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Duke Heart Pulse — January 28, 2024

January 28, 2024 / Leave a comment

Highlights of the week:

Schroder Named Surgical Director for Advanced Heart Failure

We are pleased to share that Jacob N. Schroder, MD, assistant professor of surgery, has been named Surgical Director for Advanced Heart Failure of Duke Health’s Heart and Vascular Service line and the Duke Division of Cardiovascular and Thoracic Surgery. The announcement was made Monday by Duke Surgery and Duke Heart leadership.

Dr. Schroder earned his Medical Degree from Georgetown University School of Medicine and completed both his general and cardiothoracic surgery residencies, as well as thoracic transplant surgery fellowship, at Duke University. He then joined the Duke Department of Surgery faculty in the Division of Cardiothoracic Surgery in 2012.

Since then, Dr. Schroder has helped lead transplant growth and innovation within the Duke Heart program while maintaining a deep passion for the care of advanced heart failure patients. In 2017, he accepted the role of surgical director of cardiac transplantation and has led the program to marked volume growth while maintaining outstanding survival outcomes. In 2023, Duke completed 161 heart transplants, which is the greatest annual number at any institution worldwide. In addition, the program has surpassed 2,000 total heart transplants, which has only been achieved by a handful of other programs in the U.S.

In his new role as Surgical Director for Advanced Heart Failure, he will not only oversee heart transplantation but will also oversee the Extracorporeal Membrane Oxygenation (ECMO) program, the Left Ventricular Assist Device (LVAD) program, and the Total Artificial Heart program at Duke. Additionally, Jacob will oversee conventional cardiac surgery procedures in patients with severely reduced left ventricular function. As part of his new role he will assemble a team of surgeons and multidisciplinary team members to deliver these therapies, oversee research efforts throughout these areas, and continue to drive innovation.

Dr. Schroder has been a leader in perfusion storage and was the first surgeon in North America to perform an adult heart transplant utilizing a donation after cardiac death (DCD) donor. He led the U.S. Organ Care System DCD Heart Trial, which was published last year in the New England Journal of Medicine. Importantly, the strategy of utilizing DCD donors has served to expand the donor pool by as much as 30% at adopting centers. He has also reinvigorated the combined heart–lung transplant program and facilitated increased volume in other combined heart-kidney and heart-liver transplant procedures. Jacob has also served as co-director of the 7West Cardiothoracic Intensive Care Unit (CTICU), creating an environment of enhanced patient care with collaborative surgical and intensivist oversight. He has led the application of mechanical circulatory support at Duke and performed the first successful CARMAT total artificial heart implant in North America in 2021.

In summary, he has displayed incredible dedication and passion for heart failure care and has worked tirelessly to expand our footprint in the treatment of these patients.

Congratulations, Jacob!

St. Jude Children’s Invests $13M in Duke, Columbia, and Stanford Collaboration

St. Jude Children’s Research Hospital has invested nearly $13 million toward a new collaboration with researchers at Duke, Columbia, and Stanford Universities to expand the understanding of G-protein coupled receptors (GPCR), vital proteins that have been linked to more than 100 human diseases and disorders.

The GPCR Collaborative is led by Scott Blanchard, PhD, and M. Madan Babu, PhD, of St. Jude’s. The two are partnering with Jonathan Javitch, MD, PhD, of Columbia University; Georgios Skiniotis, PhD, and Alice Ting, PhD, of Stanford University, and Robert J. Lefkowitz, MD, of Duke University School of Medicine and Duke Cardiovascular Research Center.

Lefkowitz, a cardiologist and biochemist, was awarded the Nobel Prize in Chemistry in 2012 for his studies of G-protein coupled receptors. He received the award with Brian Kobilka, MD, of Stanford.

The multi-institutional GPCR Collaborative team will integrate and improve advanced methodologies including single-molecule imaging, cryo-electron microscopy, data science, and other techniques to study GPCR biology, structure, and pharmacology. Building on insights from these studies, investigators hope to develop new therapies for many pediatric diseases, including cancer and other life-threatening conditions.

“Each group within the collaborative has a very different focus, yet there’s overlap in the methods we use in our laboratories. We each have a distinct emphasis and expertise that is lacking in the other groups,” says Lefkowitz, Chancellor’s Distinguished Professor of Medicine at Duke and member of Duke Cancer Institute. “What my lab brings to the table is, first of all, our very long history in the field. My involvement with the receptors goes back more than 50 years. So we have the long view — the history – of working with GPCRs, but we also bring a pharmacological, biochemical, and clinical perspective to the endeavor.”

The goal of the collaboration is to use the biophysical expertise of the teams to interrogate the receptors in a very deep way to try to assist in developing new strategies to develop drugs, according to Lefkowitz.

“Many of the other investigators in the collaboration bring a deep biophysical and structural orientation to the table. So the hope and expectation are for real synergy to emerge from bringing these different approaches to bear, especially from individuals who have already demonstrated successful collaborations with one another.”

St. Jude’s Children’s Research Hospital has funded six different Research Collaborative projects since 2017, including the GPCR Collaborative, with an investment of more than $80 million. By 2027, St. Jude plans to support even more collaborations focused on unanswered needs in science and medicine which will increase total investment to $160 million.

Congratulations, Bob!

Williams Receives TSF Award at STS 2024

Congratulations to cardiothoracic surgeon Adam Williams who has received the Thoracic Surgery Foundation (TSF) Every Heartbeat Matters Award for medical outreach in Honduras via our Duke Heart for Honduras program. The announcement was made during The Society of Thoracic Surgeons (STS) 60th Annual Meeting being held this weekend (Jan. 27-29) in San Antonio, TX.

The TSF, which is the philanthropic arm of the STS, offers grants of up to $35,000 for qualified surgeons who conduct charity surgical outreach work in underserved regions with underserved populations. The grant is designed to provide support for programs that educate, screen, and/or treat underserved populations to reduce the global burden of heart valve disease and other programs that advance healthcare and address underserved populations. The Every Heartbeat Matters Award is made possible through the support of Edwards Lifesciences Foundation.

Duke Heart for Honduras is an international cardiovascular surgical outreach partnership program launched in 2019 between the Division of Cardiovascular and Thoracic Surgery at Duke and the Instituto Nacional Cardiopulmonar (INCP) in Tegucigalpa, Honduras.

The socioeconomic climate of Honduras has made the provision of healthcare to its 9.5 million inhabitants difficult. There is a high rate of poverty, political instability, frequent natural disasters, and very few physicians available to diagnose and treat heart disease, let alone perform surgical cardiac interventions.

There is essentially only one cardiovascular surgeon in all of Honduras – Dr. Hugo Orellana, of the Instituto Nacional Cardiopulmonar (INCP) – with whom the Duke team collaborates. The INCP is a public hospital built roughly 75 years ago to provide specialized care for patients with tuberculosis, pulmonary, and cardiovascular diseases. The hospital has two operating rooms available. When resources permit, cardiac surgery is performed in those spaces.

“This award is key for us to continue these missions to Honduras, because it will essentially help fund all the flights we need to get the team down there,” said Williams. “That’s the biggest expense we have, so we are very excited and grateful to receive this award.”

Williams says the funding will be used to support the team’s next medical mission to Honduras, which is planned for May 11-18, 2024.

Congratulations, Adam — we are thrilled for you and the Duke Heart for Honduras team! Note: We’ll have more coverage from STS next weekend.

ICYMI: Latest Duke Publication on Diversity in Cardiology Fellowships

Congratulations to Sarah Snow, Pamela Douglas, and Brooke Alhanti for their latest publication in JAMA Cardiology. Recruiting a Diverse Cardiology Physician Workforce was published online Jan. 24, 2024.

The team reports their findings on changes in the representation of women and underrepresented racial and ethnic populations in cardiovascular disease and cardiovascular subspecialty fellowships. Using data from the Accreditation Council for Graduate Medical Education the team found percentages of women trainees in cardiovascular disease and interventional cardiology fellowships significantly increased from 2008 to 2022. While percentages of Black and Hispanic trainees in these fellowships have increased in recent years, the change is not yet statistically significant, according to the authors.

