Home » 2024 » November

Monthly Archives: November 2024

Duke Heart Pulse — November 17, 2024

November 17, 2024 / Leave a comment

Chief’s message: American Heart Association Scientific Sessions 100th year

This weekend we had the AHA Scientific Sessions meeting with our cardiology, CT and vascular surgery faculty and fellows presenting. The session have highlighted by the amazing innovation in CV care and opportunity to improve health. There were important sessions on new therapies for heart failure, more data on the weight loss therapies, and some important and amazing data on possible gene editing for cardiomyopathies. There was also the puppy booth – a favorite place to rechard among many of the session goers.

Highlights of the week:

NP’s Celebrated!

We hope all of our NPs had a wonderful Nurse Practitioner Week! The week of November 10-16 celebrates the NP profession nationally and the many contributions NPs make to Duke Heart and Duke Health. We want to take this opportunity to express our deepest gratitude for your unwavering dedication, compassion, and expertise. Your commitment to providing exceptional care to our patients is truly inspiring. Each day you make a profound difference in the lives of those you serve and your hard work does not go unnoticed.

Thank you for being the heart of our Heart team. Your contributions are invaluable, and we are incredibly fortunate to have such a talented and caring group of nurse practitioners.

Califf Delivers DOM Annual Eugene Stead Memorial Lecture

Cardiologist Robert Califf, MD, Commissioner, U.S. Food and Drug Administration, delivered the Duke Department of Medicine’s annual Eugene Stead Memorial Lecture on Friday, Nov. 15 in the Great Hall of the Trent Semans Building.

His lecture, “Seeing the World of Health and Healthcare through an Orthogonal Lens: Enduring Lessons from Dr. Stead,” was formally hosted by the Chair of the Department of Medicine, Kathleen Cooney, MD, the George Barth Geller Distinguished Professor of Medicine. The event honors the legendary Dr. Eugene Stead, who served as chair of the Department of Medicine from 1947 to 1967.

Dr. Stead’s leadership lead to the formation of the Duke Databank for Cardiovascular Diseases, which grew into the Duke Clinical Research Institute (once led by Dr. Califf); he also launched a new profession when he created the role of ‘physician assistant’ (PA). Duke’s PA program was the first in the country and is currently the top PA program in the nation. We honor Dr. Stead’s legacy each year by inviting a visiting professor to speak on health policy, innovation in health care, or another pressing topic in internal medicine. The Stead Lecture is held each November at Duke Health in conjunction with the School of Medicine’s Medical Alumni Weekend.

Shout-out to Othman & Team

We received the following message this week regarding care provided by Islam Othman, MD, and his team to an elderly patient who passed away recently.

“My 94-year-old mother was a patient of Dr. Othman, a superior cardiologist. When she died this past week, Dr. Othman called me to express his sadness at learning of her passing. He said he always looked forward to seeing her when she had an appointment. I was touched by his concern and genuine sadness at her passing. Dr. Othman is an outstanding physician; as a cardiologist, he does his best to heal hearts. As a cardiologist with a heart, his phone call to me started the healing process of my broken heart. He is a gem.” — a grateful family member

The message continued with a comment from Tamara in Patient Relations:

I spoke with the patient’s daughter this morning to express condolences and to acknowledge and appreciate the time she took to forward such incredibly kind words and an outstanding recognition of you. She reiterated the sentiments in the above compliment during our conversation and shared great appreciation for you. Thank you for all you do for your patients and their families and all of us at Duke Health. —Tamara Griffin, Duke Health Integrated Practice, Patient Relations

You lead by example, Izzy – and we are so glad you’re a member of our team!

Shout-out to Keenan & Team

This week, we received the following message from a grateful patient regarding surgery performed by Jeffrey Keenan, MD, just over one year ago and the care the patient received while in recovery at Duke Hospital.

**Please note: the following letter has been edited to protect patient privacy.

“Last year, you performed bypass open heart surgery on me at Duke University Hospital. My wife and staff told me the following: My surgery went fine, I was sent to ICU to recover and then in a few days would be sent home. However, my heart had other ideas as it started to go into V-Fib. I was placed on ECMO and received an Impella device. I was in the ICU for about 40 days but I recovered very well.

I completed cardiac rehab this past summer and met with my cardiologist for a follow-up. Testing showed a normal ejection fraction and my cardiologist is very pleased with my recovery.

I am very grateful and thank you for your help in my recovery from heart failure. I would also like to thank all the surgical staff, nurses, ICU nurses, and everybody involved with my surgery.

I just wanted you to know that I chose Duke University Hospital over other places like Wake Med. Several years ago my wife had a [health issue] that required urgent care. I took her to Duke Urgent Care and then to Duke Raleigh for surgery, and she fully recovered. I was very impressed with Duke’s care of my wife. She went home the next day.

I have no memory loss from my surgery and can do all the normal things in life one would want to do. While many bad things could have happened to me they did not. Overall it was a very positive experience for me and my family.

I had the right Doctor to operate on me at Duke. Once again, thank you for all your help and the incredible staff at Duke Medical.

Miracles don’t just happen.

