funding Program Review Committee made three awards in the Seed program, one award in the Fellow program, and one in the Scholar program. We are pleased to share the projects and scholars receiving funding for the 2022 project period which begins January 1.

Mandel Scholar Award

Ravi Karra, MD

Project: Correction of LMNA Cardiomyopathy by Cardioediting

Dilated cardiomyopathies (DCM) due to genetic mutations are common and more likely to progress to end stage heart failure compared to other types of DCM. Here, we propose the development of a system to treat genetic DCM by correcting the causal mutation, using LMNA DCM as an example. We will develop tools to genetically edit LMNA mutations and develop an ultrasound-based method to deliver these tools to the heart. These experiments can establish “cardioediting” as a potential treatment of heritable DCM.

Mandel Fellow Award

Pavitra Murali, PhD, mentored by Sudha Shenoy, PhD

Project: Trafficking of Angiotensin Receptors into autophagosomes and its impact on

β-arrestin-dependent signaling

Drugs that bind to the extracellular domains of cell-surface G protein-coupled receptors (GPCRs) are used to treat a variety of cardiovascular diseases including hypertension. Activated GPCRs trigger a signal transduction cascade that produces physiological responses including contraction/relaxation of smooth muscle cells lining arteries. GPCRs, which are bound by drugs at the plasma membrane, rapidly internalize into the cell into intracellular vesicles called endosomes and subsequently traffic into highly acidic vesicles called lysosomes where the GPCR protein is degraded into small peptides. This degradation ensures the long-term desensitization or dampening of signaling and subsiding of the physiological action. We have found that internalized angiotensin type II receptor (AT1R) localizes into a distinct population of vesicles called autophagosomes, which is an unexpected phenomenon because the pathway that invokes formation of autophagosomes called autophagy is known only for recycling organelles and protein catabolism during cell starvation. Since agonist Ang II provokes autophagy trafficking of the AT1R, we believe that this sub-cellular localization may have putative roles in defining AT1R signaling and physiologic effects. The AT1R is an essential target for drugs used to treat many forms of cardiovascular diseases including hypertension; recent evidence reveals that the AT1R mediates its physiologic effects through both G protein and β-arrestin-dependent pathways. In this proposal, I will study how the autophagy trafficking of the AT1R is regulated, and determine the relevance of this trafficking pathway to AT1R signal transduction. The proposed studies will uncover hitherto unknown molecular mechanisms in AT1R trafficking and signaling and might provide new therapeutic angles to treat high blood pressure and cardiovascular disease.

Mandel Seed Awards

Neil Freedman, MD and Christopher Holley, MD, PhD

Project: Atherogenic Mechanisms of Small Nucleolar RNAs

Atherosclerosis fundamentally involves oxidation, a chemical process that is critical for

normal cell function. When oxidation is excessive, it deranges the chemical structure of lipids and proteins and thereby adversely affects their function. The pathogenesis of atherosclerosis initiates with oxidation of the cholesterol-rich low-density lipoprotein particles, and perpetuates with excessive oxidative cell signaling—termed “oxidative stress”—in the inner layers of the artery. This project aims to attenuate excessive oxidative signaling through a novel regulatory mechanism involving particular RNA molecules known as small nucleolar RNAs, or “snoRNAs”, which are expressed throughout the body’s cells. We have found a group of four snoRNAs that augment cellular oxidative stress (Rpl13a-snoRNAs); they appear to do so by facilitating the modification of various messenger RNAs with 2’-O-methylation—a modification that reduces the translation of the messenger RNA into protein.

With previous support from the Mandel Foundation, we found that genetic deficiency of these snoRNAs in Apoe-/- mice reduces arterial levels of reactive oxygen species and attenuates atherosclerosis. Furthermore, we found that snoRNA deficiency in smooth muscle cells dramatically increases the expression of a mitochondrial protein (COX4i2) that reduces mitochondrial production of reactive oxygen species. Therefore, we hypothesize that snoRNAs augment the level of reactive oxygen species in vascular cells by methylating the messenger RNA encoding COX4i2 and thereby reducing the cellular level of COX4i2 protein.