Great job on an incredibly important topic, Sarah, Pam, and Brooke!

Loring, Piccini Appear in Latest Episode of Heart Rhythm TV

Congrats to Zak Loring and Jon Piccini for appearing in a great episode of Heart Rhythm TV. The episode, The Natural History of AF – An Echocardiographic Study was posted to the Heart Rhythm channel on YouTube yesterday.

The two were interviewed by host Roderick Tung about their latest publication, Natural history of echocardiographic changes in atrial fibrillation: A case-controlled study of longitudinal remodeling, appearing in the January 2024 issue of Heart Rhythm Journal.

Nicely done – great interview, Jon and Zak!

Jule Named ANM, 6 East

We are excited to share that Annette Jule, BSN, RN, MPH, MSN, has been named the new 6 East assistant nurse manager (ANM), effective Jan. 2, 2024. Annette was born and raised in New York City and obtained her BSN from Long Island University Brooklyn Campus. She has nursing experience in transplant, med/surg, and critical care. She relocated to Florida and while there was promoted to leadership roles in nursing both at Baptist Hospital of Miami and HCA Kendall. During this time she obtained her MPH at George Washington University and MSN in nursing leadership at Nova Southeastern University.

Please join us in congratulating and welcoming Annette in her new role!

Kudos to Keenan & CT Surgery Team!

We received a warm note from DUH chief medical officer David Gallagher letting us know about patient feedback on Jeffrey Keenan and members of the CT Surgery team.

“Jeff, we received this nice feedback (from Press Ganey HCAHPS) about the great care you and your team gave to a patient at Duke Hospital. Thank you for the high quality and compassionate care you provide to patients! Jill, thanks to all the heart surgery staff who helped this patient! Great team!” — David Gallagher, MD, chief medical officer

“I can’t say enough on how grateful I am towards my doctor Jeffrey Keenan and all staff that helped me recover from my heart surgery.” — grateful patient, name withheld for privacy

Kudos to Parker & CTICU Team!

Kudos to Phillip Parker, nurse manager of the CTICU, and the whole CTICU team for their amazing partnership and floating ICU nurses to the OTC at Duke Hospital last week.

Their teamwork is helping capacity rise to 150 in the next few weeks. Great job!

Latest Duke Heart/Med-IQ CME Course Now Available

Managing Mitral Regurgitation Based on the Mechanism of Disease, a Med-IQ CME course with Andrew Wang is now live. To learn more, please click here.

Duke Research and Innovation Week

Starting Monday, Jan. 29, Duke is hosting its annual Research and Innovation Week–this time, with a Centennial twist. Join the Office for Research & Innovation for a week of exciting events, panels, and showcases to celebrate the past, present, and future of research and innovation at Duke.

It will include discussions on:

Depolarizing Political Toxicity on Social Media
Duke and NCCU’s Ongoing Partnerships and Collaboration
Race, Ethnicity and Politics Research
Many more great topics!

Consider attending the Research Town Hall on Jan. 31 featuring Brian McAdoo, Ross McKinney, Michael Pencina, Geeta Swamy, and Kanecia Zimmerman speaking on Integrity in Scholarship: The Next 100 Years. Or, on Feb. 1, check out the session on Duke Research in 2124 with panelist Muath Bishawi, or Duke and the FDA with Lesley Curtis, Mark McClellan, and Ehsan Samei.

A great week is planned! Learn more here.

National Wear Red Day is Friday

On Friday, Feb. 2, please join us in celebrating National Wear Red Day! This annual event is a visible means of showing your support and enthusiasm for working with cardiovascular patients and heart disease survivors. No need to don a completely crimson outfit! Red accessories such as socks, shoes, ties, or earrings are a great way to show you are participating in Wear Red Day! (Note: If your work area at Duke Health requires a uniform of specific color, you must adhere to that dress code policy.)

Kick-off Heart Month by wearing some red on Friday. Another event to consider is:

22 – AHA Triangle Hands-Only CPR demonstration, Noon, via Zoom. To register please click here.

Reminder: Tier 2 Status

We are currently in Tier 2 visitation status throughout Duke University Health System. Information is available on Duke Health Now.

Upcoming Events & Opportunities

Duke Culture Survey: Jan. 29-Feb.17
Duke Centennial Research & Innovation Week: Jan. 29-Feb.2
National Wear Red Day: 2
February is Heart Month and Black History Month.

Transplant Grand Rounds

Jan. 30: Partial Heart Transplantation – Emergence of a New Paradigm with Joseph Turek. Noon. DN2003 or via Zoom.

Cardiology Grand Rounds

Jan. 30: Unraveling ketone metabolism in the failing heart with Senthil Selvaraj. 5 p.m., DN 2002 or via Zoom.

Feb. 6: Implementation strategies to address the burden of Heart Failure with Harriette Van Spall of McMaster University. 5 p.m., DN 2002 or via Zoom.

All Duke Cardiology Grand Rounds recordings are housed on Warpwire. To access recordings please visit:

Your NET ID and password are required. Enjoy!

Cardiology Grief Debrief Session

Jan. 29. Noon, In-person only: DMP 2W96

CD Fellows Core Curriculum Conference

Jan. 31: HT/Txp Case Presentation with Eric Xie. Noon. DMP 2W96 (in-person only).

Feb. 2: Introduction to SPECT with TBD. Noon. Zoom only.

Office of Faculty — Event with Israni of Stanford Medicine, Feb. 26

Academic Medicine, with all its complexities, naturally includes conflict amongst its crucial collaborators – trainees, faculty, staff, communities and more. 21st century leadership skills require all of us to strategically leverage components of this conflict for constructive change, with intentional and thoughtful actions. This talk will weave together themes from restorative justice and design thinking; and how they can be applied to artificial intelligence and JEDI (justice, equity, diversity, and inclusion), offering a case for new ways of leveraging conflict to advance a culture of connectedness and belonging. The featured speaker will be Sonoo Thadaney Israni of Stanford University’s Presence Center.

February 26: Leveraging Conflict for Constructive Change. 4-5:30 p.m., DN 2002. Presented by the Office for Faculty. Refreshments will follow. To learn more and register: https://duke.is/8/8d7f.

Upcoming CME Symposia for Spring, 2024

Feb 6: Stroke Management of the Future? The Potential Role of Factor XI/XIa Inhibitors in Secondary Stroke Prevention.

This is a DukeHeart/TotalCME event with Manesh Patel, et al. In-person at the Hyatt Regency Phoenix, 2nd floor, Phoenix Ballroom. Virtual: Livestream via MedEd On The Go, 8-9:30 p.m., EST. This evening symposium will be held during the International Stroke Conference 2024 in Phoenix.

Join experts to explore how factor XI/XIa inhibitors may transform secondary stroke prevention in patients with acute ischemic strokes and transient ischemic attack risk factors. This data-rich symposium reviews currently available therapeutics and how they affect the coagulation cascade, increasing the potential for serious bleeds. Experts outline new and emerging anticoagulation pharmacotherapy that may mitigate bleeding risks. Through interactive presentations, attendees gain a deep understanding of the rapidly evolving stroke prevention landscape, preparing them to implement the latest approaches, improve clinical practice and boost patient outcomes.

Faculty presenters:

Valeria Caso, MD, PhD of the University of Perugia
Mike Sharma, MD, MSc, FRCPC of McMaster University
Manesh R. Patel, MD of Duke Health
Ashkan Shoamanesh, MD of McMaster University

Supported by an educational grant from Bayer HealthCare Pharmaceuticals and jointly provided by Duke Heart, MedEd On The Go, and Total CME.

March 8: Cardio-Oncology/Amyloid Symposium

The Southeastern Cardio-Oncology Conference, The Future is Now will take place on March 8 at the JB Duke Hotel in Durham, NC. Event registration is open; the registration deadline is March 5.

