Duke Heart Pulse — April 28, 2024
Duke Heart Pulse – April 28, 2024
School of Medicine Spring Faculty Celebration – May 13th:
Each year we have a Spring Faculty Celebration hosted by the School of Medicine at the Doris Duke Center in the Duke Gardens. This year the celebration is May 13th from 5:00 – 7:30 pm to recognize newly tenured faculty and professors, and winners of the school of medicine awards. We are blessed to have such great faculty in Duke Heart – and again this year we had several internal and external nominations for awards. The Nominees and award winners are presented below. Please join us this year if you can to celebrate our Cardiovascular group and all of the cardiology, cardio-thoracic, vascular, and anesthesia faculty that work to ensure we deliver the highest quality of care to our patients and mentor and train the next generation. Please join us this year if you can. If you have not already RSVP’d, the invitation link is here: the invite.
Surgical Scrubs Policy Reinforcement
A key finding from a recent Joint Commission Mock Survey conducted by DUH Perioperative Services was the observation of multidisciplinary clinical team members wearing designated OR scrubs to and from the hospital.
The finding falls under standard IC.02.01.01, EP1, Infection Prevention and Control. Wearing designated surgical scrubs into the community, home & back, does not align with policy DUHS Guidelines for Surgical Attire Policy #7429.
The recommendation from the Joint Commission is for DUH to meet the required standards and maintain compliance with the system policy. The attached policy is being shared with all faculty/clinical team members who spend time in the OR as a reminder to change into and out of designated surgical scrubs upon arriving and once they are done in the OR for the day.
Perioperative leadership will reinforce this policy with the OR, SPD, and ancillary departments.
If you have any questions, please contact the DUH Perioperative Medical Director, Dr. Melissa Erickson, or the DUH Perioperative Anesthesia Medical Director, Dr. Dhanesh Gupta. Holly Garon, ACNO Perioperative Services, Tina Thomas, COD, and the OR Nurse Managers, are also available to answer questions or address concerns.
Thank you, in advance, for complying with this policy.
Andrea Knowles Joins Duke ECMO Team
After an extensive search, Andrea Knowles, BS, RRT, CES-A, has been named ECMO Manager at Duke Hospital. Andrea will report to Desiree Bonadonna, chief of Perfusion Services and director of Extracorporeal Life Support. Knowles will support the ECMO Specialist Team.
Andrea comes to Duke with fifteen years of ECMO experience, most recently as the ECMO Coordinator for Loyola University Medical Center. She will be orienting to Duke over the coming weeks and will begin managing the ECMO Specialist Team in July.
Please join us in welcoming Andrea to Duke!
Please Complete the DUHS Culture Pulse Survey
A critical part of advancing Duke Health’s culture is checking the pulse of our organization to identify what we are doing well and where we have continued opportunities to learn and grow together.
The Duke Health Culture Pulse survey launched last week and is available to all team members until May 13. The brief, 18-question survey is confidential and mobile-friendly.
This year’s survey is focused on Duke’s commitment to putting people first by asking questions, listening, and seeking diverse perspectives. The Culture Pulse survey aims to strengthen the employee experience and will take you under five minutes to complete.
Please know that your responses are completely confidential. Thank you for sharing your invaluable insights and for everything you do every day to make Duke Health an extraordinary place to work, learn, and receive care.
The link to the survey has been sent to everyone via email. Check your inbox and please make your voice heard!
Duke Heart Volunteers Recognized
In celebration of Volunteer Appreciation Week, held April 21-27, volunteers from across Duke Health were celebrated at a special breakfast at Croasdaile Country Club in Durham on Thursday, April 25. Several Duke Heart volunteers attended, including three members of our Duke Heart Patient Family Advisory Council: Kathryn Dailey, our Heart PFAC co-chair, Bob Curlee, and Sue Ann Glower.
Our many volunteers enhance the Duke healthcare team by dedicating their time, skills, and compassion to improve patient experiences and community engagement on a local, national, and global scale. There are more than 30 volunteer programs available for community involvement throughout Duke Health System.
We appreciate the invaluable support and kindness that our volunteers bring to our patients, their families, visitors, and staff. Thank you to all volunteers throughout DUHS, and especially right here within our Duke Heart care spaces.
2024 NC Walk for Victory Held
The 2024 North Carolina Walk for Victory, held on April 20 at Laurel Hills Park in Raleigh was a big success in raising valuable funds to support research into Marfan Syndrome and related connective tissue disorders. More than 200 participants attended the event, sponsored by Duke Heart, and led by Chad Hughes, MD who served as the medical director for the event. Overall, $53,500 was raised by volunteer teams and family members.
Great job!
Upcoming Events & Opportunities
- Culture Pulse 2024 April 22-May 13
Cardiology Grand Rounds
April 30: TBD. 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 required. Enjoy!
CD Fellows Core Curriculum Conference
May 1: DHP Case Presentation with Aubrie Carroll. Noon, DMP 2W96 (in-person only).
May 3: Adult Congenital Heart Disease with Richard Krasuski. Noon, Zoom only.
Upcoming CME Symposia
May 4: Duke Heart Failure Symposium
Please reach out to Christy Darnell with any questions.
Working Effectively Across Generations
June 3: Working Effectively Across Generations with Hile Rutledge, of Otto Kroeger Associates (OKA). 8:30 a.m. to Noon. Great Hall, Trent Semans Center. Sponsored by Duke School of Medicine.
Registration required: https://medschool.duke.edu/blog/register-now-working-effectively-across-generations
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:
April 23 — Kimberly Ward (DCRI)
Winston-Salem Journal
Sheriff: Drones can help ‘change the atmosphere’ when it comes to cardiac arrest response
April 24 — Marat Fudim
STAT News
Decline in heart failure deaths has been undone, led by people under 45
April 24 — Harry Severance
Becker’s Hospital Review
How the FTC’s noncompete ban could change the physician workforce
April 23 — Project Baseline
tctMD
Duke Heart Pulse — April 21, 2024
Highlights of the week:
Rambarat Named Chief Cardiology Fellow, 2024-2025
We are excited to share that our Duke cardiology fellows have elected Paula Rambarat, MD to serve as chief cardiology fellow for 2024-2025. Please join us in congratulating Dr. Rambarat and welcoming her to her new role!