The Mandel Seed Grant will allow us to continue our snoRNA atherosclerosis studies until we can secure NIH funding. Specifically, this new application seeks to achieve the following aims: (1) to determine whether antagonizing snoRNA function with antisense oligonucleotides reduces atherosclerosis in low-density lipoprotein receptor-deficient (Ldlr-/-) mice, and thereby to determine whether snoRNAs can be targeted therapeutically, and (2) to determine in vascular smooth muscle cells and macrophages whether the pre-mRNA encoding COX4i2 is a target of snoRNA-guided methylation, and thereby to elucidate molecular mechanisms underlying the effects of snoRNAs on cellular oxidative stress. Completing these aims will advance our work toward publishing our first manuscript and obtaining NIH support for our ongoing investigations into the anti-atherogenic therapeutic potential of snoRNA-targeted strategies.

Christopher Kontos, MD

Project: Regulation of endothelial metabolism by the Tie1 receptor tyrosine kinase

In the presence of oxygen, cells typically generate energy by breaking down glucose through glycolysis, and then the byproduct, pyruvate, is used by mitochondria to generate ATP through aerobic respiration. Under anaerobic conditions lacking oxygen, cells are unable to utilize mitochondrial respiration, and after glycolysis, pyruvate gets converted to lactate, which is then shuttled out of the cell. Although oxidative metabolism is more efficient than anaerobic glycolytic metabolism in terms of energy production, some cells paradoxically utilize glycolysis as their main form of energy production even in the presence of oxygen.

This phenomenon of “aerobic glycolysis”, was first described by Dr. Otto Warburg (also known as the “Warburg Effect”) in cancer cells. Interestingly, aerobic glycolysis occurs not only in aberrant cancer cells, but it is the primary metabolic pathway that endothelial cells lining the vasculature use to generate energy. Alterations in endothelial cell metabolism are a hallmark of their activation, which occurs during new blood vessel growth and inflammation, and while this activation may be helpful in some contexts, e.g., growth of new blood vessels in response to exercise, the activation of endothelial cells in large arteries can be harmful and lead to atherosclerosis and high blood pressure. When endothelial cells are activated, their metabolism changes to increase their rate of glycolysis, but how they do this is not completely understood.

We hypothesize that the endothelial receptor tyrosine kinase Tie1, which is increased in activated endothelial cells, is partially responsible for altering the metabolism of these activated endothelial cells, and that blocking Tie1’s role in this metabolic shift may help prevent vascular dysfunction and subsequent cardiovascular disease.

Huanghe Yang, PhD

Project: Demystify flow-activated chloride conductance in endothelium and its role in hypertension

Mechanical forces are fundamental in cardiovascular health and disease. Lining the interior surface of blood vessels, the endothelium constantly senses blood flow-induced shear and stretch forces and converts these mechanical stimuli into biochemical signals. Endothelial mechanotransduction is therefore central for both acute vasoregulation and chronic vascular remodeling; and malfunction of endothelial mechanotransduction contributes to cardiovascular diseases including hypertension and atherosclerosis. Mechanosensitive ion channels (MSCs) are the primary mechanotransducers in the endothelium. The endothelial MSCs, including the recently discovered mechanosensitive PIEZO1 calcium permeable channel, have been extensively investigated. Nevertheless, the molecular identity and pathophysiological role of an endothelial flow-activated chloride conductance (FACC) still remain elusive.

Our preliminary results showed that the FACC is significantly upregulated in angiotensin II (Ang II)-treated endothelial cells in vitro, highlighting the urgency to uncover its molecular identity and contribution in hypertension. With this Seed Grant, we aim to acquire critical preliminary results to strengthen our hypothesis that the functional coupling between Piezo1 mechanosensitive calcium channel and TMEM16A calcium-activated chloride channel (CaCC) gives rise to the FACC and enhanced endothelial FACC contributes to hypertension. I anticipate to utilize this opportunity to establish collaborations with CVRC investigators and submit an NIH R01 to further understand FACC in endothelial biology and diseases.

Congratulations to all Mandel funding recipients – we look forward to learning more about your work!

ICYMI: 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization

Congratulations to Brittany Zwischenberger and Sunil Rao, two members of the writing team for the latest Guidelines for Coronary Artery Revascularization which were co-published online in the Journal of the American College of Cardiology and in Circulation on Thursday. ACC/AHA Joint committee members from Duke include: Sana Al-Khatib, Adrian Hernandez, W. Schuyler Jones, and Dan Mark.