Duke cardiologists Michel Khouri and Ravi Karra of Duke’s Precision Cardiomyopathy Program will be presenters during the symposium.

Keynote to be provided by Avirup Guha, director of cardio-oncology and assistant professor of medicine at Augusta University’s Georgia Cancer Center.

The symposium is presented by Duke Cancer Network (DCN) in collaboration with Duke Cancer Institute. For more information, please contact Beth Tanner of DCN.

April 12: Duke Sports Cardiology & Sudden Death in Athletes

May 4: Duke Heart Failure Symposium

Registration is not yet open for the April 12 or May 4 symposia, but if you have questions about either event, please reach out to Christy Darnell.

Angels Among Us Walk & 5K, April 27

Our friends and colleagues at the Preston R. Tisch Brain Tumor Center (BTC) will hold their 31^st annual Angels Among Us Walk on April 27 at the corner of Erwin Road and Flowers Drive on the Duke Medical Center campus. The Angels Among Us 5K and Walk of HOPE will begin with a 5K run followed by great entertainment, children’s activities, delicious food, and fun for the entire family.

A ceremony will begin the walk of hope through the Duke Medical Campus and the Sarah Duke Gardens. Proceeds from the event support the Preston Robert Tisch Brain Tumor Center at Duke. Visit www.angelsamongus.org to learn more.

Please consider supporting our Duke BTC colleagues and their annual event!

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.

Duke Heart in the News:

January 12 — Nishant Shah

Healthcentral.com

What’s a “Mini” Heart Attack?

January 19 — Robert Lefkowitz

Memphis Business Journal

St. Jude Children’s Research Hospital invests $13M in Duke, Stanford, Columbia University collaboration

January 19 — Jonathan Piccini

Cardiovascular Business

ICE-guided Watchman procedures linked to safety concerns—is TEE better for LAAO or will things improve?

January 19 — Duke Heart study

Woman’s World

Doctors Reveal the Best Sleeping Position to Outsmart Nighttime Leg Pain

*refers to this Duke study

January 20 — Brittany Zwischenberger

The New York Times

The Heart Surgery That Isn’t as Safe for Older Women

January 23 — Stephen Greene

Medscape

Deaths Linked to Substance Use, CVD on the Rise

January 23 — Kristin Newby

Consumer Reports

El mejor chequeo para tu corazón

January 24 — Sarah Snow

Healio/Cardiology Today

Women in CV fellowships on the rise; not so among other underrepresented groups

January 24 — Duke University Hospital

Becker’s ASC Review

The top 317 cardiology facilities for Medicare members, per Aetna

January 24 — Duke Heart study

Today’s Geriatric Medicine

Statins: Reducing Racial Disparities

*references this Duke study.

January 25 — Nenad Bursac

Genetic Engineering & Biotechnology News

Cancer Mutation That Spurs Cell Division Helps Heart Models Run at Full Gallop

January 25 — Nenad Bursac

WPTF/680 News Radio

Mutation in skin cancer may help recovery from heart attacks

*clip begins @ 12:12:48

Duke Heart Pulse — January 21, 2024

January 21, 2024 / Leave a comment

Highlights of the week:

Bloomberg Grant Funds Innovative Partnership for Early College High School in Durham

A partnership between Duke Health, Durham Technical Community College, and Durham Public Schools has been awarded a transformative $29.5 million grant from Bloomberg Philanthropies to establish an early college for high school students interested in pursuing healthcare careers upon graduation.

The grant is one of 10 awarded nationally through Bloomberg Philanthropies’ “Student-centered, Market-driven Healthcare Education Initiative.” The initiative’s goal is to address critical healthcare workforce needs while preparing young adults for successful careers in the field.

“For too long, our education system has failed to prepare students for good jobs in high-growth industries,” said Michael R. Bloomberg, founder of Bloomberg Philanthropies and Bloomberg LP and 108th mayor of New York City. “By combining classroom learning with hands-on experience, these specialized healthcare high schools will prepare students for careers with opportunities for growth and advancement. America needs more health care workers, and we need a stronger, larger middle-class – and this is a way to help accomplish both goals.”

The Durham partnership will provide the preparation needed for careers in nursing, allied health, surgical tech, and clinical research. The key elements of the partnership are:

Interested Durham Public Schools (DPS) students in grades 9-12 will attend the early college high school and simultaneously earn both a high school diploma and an associate degree or workforce credential for aligned healthcare occupations.
The Middle College at Durham Tech will expand to an early college high school and will be housed at Durham Tech (DTCC) in a newly renovated space, with the school opening in the fall of 2025.
Upon graduation, students will have an immediate pathway to jobs or research roles at Duke Health.

“This partnership is about much more than an innovative educational approach,” said J.B. Buxton, president of Durham Tech. “It’s about creating a high-quality pathway to some of the most important jobs in our community. It’s about making sure our healthcare workforce looks like the patients it serves. It’s about improving the quality of patient care and the health outcomes for all. It’s about the role of education and health in improving people’s lives.”

The program is expected to open in the fall of 2025 with an initial class of 100 ninth graders, then enroll additional classes of 100 students for each of the next three years.

The Bloomberg Philanthropies grant will allow Durham Public Schools to further increase Durham’s talent pipeline in the healthcare sector. The district currently offers medical career-focused courses and experiences through its City of Medicine Academy.

“This innovative partnership marks a significant milestone in our collective commitment to provide students with unparalleled opportunities and prepare them for successful futures in the dynamic health sciences sector,” said Pascal Mubenga, superintendent of Durham Public Schools. “This will also help us keep qualified talent right here in Durham to strengthen our network of care.”

Students will graduate with one or more credentials required to fill high-demand positions, including certified nursing assistant, emergency medical technician, phlebotomist, and central sterile processing technician.

Duke University Health System (DUHS), which comprises Duke’s hospitals, clinics, and other patient care services, is expected to hire at least 60 students directly after graduation from the early college high school, fulfilling a critical need for a diverse and skilled workforce. To promote retention and career advancement, the health system will provide mentoring, flexible scheduling, and assistance with other support services such as transportation or childcare.

“This exciting new partnership encompasses education, research, patient care, and community enhancement to advance a bold and innovative healthcare education model for Durham,” said Vincent E. Price, president of Duke University. “We are grateful to Bloomberg Philanthropies for supporting this vital work, and thankful for our innovative regional partners as we create compelling new opportunities for Durham students and address critical workforce shortages.”

This initiative reflects Duke’s broad commitment to forging partnerships to support strategic community priorities such as college and career readiness. Through Bloomberg Philanthropy’s generosity, this innovative model of collaboration will provide significant opportunities for young people to be prepared as the next generation of leaders in health care as well as advance the overall well-being of communities.

“Through this collaboration, we will advance economic stability and economic mobility within our communities by expanding educational and career opportunities while addressing critical workforce shortages,” said Craig T. Albanese, chief executive officer of Duke University Health System. “Duke Health’s engagement in this partnership, led by Debra Clark Jones, our associate vice president for Community Health, is one of many DUHS initiatives aimed at improving the overall health, both clinically and socially, of the communities we serve.”

“Duke Health is committed to health equity where everyone in our community has a fair and just opportunity to be their healthiest,” said Debra Clark Jones, associate vice president for Community Health at Duke Health. “Working collaboratively with our community partners to remove barriers to education and good jobs is critical to advancing health equity. I cannot be prouder of leading this important effort on behalf of Duke Health. This initiative is a great example of how we improve overall community health by partnering with intention and leveraging our respective strengths and assets.”

In addition to providing a direct pathway to healthcare jobs, an apprenticeship program through the Duke University School of Medicine will offer a direct route for students to pursue clinical research.

“We are delighted by this opportunity to extend and deepen our work with local education partners,” said Mary E. Klotman, Duke University’s executive vice president for health affairs and dean of Duke University School of Medicine.

“Duke brings strength to this partnership not only as the lead employer for this program but also because we are especially well-positioned to support learners,” Klotman said. “This initiative’s innovative apprenticeship program will offer a more direct pathway for talented young people to enter the profession in clinical research units across Duke. This helps address acute talent shortages while allowing students to gain professional experience in a supportive learning environment.”