They happen because of the wonderful people in the world like you.” — a grateful patient

Bystanders More Likely to Perform CPR with Instructions from 911 Operators

Women are less likely to receive CPR from a bystander than men when stricken with a cardiac arrest outside of a hospital, Duke Health researchers found. This disparity was eliminated, however, when 911 operators guided an emergency caller through CPR steps, helping ease apprehensions about administering chest compressions to women.

When guided by a 911 operator, bystanders performed CPR on women 44% of the time and on men 40% of the time. Without this guidance, bystander CPR dropped to 9% for women and 11% for men.

The findings were presented at the American Heart Association’s Resuscitation Science Symposium on Nov. 11. Researchers say it offers significant insight into improving the 10% rate of survival for people who experience cardiac arrest outside of a hospital.

“Prompt delivery of CPR doubles a patient’s chance of survival from out of hospital cardiac arrest,” said Audrey Blewer, PhD, the study’s lead author and assistant professor in the Departments of Family Medicine and Community Health and Population Health Sciences at the Duke University School of Medicine.

“What encourages me from a research standpoint is that there are so many opportunities to increase that number, and that’s really a matter of everybody working together and working towards the chain of survival from cardiac arrest,” Blewer said.

To arrive at the findings, the team examined a database of nearly 2,400 emergency calls for cardiac arrest in North Carolina. They found that CPR was administered in 52% of all calls; of the cases where CPR was performed, 911 operators provided assistance 81% of the time.

The data for this study comes from the RACE CARS Trail, a seven-year collaboration between Duke Clinical Research Institute and other hospitals and emergency medical agencies across North Carolina, funded by the National Institutes of Health, and aimed at improving survival rates for cardiac arrest.

The study builds off previous research where Blewer and her colleagues found women were less likely to receive CPR no matter what neighborhood they were in.

“We know, based off of prior qualitative studies, some of the reasons why people are hesitant to do CPR on women center around the fear of being perceived as touching them inappropriately,” said Blewer.

“There’s also that aspect of frailty,” Blewer said, adding that the average age of a person in need of CPR is around 63. “Some women are smaller. There are concerns, especially when the person in need of CPR is elderly, that whoever is performing CPR on them may be breaking the ribs, hurting them, harming them.”

Blewer points to CPR training as another area for potential revision, with the anatomy of the manikin remaining largely the same over the past 30 years. She hypothesizes that training on manikins with breasts may improve CPR delivery for women.

In addition to Blewer, study authors include Konstantin A. Krychtiuk, Harman Yonis, Monique A. Starks, Hayden B. Bosworth, Carolina Malta-Hansen, Stephen Lee Powell, Lisa Monk, Lisa A. Kaltenbach, Hussein R. Al-Khalidi, Steve Vandeventer, Bryan McNally, Sana M. Al-Khatib, Daniel Mark, and Christopher B. Granger.

The study received funding from the RACE-CARS Trial (5UH3HL146935) and BIRCWH (K12AR084231).

Duke Hospitals Again Earn ‘A’ Grades for Patient Safety in Leapfrog Survey

For 13 consecutive grading periods, Duke University Hospital, Duke Regional Hospital, and Duke Raleigh Hospital, a campus of Duke University Hospital, received top scores for patient safety from The Leapfrog Group.

The “A” scores for Leapfrog’s fall 2024 survey are part of the group’s Hospital Safety Grades Assessment, issued to hospitals every six months. This is the only hospital ratings program focused exclusively on preventable medical errors, infections, and injuries that kill more than 500 patients a day nationally.

Duke Health’s three hospitals were among nearly 3,000 hospitals surveyed across the country. Only 30% of hospitals nationwide achieved “A” hospital safety grade for the fall 2024. In North Carolina, Duke University Health System hospitals were among 43 hospitals to achieve the grade.

The Leapfrog Group is an independent nonprofit organization led by the nation’s leading employers and private health care experts. Twice each year, it collects and analyzes data based on more than 30 national performance measures of errors, accidents, injuries, and infections, as well as systems hospitals have in place to prevent harm. The letter grades assigned to hospitals help people make informed decisions to protect themselves and their families.

Comparisons of hospital scores locally and nationally are available here.

Duke Implements Enhanced Online Security Measures

As online threats continue to evolve, Duke continues to review and adapt its cybersecurity measures to protect users and safeguard data. As a result, several changes will be implemented over the next several months. These updates will focus on Duo Mobile, Duke Unlock, and 1Password. Click here to learn more.

Reflect and Connect During the Holiday Season

The holiday season can be a busy, stressful, and isolating time for many. Duke Personal Assistance Service (PAS) is hosting three “Reflection and Connection” sessions that will use storytelling as a means of reducing stress and creating a stronger sense of connection with yourself and others.

The sessions will be held remotely via Zoom. Participants will be guided through practices of a mini-mental makeover and expressive writing to reflect and nurture empathy and a sense of meaning in response to stress – whether personal, professional, or related to current events or the stress and pressures (and joys) of the holiday season.

Writing exercises are for the sole use and benefit of participants, who are not required to share anything they write. Registration is required. You can attend any/all of the sessions offered.