Congratulations to Helen Barnes!

Duke Heart’s leadership team wishes to congratulate Helen Barnes who graduated yesterday from University of Mount Olive with a Bachelor of Science degree in Business Administration in Healthcare Management.

“Helen is a great asset who is always willing to partner on new projects with a ready smile and kind words,” said Laura Blue, DNP, VAD Program Team Lead. “I am so proud of her for pursuing her dream of getting her degree and I think she is a great role model for others who wish to pursue their education. Helen was a big supporter of mine when I was working on my doctorate. When she came to me and let me know she felt she could achieve this, I wanted to support her as much as she had supported me. I am really excited for her.”

Barnes, a dedicated member of the Duke family since 1999, has functioned as an administrative assistant with the Duke’s Ventricular Assist Device program for 11 years. Helen partnered with leadership to develop and successfully lead her final project, “Optimizing Incoming Communication in a Multidisciplinary Subspecialty Clinic.”

Congratulations, Helen!

Hofmeister Lands Emerging Leaders Grant

Karl Hofmeister, a 2021 graduate of Duke’s Cardiac Ultrasound Certificate program, has been selected by the Society of Diagnostic Medical Sonography (SDMS) Foundation for their 2022 Emerging Leaders Grant Recipient Program. Hofmeister’s cohort will participate virtually in a variety of leadership education opportunities that are designed to engage them in meaningful dialogue and projects related to the future of the profession and leadership volunteerism.

Hofmeister was the first recipient of our Cardiac Ultrasound Certificate program’s inaugural outstanding student award, which is now named after Joseph Kisslo, MD.

The Emerging Leaders program will culminate with one participant being selected to receive a grant to attend the Fall SDMS and SDMS Foundation Board of Directors Meetings, Liaison Meetings, and the 2022 SDMS Annual Conference.

Congratulations, Karl!

Upcoming Events & Opportunities

SI4R Training Workshop

December 14: Stepping in 4-Respect (SI4R) Workshop for Duke Division of Cardiology. 5-7 p.m. Zoom (Details in email from Kim Dorman)

As part of the Department of Medicine Civility Champion initiatives, a 2-hr zoom workshop for all faculty, staff, and trainees throughout all DOM divisions has been developed. Civility Champions are trained faculty, fellows, and chief residents who provide informal support in response to incidents of bias, harassment, or other unprofessional behaviors, and to help those affected understand their options for intervention and reporting. People generally come to Civility Champions after the fact, and the Champions debrief their experiences every quarter.

The workshop that Drs. John Duronville, Jane Gagliardi, Anita Kelsey, Camille Frazier-Mills, Daniella Zipkin, Laura Previll, and Sophia Weinmann will be presenting to the Cardiology clinical faculty is entitled Stepping In 4-Respect. It is being offered twice and is a new component of these civility efforts designed to teach faculty the skills needed to step in (be an “upstander”) in the moment, with a particular focus on race-, ethnicity- and gender-based incidents. This workshop is supported by Dr. Kathleen Cooney, Chair of the DOM, and will be provided to each division’s faculty over the coming months.

Please be sure to attend the workshop on Dec. 14 if you missed the one on Nov. 30. Additional details about registration, the structure and goals of the workshop appeared in the email invitation.

Duke Well-Being Ambassador Virtual Course

January 11 – March 15: The Well-being Essentials for Learning Life-Balance (WELL-B) weekly webinar series begins January 11, 2022 at 3 p.m. EST. For only one hour a week for 10 weeks, healthcare workers can learn about the science and practice of well-being from Dr. Bryan Sexton, Dr. Carrie Adair, and Dr. Kyle Rehder. These strategies can enhance your well-being, and through sharing, the well-being of your co-workers. Available to all Duke Health employees and those outside of Duke as well. More information: bit.ly/dukewellb. Offered by the Duke Center for Healthcare Safety and Quality.

Duke Research Week 2022

Save the Date: Wear Your Red

Save the Date: Support the Marfan Foundation

February 11: An Evening with Heart to benefit The Marfan Foundation. 7-10 p.m. at The Maxwell in Raleigh, NC. A Valentine’s Day weekend event with silent auction, cocktails, heavy hors d’oeuvres and entertainment. Cocktail attire. Tickets required. For information, visit: https://bit.ly/3cHIBYD.