Rambarat was born and raised in Barbados. She moved to Chapel Hill, NC in her junior year of high school and graduated from East Chapel Hill High School. Then, she attended Duke University, where she majored in biology and minored in Spanish. Subsequently, she received her medical degree from Columbia University Vagelos College of Physicians and Surgeons. During medical school, she was awarded a Howard Hughes Medical Institute research fellowship and worked in the lab of Dr. Robert Lefkowitz here at Duke. Rambarat completed an Internal Medicine residency at Massachusetts General Hospital and returned to Duke for a Cardiovascular Disease fellowship. She is pursuing a Duke Clinical Research Institute fellowship followed by advanced training in heart failure and transplant cardiology. In her free time, she enjoys spending time with her family, hiking, running, and cooking.
Dr. Ramabarat will on-board with Dr. Lerman during May. She officially takes the role at the end of June.
Many thanks to Joseph Lerman, MD for the incredible job he has done serving as chief cardiology fellow this past year!
Congratulations, Paula!
ACC.24: Summary of Duke ACC Presentations
Faculty experts from across Duke Heart and the Duke Clinical Research Institute (DCRI) shared insights and expertise on the latest cardiology research as part of more than 100 late-breaking studies, Meet the Expert opportunities, presentations, panels, and posters during the 2024 American College of Cardiology (ACC) Scientific Sessions held April 6-8 in Atlanta.
Duke kicked off the conference with AEGIS-II and EMPACT-MI presented as part of the opening late-breaking research session. The two presentations culminated in six publications in major medical journals.
Therapy Shows Promise in Delaying Hospitalizations for HF: Results from EMPACT- MI
About 800,000 people in the U.S. suffer a heart attack every year, and approximately 30% of them will go on to develop heart failure. There are limited treatments to prevent or slow that development.
A large international study coordinated and conducted by the DCRI found that the diabetes drug empagliflozin (marketed under the brand name Jardiance) did not reduce deaths. Secondary findings show it did slow the time to first hospitalization for heart failure and reduced the total number of subsequent heart failure hospitalizations. The results from the EMPACT-MI trial were published simultaneously with the ACC presentation in the New England Journal of Medicine, Circulation, and the Journal of the American College of Cardiology. Details of the meta-analysis are in press in The Lancet Diabetes & Endocrinology. The study was led by Schuyler Jones, MD and Adrian Hernandez, MD from the Duke/DCRI.
The study findings on lower rates of heart failure offer some hope and underscore the importance of preventing poor outcomes after a heart attack, according to DCRI executive director and site principal investigator, Adrian Hernandez, MD, MHS.
“Developing heart failure is one of our major public health problems, and any step that gets us closer to preventing it is a step in the right direction,” Hernandez said. “After a heart attack, we should really be focused on how to prevent problems, especially the development of heart failure. This therapy fills in that gap.”
AEGIS-II Misses Primary Endpoint; Data Suggest Further Research into HDL Modification is Warranted
Primary results from the AEGIS-II trial showed that infusions of the human plasma-derived apolipoprotein A-I CSL112 did not significantly lower the risk of major adverse
cardiac events through 90 days for people who had recently suffered a heart attack. However, exploratory analysis showed that patients who received the treatment had numerically lower rates of cardiovascular (CV) death and myocardial infarction (MI), type-1 MI, and stent thrombosis-related MI compared to placebo. Primary results were published in the New England Journal of Medicine and exploratory results were published in the Journal of the American College of Cardiology.
“It’s probably the most important trial looking at HDL modification or altering HDL efficacy in terms of limiting cardiovascular events,” said Thomas Povsic, MD, PhD, one of the study investigators and first author of the JACC paper. “I think there are signals that it did work, but the overall effects were relatively modest and what we showed is that on certain kinds of heart attacks, it does seem to prevent downstream cardiovascular events. That would need validation in a separate clinical trial.”
Also notable from AEGIS-II was the efficiency of the study’s operations. The AEGIS-II team enrolled more than 18,000 participants across 46 countries amid the COVID-19 pandemic, with only two lost to follow-up. The DCRI managed the study data and managed the 193 U.S. sites, which enrolled more than 1,800 high-risk acute MI patients, with none lost to follow-up.
“We have long-standing relationships with many of our sites in the U.S., so I think one of the things that we bring to the table is that we know a lot of sites that will enroll well and are high quality sites that will follow their patients,” Povsic said during a Meet the Expert event following the late-breaker session. “We have relationships with country leaders throughout the world. I was one of the country leaders in the U.S., and we had a lot of contact with our sites to make sure that they were following patients and doing all the other things that we talk about in clinical trials to make sure the trial is well run, and this trial was really well run.”
Pagidipati Provides Practical Tips for Harnessing the Power of Anti-Obesity Medications
Anti-obesity medications squarely fit within a cardiologist’s scope of practice and should be used in combination with lifestyle changes, according to cardiologist Neha Pagidipati, MD, MPH, presenting during a Saturday afternoon ACC session.
Referencing studies including STEP HFpEF, SELECT, STEP 1, STEP 4, SURMOUNT 1 and SURMOUNT 4, Pagidipati discussed the relevance and benefits of newer weight loss drugs such as semaglutide, liraglutide, and tirzepatide, and then outlined how she introduces patients to the medications and increases their dosing gradually.
“These therapies don’t just help patients lose weight, they are CV-risk reduction agents,” said Pagidipati, underscoring the relevance of the drugs for cardiologists. She also emphasized the need for lifestyle changes in concert with the medications.
“No amount of medicine is going to help a patient become healthier if they don’t understand what they’re supposed to be doing in their life in terms of exercise and diet,” she said. “All of these studies were predicated upon some lifestyle change happening for all of these patients.”
