Highlights of the week:
February kicked off with several events that were aimed at raising awareness around heart disease and specifically cardiovascular disease in women with GoRed events on Friday February 2nd. We have several examples below of our heart center community including faculty, fellows, staff and patients engaged in Heart Month awareness events. We also highlight the ongoing work within the Heart Center around research and patient care. In upcoming weeks we will highlight the recent STS meeting and some our CT surgery and cardiology care and advances in valvular heart disease. Included below are some pictures from the GoRed – Red Dress event at the Lincoln center in NYC this week that a few of our faculty were able to attend and walk the red carpet.
Voora Appointed Exec Director of VA National Pharmacogenomics Program
Congratulations to Deepak Voora, MD, associate professor of medicine in cardiology! Voora has been appointed Executive Director for the Veterans Affairs National Pharmacogenomics Program.
Since 2019, Voora and his team have designed and implemented an end-to-end system for implementing pharmacogenomics (PGx) into routine clinical care across the VA. This includes access to PGx testing, funding, patient- and provider education, changes to the electronic medical record, clinical decision support systems, population health management tools, pharmacist consultation, and implementation workflows targeting specific patient populations most likely to benefit from PGx testing.
The VA’s National Pharmacogenomics Program currently supports PGx testing and services for the nearly 30,000 U.S. Veterans throughout the Veterans Health Administration (VHA) who are prescribed more than 60 common medications that are impacted by PGx each year. The Veterans Health Administration consists of more than 110 Veterans Affairs Health Care systems.
Heart Team Launches Use of Renal Denervation Device; 1st in VAHS & NC
Duke cardiologists Tony Gutierrez, MD, the Durham Veterans Affairs Medical Center (VAMC) Cath Lab Director, and Raj Swaminathan, MD, the Durham VAMC Chief of Cardiology, have performed the first renal denervation procedures for the treatment of hypertension in the Veterans Affairs Healthcare System (VAHS). The team used a recently FDA-approved ultrasound renal denervation device, making it the first commercial use of the device in the entire VAHS and any hospital in NC.
Hypertension, also known as ‘high blood pressure,’ puts those who have it at risk for heart disease and stroke — the leading causes of death in the U.S. Nearly half of adult Americans have the condition, but only about one in four have it under control, according to the Centers for Disease Control. The latest guidelines from the American College of Cardiology and the American Heart Association define stage 1 hypertension as a blood pressure at or above 130/80 mmHg and stage 2 hypertension as a blood pressure at or above 140/90 mmHg.
Initial treatments for hypertension are usually lifestyle interventions and medications that can help lower blood pressure. Despite those treatments, more than one-half of individuals do not achieve recommended treatment goals, according to a recent position statement from the Society for Cardiovascular Angiography & Interventions (SCAI). The statement’s team of co-authors, led by Swaminathan, cite the limitations of medical therapy as medication cost, adverse side effects, limited access, and poor adherence.
With the FDA’s approval of two renal denervation devices last year, treatment options are expanding for those with uncontrolled or resistant forms of hypertension, particularly among those at greatest cardiovascular risk.
“The prevalence of hypertension in our Veterans is anywhere from 71 to 87 percent,” Gutierrez says. “The technology that we have now is pretty advanced to go ahead and treat the nerves around the arteries.”
The renal denervation devices are used to disrupt the nerve signals going to the kidneys. The procedure treats high blood pressure and conditions related to high blood pressure, according to Swaminathan. Of the two approved devices, one uses ultrasound technology and the other utilizes radiofrequency ablation.
“Blood pressure control has plateaued over the last decade and existing treatment strategies, including lifestyle changes and medications, are often not enough,” Swaminathan adds. “Renal denervation is a new technology to treat high blood pressure that is safe, durable, and is ‘always on’.”
The patients treated at the Durham VA both had resistant hypertension and were referred to the team by cardiologist Michelle Kelsey, MD, who has built a robust cardiology prevention clinic at the Durham VAMC. The procedures were performed in December.