Dates:

Tuesday, Nov. 26, from 4–5 p.m.
Tuesday, Dec. 17, from 4–5 p.m.
Tuesday, Jan. 14, from 4–5 p.m.

Register Here

Duke Health Baxter IV Fluid Update

Thanks to all who continue to assist in our conservation strategies!

Please continue to follow all previously communicated conservation strategies.
Updates on this situation can be found on Duke’s Baxter Operational Updates page on Sharepoint.

Upcoming Events & Opportunities

Nov. 18-22: Grief Awareness Week

Cardiology Grand Rounds

Nov. 19: Spirals, Paradigms, and the Progression of Heart Failure with Piotr Ponikowski. 5 p.m., DN2002 or via Zoom .

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

2024 CGR Recordings

NET ID and password are required. Enjoy!

CD Fellows Core Curriculum Conference

November 20: TBD. Noon, DN 2001.

November 22: Right-sided Valve Guidelines with Bharathi Upadhya. Noon, Zoom.

November 27: DHP Conference with Jemi Galani. Noon, DN2001.

November 29: NO CONFERENCE. Happy Thanksgiving!

Grief Symposium, November 20

Duke Health will hold the 2024 Grief Symposium on Wednesday, November 20. The event is hosted by the DUHS Employee Experience team. The keynote speaker will be Rebecca Feinglos, founder of Grieve Leave, will present “Grief in Healthcare.” The symposium will also include a panel discussion on how to communicate immediately after a loss and a discussion with Dr. Tony Galanos on re-entry into the workplace after a significant loss.

Grief Symposium – Wednesday, November 20

Education Event | 8:30 – 10:30 a.m.
Grief Circles | 10:30 – 11:30 a.m.

Both in-person and virtual opportunities are available. Click here to register.

Cardiovascular Research Symposium

Dec. 3-4, 2024 at Weill Cornell’s Belfer Research Building, 413 East 69th Street, NYC.

The keynote speaker this year is Anthony Fauci, MD. Previous Duke Cardiology faculty member Geoff Pitt is the Cornell host for the December event, and Howard Rockman is the Duke organizer. Current Duke Cardiology faculty speaking include Conrad Hodgkinson, Rockman, Ching Zhu, Sudarshan Rajagopal, and Sreekanth Vemulapalli.

The Duke Cardiovascular Research Center and the Cardiovascular Institutes of Stanford and Penn are partnering to present the Symposium, which will rotate locations each cycle.

Registration and additional information can be found here.

Cardio Sim Creator Competition

The ACC is accepting submissions for the Cardio Sim Creator Competition, a prestigious recognition for outstanding innovation in the field of cardiac simulation.

The submission deadline is Friday, Dec. 6 at 11:59 p.m. To learn more, please visit this link.

2025 Duke Safety & Quality Conference Date Announced

The Duke Safety & Quality Conference will be held on April 17, 2025. Abstracts are due Sunday, January 5, by 5 p.m.

Click here to learn more and to review submission criteria.

Duke Health Hurricane Helene Relief Efforts

You can join our support efforts in a number of ways:

Check for updates on the Duke Health intranet page (NET ID required)
Sign up to volunteer with our SMAT team to deploy to provide disaster relief.
Make a financial donation to the American Red Cross.

Have news to share?

If you have news to share with the Pulse readership contact Tracey Koepke, director of communications for Duke Heart & Vascular 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 team. Please call with any questions: 919-681-2868. Feedback on Pulse is welcome and encouraged. Submissions by Noon on Wednesdays will be considered for weekend inclusion.

Duke Heart in the News:

November 8 — Susan Dent (oncology)

Oncology News Central/Supportive Care Podcast

Cardiology’s Growing Place in Cancer Treatment, with Dr. Susan Dent

November 11 — Duke University Hospital and Donovan Harbison

WPTF-AM Raleigh

Update: Artificial Heart Patient Recovering

November 11 — Audrey Blewer (Family Medicine)

WTVD Durham

New study finds that bystanders are more likely to perform CPR with instructions from 911

November 11 — Audrey Blewer

AHA Newsroom

911 dispatcher assistance improved chances of receiving bystander CPR

November 11 — Audrey Blewer

Health Day

Bystanders More Readily Perform CPR If 911 Operator Instructs

November 11 — Duke University Hospital

Mix 99.5 (Triad, NC)

North Carolina Hospital Crowned ‘Best In State’ For 2025

November 12 — Robert Mentz

CardioNerds

Guidelines: 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure – Question #39 with Dr. Robert Mentz

November 14 — Renato Lopes

Medical Dialogues

New Study Reveals Best Antithrombotic Regimen for Atrial Fibrillation Post-ACS/PCI: Apixiban and P2Y12 Inhibitor Shine

Duke Heart Pulse — November 10, 2024

November 10, 2024 / Leave a comment

Chief’s Message:

We were lucky to have our Heart Leadership Council Meeting on Friday. The meeting is a place where we can present where we think the field of cardiovascular medicine is going and get feedback from this group of leaders, some of whom are grateful patients. The group is led by Bob Keegan, and they were engaged and supportive of all the work our group is doing. We also had our fourth annual “Shark Tank” competition to see awards and projects presented by our Faculty. There were some big ideas that we hope will change the course of the work, research, and training we do. I am including a picture here of Senthil Selvaraj presenting some follow up to a prior award. We are grateful for the leadership and support from this group of ambassadors and look forward to continuing to have them support and engage in supporting our work to discover and deliver cardiovascular health.