Pagidipati went on to share the three things she discusses with her patients to ensure the medications are most effective:
- Move more: “Whatever you’re doing, do more than what you’re doing.”
- How much you eat: “It helps if you eat less, for most of us, and these agents will help us do that.”
- What you eat: “In general, I recommend the Mediterranean diet, low salt, low carb, if they’re trying to lose weight, as well.”
- When starting patients on anti-obesity medications, a slow and gradually increasing approach is best.
“The key to remember is start low, go slow,” Pagidipati said. “Start at the lowest dose with patients, and I titrate every four weeks. I only titrate up to the next dose if and when their gastrointestinal symptoms have improved. If they’re queasy, have nausea, and you titrate up for them, it’s just going to get worse. Also, I tend to wait until their weight loss plateaus, and usually at four weeks it does.”
Keys to Improving Healthspan in Older Adults with Ischemic Heart Disease
During a session focused on improving healthspan in older adults with ischemic heart disease, Karen Alexander, MD, first sought to point out the elephant in the room: “everyone dies,” she said.
“This is not a reason that we shouldn’t be working very hard to improve quality of life before death, but we need to be aware of that, because our patients are aware of that, and as we ask them to participate in research, I think that’s on their mind to a degree.”
In aiming to generate evidence among older adults, Alexander recommended:
- considering the uniqueness of the older population, and the underlying processes unique in that age group.
- appreciating and leveraging new ways of doing research that are virtual and aligned with care.
- thinking about the outcomes that matter to the patients.
Alexander highlighted the approach taken by the ongoing PREVENTABLE study, which is finding potential participants aged 75 and older using a cohort query applied to the electronic health record. Sites then approach patients and randomize them to atorvastatin 40 mg. or placebo. Participants are tracked to determine whether they meet the primary outcome which is one that matters to the patients — survival free of dementia and persisting disability.
Researchers have made participation easy by shipping the study drug directly to patient homes and enrolling about half of the population remotely.
“This can be done,” Alexander said. “We’re having a very simple intervention, which is the atorvastatin 40 mg. versus placebo — but you could imagine how this could be replicated based on our experience in other situations.”
Keeping in mind the participant population’s desire to try new interventions is key, Alexander concluded.
“As we’re beginning to think about these fancy new interventions, we have to stop ourselves and remember the population we’re asking to go on this journey and to be in the trial boat with us. From PREVENTABLE, the one thing we have learned is that older adults are in that phase where they really don’t want to rock the boat. This is an important thing to partner with our participants and make sure they’re interested in joining us.”
What’s Now, and What’s Next for Treating High Blood Pressure?
Nearly half of adults have hypertension or are taking medication to manage hypertension. Hypertension, also known as high blood pressure, is defined as systolic blood
pressure greater than 130 mmHg or diastolic blood pressure greater than 80 mmHg.
An ACC session focused on high blood pressure reviewed the issue and the forthcoming therapies that could help to better manage the condition.
Highlighting the SPRINT study — which showed a reduction in all-cause mortality, relative risk reduction in heart failure, and reduction in stroke — Duke cardiologist Chris Granger, MD, noted that it provides a helpful example of what can be done, while also showing the limitations.
After emphasizing the study’s impressive results, Granger discussed the aftermath.
“The long-term follow-up, after two or three years after the trial was finished, the blood pressure difference between the two groups had vanished, the benefit for mortality and CV mortality had vanished,” he said. “This is in a setting where people had done the trial, they knew the benefits, it was with the same patients who knew the benefits, so this shows us that our current systems are really a failure, even in optimal settings.”
For now, key strategies for treating hypertension he highlighted include:
- targeting blood pressure less than 130 mmHg systolic for patients with or high-risk for cardiovascular disease using combination drugs titrated monthly.
- home monitoring.
- ensuring patient access to advanced practice providers, pharmacists, and algorithms measuring and promoting medication adherence.
New possibilities on the horizon could improve treatment of hypertension, Granger added.
“New treatments, like zilebesiran, I think will provide important, perhaps transformational opportunities for treating high blood pressure, in this case through a potent, what appears to be safe based on preliminary data, and sustained inhibition of the renin-angiotensin system with a treatment given once every six months as a subcutaneous injection.” he said, adding that more trials are needed and ongoing to assess efficacy and safety.
TRANSFORM-HF Modified On-Treatment Analysis Supports Primary Results
DCRI Fellow Mark Kittipibul, MD, shared results from a modified on-treatment analysis of the effects of torsemide vs. furosemide after discharge in patients hospitalized with heart failure from the TRANSFORM-HF trial.
The analysis showed no significant difference in mortality between the on-treatment groups of the two diuretics at discharge or after one month.
“In this post-hoc on-treatment analysis of TRANSFORM-HF — inclusive of all randomized patients, unless they were confirmed to be non-adherent — there was no significant difference in outcomes between torsemide and furosemide,” said DCRI Fellow Mark Kittipibul at ACC reviewing the effects of the two diuretics in heart failure patients after hospital discharge. “These findings support the robustness of the primary trial results.”
Primary results from TRANSFORM-HF were first shared by Robert Mentz, MD, during a late-breaking science session at the 2022 American Heart Association Scientific Sessions.
New Study Shows Fortified Eggs did not Raise Cholesterol
A study led by Duke researchers offers new evidence on fortified eggs’ health effects. In a modest-sized randomized trial, researchers found that fortified eggs — meaning those enriched with various vitamins or nutrients — did not significantly impact bad cholesterol (LDL cholesterol) or good cholesterol (HDL cholesterol) over the course of the four-month study.
A secondary finding hinted there could be some benefit associated with fortified egg consumption for older patients and patients with diabetes. The finding was not statistically significant due to the number of study participants, but senior researcher and heart failure cardiologist Robert Mentz, MD said it’s an interesting signal that the researchers would like to investigate in future work.
The study’s first author and DCRI Fellow Nina Nouhravesh, MD said the study can be viewed as a pilot.