The early college high school could help ensure that a significant percentage of new frontline healthcare workers reflect the Durham communities served by DUHS. Because Durham Public Schools is one of the most diverse districts in the region, with approximately 81% non-white students, the graduates of the early college who join DUHS could help improve healthcare access, patient care and engagement, and equity in health outcomes.

“The Bloomberg grant provides a unique opportunity for Durham Public Schools, Duke Health, and Durham Tech to create a transformative educational partnership that will be a “win” for everyone in our community,” said Tara Fikes, Durham Tech Board of Trustees chairwoman. “As a result, DPS students will have a pathway through Durham Tech to well-paying jobs in health care, helping to address the shortage of workers in the field while providing greater access to health care for all residents.”

Administratively, the early college high school will be part of the DPS system, operated jointly by the public school system and Durham Tech. DPS will provide high school teachers, a principal, support staff, student services, and curricular resources. Students will also be dually enrolled at DTCC, which will begin renovating a building on-site to house the new school.

DUHS will also contribute employee time to engage with students in classroom projects, co-teach, and supervise work-based learning opportunities. In addition, the health system will evaluate the program and calculate its overall value and measures of success.

“The plans and aspirations of our partnerships align with the Bloomberg initiative’s vision,” said Bettina Umstead, chair of the Durham Public Schools Board of Education. “Together, we will create innovative education models, prepare young adults for successful career opportunities, and address critical shortages in health care talent, ultimately ensuring our DPS students connect with health care career opportunities in their home, the City of Medicine.”

ICYMI: The Heart Surgery That Isn’t as Safe for Older Women

We want to draw your attention to an excellent consumer news article on an important topic published in Saturday’s issue of The New York Times. ‘The Heart Surgery That Isn’t as Safe for Older Women’ features the experiences of several women who underwent coronary artery bypass grafting (CABG) procedures; the piece includes a quote from Duke cardiothoracic surgeon, Brittany Zwischenberger, MD, and references two 2023 publications – one a retrospective cohort study published in JAMA Surgery, the other is the accompanying editorial to that study. Zwischenberger, along with Jennifer Lawton of Hopkins, is a co-author of the editorial.

A Call to Action to Improve Outcomes in Women Undergoing Surgical Coronary Revascularization, by Zwischenberger and Jennifer S. Lawton, MD.

Operative Outcomes of Women Undergoing Coronary Artery Bypass Surgery in the US, 2011 to 2020, by Mario Gaudino, MD, PhD, MSCE (Weill Cornell Medicine), et al.

Duke Culture Survey Launching Jan. 29

In his 2020 Juneteenth address, Duke University president, Vincent E. Price committed to surveying all faculty, students, and staff to assess and inform Duke’s progress in addressing bias and promoting respect, meaningful inclusion, and true equity in our community.

As a result, Duke University staff, faculty, and students were asked to respond to an April 2021 Duke Campus Survey. Nearly 13,000 of us did so. That effort helped identify areas of concern and priorities as we moved forward in our racial equity work. That first survey was an essential step to document where we were.

On Jan. 29, the second Duke Campus Survey will launch — this and all surveys to follow — will ensure we are continuing to move toward equity. The survey will be repeated every three years to track our progress.

If you would like Duke to be a place where everyone has an equal chance to thrive, please take the survey. By sharing your experience, you will help Duke leaders understand our progress as we strive to create a more equitable Duke. The survey is anonymous and will be open between Jan. 29 and Feb. 16.

Keep an eye out on your email for further information. Thank you!

Shout-out to Conway

A big shout-out to cardiology clinical pharmacist, Monique Conway!

“Monique is amazing—consistently helping to make sure our patients are on appropriate therapies and teaching the house staff (and sometimes the attendings!) about new studies and evidence. Her support and participation are an essential part of providing excellent care to our inpatients.

What truly inspired me this week is that she also goes out of her way to care for the patients by making sure they can purchase their medications, and she even helped one of our patients find clothes to wear home on a cold day. We are very grateful to have her as part of our team!” – Cary Ward, MD

Nice job, Monique!

Kudos to Gaca & Zwischenberger!

We received terrific feedback on Drs. Jeff Gaca and Brittany Zwischenberger via the Patient & Visitor Relations monthly report this week.

“Patient stated that despite the busy unit Dr. Gaca and Dr. John help saved patient’s life.”

“Patient stated that Dr. Brittany Zwischenberger is one of the best doctors he has ever had. She is very knowledgeable and has a good personality. She made him and his wife feel confident.”

Well done, Jeff and Zwisch!

Shout-outs to Members of Duke’s Heart Failure Team!

We wanted to share a large group of shout-outs regarding team member efforts in clinical research trial recruitment! Congratulations to Lacey Taylor and Stephen Greene for enrolling the first patient into GOALS-HF and to Kim Biever, Aferdita Spahillari, and Marat Fudim for enrolling a patient into FASTR!

Additional gratitude from Kim Biever: “To Tracy DeWald for approaching the patient for the FASTR trial and filling multiple furosemide syringes over the course of a few days- most impressively, the last one on Sunday evening; to Isha Amin, Shelley Thompson, John Lazzari, Jaime McDermott, Aferdita Spahillari and Stephen Greene for coordination of care, chart documentation and for answering my endless questions about fluid volume; to Marat Fudim for promptly signing what seemed to be at least a hundred orders, and last, but not least, to Ashley Frazier, Laura Dickerson and the nursing staff for ensuring proper staffing levels and for going above and beyond their clinical duties to ensure that our research efforts went smoothly. I appreciate your assistance more than you could ever know! Thank you!”

Way to go, team!!!

Duke My Chart is Now My Duke Health

Last week, Duke My Chart transitioned to My Duke Health. Neither patients nor staff need to make any changes – login information will remain the same. However, accessing My Duke Health via smartphone or tablet will require downloading the new app which is now available in Google Play and in the Apple App Store, or by visiting MyDukeHealth.org.

Reminder: Tier 2 Status

We are currently in Tier 2 visitation status throughout Duke University Health System. Information is available on Duke Health Now.

Upcoming Events & Opportunities

Duke Culture Survey: Jan. 29-Feb.17
National Wear Red Day is Friday, Feb. 2!
February is Heart Month

Cardiology Grand Rounds

Jan. 23: All you need to know about the new AF guidelines in the new year! with Jonathan Piccini. 5 p.m., DN 2002 or via Zoom.

Jan. 30: Unraveling ketone metabolism in the failing heart with Senthil Selvaraj. 5 p.m., DN 2002 or via Zoom.

Feb. 6: Implementation strategies to address the burden of Heart Failure with Harriette Van Spall of McMaster University. 5 p.m., DN 2002 or via Zoom.

All 2023 Duke Cardiology Grand Rounds recordings are housed on Warpwire. To access recordings please visit: https://duke.is/DukeCGR; NET ID and password required. Enjoy!

CD Fellows Core Curriculum Conference

Jan. 24: EP Case Presentation with Andrew Andreae, MD and Damarcus Ingram, MD. Noon. DMP 2W96 (in-person only).

Jan. 26: Cath Lab Math with Thomas Bashore, MD. Noon. Zoom only.

Office of Faculty — Event with Israni of Stanford Medicine, Feb. 26

Academic Medicine, with all its complexities, naturally includes conflict amongst its crucial collaborators – trainees, faculty, staff, communities, and more. 21st century leadership skills require all of us to strategically leverage components of this conflict for constructive change, with intentional and thoughtful actions. This talk will weave together themes from restorative justice and design thinking; and how they can be applied to artificial intelligence and JEDI (justice, equity, diversity, and inclusion), offering a case for new ways of leveraging conflict to advance a culture of connectedness and belonging. The featured speaker will be Sonoo Thadaney Israni of Stanford University’s Presence Center.