Highlights of the week:

Keenan Named Surgical Director, Mechanical Circulatory Support

Jeffrey Keenan, MD, assistant professor of surgery at Duke, has been named Surgical Director, Mechanical Circulatory Support. The announcement was made by Carmelo Milano, MD, the Joseph and Dorothy Beard Professor of Surgery and Division Chief of Cardiovascular and Thoracic Surgery, who previously held the role.

Dr. Keenan completed his general and cardiothoracic surgery training here at Duke. After completing his training, he joined the University of Washington as an assistant professor in their Division of Cardiothoracic Surgery before being recruited back to Duke. As a member of Duke’s CT surgery division, he has done a great job supporting adult cardiac surgery, cardiac transplantation, and mechanical circulatory support. Jeff brings a tremendous work ethic, great communication, and team-player skills to our division and the Duke Heart service line.

In his new role, Dr. Keenan will work closely with Stuart Russell, MD, Medical Director, MCS, and Stephanie Barnes, Clinical Director for Advanced Heart Failure.

Important responsibilities in this role include:

Providing surgical oversight of the durable VAD program.
Serving as surgical site principal investigator on national trials of MCS devices at Duke, continuing to drive innovation in this space.
Reinvigorating our effort to organize a multi-disciplinary cardiogenic shock team.
Overseeing quality improvement initiatives and databases related to MCS within Duke Health.

Furthermore, Dr. Keenan will work closely with Jacob Schroder, MD, Surgical Director, Advanced Heart Failure and Duke’s Heart Transplantation Program and co-director of the Cardiothoracic Surgery ICU, to strengthen MCS for transplant-bridging. He will also work closely with Jeff Gaca, MD, Section Chief, Adult Cardiac Surgery, to help enhance MCS support for high-risk cardiac surgery.

Congratulations, Jeff!

Thank you, Dr. Milano!

Words of gratitude and appreciation for Dr. Carmelo Milano’s years at the helm of our Mechanical Circulatory Support team poured in after he announced that Jeff Keenan would be stepping into the role of surgical director. We wanted to share some of those thoughts here with the entire Duke Heart team:

Just wanted to point out that Carmelo has run the MCS program since joining the faculty at the turn of the century so this transition is the end of an era. On behalf of the heart failure docs and Cardiology – Carmelo, thanks for all of your care of patients at Duke, your leadership in the surgical LVAD world, and your tireless effort to make Duke the best place in the world for surgical care of end-stage heart failure patients. We are so fortunate to have you, Jacob, and Jeff to work with. Looking forward to the next 25 years with Jeff. — Stu Russell, MD

Dr. Milano’s knowledge, passion for MCS therapies, and compassion for patients made the best leader for this therapy at Duke. I always knew we could count on him to get in to see any patient even when on vacation, or to get a case posted ASAP if it was best for the patient. His brilliant and humble approach helped us to partner with others and to draw the best and brightest to this field. It has been a privilege to partner with him to build the Duke program. — Laura Blue, NP

The advanced heart failure program at Duke has grown — under Dr. Milano’s leadership — into a world powerhouse. Thank you, Carmelo, and congratulations, Jeff. – Chet Patel, MD

I echo the remarks with much gratitude for Carmelo’s steady and visionary leadership in growing the MCS program in volume, quality, and evidence generation. And with equal enthusiasm and great anticipation for the dawn of a new era of innovation and team-based decision-making under Jeff’s leadership. As for our team, you can continue to count on our unwavering support, as we partner with you 24/7/365 in the care of these complex patients during some of the most vulnerable moments in their heart failure journey – the perioperative and critical care stages. Congratulations Jeff! – Mihai Podgoreanu, MD

AHA Sessions & Annual Duke Gathering

We are all looking forward to the 2024 American Heart Association Scientific Sessions coming up next weekend. Please join us at our Annual Duke-DCRI reception on Saturday, Nov. 16 from 5:30-8:30 p.m.!

Where? Marriott Marquis Chicago – Grand Horizon E
Time: 5:30 – 8:30 p.m.
Date: Saturday, Nov. 16

Questions? Please email Elizabeth.Evans@duke.edu or Willette.Wilkins@duke.edu

Selvaraj Receives DOM Research Award

Congratulations to Senthil Selvaraj, MD! We learned this week that he is one of two recipients selected by the Department of Medicine (DOM) for their inaugural Rising Star Research Excellence Award.

The Rising Star Research Excellence Award recognizes junior faculty in the DOM for their burgeoning excellence in producing new insights into important biomedical problems. These insights may be delivered using clinical, translational, or basic research approaches and are demonstrable by high-quality peer-reviewed publications, the acquisition of competitive external funding, and the development of sustainable research programs that enhance Duke’s research enterprise.

Great news, Senthil – congrats!