The Duke Center for Aortic Disease, led by cardiovascular surgeon Chad Hughes, works closely with Marfan patients, their family members and the Marfan Foundation. We are the only location in NC offering access to comprehensive aortic surgical interventions as well as coordinated cardiovascular care and genetic counseling for patients with Marfan syndrome and other connective tissue disorders such as Loeys-Dietz. If you’re interested in learning more about the work being done at Duke or would like to partner or otherwise get involved, please contact Dr. Hughes or Melissa Merrill Burkett, ACNP.

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. Submissions by Noon, Wednesdays, to be considered for weekend inclusion. Note: Pulse will be taking a break for the holidays from Dec. 26 through Jan. 2; we’ll return on Jan. 9, 2022!

Duke Heart in the News:

December 3 — E. Hope Weissler and W. Schuyler Jones

tctMD

Statins Underprescribed in PAD Before and After Interventions

https://duke.is/722jz

December 7 — E. Hope Weissler and W. Schuyler Jones

Physician’s Weekly

PAD: Statin Prescribing After Revascularization Still Low

https://duke.is/mmhc7

December 8 — Amanda Coniglio

NIH

Rare gene mutation in some Black Americans may allow earlier screening of heart failure

https://bit.ly/3IGG8N5

December 9 — Duke University Hospital

Becker’s Hospital Review

27 cardiology firsts in 2021

https://bit.ly/3lVQ77f

December 9 — Amanda Coniglio

Clinicalomics

Mutation Linked to Heart Failure in People of African Descent

https://bit.ly/3EKmCNf

Division of Cardiology Publications Indexed in PubMed December 2-8, 2021

Becher PM, Schrage B, Benson L, Fudim M, Corovic Cabrera C, Dahlström U, Rosano GMC, Jankowska EA, Anker SD, Lund LH, Savarese G. Phenotyping heart failure patients for iron deficiency and use of intravenous iron therapy: data from the Swedish Heart Failure Registry. Eur J Heart Fail 2021:10.1002/ejhf.2338. PM: 34476878.

Bernstein E, Wang TY. Point-of-Care Ultrasonography: Visually Satisfying Medicine or Evidence-Based Medicine? JAMA Intern Med 2021:10.1001/jamainternmed.2021.5831. PM: 34633409.

Carnicelli AP, Li Z, Greiner MA, Lippmann SJ, Greene SJ, Mentz RJ, Hardy NC, Blumer V, Shen X, Yancy CW, Peterson PN, Allen LA, Fonarow GC, O’Brien EC. Sacubitril/Valsartan Adherence and Postdischarge Outcomes Among Patients Hospitalized for Heart Failure With Reduced Ejection Fraction. JACC Heart Fail 2021;9(12):876-886. PM: 34509408.

Del Rosario M, Guduguntla V, Wang TY. Nonfatal Myocardial Infarction-Poor Surrogate for Mortality. JAMA Intern Med 2021:10.1001/jamainternmed.2021.5713. PM: 34694340.

Escaned J, Cao D, Baber U, Nicolas J, Sartori S, Zhang Z, Dangas G, Angiolillo DJ, Briguori C, Cohen DJ, Collier T, Dudek D, Gibson M, Gil R, Huber K, Kaul U, Kornowski R, Krucoff MW, Kunadian V, Mehta S, Moliterno DJ, Ohman EM, Oldroyd KG, Sardella G, et al. Ticagrelor monotherapy in patients at high bleeding risk undergoing percutaneous coronary intervention: TWILIGHT-HBR. Eur Heart J 2021;42(45):4624-4634. PM: 34662382.

Hess CN, Debus ES, Nehler MR, Anand SS, Patel MR, Szarek M, Capell WH, Hsia J, Beckman JA, Brodmann M, Diaz R, Habertheuer P, Leeper NJ, Powell RJ, Sillesen H, Muehlhofer E, Berkowitz SD, Haskell LP, Bauersachs RM, Bonaca MP. Reduction in Acute Limb Ischemia with Rivaroxaban versus Placebo in Peripheral Artery Disease after Lower Extremity Revascularization: Insights from VOYAGER PAD. Circulation 2021:10.1161/CIRCULATIONAHA.121.055146. PM: 34637332.