“While it was modest in size, it did include a broadly generalized population,” Nouhravesh said. “The average age of participants was 66 years, half were women, and more than 25% identified as Black.”
ICYMI: Bill Kraus MGR Presentation, April 19
If you were unable to attend Friday morning Medicine Grand Rounds, the presenter was Bill Kraus, MD on ‘A Detailed Analysis of Cardiac Rehabilitation on 180-day All-Cause Hospital Readmission and Mortality. You can view the recording here: https://duke.is/5/jjy3
Happy Birthday, Chris Granger!
A belated Happy Birthday to Chris Granger, MD – his team members in the CICU helped celebrate his special day with him this past week. Happy Birthday, Chris!
Culture Pulse Survey Launches This Week
The Duke Health Culture Pulse survey launches tomorrow, April 22, and is available to team members until May 13. The brief, 18-question survey is confidential and mobile-friendly. Visit the Culture Pulse 2024 page on DHN for a Zoom background, flyer, and more.
This year’s Culture Pulse will focus on our commitment to putting people first by asking questions, listening, and seeking diverse perspectives. The Culture Pulse survey aims to strengthen the employee experience and will take you under five minutes to complete.
The link to the survey will arrive via email tomorrow. Check your inbox!
Upcoming Events & Opportunities
- April is National Donate Life Month
- Annual reminder as part of Duke’s “check yourself” campaign: please make sure your contact information is up to date in Duke@Work
- Culture Pulse 2024 April 22-May 13
- Duke Farmers Market season opens this week! Starting April 25, the Farmers Market will be held every Thursday from 11 a.m. to 2 p.m. on the DMP Greenway.
Cardiology Grand Rounds
April 23: No CGR tonight. (Faculty Meeting, division of cardiology)
April 25: New Insight into the Physiology of Heart Failure with Preserved Ejection Fraction with Satyam (Tom) Sarma, MD of UT Southwestern. 5 p.m., DN 2002 or via Zoom. *Please note this is a Thursday evening presentation.
All Duke Cardiology Grand Rounds recordings are housed on Warpwire. To access recordings please visit:
NET ID and password required. Enjoy!
CD Fellows Core Curriculum Conference
April 24: EP Case Presentation with Aman Kansal and Eric Xie. Noon, DMP 2W96 (in-person only).
April 26: EKG Review with Tom Bashore. Noon, Zoom only.
Upcoming CME Symposia
May 4: Duke Heart Failure Symposium
Please reach out to Christy Darnell with any questions.
Working Effectively Across Generations
June 3: Working Effectively Across Generations with Hile Rutledge, of Otto Kroeger Associates (OKA). 8:30 a.m. to Noon. Great Hall, Trent Semans Center. Sponsored by Duke School of Medicine.
Registration required: https://medschool.duke.edu/blog/register-now-working-effectively-across-generations
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:
April 12 — Pamela Douglas
Healio
Pamela S. Douglas, MD, highlights need for diversity in clinical trials leadership
April 12 — Neha Pagidipati
tctMD
Triglyceride-Lowering Therapies Provide Favorable Outcomes in Early Testing
April 16 — Charlotte Reikofski
AARC
Want to Work with Kids? Here’s What You Need to Know First!
April 16 — Jennifer Rymer
tctMD
TARGET BP 1: Alcohol-Based RDN Promises Single Treatment for Resistant BP
April 16 — Dawn Coleman
Vascular Specialist
April 16 — Duke Clinical Research Institute
Medscape
Chelation Therapy and CV Risk: Why TACT2 Showed No Benefit
April 17 — Jennifer Rymer
Medscape
Alcohol-Mediated Renal Denervation Promising in Hypertension
April 18 — William Kraus and Kim Huffman
Mirage.News
Research: Calorie Limitation’s Complex Role in Aging
April 18 — Joseph Lerman
tctMD
In Transporting Donor Hearts, SherpaPak Shows Promise Over Traditional Coolers
Duke Heart Pulse — April 14, 2024
Duke Heart Pulse – April 14, 2024
Highlights of the week:
ACC.24: Narcisse Selected for 2024 ACC Career Development Award
We are excited to share that Duke cardiology fellow Dennis I. Narcisse, Jr., MD, MS, is one of three recipients of the 2024 American College of Cardiology/Association of Black Cardiologists Merck Research Fellowship. The fellowship awards were presented on Monday, during the last day of the ACC Scientific Sessions in Atlanta.
Three awardees are selected each year to receive a one-year fellowship in the amount of $100,000 as salary support for one year of research in adult cardiology. Narcisse was selected along with Colette DeJong, MD of the University of California, San Francisco and Xiaowen Wang, MD, MPH of Massachusetts General Hospital.
The ACC is committed to inspiring and investing in the next generation of cardiovascular clinicians, scientists and leaders. The ACC’s Career Development Awards provide opportunities for rising stars in cardiology to gain access to leadership development, mentorship and knowledge-building that will help them grown in their chosen areas of expertise.
In addition to the ACC/ABC Merck Research Fellowships, other ACC Career Development Awards announced on Monday included the Hani Najm Global Scholar Award and the William A. Zoghbi International Research Awardee.
Congratulations, Dennis!
DHIP Leadership News
Leadership announcements were made this week by Tom Owens, MD executive vice president and chief operating officer of Duke Health Integrated Practice (DHIP), and John Sampson, MD senior vice president of DHIP.
Paul R. Newman, a senior DHIP and DUHS leader, will lead several strategic priorities for Duke Health, including funds 
flow and clinical effort models, implementation of mission-based accounting, physician partnership development to enable growth, and the development of other strategic initiatives that may arise.
Simon Curtis has been named Chief Operating Officer for DHIP. Reporting to Owens and Sampson, and in collaboration with the DHIP leadership team, Simon will partner with the clinical departments and DUHS to drive operational excellence across the practice in areas such as clinician recruitment planning, clinical operations, access, and patient experience.
These updated roles are effective immediately.
Celebrating the Eclipse
Members of Duke Heart’s cardiology team celebrate the eclipse at a solar eclipse watch party, on April 8, 2024.