Shout-out to Schanze

We received the following shout-out for Emily Schanze from cardiac sonographer Katie Nobles for the exceptional work done by Emily last weekend:

“Hi all, I just wanted to send out this email to let you know that Emily, serving as North charge, this weekend has been an absolute superwoman for lack of better words. I’m pretty sure she figured out how to clone herself at some point. Not only did she handle scheduling the patients, dealing with Stats, and phone calls, but she also coordinated for taps, Ice Cases, TAVRs and TEE’s. Not to mention on top of all this she has been helping transport patients to and from their rooms to the north lab, along with helping with Definity or bubble studies as needed. I honestly don’t know how she managed to do everything she has done this week while going far above and beyond her “job title”. She even scanned a patient during lunch when needed!!!

I truly cannot applaud her enough for all she did this week! So appreciated!!!” — Kathryne “Katie” Nobles, RCS, Cardiac Sonographer, Cardiac Diagnostic Unit

In addition to being a very busy weekend, it was the CDU’s first week of the new reporting and viewing system, Lumedx. Way to go, Emily!

Shout-out to the CDU, Anesthesia & Support Teams

It was another amazing week in Duke Heart – with a lot of gratitude to share! We received the following messages regarding particularly high volumes in our CDU:

“I wanted to send kudos to the CDU staff at Duke North and anesthesia today. Our board had 20 procedures today with 10 TEEs alone (including one who had to be done in an EP lab due airway requirement pre-procedure), 3 TEE/CV, and many additional DCCVs that turned into TEE/DCCV due to missed anticoagulation doses. There was also a complicated mix of cases including several mitral valve evaluations, cardiac mass evaluations, congenital cases, and severe cardiomyopathies with rapid atrial arrhythmias.

Due to the nursing leadership of Shari Starr and April Dickerson we were able to run four rooms for procedures. The nurses themselves transported patients to make sure the work flow kept flowing without delays. The rooms were turned around extremely fast and consents were done in rolling fashion both from the imaging and anesthesia teams. Our anesthesia team (CRNA Brad Deen and attending Dr. Katherine Sun) were phenomenal and helped move the day along so that procedures would get done. CRNA Chad Ragains also volunteered to help on his admin day to move the day forward. Additionally, our sonographers were amazing with having TEE probes ready to go and supporting each other with breaks. Given the high TEE volume, we actually ran out of probes stocked at north a couple of times, and the sonographers expedited the cleaning and recycling to avoid any delays. Our fellow Jonathan Hanna also was prepared to get through the procedures and masterfully made sure things were organized to get it done. He was well read on all the cases and had them all triaged for who would need anesthesia. Furthermore, his enthusiasm and excitement was contagious!

With the help of the entire team we got through all procedures on the board to hopefully avoid adding on to the next day. This could not have been done without the CDU team effort. I certainly wanted to give them a shout out for their hard work and support. They are certainly a reason why Duke Heart Center is a special place. I feel lucky to work with this team.” — Nishant Shah, MD

“Nishant – thanks so much for the note… to my knowledge, this is the largest number of procedures that we’ve ever done in a day in the CDU. It also represents a continuation of the large number of procedures we’ve been doing on a daily basis for at least the past week, inclusive of long procedures (VSD closures, paravalvular leak closures, etc…) that we’ve been doing in the cath lab as well as our usual daily census of 150-200 TTEs.

A huge thank you to the entire CDU team, including nursing, sonographers, fellows, attendings, CRNAs, anesthesia, and our colleagues in the EP lab for making this possible.

You’ll remember that I sat in a room at the end of September and had the opportunity to tell our colleagues and young faculty not to overlook the quality of the people we get to work with and that I don’t spend an instant worrying about whether our team in the CDU will always endeavor to do the “right thing”. This is yet another example of why I said that.” – Sreek Vemulapalli, MD

“Could not agree more, Sreek! Thank you so much Nishant and everyone! Our team is exceptional. Last few months we did many challenging but interesting cases. Yesterday, we had a very challenging VSD closure that lasted for 6 hours but ended with a great result. In addition, I want to thank our fellows for their hard work! And last but not least I would like to thank Anita for guiding us through every challenge! Fantastic job everyone!” — Fawaz Alenezi, MD

“While I will say it was a tiring day to get through all those cases. It was a very smooth and efficient day and it took us all to safely accomplish that and do the right things for our patients. It took the nurses there today (Shari, Hedva, Brandon, Randy, Kiah, Kelly and myself), our cardiology team John Hanna and Nishant, the anesthesia team, the sonographers (Courtney and Andrea) along with Hana our NA and the rest of the team to just know we were all busy and help support us and the rest of the team throughout the other needs. Final count was 19 procedures, 1 stress echo, among many more echos. This truly represents the CDU, the strong will and determination we all have to assure we are taking care of not only our patients but each other. – April Dickerson

“Thanks to the whole CDU/Echo team for amazing commitment to our patients, colleagues, and fellows.” – Manesh Patel, MD

“Thanks for sharing the amazing work by the CDU team today and every day. We have a tremendous multidisciplinary team in the CDU performing quality exams and unique exams and procedures every day that make Duke Heart such a tremendous place to receive care! Kudos and thanks to the CDU team!!” – Jill Engel

Incredible work, everyone! Not only is our CDU a great place for care, but we also have amazing colleagues who are happy to share their kudos and shout-outs.