Hsia J, Kavanagh ST, Hopley CW, Baumgartner I, Berger JS, Fowkes GR, Jones WS, Mahaffey KW, Norgren L, Patel MR, Rockhold F, Blomster J, Katona BG, Hiatt WR, Bonaca MP. Impact of chronic kidney disease on hemoglobin among patients with peripheral artery disease treated with P2Y inhibitors: Insights from the EUCLID trial. Vasc Med 2021;26(6):608-612. PM: 34082620.

Ma Z, Viswanathan G, Sellig M, Jassal C, Choi I, Garikipati A, Xiong X, Nazo N, Rajagopal S. β-Arrestin-Mediated Angiotensin II Type 1 Receptor Activation Promotes Pulmonary Vascular Remodeling in Pulmonary Hypertension. JACC Basic Transl Sci 2021;6(11):854-869. PM: 34869949.

Mack M, Carroll JD, Thourani V, Vemulapalli S, Squiers J, Manandhar P, Deeb GM, Batchelor W, Herrmann HC, Cohen DJ, Hanzel G, Gleason T, Kirtane A, Desai N, Guibone K, Hardy K, Michaels J, DiMaio JM, Christensen B, Fitzgerald S, Krohn C, Brindis RG, et al. Transcatheter Mitral Valve Therapy in the United States: A Report From the STS-ACC TVT Registry. J Am Coll Cardiol 2021;78(23):2326-2353. PM: 34711430.

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Matsue Y, Sama IE, Postmus D, Metra M, Greenberg BH, Cotter G, Davison BA, Felker GM, Filippatos G, Pang P, Ponikowski P, Severin T, Gimpelewicz C, Voors AA, Teerlink JR. Association of Early Blood Pressure Decrease and Renal Function With Prognosis in Acute Heart Failure. JACC Heart Fail 2021;9(12):890-903. PM: 34627724.

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Duke Heart Pulse week ending 12-5-2021

December 5, 2021 / Leave a comment

Highlights of the week:

New Faculty Spotlight: Brandy Patterson, MD

One of our newest faculty members, Brandy Patterson, MD, joined the Duke Heart faculty in July as an assistant professor of medicine in the division of cardiology. She is a welcome addition to our growing cardio-oncology program and member of the general cardiology team, seeing patients at Duke Cardiology’s South Durham clinic; in Clinic 2F/2G, and in the Duke Cancer Center.

Patterson completed fellowship in cardiology at the University of Florida after earning her MD from the Leonard M. Miller School of Medicine at the University of Miami, and completing residency at Allegheny General Hospital in Pennsylvania. During fellowship she became fully attuned to the lack of women enrolled in research clinical trials — particularly those focused on cardiovascular disease — and realized how much work was still needed to educate women about their risk for developing heart disease.

“I was lucky to join the fellowship program in Florida when I did. There were a large number of female faculty members there and they all understood this problem,” Patterson said. “Many women attribute early-onset heart symptoms simply to getting older, or to putting on a bit of weight. I was astounded by the number of female patients I was seeing that did not recognize heart disease as a woman’s disease. I knew I needed to do something about this.”

After fellowship, she joined the faculty at the University of Pennsylvania where her clinical focus was on treating women with heart disease. From there, she headed to the University of Virginia where she launched a number of efforts aimed at women – she started a women’s heart health group called ‘Club Red’; organized regular community talks for women; partnered with a nutritionist to hold regular community cooking classes; and led walks in the community, all to better engage with women around living a heart-healthy lifestyle. She was able to take her messaging further when she became a regular guest on the local NBC news affiliate in Charlottesville, where they had a medical news segment called ‘House Call’ and then developed one with Patterson in mind, called ‘Straight Talk MD’.

As these community efforts were gaining momentum, a fellow faculty member left UVA and Patterson inherited a number of her patients — many of whom had received treatment for breast and other cancers. As she saw more and more heart patients with a history of cancer treatment, she became increasingly interested in understanding the cardiotoxicity associated with the drugs her patients were or had been taking. Her exploration into this area led her to spearhead the creation of UVA’s cardio-oncology program with two other cardiologists there – a team she led as medical director until her departure for Duke.