The renal denervation approach begins with the cardiologist identifying and targeting appropriate segments of the renal arteries with adjacent renal nerves. A catheter is then threaded carefully through blood vessels toward the renal arteries. Once the catheter reaches its target area, energy (using ultrasound or radiofrequency) is delivered and disrupts nerve signals without damaging the arteries or surrounding tissues. The interrupting of nerve signals is what can help reduce high blood pressure, says Swaminathan.
“The overall objective of renal denervation is to provide long-term reduction in blood pressure, especially to Veterans who may not respond well to medication alone,” Gutierrez adds.
Swaminathan says the Position Statement is currently being used by industry and health systems as a guide to launch renal denervation programs around the country.
Congratulations, Raj, Tony, and Michelle!
Duke Celebrates National Wear Red Day!
Thanks to everyone who joined us in wearing red on Friday to celebrate National Wear Red Day! It was terrific to see so many of our teams sporting a bit of red. Check out these pics from teammates throughout Duke University Hospital, Duke Raleigh Hospital and Duke Regional Hospital.
This was a great way for our teams to kick off Heart Month!
Next up:
Hands-Only CPR demonstration:
For team members at Duke who are not required to have BLS certification, please consider participating in the upcoming virtual AHA Triangle Hands-Only CPR demonstration, being held at Noon on Feb. 22. To register please click here. You’ll then receive a confirmation with the Zoom link. Help us reach 100+ participants from Duke Health!
Duke Heart Team Wins Family-Centered Care Award
Congratulations to Callie Tennyson, John Oliver, Dustin Tart, Karen Jooste, Kelly Kester, and their collaborators — Bradi Granger, Catie Dunn, and Kayla Brooks — for receiving the Society of Critical Care Medicine’s (SCCM) “Family-Centered Care Innovation Award” for Duke University Hospital. The award was formally presented during the SCCM’s 53rd Critical Care Congress held last week in Phoenix, AZ.
The Family-Centered Care Innovation Award is presented annually to a program that
demonstrates novel, effective methods of providing care to critically ill and injured patients and their families. The team was recognized for their project, Interprofessional Education for Family Care During Resuscitation.
Way to go!
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
- February is Heart Month and Black History Month.
- February 7-14 is Congenital Heart Defect Awareness Week
- February 11-17 is Heart Failure Awareness Week
- Wednesday, Feb. 14 is National Donor Day
Cardiology Grand Rounds
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.
Feb. 13: Breaking Barriers: The future of heart transplantation with Joseph Lerman. 5 p.m., DN 2002 or via Zoom.
All Duke Cardiology Grand Rounds recordings are housed on Warpwire. To access recordings please visit:
NET ID and password are required. Enjoy!
CD Fellows Core Curriculum Conference
Feb. 7: HT/Txp Case Presentation with Ivan Nenadic Wood. Noon. DMP 2W96 (in-person only).
Feb. 9: Cardiac PET with Salvadore Borges-Neto. 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.
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 26 — Karen Alexander
Heart.org
What is a heart attack? Cardiologists explain the condition following death of NBA coach
January 26 — Robert Lefkowitz
Business Minds Coffee Chat (podcast)
Episode 123: From Yellow Beret to Nobel Laureate
January 27 — Nenad Bursac and Nicholas Strash
Tech Explorist (IN)
Healing hearts with skin cancer genes
January 29 — Joseph Turek and the Monroe family
The Science Times
January 29 — Robert Lefkowitz
Freedom Pact (podcast)
Episode 317: Dr Robert Lefkowitz – Nobel Prize Winner Shares The Secrets To Unlocking Your Genius
January 29 — G. Chad Hughes
Medpage Today
Cooling Technique Frowned Upon in Aortic Arch Surgery
January 30 — Duke University Hospital
Yahoo News/Insider Monkey
30 Best Cardiology Hospitals In the US
February 2 — Manesh Patel
Triangle Business Journal
Their battle: Slow the growth of heart disease
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