2025 Duke Safety & Quality Conference Date Announced

The Duke Safety & Quality Conference will be held on April 17, 2025. Abstracts are due Sunday, January 5, by 5 p.m.

Click here to learn more and to review the submission criteria.

Duke Health Leadership Updates

Elizabeth Howe has been named Ambulatory Associate Vice President of Performance Excellence. The news was announced on Monday, Nov. 4 by Simon Curtis, COO of DHIP, and Heather Marstiller, COO of Duke Primary Care.

Morgan Jones has been named Chief Strategy Officer for DUHS. The news was announced on Tuesday, Nov. 5 by Craig Albanese, MD, CEO of DUHS.

Congrats to both!

Duke Health Baxter IV Fluid Update

Thanks to all who continue to assist in our conservation strategies!

Please continue to follow all previously communicated conservation strategies.
Updates on this situation can be found on Duke’s Baxter Operational Updates page on Sharepoint.

Reflect and Connect During the Holiday Season

Writing exercises are for the sole use and benefit of participants, who are not required to share anything they write. Registration is required. You can attend any/all of the sessions offered.

Dates:

Tuesday, Nov. 26, from 4–5 p.m.
Tuesday, Dec. 17, from 4–5 p.m.
Tuesday, Jan. 14, from 4–5 p.m.

Register Here

Upcoming Events & Opportunities

Nov. 10-16: National Nurse Practitioner Week

Nov. 18-22: Grief Awareness Week

Cardiology Grand Rounds

Nov. 12: Devices in Heart Failure with Marat Fudim. 5 p.m., Zoom only.

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

2024 CGR Recordings

NET ID and password are required. Enjoy!

CD Fellows Core Curriculum Conference

November 13: Board Review with Paula Rambarat and Nishant Shaw. Noon, DN 2001.

November 15: Fellow’s Forum with Paula Rambarat and APDs Noon, Zoom.

Grief Symposium, November 20

Grief Symposium – Wednesday, November 20

Education Event | 8:30 – 10:30 a.m.
Grief Circles | 10:30 – 11:30 a.m.

Both in-person and virtual opportunities are available. Click here to register.

Cardiovascular Research Symposium

Dec. 3-4, 2024 at Weill Cornell’s Belfer Research Building, 413 East 69th Street, NYC.

The Duke Cardiovascular Research Center and the Cardiovascular Institutes of Stanford and Penn are partnering to present the Symposium, which will rotate locations each cycle.

Registration and additional information can be found here.

Cardio Sim Creator Competition

The ACC is accepting submissions for the Cardio Sim Creator Competition, a prestigious recognition for outstanding innovation in the field of cardiac simulation.

The submission deadline is Friday, Dec. 6 at 11:59 p.m. To learn more, please visit this link.

Special thanks to Midge Bowers for alerting us to this opportunity! She is the only NP on the ACC Simulation Council and wanted to share this opportunity with all of our fellows, faculty and staff in Duke Heart.

Duke Health Hurricane Helene Relief Efforts

You can join our support efforts in a number of ways:

Check for updates on the Duke Health intranet page (NET ID required)
Sign up to volunteer with our SMAT team to deploy to provide disaster relief.
Make a financial donation to the American Red Cross.

Have news to share?

Duke Heart in the News:

November 1 — Jennifer Green

The Cardiology Advisor

Diabetes and Pregnancy: Cardiovascular Risk Postpartum

November 3 — Crystal Tyson (nephrology)

Time News (Cuba)

Discover the Dash diet, which can help reduce blood pressure

November 4 — Jennifer Rymer

tctMD

PAD Patients’ Views on Decisions and Outcomes Hinge on Sex, Race/Ethnicity: ELEGANCE

November 5 — Duke University Hospital

Becker’s Hospital Review

Top-ranked hospitals for pacemaker placement, by state

November 6 — Nina Nouhravesh

MSN/Scripps News

Eggs might not be that bad for your heart health, study says

Duke Heart Pulse — November 3, 2024

November 3, 2024 / Leave a comment

Highlights of the week: Daylight Savings:

Hopefully you all got more use from your extra hour last night for sleep as we had daylight savings with fall back of one hour. It is a good time to consider the significant scientific work that has happened over the last 7-10 years in circadian rhythm research. This includes the 2017 Nobel Prize to three researcher that isolated the Period gene that produces the protein that builds up during nighttime hours and gets degraded during the day and the feeback loop. There are significant newer insights into these control mechanisms and how they can affect many health conditions and disorders. Finally, this last version of the AHA life’s goals includes in the Life’s essential 8 – sleep as one of the core health issues. We have lots of ongoing work in this space – and will be interesting to see if the daylight savings system continues in the years to come. Given the election week and many later nights with groups up – likely important to ensure we continue to focus on getting sleep and early am activity and daylight as they seem to improve overall well-being.

Happy Diwali!

We hope all who celebrated Diwali this past week had a joyous and peace-filled holiday!