February 26: Leveraging Conflict for Constructive Change. 4-5:30 p.m., DN 2002. Presented by the Office for Faculty. Refreshments will follow. To learn more and register: https://duke.is/8/8d7f.

Upcoming CME Symposia for Spring, 2024

March 8: Cardio-Oncology/Amyloid Symposium

The Southeastern Cardio-Oncology Conference, The Future is Now will take place on March 8 at the JB Duke Hotel in Durham, NC. Event registration is open; the registration deadline is March 5.

Cardiologists Drs. Michel Khouri and Ravi Karra of Duke’s Precision Cardiomyopathy Program will be presenters during the symposium.

Keynote to be provided by Dr. Avirup Guha, director of cardio-oncology and assistant professor of medicine at Augusta University’s Georgia Cancer Center.

The symposium is presented by Duke Cancer Network (DCN) in collaboration with Duke Cancer Institute. For more information, please contact Beth Tanner of DCN.

April 12: Duke Sports Cardiology & Sudden Death in Athletes

May 4: Duke Heart Failure Symposium

Registration is not yet open for the April 12 or May 4 symposia, but if you have questions about either event, please reach out to Christy Darnell.

Have news to share?

Duke Heart in the News:

January 12 — Amanda Craig

Cardiovascular Business

Heart transplant recipients face increased risk of maternal complications when giving birth

January 12 — Brian Duscha

Healio/Cardiology Today

Each cardiac rehab session attended cuts readmission, death risk by 2%

January 12 — Joseph Turek

Univision

Un trasplante parcial de corazón salva la vida de una bebé: te explicamos cómo es este procedimiento

January 15 — Kristin Newby

Consumer Reports

Best Checkup for Your Heart

January 16 — Joseph Turek and the Monroe family

El Pais

El hito del pequeño Owen: el trozo de corazón trasplantado para curarle un fallo cardíaco crece con él

January 16 — Adrian Hernandez

Heart.org

Beyond breathing: How COVID-19 affects your heart, brain and other organs

January 16 — Cynthia Shortell

Vascular News

We still have a lot more work to do

January 17 — Duke Health

Becker’s Hospital Review

13 major health systems partner with high schools in $250M Bloomberg initiative

January 17 — Duke Health

Healthcare Innovation

Bloomberg Workforce Initiative Connects Health Systems, Public Education

January 17 — Adrian Hernandez

Associated Press/Sinembargo.mx

La COVID no es “vencer el resfrío” y ya. Deja daños en corazón, cerebro y más órganos

January 17 — Pamela Douglas

tctMD

Doctors on Overdrive: Fewer Breaks Equal More Burnout

January 17 — Joseph Turek

La Nacion (Argentina)

“El hito de Owen”. El tejido de corazón trasplantado que crece con el bebé que lo recibió

January 17 — Adrian Hernandez

NPR/1A

What’s New With COVID-19?

* carried by WUNC and 480+ affiliated stations nationally

Duke Heart Pulse — January 14, 2024

January 14, 2024 / Leave a comment

Highlights of the week:

Shah Named Associate Dean for Translational Research

Svati H. Shah, MD, MS, MHS, has been named associate dean for translational research, effective immediately.  

In this role, Shah will serve in an expanded capacity from her previous role as associate dean of genomics. She will provide strategic vision, development, and oversight of translational research initiatives within the School of Medicine. Specifically, she will be responsible for overseeing biobanking service centers and the integration of large biologic datasets including storage and computer environments. Her leadership portfolio will also include the OneDukeBio Integrated Biospecimen Network. She will collaborate closely with associate and vice deans in related disciplines to ensure program alignment across the School of Medicine.

Shah has been a member of the Department of Medicine’s cardiology faculty since 2005. Currently, she is Ursula Geller Distinguished Professor of Research in Cardiovascular Disease, professor of bioinformatics and biostatistics, director of the Duke Center for Precision Health within the Duke Clinical and Translational Science Institute (CTSI), director of the Duke School of Medicine Precision Genomics Collaboratory, director of the Adult Cardiovascular Genetics Clinic, and a member of the Duke Molecular Physiology Institute and Duke Clinical Research Institute. She is the founding director of the Duke Center for Precision Health, chair of the research committee for the Board of Directors of the American Health Association, and a member of the Board of Directors of the Sarnoff Foundation.  

Shah is a physician-scientist and practicing cardiologist who sees patients and families with cardiovascular genetic disorders. Upon completing her internal medicine residency at the Brigham and Women’s Hospital, she came to Duke for a cardiology fellowship in 2001, where she also completed a master’s degree in medical genomics and a postdoctoral fellowship in genetic epidemiology. 

Congratulations, Svati!

Selvaraj Selected for 2024 ASCI Award

We are thrilled to share that Senthil Selvaraj, MD has been selected as a recipient of an American Society for Clinical Investigation (ASCI) 2024 Young Physician-Scientist Award (YPSA). The ASCI award is a significant early-career achievement and highly competitive; there were 172 nominations this year for 52 awards.

Selvaraj, an assistant professor of medicine in cardiology (Advanced Heart Failure and Transplant) at Duke and a faculty member in the Duke Molecular Physiology Institute is a past recipient of ASCI’s inaugural Emerging-Generation Awards in 2022 while he was at the University of Pennsylvania Perelman School of Medicine.

This is the second consecutive year that a faculty member from Duke Heart has earned one of ASCI’s YPSAs. Jennifer Rymer, MD, MBA, received a 2023 ASCI YPSA.

Way to go, Senthil! Congratulations!!

Duke Centennial Kick-off Features Easton Sinnamon, Joe Turek of Duke Heart

Duke University’s Centennial Celebration Kickoff was held Tuesday, Jan. 9 in Cameron Indoor Stadium. It was a fantastic event with hosts (and alums!) Ken Jeong, comedian and actor, and Lisa Borders, former president of the Women’s National Basketball Association, along with a special appearance by Mike Krzyzewski. The trio helped highlight the many contributions the faculty, staff, students, and alumni have made over the years. Notable VIPs included Drs. Joseph Turek and Louise Markert who appeared as part of a special segment featuring the story of Easton Sinnamon, the now 3-year-old boy who received the world’s first combination heart transplant-thymus procedure here at Duke in 2021. Sinnamon is doing great, and his story stole the show!

If you did not get the opportunity to attend in person or to view the livestream, we have links for you! To see an overview and editor selection of key moments, visit https://100.duke.edu/story/start-of-a-centennial/

To get all the details regarding Duke’s Centennial and associated events, please visit the Centennial web page.

Kudos to Cox!

Kudos to Gail Cox for her assistance with a patient of Bill Kraus’ who was having anemia and dyspnea in a post-operative period. The patient and their family, who live in Western Virginia, reached out to whomever they knew at Duke to handle this difficult and frightening situation.

During their emergency, they had pulled their car over on the road after getting someone to take the call at Duke — that amazing person turned out to be Gail Cox. Cox listened to their description of the issue and then arranged for a Duke admission.

In gratitude, they sent a card to their care team – the card states:

“Dear Gail, We are so appreciative for your help and advocacy. We were struggling to get the help (for patient/name withheld) needed after surgery. You were there to get them the care they needed at Duke. They were able to come home and begin healing. Forever grateful.”

Nicely done, Gail!!!

Duke MyChart Transitioning to My Duke Health

On January 17, Duke MyChart will transition to My Duke Health, a sleek new online portal – app and website – with improved functionality and visual appeal.

My Duke Health is expected to provide a tailored, Duke-specific online experience for Duke Health patients, and puts all the convenient features of Duke MyChart into one place. By logging into the portal patients can:

Make in-person appointments for provider visits, lab work, imaging, and other tests like screening mammograms and sleep studies.
Schedule and attend virtual appointments with primary care providers and specialists.
Check-in for appointments up to 5 days ahead of time to save time on the day of an appointment.
Communicate with providers, view after-visit notes and test results.
Pay bills and view documents

Patients will be able to easily access urgent care virtual visits and view urgent care wait times. There is an option to read Duke Health news and learn about upcoming events, view articles related to the topic of the month, and search through an educational health library. The My Duke Health library contains hundreds of educational materials including short videos and other resources.