Patterson, who was raised in South Florida, was drawn to medicine from an early age. Her mother, an operating room nurse, periodically brought her to the hospital in which she worked. There, she had ample opportunity to observe her mother’s work, her interactions with colleagues and patients, and to learn about the OR space. Her father, a former professional baseball player who pitched for the New York Yankees, endured a number of injuries over time that required surgical intervention, rehabilitation and physical therapy.

“I really developed a deep understanding of what the patient experience is like by living in the footsteps of not only my mother, but my father and his experiences with numerous orthopedic surgeries and the toll it took on us as a family,” Patterson said while reflecting on her choice to pursue a career in medicine. “I wanted to develop and maintain a personal connection with people to increase patient’s healthy life years without disability.”

Having grown up with athletic parents, she was involved in multiple sports from an early age and has always been drawn to living a healthy lifestyle, eating right and exercising. She says she has always has been a big advocate for the joy of movement and to following a Mediterranean-style diet. Patterson and husband Richard Shannon, MD, have a 7-year-old daughter. They enjoy playing golf and tennis, as well as hiking, swimming, and traveling.

Shannon was recruited to Duke two years ago. When the opportunity presented itself for Patterson to join Duke Heart’s growing cardio-oncology program, she jumped at the chance.

“I am very humbled to be a part of this prestigious group and am looking forward to seeing where this opportunity leads. Duke has an amazing health system and this is a tremendous opportunity for us,” she added.

If you have not yet had the opportunity to meet Brandy, we hope you’ll take time to do so. We are thrilled to have her as a member of the Duke Heart team!

Daubert & Team Receive $7.9M NHLBI Grant to Examine CAC Scoring

Congratulations to Melissa Daubert and her co-investigators at Johns Hopkins and Wake Forest University. Daubert and her research partners have received a $7.9 million, five-year R01 grant from the National Heart, Lung and Blood Institute (NHLBI) to study the use of coronary artery calcium (CAC) scoring to identify who is the most likely to benefit from statin therapy and in whom preventive therapy with statins may not yield a meaningful clinical benefit. CAC PREVENTABLE, an ancillary study to the Pragmatic Evaluation of Events and Benefits of Lipid-lowering in Older Adults (PREVENTABLE) Trial, will enroll 10,000 participants age 75 years and older to undergo baseline CAC scanning and high-sensitivity troponin testing. The study will be led by Melissa Daubert, MD at Duke; Michael Blaha, MD, MPH at Johns Hopkins University, and Nicholas Pajewski, PhD at Wake Forest University.

“By directly visualizing atherosclerotic plaque with CAC scanning and measuring subclinical myocardial injury with high-sensitivity troponin, we believe CAC PREVENTABLE is the most promising for informing person-centered care in older adults,” says Melissa Daubert, MD, associate professor of medicine in cardiology at Duke and director of the Multimodality Imaging Core Laboratory at Duke Clinical Research Institute. “CAC PREVENTABLE could fundamentally change the approach to preventive therapy, potentially limiting overtreatment and focusing statin therapy on those most likely to benefit.”

Current guideline-approved risk prediction models are heavily weighted by age, indiscriminately assigning high-risk status and therefore recommending treatment for nearly all older adults even before the age of 75. Accurate person-centered risk prediction at older ages remains unachievable using traditional risk factor models as these approaches do not capture lifetime cumulative exposure or account for individual resiliency to disease. It also raises concerns about overmedication, drug-drug interactions, lack of personalization, and misallocation of limited healthcare resources in an aging population which often requires multiple pharmacotherapies.

Grant funding began on Sept. 1, 2021. The team expects to enroll their first patient in March, 2022.

Congratulations, Melissa – we look forward to hearing more about this as the study progresses!

2022 Incoming Cardiology Fellows Announced

We are pleased to announce the newest members of the Duke Heart team — our incoming cardiology fellows for July, 2022. We are thrilled to have them join us!

Andrew Andreae, MD, joining us after completing residency at Duke; a graduate of Virginia Commonwealth University School of Medicine.

Michael Cosiano, MD, joining us after completing residency at Duke; a graduate of Weill Cornell Medicine.

David Elliott, MD, joining us after completing residency at Duke; a graduate of Duke University School of Medicine.

Nathan Goodwin, MD, joining us after completing residency at Duke; a graduate of the University of Missouri School of Medicine.

Aman Kansal, MD, joining us after completing residency at Duke; a graduate of Duke University School of Medicine.