Duke & UHC Reach Agreement

We were delighted to learn that Duke Health will remain in-network for patients with United Healthcare. For updates and additional information related to the agreement, you can read about it here and here. A UHC announcement can be found here.

Duke-Led Model Identifies Pathogenic Variants in Cardiac Patients, Offers Diagnostic Hope

Currently, many patients receive inconclusive results from genetic testing, leaving them without a clear diagnosis or a path forward for treatment, but a new model developed by researchers at Duke University could help increase the number of patients receiving positive test results, providing them with valuable information that could guide treatment decisions. Results were published on Oct. 29 in Circulation: Genomic and Precision Medicine.

By incorporating factors such as minor allele frequencies, gene expression in cardiovascular tissues, splicing effects, conservation scores, and the location of the variant relative to known pathogenic variants, their model predicts with high accuracy whether a variant is likely to be pathogenic.

The team used the model on the CathGen cohort – a collection of patients undergoing cardiac catheterization – and identified individuals carrying likely pathogenic variants. “A majority of those people carrying predicted pathogenic variants displayed symptoms that would allow us to provide a diagnosis based on genetics,” said Megan E. Ramaker, PhD, a postdoctoral associate with Duke Molecular Physiology Institute. Ramaker added that it would also help clinicians prescribe medicines to treat individual conditions more effectively, as some treatments are gene-specific.

While the model was developed with a focus on cardiovascular tissue, it can be adapted for other diseases. “You could input a tissue relevant to your disease of interest, like cancer, and modify the model accordingly,” Ramaker said. This opens up the possibility for researchers in other fields to fine-tune the model for their own needs.

Next, the team plans to work on expanding the use of this tool to larger genetic biobanks, such as the UK Biobank, All of Us, and OneDukeGen. They are also applying it to investigate genetic variants linked to cardiac amyloidosis, a rare inherited disease that leads to plaque buildup in the heart, similar to how Alzheimer’s disease affects the brain.

“There are a lot of machine learning tools to predict variant pathogenicity,” Ramaker said, “but this is the first one that is tissue-specific and publicly available.”

Ramaker’s co-authors include Jawan Abdulrahim, MD; Kristin M. Corey, MD; Ryne C. Ramaker, MD, PhD; Lydia Coulter Kwee, PhD; William E. Kraus, MD, and Svati H.Shah, MD, MS, MHS.

Kraus Celebrated

Bill Kraus, MD was celebrated on Wed., October 30 for his 30 years as medical director of Duke’s Cardiac Rehabilitation program. (A hat tip to the folks responsible for the t-shirts. Well done!)

Congratulations, Bill — you’ve impacted so many patients and all of your colleagues. Thank you for all you do!

Sketch Celebrated

Mike Sketch, MD was celebrated by several DHP team members on Friday, Oct. 25 to recognize his last week of rounding there. The team wanted to thank Sketch, ahead of his pending retirement, for his many years teaching the Duke house staff. In attendance was Jemi Galani and her team, along with a few of the cardiovascular fellows, as well as Anita Kelsey.

You’re going to be missed, Mike!

Shah Presented with the Gill H&V Award

Congratulations to Svati Shah! Shah was recently presented with the 2024 Gill Heart and Vascular Institute Award for Outstanding Contributions to Cardiovascular Research. The award recognizes notable and life-long achievements in research that have had a sustained impact on understanding cardiovascular biology and disease and/or that have changed the standard of cardiovascular clinical care.

The award was presented to Shah on Sept. 20 during the University of Kentucky College of Medicine’s 26th Annual Cardiovascular Research Day, held at Central Bank Center in Lexington, KY.

Congratulations, Svati!

16th Annual PH Symposium Held

Our 16th Annual NC Research Triangle Pulmonary Hypertension Symposium was held Friday, Nov. 1 at the Durham Convention Center. The program was geared toward pulmonologists, cardiologists, nurses, pharmacists, and other care providers involved in the care and treatment of patients with pulmonary hypertension. The event was also open to patients and their family members.

Overall, the event attracted more than 160 healthcare professionals and industry representatives, and more than 70 patients and family caregivers.

Speakers included Diane Ramirez of the Pulmonary Hypertension Association Board of Trustees; Terry Fortin, MD; Sudar Rajagopal, MD, Jordan Whitson, MD, and Richard Krasuski, MD (all of Duke Health), and H. James Ford, MD and Laura Nowicki, RN (of UNC), among many others.

The event was sponsored by Duke Health, UNC School of Medicine, and the Pulmonary Hypertension Association.

Great job, all!

Pena to Serve as Nurse Manager DUH 3300, Effective November 4th

Duke Heart is pleased to announce that Heather Pena, MSN, RN, CCRN, CPPS, will become Nurse Manager Operations for Duke University Hospital’s Cardiothoracic Stepdown Unit 3300 effective November 4th.

Heather will co-manage 3300 with Kasey Jacobson until November 29. Heather earned a Bachelor of Science in Nursing from UNC at Chapel Hill in 2012 and her Master’s in Nursing Leadership from East Carolina University in 2022. She joined the Duke Heart Team as a new graduate nurse on 3200 in July 2012 and has served as Strategic Services Associate, Patient Safety and Quality Improvement since 2019.