Soon, patients will be able to chat with a virtual assistant, view personalized resource pages based on their health needs, and connect with Duke Health Listens, an online community in which patients can offer direct feedback about their healthcare experience, and help us advance better health together.

NOTE: Accessing My Duke Health via smartphone or tablet will require downloading the new app which will be available on Jan. 17 at 10 a.m. in Google Play and in the Apple App Store, or by visiting MyDukeHealth.org.

Cardio-Oncology/Amyloid Symposium Announced

The Southeastern Cardio-Oncology Conference, The Future is Now will take place on March 8 at the JB Duke Hotel in Durham, NC. Event registration is open; the registration deadline is March 5.

Duke cardiologists Drs. Michel Khouri and Ravi Karra will be presenters during the symposium. Keynote to be provided by Dr. Avirup Guha, director of cardio-oncology and assistant professor of medicine at Augusta University’s Georgia Cancer Center.

The symposium is presented by Duke Cancer Network (DCN) in collaboration with Duke Cancer Institute. For more information, please contact Beth Tanner of DCN.

New Visitor Restrictions In Effect

Duke Health has updated visitation restrictions as of Wednesday, January 3.

Visiting hours are from 8 a.m. to 9 p.m.
Visitors must check in at the hospital information desk to receive a visitor badge to enter inpatient areas.
All visitors must be age 12+. (Visitors in some clinical areas must be age 18+.)
Minors are required to be attended by an adult age 18+ at all times.
A maximum of two visitors are allowed per patient.
Visitors must check out upon departure at a kiosk or with information desk staff.
Visitors with fever, cough, or other flu-like symptoms should not visit.

For more details, refer to the Tier 2 visitation standard work document. Updated signage is posted.

Please note: Additional visitation and masking precautions may apply to certain patient populations, including COVID-19/Special Airborne Contact, oncology, end-of-life, and overnight visitors. Please follow all unit guidelines. Exceptions to visitation restrictions may be granted based on special circumstances, including without limitation, to permit Compassionate Care Visitors.

Upcoming Events & Opportunities

National Wear Red Day is Friday, Feb. 2!
February is Heart Month

Cardiology Grand Rounds

Jan. 16: No CGR today.

Jan. 23: All you need to know about the new AF guidelines in the new year! with Jonathan Piccini. 5 p.m., DN 2002 or via Zoom.

Jan. 30: Unraveling ketone metabolism in the failing heart with Senthil Selvaraj. 5 p.m., DN 2002 or via Zoom.

Feb. 6: Implementation strategies to address the burden of Heart Failure with Harriette Van Spall of McMaster University. 5 p.m., DN 2002 or via Zoom.

All 2023 Duke Cardiology Grand Rounds recordings are housed on Warpwire. To access recordings please visit: https://duke.is/DukeCGR; NET ID and password required. Enjoy!

CD Fellows Core Curriculum Conference

Jan. 17: DHP Case Presentation with Aarti Thakkar, MD. Noon. DMP 2W96 (in-person only).

Jan. 19: Hypertrophic Cardiomyopathy with Andrew Wang, MD. Noon. Zoom only.

Office of Faculty Announces Event with Israni of Stanford Medicine, Feb. 26

February 26: Leveraging Conflict for Constructive Change. 4-5:30 p.m., DN 2002. Presented by the Office for Faculty. Refreshments will follow. To learn more and register: https://duke.is/8/8d7f.

Upcoming CME Symposia for Spring, 2024

Heads up on some CME dates you might want to put on the calendar for next year. Our Duke Sports Cardiology & Sudden Death in Athletes symposium will be held at the Trent Semans Center on Friday, April 12, 2024. And our Duke Heart Failure Symposium will be held at the Durham Hilton on Saturday, May 4, 2024.

Registration won’t be open for a while, but if you have any questions about either event, please reach out to Christy Darnell.

As soon as registration opens, we’ll have that listed here in Pulse.

Have news to share?

Duke Heart in the News:

January 4 — Joseph Turek

Le Monde (France)

Le premier nouveau-né ayant bénéficié d’une transplantation cardiaque partielle a aujourd’hui 14 mois

January 4 — Joseph Turek

Scripps News

Baby thriving a year after world’s first partial-heart transplant

January 4 — Joseph Turek

Medical Design & Development

‘World’s First’ Partial Heart Transplant Forms Functioning Valves and Arteries

January 4 — Joseph Turek, Lillian Kang, Douglas Overbey, and Michael Carboni

Nature

A record-setting transplant heals a baby’s broken heart

January 5 — Joseph Turek and Michael Carboni

Healio/Cardiology Today

Valves from world’s first partial heart transplant growing with child recipient

January 5 — Robert Mentz

tctMD

Top Heart Failure News of 2023

January 7 — Harry Severance

KevinMD.com/Medpage Today

Leaders advise us to accept it as a job norm: violence and abuse in the health care workplace

January 8 — Brian Duscha and William Kraus

Knowridge (Australia)

Cardiac rehab is a lifesaving choice for people with heart disease

January 8 — Duke University Hospital

Press Ganey

2023 recipients of the Human Experience Pinnacle of Excellence Award

January 8 — Brian Duscha

WPTF (Raleigh)

Rehab helpful for recovering heart patients

*clip begins @ 15:41:27

January 9 — Carolina Tennyson

U.S. News & World Report

Why Nurse Practitioner Is the No. 1 Job of 2024

January 10 — Joseph Turek

Noticias del Mundo

El corazón trasplantado del bebé Owen crece con él por primera vez en el mundo

Duke Heart Pulse — January 7, 2024

January 7, 2024 / Leave a comment

Pulse – January 7, 2024

Highlights of the week:

Study of Duke Heart Attack Patients Finds Definitive Benefit of Cardiac Rehab

The benefits of doing cardiac rehabilitation after a heart attack might seem obvious, but studies have provided surprisingly underwhelming findings.

Now an analysis from Duke Health offers definitive evidence for heart attack patients or those who have had procedures to clear blockages: Cardiac rehab saves lives and keeps people out of the hospital — no matter their age, sex, education level, income level, or race.

Publishing in the Journal of Cardiopulmonary Rehabilitation and Prevention, the researchers showed that fewer than 10 percent of patients with cardiovascular disease who can do so participate in cardiac rehab; and those who do have a 43 percent reduction in either mortality or readmission compared to those who do not.

“Our study shows that no matter who your patient is, what clinical characteristics they have, what type of intervention they have to clear blockages — if you send them to cardiac rehab, the benefit is far greater than what previous studies have shown,” said lead author Brian Duscha, an exercise physiologist at Duke.

Duscha and colleagues — including senior author William Kraus, MD, professor of cardiology in Duke’s Department of Medicine – said previous studies about the impact of cardiac rehab had limitations that skewed the findings. Notably, studies often included all discharged heart patients, including those with frailties or conditions that required them to live in a facility without access to rehab, or those who lived too far away from an available rehabilitation center that ruled out participation in a rehab program.

The Duke team analyzed the health records of 2,641 patients in Duke Health hospitals with coronary artery disease; all were considered able to do cardiac rehab at the Duke facility given distance or rehab location. Included patients were those with myocardial infarction and/or who had blockages requiring stenting or bypass surgery.

Among those who were ruled out were patients heading to skilled nursing care, those with valve replacements and heart transplant recipients, or those living more than 50 miles from the Duke rehab center. The researchers accounted for demographics, comorbidities, medical therapies, and demographics in their analysis.

“Not controlling for all these factors may explain the inconsistent findings from other studies assessing cardiac rehab’s impact on clinical outcomes,” Duscha said.

The researchers found that only about 8 percent (214) of the eligible discharged patients actually participated in at least one session of cardiac rehab; 93 percent of those who participated, however, attended five or more sessions.

“Importantly, attending even five sessions equated to a 10 percent significantly reduced risk of readmission or mortality,” Duscha said.