Shout-out to Goodwin!
A big shout-out to cardiology fellow Nate Goodwin for his compassion in taking care of a very sick CCU patient.
“The patient’s family really appreciated his personal touch and his ability to share their pain. I was very impressed. I also applaud the fact that in the middle of a challenging pathophysiology with no clear way out, he never ignored the human component of our job. If my mom or dad got sick, I’d want Nate taking care of them.” — Ivan Nenadic Wood, MD, PhD
Nicely done, Nate. We’re so glad you were present for this family.
Shout-out to Stephanie Buck!
Duke Heart APP Stephanie Buck was in the right place at the right time for a passenger in distress. On a flight to the Dominican Republic a 15-yr old male went into anaphylaxis after eating goat cheese. The passenger did not have an epi pen. When flight attendants asked if a medical professional was onboard, Buck responded. Although the flight emergency kit did not have an epi pen, the did have epi in a glass ampule. Buck took control of the situation, successfully administering the epi and Benadryl, and managed care for the passenger like the amazing professional she is, even while off-duty! She continued to monitor the patient until the flight safely landed and EMS was able to take over.
“I think this is a great example of why Duke Providers are the best and can handle even the scariest situations whether at work or out in the community,” said Roman Ross, MSN, ANP-C for the division of cardiovascular and thoracic surgery.
Kudos to Hughes and Duke Aortic team
We received terrific patient feedback on Dr. Chad Hughes and the aortic team this week. Via Press Ganey HCAHPS, we received a note that states:
“Can’t say enough about Dr. Hughes and his team. I received the very best surgical expertise and care. I’m very, very fortunate.” — a grateful patient
Dr. Hughes, we received this nice feedback about the great care you and your team gave to a patient at Duke Hospital on Heart service unit 3300. Thank you for the high quality and compassionate care you provide to patients.” — David Gallagher, MD, Chief Medical Officer, DUH
“Kudos Dr. Hughes for the tremendous comments. Agree that we are fortunate to have you and the entire aortic team at Duke Heart and Health!” — Jill Engel, VP, Duke Heart & Vascular Services
This Coming Saturday: Support Duke’s Aortic Team & NC Walk for Victory
Duke Heart is again serving as the presenting sponsor of the upcoming NC Walk for Victory in support of Marfan Syndrome, LDS, VEDS and related conditions, with Dr. Chad Hughes serving as co-medical chair for the walk along with Carly Scarborough of Levine Children’s Hospital.
The event is scheduled for 12-3 p.m. on Saturday, April 20 at Laurel Hills Park in Raleigh. To learn more, please visit the NC Walk website and consider joining the Duke Aorta team to raise funds for research!
Flu Season is Officially Over
After consultation with Duke Infectious Diseases, the Health System has defined Monday, April 1, as the official end of the flu season. For the purposes of the Duke University Health System (DUHS) Healthcare Worker Flu Vaccination Policy, new staff/providers who have joined DUHS on or after April 1 will not be required to be vaccinated against the flu or have an approved exemption. However, they will be required to comply with flu vaccination policy during the Fall 2024 flu vaccination period.
Upcoming Events & Opportunities
- April is National Donate Life Month
- Annual reminder as part of Duke’s “check yourself” campaign: please make sure your contact information is up to date in Duke@Work
- Culture Pulse 2024 survey period starts April 22!
Cardiology Grand Rounds
April 16: Cancelled
April 23: TBD
April 25: New Insight into the Physiology of Heart Failure with Preserved Ejection Fraction with Tom Sarma, MD of UT Southwestern. 5 p.m., DN 2002 or via Zoom. *Please note this is a Thursday evening presentation.
All Duke Cardiology Grand Rounds recordings are housed on Warpwire. To access recordings please visit:
NET ID and password required. Enjoy!
CD Fellows Core Curriculum Conference
April 17: HF/Txp Case Presentation with Aarti Thakkar. Noon, DMP 2W96 (in-person only).
April 19: Genetics and CVD with Svati Shah. Noon, Zoom only.
Upcoming CME Symposia
May 4: Duke Heart Failure Symposium
Please reach out to Christy Darnell with any questions.
Working Effectively Across Generations
June 3: Working Effectively Across Generations with Hile Rutledge, of Otto Kroeger Associates (OKA). 8:30 a.m. to Noon. Great Hall, Trent Semans Center. Sponsored by Duke School of Medicine.
Registration required: https://medschool.duke.edu/blog/register-now-working-effectively-across-generations
Improving Conversation Skills with Seriously Ill Patients
In an effort to ensure that clinicians feel comfortable and empowered to have difficult conversations regarding goals of care with patients and their families, members of the Duke Hospice and Palliative Care team offer VitalTalk communication trainings so that they can help clinicians do their best to take care of our patients.
VitalTalk skills training is open to those involved in conducting or supporting Goals of Care conversations for our patients with serious illness across Duke Health. The course consists of a 30-minute didactic lecture in the LMS system, followed by a 3-4 hour skills practice-session. CME/CEU credits are available once both activities (LMS and live practice) are completed.
A limited number of seats are available in each of the upcoming online VitalTalk skills practice courses – use https://duke.is/VitalTalk to view available dates and times and to register.
If you have any questions, please contact Jonathan Fischer, MD, medical director of palliative care for Duke’s Population Health Management Office.