Allie Levin, MD, joining us after completing residency at Massachusetts General Hospital; a graduate of Columbia University Vagelos College of Physicians and Surgeons.

Anthony Lin, MD, joining us after completing residency at the University of California at San Francisco; a graduate of Duke University School of Medicine.

Paula Rambarat, MD, joining us after completing residency with Massachusetts General Hospital; a graduate of Columbia University Vagelos College of Physicians and Surgeons.

Jessica Regan, MD, joining us after completing residency at Duke; a graduate of Virginia Commonwealth University School of Medicine.

Belal Suleiman, MD, joining us after completing residency at University of Texas Southwestern; a graduate of the University of Kentucky College of Medicine.

Congratulations to all!

Photo Submission: Joey Harrington, Journal Club

Our Journal club met this week — shown here is cardiology fellow Joey Harrington (with Tillie) presenting on the Danish LOOP Study along with Bernie Gersh. Photo courtesy of Christopher Granger.

Shout-out to Corley!

We received a note this week in appreciation of cardiology fellow, Ali Corley:

“Anna Lisa, ICC fellows were out of town, so Dr. Corley covered them at the VA today. She did a fantastic job and delivered several stents in the process. She will do great in her ICC year.” — Tony Gutierrez

Nicely done, Ali!

HF section Gathered for Holiday Cheer at the Mentz House.

The HF Section gathered together for a Holiday Party at Rob Mentz’ house on Friday Night. The group had an enjoyable evening with representation from the fellows, APPs, OHT/VAD coordinator teams, research team, cardiologists and surgeons. It was so nice to be able to get together as a group while enjoying a beautiful evening outdoors. Festive food, drinks and karaoke rounded out the evening. Thank you to the whole group for an amazing year!

Upcoming Events & Opportunities

Cardiology Grand Rounds

December 7: Visiting lecture with Anubha Agarwal of Northwestern Medicine Feinberg School of Medicine. 5 p.m. Webex.

SI4R Training Workshop

December 14: Stepping in 4-Respect (SI4R) Workshop for Duke Division of Cardiology. 5-7 p.m. Zoom (Details in email from Kim Dorman)

The workshop that Drs. John Duronville, Jane Gagliardi, Anita Kelsey, Camille Frazier-Mills, Daniella Zipkin, Laura Previll, and Sophia Weinmann will be presenting to the Cardiology clinical faculty is entitled Stepping In 4-Respect. It is being offered twice and is a new component of these civility efforts designed to teach faculty the skills needed to step in (be an “upstander”) in the moment, with a particular focus on race-, ethnicity- and gender-based incidents. This workshop is supported by Dr. Kathleen Cooney, Chair of the DOM, and will be provided to each division’s faculty over the coming months.

Please be sure to attend the workshop on Dec. 14 if you missed the one on Nov. 30. Additional details about registration, the structure and goals of the workshop appeared in the email invitation.

Duke Well-Being Ambassador Virtual Course

January 11 – March 15: The Well-being Essentials for Learning Life-Balance (WELL-B) weekly webinar series begins January 11, 2022 at 3 p.m. EST. For only one hour a week for 10 weeks, healthcare workers can learn about the science and practice of well-being from Dr. Bryan Sexton, Dr. Carrie Adair, and Dr. Kyle Rehder. These strategies can enhance your well-being, and through sharing, the well-being of your co-workers. Available to all Duke Health employees and those outside of Duke as well. More information: bit.ly/dukewellb. Offered by the Duke Center for Healthcare Safety and Quality.

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. Submissions by Noon, Wednesdays, to be considered for weekend inclusion. Note: Pulse will be taking a break for the holidays from Dec. 26 through Jan. 2; we’ll return on Jan. 9, 2022!

Duke Heart in the News:

November 24 — Jacob Schroder

WNCN CBS-17* (Raleigh, NC)

NC family thankful after father’s new generation artificial heart replaced with donor heart at Duke

https://duke.is/9mb9a

*story also carried by Fox-8 Greensboro, Fox-43 Myrtle Beach & NBC-10 Norfolk

November 24 — Tracy Wang

tctMD

Select COVID-19 Patients May Benefit From Postdischarge Anticoagulation

https://duke.is/jsp4y

November 26 — Jacob Schroder

WWAY ABC-3 (Wilmington, NC)