Kraus added that for every session attended, the risk of death or rehospitalization declined by 2 percent.

“Bottom line – cardiac rehabilitation is effective. It keeps people out of the hospital, saving both money and lives. Why wouldn’t you do that?” Kraus said.

In addition to Kraus and Duscha, study authors include Leanna M. Ross, Andrew L. Hoselton, Lucy W. Piner, and Carl F. Pieper.

The study received funding support from Duke research funds and the Johnston Distinguished Professorship.

First Barostim Implant Performed at Duke

Duke’s first Barostim implant was performed last month by vascular surgeon Chandler Long, MD, as part of a cross-departmental collaboration. Barostim is an implantable device now being used in heart failure patients with reduced ejection fraction.

Duke is currently offering this to patients referred to the Heart Failure Device Clinic for screening. The providers there, including Leilani Gomez, Todd McVeigh, and Marat Fudim, will screen, follow, and titrate the devices for patients in parallel to their routine care at Duke.

“This therapy will provide an alternative and complementary approach to medications for patients with symptomatic HFrEF (over 35 or less) and NYHA 2-3 symptoms despite GDMT,” according to Fudim.

In the future, the team plans to have providers manage the screening and referrals for implants themselves, but titration of devices will remain with the HF Device Clinic.

161 Hearts Transplanted at Duke in 2023

A final count has revealed that our team transplanted 161 hearts in 2023. To celebrate this record, and for reaching our 2000th heart transplant milestone, our team shared special cookies throughout the units last week. We will have our final total thoracic support (Transplant / VAD / Temporary VAD) data in the upcoming weeks. Again Duke Heart is leading the country in many of these areas

Kudos to all!

World’s First Partial Heart Transplant Proves Successful in First Year

The world’s first partial heart transplant has achieved what researchers have spent more than a year hoping for — functioning valves and arteries that grow along with the young patient, as hypothesized by the pioneering team behind the procedure at Duke Health.

The procedure was performed in the spring of 2022, in an infant who needed heart valve replacement. The previous standard of care — using valves that were non-living — would not grow along with the child, requiring frequent replacement, entailing surgical procedures that carry a 50 percent mortality rate.

A study led by Duke Health physicians, appearing online Jan. 2 in the Journal of the American Medical Association, found that the new manner of valve procurement used during the partial heart transplant led to two well-functioning valves and arteries that are growing in concert with the child as if they were native vessels.

“This publication is proof that this technology works, this idea works and can be used to help other children,” said Joseph W. Turek, MD, PhD, first author of the study and Duke’s chief of pediatric cardiac surgery, who led the landmark procedure.

The study also found the procedure requires about a quarter of the amount of immunosuppressant medication than a full heart transplant, potentially saving patients from detrimental side effects that might compound over decades.

Turek said the innovation has paved the way for a domino heart transplant, where one heart can save two lives. During a domino heart transplant, a patient who has healthy valves but needs stronger heart muscle receives a full heart transplant; their healthy valves are then donated to another patient in need, creating a domino effect.

“You could potentially double the number of hearts that are used for the benefit of children with heart disease,” Turek said. “Of all the hearts that are donated, roughly half meet the criteria to go on to be used for full transplant, but we believe there’s an equal number of hearts that could be used for valves.”

“If you introduce the donated hearts that weren’t being put to use into the supply chain and add the valves from domino heart transplants, that can create a substantial change,” Turek said.

The partial heart transplant procedure has been performed 13 times at four centers around the world, including nine at Duke, several of which have been domino heart transplants.

Turek said bringing this innovation to a clinical trial would be the next step to achieving the volume in procedures that would change the availability of hearts by a large amount.

“This innovation adds a lot to the whole donation community,” Turek said, “because it’s treating more kids, while also honoring the wishes of selfless donor parents who’ve given the ultimate gift. It allows them to offer hope to another child in the process.”

Preclinical data was supported by the Brett Boyer Foundation.

In addition to Turek, study authors include Lillian Kang, Douglas Overbey, Michael P. Carboni, and Taufiek K. Rajab.

Sports Performance Coach Takes the Lead Against Sarcoidosis Thanks to Expert Care at Duke

In Fall 2019, William Stephens learned he had cardiac sarcoidosis, a rare autoimmune disease that causes inflammation in the heart. A team of Duke doctors helped Stephens continue to work as a sports performance coach for Duke basketball players. Years later, he experienced a life-threatening sarcoidosis “flare” that sent him to the emergency department. Duke sarcoidosis experts stabilized Stephens quickly and established a more aggressive treatment regimen. Today, his sarcoidosis is in full remission, and the 58-year-old is happy to feel better. “This disease will kill you if you don’t get on top of it,” Stephens said. “I’m very blessed.”

Something’s Not Right

William Stephens prioritized health from a young age. After spending more than a decade in law enforcement, winning a handful of high-profile powerlifting championships, and becoming a certified strength and conditioning specialist, Stephens joined Duke basketball in 1998. He prioritized living a healthy lifestyle at home and work so when he started noticing fatigue and chest pressure in the summer of 2019, he knew something wasn’t right.

Cardiac Sarcoidosis Diagnosis

Stephens’ primary care doctors ordered a battery of tests, which showed his heart rate was dangerously low and inconsistent, and imaging scans showed scarring on his heart. Both signs indicated Stephens could have sarcoidosis. Its cause unknown, sarcoidosis encourages the immune system to form clumps of inflammatory cells that can attack organs including the heart (doctors call this cardiac sarcoidosis). Common sarcoidosis risk factors include age (between 20 and 60 years old) and African American descent, both of which applied to Stephens.

Recognized Sarcoidosis Clinic

Stephens’ doctors referred him to Duke’s Sarcoidosis Clinic, which is recognized by international organizations like the World Association for Sarcoidosis and Other Granulomatous Disorders (WASOG). The clinic’s specially trained providers work together to treat people with sarcoidosis and related complications. Stephens met advanced heart failure specialist Ravi Karra, MD; electrophysiologist James Daubert, MD; and rheumatologist Jayanth Doss, MD.

“Our multidisciplinary providers have expertise in different areas of sarcoidosis, and we work as a team,” Dr. Karra said. He likened it to legendary Duke men’s basketball Coach Mike Krzyzewski’s well-known teamwork analogy: a fist is much more powerful than five individual fingers.

Treatment Plan Includes Heart Device

To address Stephens’ immune response, decreased heart function, and heart rhythm issues, Drs. Karra, Daubert, and Doss recommended medications as well as a combination pacemaker/implantable cardioverter defibrillator (ICD).

“I’ll never forget that phone call when Dr. Daubert told me I had to get a pacemaker. It was a shock,” Stephens said. “Your mind goes a lot of places when someone says, ‘You need something to help your heart do what it’s supposed to do.’ That was hard to digest.”

A Dangerous Flare

Stephens’ pacemaker/ICD was surgically implanted in October 2019. He felt better, returned to work, and had regular check-ups with his doctors. In Spring 2022, Stephens was driving by Duke University Hospital when he felt like someone hit his car from behind. When it happened again, he realized he was being shocked by his ICD. That meant his heart was in a dangerous rhythm. He called his Duke care team, who immediately sent him to the emergency room. “By the time I got to the ER, they took me right back and got everything under control,” Stephens said.

According to Dr. Karra, Stephens was experiencing unstable ventricular tachycardia, a dangerous arrhythmia, or irregular heartbeat that doctors call a “VT storm.” PET scans showed increased inflammation in Stephens’ heart, indicating a sarcoidosis flare — a sudden worsening of an otherwise stable condition. His doctors recommended more aggressive treatment with a different combination of medications. Quick, expert treatment at Duke probably saved his life that day, Stephens said. Four days later, he returned home.

Looking Forward

Since then, follow-up PET scans have shown no evidence of sarcoidosis activity. Stephens is now in his 26th year with Duke athletics and said he’s grateful for how in-tune Duke providers are with their patients.