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:
April 4 — Nina Nouhravesh
India Today
Eggs may not increase your cholesterol. Study explains
April 6 — Tom Povsic
tctMD
Full AEGIS-II Results: Raising HDL With Apo A-I No Help After Acute MI
April 6 — Stephen Greene
HCP Live
Don’t Miss a Beat: EMPACT-MI at ACC.24, with Javed Butler, MD
April 7 — Wayne Batchelor
Medscape
Ticagrelor Alone Cuts Bleeding Without More Events Post-PCI
April 7 — Mark Kittipibul
HCP Live
April 7 — Manesh Patel
tctMD
Long-Awaited RCT Data Show Survival Benefit With Impella CP: DanGer Shock
April 8 — Robert Mentz
Associated Press
April 8 — Mark Kittipibul
HCP Live
Modified On-Treatment Analysis Confirms Results of TRANSFORM-HF
April 8 — Mitchell Krucoff
NBC News
10 doctors on FDA panel for Abbott heart device had financial ties to the company
April 8 — Madhav Swaminathan
Diagnostic Imaging
April 8 — Wayne Batchelor
Healio/Cardiology Today
Routine use of Impella CP for STEMI-related cardiogenic shock confers survival benefit
April 8 — Wayne Batchelor
Healio/Cardiology Today
Long-term DAPT may not be needed for patients with ACS after angioplasty, stenting
April 8 — Duke University Health System
The People’s Pharmacy
Eggs Are Bad – No, Eggs Are Good – Huh?
April 8 — Nina Nouhravesh
Easy Health Options
Eggs’ Bad Rap Cheats Those Who Need Their Benefits Most
April 8 — Adrian Hernandez
Medical Xpress
ACC: Empagliflozin cuts heart failure hospitalization risk after AMI
April 9 — Neha Pagidipati
Medscape
Early Olezarsen Results Show 50% Reduction in Triglycerides
April 10 — Sreekanth Vemulapalli
Becker’s Hospital Review
The biggest challenges facing cardiology, per 12 leaders
April 10 — Neha Pagidipati
Medscape
Substantial Triglyceride Reduction With Plozasiran
April 10 — Jennifer Rymer
Medpage Today
FFR-Guided Complete Revascularization Did Not Improve Outcomes in MI Patients
April 10 — Duke University Hospital
Becker’s Hospital Review
472 hospitals honored for patient safety, price transparency
April 11 — Manesh Patel
Salt Lake City Star Tribune
Medtronic study puts spotlight on how one of its heart devices can help women
April 11 — Jay Lusk (Population Health)
Healio
Low socioeconomic status raises mortality odds in pulmonary conditions
April 11 — Svati Shah
Time
How to Talk to Your Family About Their Heart Health History
April 12 — Jennifer Rymer
Medscape
Duke Heart Pulse — April 7, 2024
Chief’s message:
The American College of Cardiology 2024 meeting was this weekend with several of our faculty and fellows presenting at the meeting. We also had the opportunity to catch up with colleagues and friends. Please find some pictures from the meeting.
Highlights of the week:
Hughes Named Chief, Section for Aortic Surgery
Chad Hughes, MD, Professor of Surgery, has been appointed the inaugural Chief for the Section of Aortic Surgery, a new section housed jointly within the Divisions of Cardiothoracic Surgery and Vascular and Endovascular Surgery. Hughes will also serve as co-director, with vascular surgeon Chandler Long, MD, of the Duke Center for Aortic Disease. The announcement was made on April 3 by Dr. Carmelo Milano, chief of Cardiovascular and Thoracic Surgery, and Dr. Dawn Coleman, chief of Vascular Surgery.
Hughes completed his undergraduate training at Wake Forest University and medical school at Duke University. He subsequently completed his training in both general surgery and CT surgery at Duke University. In 2005, he completed an additional aortic surgery fellowship at the University of Pennsylvania under the instruction of Dr. Joseph Bavaria, a renowned leader in aortic surgery.
Hughes joined the faculty here at Duke as an assistant professor of surgery, and in 2020, he rose to the rank of Professor of Surgery. He has developed one of the largest practices of aortic surgery in the country with national and regional referrals. At Duke, he started the transcatheter aortic valve replacement program with Dr. Kevin Harrison. Additionally, along with Dr. Richard McCann, he developed stent grafting for aortic pathology at this institution.
Hughes has served as a model of the academic surgeon with over 250 peer-reviewed publications, multiple national speaking engagements, and a prominent role as an associate editor for the Annals of Thoracic Surgery. He has driven innovation of care for aortic pathology at a national level.
This divisional reorganization is focused on enabling further collaboration between CT surgery, vascular surgery, and cardiology. In this new role, Dr. Hughes will focus on further expansion of aortic surgery, innovation around aortic pathology, and mentoring younger faculty and trainees in aortic surgery.
Congratulations, Chad!
Thomas Receives HRS Youngblood Leadership Award
We were thrilled to learn this week that cardiac electrophysiologist Kevin Thomas, MD, professor of medicine in cardiology and vice dean for Diversity, Equity and Inclusion for Duke School of Medicine, has been selected by the Heart Rhythm Society (HRS) to receive it’s 2024 James H. Youngblood Excellence in Leadership Award.
The Youngblood Leadership Award recognizes a member of the HRS who has demonstrated exemplary leadership by leading an initiative that has had a community-wide impact.
You have certainly done that and more — congratulations, Kevin!
Anne Cherry, MD to Receive Inaugural SCA Presidential Citation
Congratulations to Anne Cherry, MD, associate professor of anesthesiology at Duke. She has been selected as the first recipient of the Society of Cardiovascular Anesthesiology’s (SCA) newest award – the Presidential Citation Award. Cherry was selected by Dr. Kathryn Glas, current president of the SCA and chair of anesthesiology at the University of Arizona.
The Presidential Citation will be awarded annually at the discretion of the President of SCA to an individual who has made an important contribution to the field of cardiovascular anesthesia through one (or several) of the following:
- An early career accomplishment
- Research contribution
- Education contribution
- DEI contribution through the advancement of minority interests
- Service to the SCA
Cherry will be presented with the 2024 Presidential Citation during the SCA Annual Meeting being held in collaboration with the American Association for Thoracic Surgery from April 27-30 in Toronto, Canada.
Congratulations, Anne!
Holley to Receive DOM Excellence in Education Award
We are pleased to share that Christopher Holley, MD, PhD, has been selected as the recipient of Duke’s 2024 Department of Medicine Excellence in Education Award for the division of cardiology. His nomination, in part, reads:
“As a member of our clinical team, Holley teaches cardiovascular disease and advanced heart failure and transplantation fellows during Transplant or VAD rounds and gives high-yield lectures in these areas, receiving stellar teaching evaluations from our trainees. As a skilled researcher, he teaches and mentors undergraduate, graduate, and post-graduate trainees on the role of non-coding RNA (ncRNA) in cardiovascular health and disease.