“We are a very patient-centered program,” Dr. Karra said. “And for Mr. Stephens, we considered things very carefully. What does it mean for him to go back to work? How can he be productive in his role and his job? We want to help people not only prolong their lives but also to enjoy it and have fulfilling experiences.”

Dr. Karra emphasized that Duke can offer the full range of sarcoidosis treatment options, including heart and other organ transplants for the most severe cases. “We can help people at all stages of their disease, including very complex sarcoidosis that’s no longer responding to treatment,” he said. “That’s not true anywhere else in North Carolina.”

Stephens’ story was published last week on DukeHealth.org.

Selvaraj Receives FSR Research Grant Award

Congratulations to Senthil Selvaraj!

The Foundation for Sarcoidosis Research (FSR) announced last month that Selvaraj was one of two $50,000 grant award winners in support of research aimed at improving the diagnosis, management, and treatment of cardiac sarcoidosis.

Selvaraj, an assistant professor of medicine in the Section of Advanced Heart Failure and Transplant at Duke University Medical Center and faculty member at the Duke Molecular Physiology Institute was selected for his innovative project, “Diagnostic Utility of SGLT2 Inhibition to Facilitate Myocardial Glucose Suppression During Evaluation of Cardiac Inflammation on FDG-PET,”

“We are absolutely delighted to receive this funding support from the FSR,” says Selvaraj. “With this grant, we aim to improve the specificity of cardiac sarcoidosis diagnosis with FDG-PET using a novel strategy incorporating combined SGLT1/2 inhibition with sotagliflozin. Further, we leverage a strong academic collaboration between Duke University and the University of Pennsylvania with co-PI Dr. Paco Bravo.”

“FSR is thrilled to support this extraordinary project through our cardiac sarcoidosis-specific grant,” says Mary McGowan, FSR’s CEO. “The learnings from this research could be groundbreaking in improving diagnosis, prognosis assessment, and treatment management of not only those living with cardiac sarcoidosis but for many other inflammatory diseases.”

The FSR’s second grant award goes to Daniela Čiháková, MD, PhD, of Johns Hopkins University School of Medicine and Department of Molecular Microbiology and Immunology for her project, “3D Morphological and Spatial Transcriptomic Analysis of Cardiac Sarcoidosis.”

To learn more about FSR’s Research and Grant Programs, please visit www.stopsarcoidosis.org/fsr-grants/.

1st DUH BEE Award Recognizes Simpson

We are pleased to share that Danielle Simpson, Health Unit Coordinator for 3100, received the very first BEE Award at Duke University Hospital the week of Dec. 19, 2023. The Being Exceptional Everyday (BEE) award is presented to unlicensed personnel who patients and their loved ones nominate for going above and beyond to make a difference in their or their loved one’s care.

There will be 6 winners announced quarterly across DUH for this award.

Congratulations to Danielle for her exceptional work in caring for our patients and their loved ones!

ICYMI: Duke Heart Contributes to Cardiovascular Manual for the Advanced Practice Provider

Congratulations to the following members of the Duke Heart team for their contributions to the recently published Cardiovascular Manual for the Advanced Practice Provider.

Allen Stephens, Todd McVeigh, and Cary Ward along with Elisabeth A. Powell (Banner University) and Larry Watts (Atrium Health) co-authored chapter 19 on Infective Endocarditis; Carolina Tennyson author of chapter 21 on Heart Failure with Preserved Ejection Fraction; and Allison Dimsdale who co-authored chapter 30 on Prevention of Cardiometabolic Disease with Christopher Kelly of UNC.

The book was published last month by Springer (eBook ISBN 978-3-031-35819-7, Print ISBN 978-3-031-35818-0).

Great work! Congratulations to all!

New Visitor Restrictions In Effect, Jan. 3, 2024

Due to the increase in respiratory illness throughout our communities and after consulting with our Infectious Disease and Infection Prevention experts, Duke has updated visitation restrictions as of Wednesday, January 3.

Visiting hours are from 8 a.m. – 9 p.m.
Visitors must check in at the hospital information desk to receive a visitor badge to enter inpatient areas.
All visitors must be age 12+. (Visitors in some clinical areas must be age 18+.)
Minors are required to be attended by an adult age 18+ at all times.
A maximum of two visitors are allowed per patient.
Visitors must check out upon departure at a kiosk or with information desk staff.
Visitors with fever, cough, or other flu-like symptoms should not visit.

For more details, refer to the Tier 2 visitation standard work document. Updated signage is posted.

These changes are being implemented at Duke University Hospital, Duke Regional Hospital, and Duke Raleigh Hospital, as well as Duke Ambulatory Surgery Center, Duke Health Center Arrington, Duke North Pavilion, and the James E. Davis Ambulatory Surgical Center.

We realize that these changes may be challenging to patients, visitors, and team members. We appreciate your support as we continue to implement practices that ensure we provide a safe place for healing.

Please note: Additional visitation and masking precautions may apply to certain patient populations, including without limitation, COVID-19/Special Airborne Contact, oncology, end-of-life, and overnight visitors. Please follow all unit guidelines. Exceptions to visitation restrictions may be granted based on special circumstances, including without limitation, to permit Compassionate Care Visitors.

Upcoming Events & Opportunities

Happy 100^th Birthday, Duke University! 2024 marks the centennial anniversary of the founding of Duke University. The Centennial Celebration Kickoff will take place at 4 p.m. in Cameron Indoor Stadium on Tuesday, Jan. 9, followed by a ‘Winter Chill’ reception outside in K-ville at 5:30 p.m. The Kickoff requires a ticket for entry, but the reception is open to all Duke faculty, staff, students, alumni, and guests. To get all the details, please visit the Centennial web page. Stay tuned for a full year of celebratory events!

Cardiology Grand Rounds

Jan. 9: All you need to know about the new AF guidelines in the new year! with Jonathan Piccini. 5 p.m., DN 2002 or via Zoom.

All 2023 Duke Cardiology Grand Rounds recordings are housed on Warpwire. To access recordings please visit: https://duke.is/DukeCGR; NET ID and password required. Enjoy!

CD Fellows Core Curriculum Conference

Jan. 10: EP Case Presentation with Belal Suleiman, MD, and Aubrie Carroll, MD. Noon. DMP 2W96 (in-person only).

Jan. 12: PAD-Aorta with Jennifer Rymer, MD. Noon. Zoom only.

MDEpiNet: RAPID PASSION CV Virtual Think Tank, Jan. 9

Predictable And SuStainable Implementation Of National CardioVascular Registries: PASSION CVR — Registry-Supported Infrastructure Development for Prospective Trials: Pathways for DEI and “Long, Long” Term Vital Status Use Cases

Tuesday, January 9, 2024, 12:00 p.m. – 4:00 p.m. EST

Meeting Objectives:

Pragmatic aspects of CV device research approaches to DEI issues.
Pragmatic aspects of developing a streamlined, high quality, “long, long” (> 5 yr) vital status profile that could be predictably and reliably accessed by clinical trial sponsors and sufficient for public health safety assessments going forward.

Click Here to register!

Office of Faculty Announces Event with Israni of Stanford Medicine, Feb. 26

Academic Medicine, with all its complexities, naturally includes conflict among its crucial collaborators – trainees, faculty, staff, communities, and more. 21st century leadership skills require all of us to strategically leverage components of this conflict for constructive change, with intentional and thoughtful actions. This talk will weave together themes from restorative justice and design thinking; and how they can be applied to artificial intelligence and JEDI (justice, equity, diversity, and inclusion), offering a case for new ways of leveraging conflict to advance a culture of connectedness and belonging. The featured speaker will be Sonoo Thadaney Israni of Stanford University’s Presence Center.

February 26: Leveraging Conflict for Constructive Change. 4-5:30 p.m., DN 2002. Presented by the Office for Faculty. Refreshments will follow. To learn more and register: https://duke.is/8/8d7f.

Upcoming CME Symposia for Spring, 2024

Registration won’t be open for a while, but if you have any questions about either event, please reach out to Christy Darnell.

As soon as registration opens, we’ll have that listed here in Pulse.

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