Furthermore, he is committed to educating the next generation of cardiovascular specialists by actively participating in fellowship recruitment. He serves as an Associate Program Director of the Cardiovascular Disease fellowship, as a co-lead in the Department of Medicine’s Physician Scientist Training program, and as core faculty in the Medical Scientist Training Program. In all these roles, his passion for educating current and future trainees is evident.”
This annual DOM award recognizes one faculty member in each division in recognition of outstanding teaching and commitment to the education and professional development of fellows, residents, and students. He will be recognized during the DOM Annual Celebration on May 2.
Congratulations, Chris!
Small Selected for DOM Administrative Excellence Award
Congratulations to Duke Cardiology GME coordinator Brianna Small! We learned this week that she has been selected to receive the Department of Medicine’s Rising Star Award for Administrative Excellence.
She will be recognized during the Annual Chair Award dinner celebration later this spring.
Hooray, Brianna!
ACC.24: Therapy Shows Promise in Delaying Hospitalizations for Heart Failure
About 800,000 people in the U.S. suffer a heart attack every year, and about 30% of them will go on to develop heart failure. There are limited treatments to prevent or slow that development.
A large international study led by Duke researchers investigated whether the diabetes drug empagliflozin (marketed under the brand name Jardiance) might prevent heart failure in patients after they had suffered acute myocardial infarction.
While the study found that the drug did not reduce deaths, secondary findings show it did slow the time to first hospitalization for heart failure and reduced the total number of subsequent heart failure hospitalizations.
The secondary findings are published in the journal Circulation and presented at the American College of Cardiology’s Annual Scientific Session on April 6. Other findings from the study, called EMPACT-MI, were also simultaneously published in the New England Journal of Medicine and the Journal of the American College of Cardiology.
Empagliflozin was originally approved for use in patients with diabetes, but investigators chose to study the drug based on earlier findings that it showed benefit in preventing active heart failure from becoming worse. The study was funded by two companies that manufacture the drug – Boehringer Ingelheim and Eli Lilly and Company.
The study enrolled 6,522 patients across 22 countries, with roughly half randomly assigned to receive the therapy and the other half placebo. Both groups otherwise received standard care. Investigators credit the study’s simple design to its broad reach.
The Duke Clinical Research Institute coordinated and led the conduct of the trial.
The study findings on lower rates of heart failure offer some hope and underscore the importance of preventing poor outcomes after a heart attack, according to principal investigator and corresponding author, Adrian Hernandez, MD, director of the Duke Clinical Research Institute.
“Developing heart failure is one of our major public health problems, and any step that gets us closer to preventing it is a step in the right direction,” Hernandez said. “After a heart attack, we should really be focused on how to prevent problems, especially the development of heart failure. This therapy fills in that gap.”
Hernandez said he would be curious to investigate the secondary findings further, especially because there are so many different factors that can play out after a heart attack.
“Heart attacks are pretty dynamic – in the first 24 hours things can change for the better or the worse; you can end up having a small heart attack or a big one,” Hernandez said. “We don’t know if there could be a difference in results from the therapy depending on the type of event and the timing of giving a treatment. Those could be areas to consider.”
In addition to Hernandez, study authors for the Circulation publication include Jacob A. Udell, W. Schuyler Jones, Stefan D. Anker, Mark C. Petrie, Josephine Harrington, Michaela Mattheus, Svenja Seide, Isabella Zwiener, Offer Amir, M. Cecilia Bahit, Johann Bauersachs, Antoni Bayes-Genis, Yundai Chen, Vijay K. Chopra, Gemma Figtree, Junbo Ge, Shaun Goodman, Nina Gotcheva, Shinya Goto, Tomasz Gasior, Waheed Jamal, James L. Januzzi, Myung Ho Jeong, Yuri Lopatin, Renato D. Lopes, Béla Merkely, Puja B. Parikh, Alexander Parkhomenko, Piotr Ponikowski, Xavier Rossello, Morten Schou, Dragan Simic, Philippe Gabriel Steg, Joanna Szachniewicz, Peter van der Meer, Dragos Vinereanu, Shelley Zieroth, Martina Brueckmann, Mikhail Sumin, Deepak L. Bhatt, and Javed Butler.
ACC.24: Congrats to all Duke Researchers & Presenters!
The Annual Scientific Sessions for the American College of Cardiology is well underway this weekend in Atlanta. We’ve had significant news coverage for the poster presentation on the fortified eggs study, findings of which were released last week ahead of the ACC. We anticipate additional news coverage on the EMPACT-MI study results (highlighted above) and look forward to coverage of many other presentations by our Duke Heart team.
Carolyn Lekavich, PhD, presented an abstract on Saturday — Advancing Heart Failure Prevention: Echocardiogram Ventricular-Arterial Coupling (VAC) Signaling Early Heart Failure with Preserved Ejection Fraction (HFpEF).
Heading into ACC, there were 113 presentations planned related to research performed with or by Duke team members, including two late-breakers (EMPACT-MI, and the AEGIS II trial), many poster presentations, abstracts, and contributions including those with:
- Karen Alexander
- John Alexander
- Gerald Bloomfield
- Adam DeVore
- Pamela Douglas
- Michael Felker
- Marat Fudim
- Christopher Granger
- Jennifer Green
- Stephen Greene
- Josephine Harrington
- Adrian Hernandez
- Schuyler Jones
- Michelle Kelsey
- Mark Kittipibul
- Larry Jackson
- Renato Lopez
- Daniel Mark
- Robert Mentz
- Kristin Newby
- Nina Nouhravesh
- Neha Pagidipati
- Kishan Parikh
- Manesh Patel
- Jonathan Piccini
- Sean Pokorney
- Jennifer Rymer
- Nishant Shah
- Svati Shah
- Monique Starks
- Sreekanth Vemulapalli,
Nicely done, all!
Shout-out to Osude!
A hat tip & shout-out to cardiovascular disease fellow Nkiru “KiKi” Osude, MD, for her work in the community to promote heart health!
Osude recently served as a guest speaker — along with faculty member Monique Starks, MD — at the 2024 Shades of Green “Goes Red” Fashion Show and Luncheon, a charity fundraising event to help promote cardiovascular disease awareness throughout the community, sponsored by the Durham chapter of The Links, Incorporated.
The event, in part, highlighted the importance of heart health and community efforts to improve cardiovascular health. The Links, Incorporated is a group of more than 15,000 professional women of color dedicated to improving the well-being of Durham citizens through leadership, philanthropy, and service.
Osude was also featured in a heart-health promotional flyer as part of the work being done by Durham’s Community Health Coalition.
Way to go, KiKi! 
Duke Heart & 2024 NC Walk for Victory
Duke Heart will again serve as the presenting sponsor of the upcoming NC Walk for Victory in support of Marfan Syndrome, LDS, VEDS and related conditions, with Dr. Chad Hughes serving as co-medical chair for the walk with Carly Scarborough of Levine Children’s Hospital.
The event is scheduled for 12-3 p.m. on Saturday, April 20 at Laurel Hills Park in Raleigh. To learn more, please visit the NC Walk website and consider joining the Duke Aorta team to raise funds for research!
ICYMI: April Leadership Town Hall
The most recent DUHS Leadership Town Hall was held on Tuesday, April 2 via Zoom. If you missed it and would like to watch the recording, it is available on Leadership Exchange.
Upcoming Events & Opportunities
- April is National Donate Life Month
- April 6-8, American College of Cardiology Scientific Sessions, Atlanta.
Cardiology Grand Rounds
April 9: Heart Failure: Does Sex Really Matter? with Carolyn Lam, of Duke-NUS MD. 5 p.m., DN 2002 or via Zoom.
April 16: TBD
April 23: TBD
April 25: New Insight into the Physiology of Heart Failure with Preserved Ejection Fraction with Tom Sarma, MD of UT Southwestern. 5 p.m., DN 2002 or via Zoom. *Please note this is a Thursday evening presentation.
All Duke Cardiology Grand Rounds recordings are housed on Warpwire. To access recordings please visit:
NET ID and password required. Enjoy!
CD Fellows Core Curriculum Conference
April 10: Cardiology Fellows Lunch with Carolyn Lam. Noon, DMP 2W96 (in-person only).
April 12: Journal Club with TBD. Noon, Zoom only.
Upcoming CME Symposia
April 12: Duke Sports Cardiology & Sudden Death in Athletes
May 4: Duke Heart Failure Symposium
For any questions you might have about either event, please reach out to Christy Darnell.
2024 Feagin Leadership Forum
Consider joining members from throughout the Duke community for a special Duke Centennial event, the 15th Annual Feagin Leadership Forum at the JB Duke Hotel on May 17-18. The theme for the Forum is Compassion, Collaboration, and Compromise: Leadership in a Polarized World. World class leaders from business, healthcare, the military and athletics will be sharing their leadership expertise and how they address the challenges of our complex world. There will be special welcomes from Duke leaders, and the future leaders of healthcare — this year’s Feagin Leadership Scholars — will share their work and leadership insights.
For more details, go to https://www.feaginleadership.org/schedule-1.
To register, visit: https://www.feaginleadership.org/2023registration-1.
Improving Conversation Skills with Seriously Ill Patients
In an effort to ensure that clinicians feel comfortable and empowered to have difficult conversations regarding goals of care with patients and their families, members of the Duke Hospice and Palliative Care team offer VitalTalk communication trainings so that they can help clinicians do their best to take care of our patients.
VitalTalk skills training is open to those involved in conducting or supporting Goals of Care conversations for our patients with serious illness across Duke Health. The course consists of a 30-minute didactic lecture in the LMS system, followed by a 3-4 hour skills practice-session. CME/CEU credits are available once both activities (LMS and live practice) are completed.
A limited number of seats are available in each of the upcoming online VitalTalk skills practice courses – use https://duke.is/VitalTalk to view available dates and times and to register.
If you have any questions, please contact Jonathan Fischer, MD, medical director of palliative care for Duke’s Population Health Management Office.
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:
March 20 — Richard Shannon
The Assembly
Why Breast Cancer Screening Fails Many Women
March 29 — Nina Nouhravesh
Everyday Health
Eggs May Actually Be Okay for Your Heart
March 29 — Nina Nouhravesh
Earth.com
Eggs aren’t just for Easter — eating them is no longer considered unhealthy
March 29 — Nina Nouhravesh
The Washington Times
Never mind: New study finds eggs won’t worsen cholesterol, may even improve heart health
March 29 — Nina Nouhravesh
Times Now (India)
High cholesterol diet: Study claims eggs won’t increase your cholesterol levels
March 29 — Nina Nouhravesh
Medical Dialogues (India)
March 29 — Nina Nouhravesh
Arab Times (Kuwait)
New study challenges notion of eggs’ impact on cholesterol levels
March 30 — Nina Nouhravesh
The Mirror (UK)
‘Myth’ that eggs are bad for the heart and raise cholesterol debunked by scientists
April 1 — Nina Nouhravesh
Healio
Top in cardiology: Benefits of fortified eggs; FNIH to study preeclampsia biomarkers
April 2 — Nina Nouhravesh
Scripps News
Eggs might not be that bad for your heart health, study says
*carried by 60+ Scripps affiliates nationally
April 2 — Duke Clinical Research Institute
Code List
According to cardiologists, this long-shunned food is not so bad
April 4 — Duke University Medical Center
Mass Device
Paragonix begins full U.S. launch of donor lung preservation system
April 4 — Duke University Medical Center
Medical Design & Development
Paragonix Begins Full Commercial Launch for Donor Lung Preservation System
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