During her time at Duke, Heather advanced on the clinical ladder by becoming a CNIV and has held a variety of roles on 7West including Clinical Lead, Preceptor, Charge Nurse, HAI champion, and numerous committee roles. As an SSA, she has been heavily involved with safety and quality initiatives including, reduction in HAI, pressure injuries, falls, and CT Evidence-Based Care. She has been part of many team building and leadership activities throughout the Heart Center and beyond, including support of the career ladder and onboarding/education initiatives, support of Healthy Work Environment, and multiple presentations at national conferences annually.

Please join us in congratulating and welcoming Heather to her new role.

Sanner to Serve as Nurse Manager DUH 6 East, Effective November 4th

Duke Heart is pleased to announce that Abigail “Abby” Sanner BSN, RN, CNML, CCRN will become Nurse Manager Operations for Duke University Hospital’s Cardiothoracic Surgery Stepdown Unit 6 East effective November 4th.

Abby will co-manage 6 East with Ciarra Ashley until Ciarra transitions to her new role in December. Abby earned a Bachelor of Science in Nursing from Rockford University in 2018. She joined the Duke Heart Team as an experienced nurse on 7 East in May 2020 and has served as Assistant Nurse Manager since August 2022.

During her time at Duke, Abby advanced on the clinical ladder by becoming a CNIII and has held a variety of roles on 7 East including Preceptor, Charge Nurse, and Skin Care Champion. As Assistant Nurse Manager, she has been involved with safety and quality initiatives including the development of an ICU float to cardiology step-down guide, AirTAP trial for pressure injury prevention, and the institution of the “welcoming team” for new graduate RNs, especially those new to the Raleigh/Durham area. She has been part of team building and leadership activities throughout the Heart Center including presenting at Heart Center Charge Nurse meetings and development and implementation of the Heart Center Leadership Escalation Pathway to help provide support to off-shift charge nurses.

Please join us in congratulating and welcoming Abby to her new role.

Cardio Sim Creator Competition

The ACC is accepting submissions for the Cardio Sim Creator Competition, a prestigious recognition for outstanding innovation in the field of cardiac simulation.

The submission deadline is Friday, Dec. 6 at 11:59 p.m. To learn more, please visit this link.

Duke Regional Leadership Changes

In a letter to staff on Oct. 30, Greg Pauly and Tom Owens announced that Devdutta Sangvai, MD, MBA, will step down as president of Duke Regional Hospital. He will remain at Duke to continue his research and to care for patients.

The announcement states:

“Colleagues,

With a deep sense of gratitude for his service leading Duke Regional Hospital (DRH) through significant change and transition, Dr. Devdutta (Dev) Sangvai, MD, MBA, has decided to step down from his role as President to pursue his passion for academic medicine and research at Duke. Dr. Sangvai, who has dedicated over two decades to clinical excellence and innovative healthcare administration, is returning to his academic roots at Duke to focus on teaching, advancing clinical research, and contributing to family medicine.

Dev’s leadership across the Duke University Health System (DUHS) enterprise has been transformative. His strategic initiatives have notably advanced population health management, created partnerships to promote equity in care, and launched value-based care models that significantly impacted patient outcomes. Under his leadership, Duke Regional Hospital has achieved recognition for social responsibility and excellence in care, including Magnet Hospital accreditation and advanced certifications in diabetes and behavioral health care. Throughout his tenure, Dev’s commitment to the health system and the broader community has been unwavering, marked by national leadership roles and innovations that have set a high standard in patient care.

In the interim, we have asked Jason Carter, Chief Operating Officer (COO), to serve as the President at Duke Regional, while continuing his COO responsibilities. We are appreciative of Jason’s willingness to step in during this time. Dev has graciously offered to collaborate with Jason and the leaders across his portfolio to help with the transition through the end of the calendar year.

As Dev steps down to embrace his academic and research pursuits fully, please join me in thanking him for his invaluable contributions. We look forward to his continued impact in advancing medical knowledge and inspiring future generations.”

Shout-out to Grover!

We are thrilled to welcome Phoenix Grover, who joined us in August as our new cardiovascular genetic counselor in the HF clinic! This week, she went above and beyond by preparing and discussing genetic testing results for a family seen in Clinic. Phoenix created a thoughtful presentation with visuals to clarify the results and guide the family on potential risks. She demonstrated exceptional thoroughness, patience, and empathy, addressing all their concerns with care.

Thank you, Phoenix, for your dedication to helping families navigate cardiomyopathy care. Great job! — Karen Flores Rosario, MD

Shout-out to Duke Heart from Pauly

ICYMI, in a message to staff this week from Greg Pauly, president of Duke University Hospital, our team received a shout-out regarding our work with the BiVACOR total artificial heart. That portion of his message reads as follows:

“I am thrilled to share that our Duke Health Cardiothoracic team recently performed the world’s second BIVACOR Total Artificial Heart procedure for a patient waiting for a heart transplant. This device completely replaces a patient’s heart and pumps blood through the body, which allows our teams additional time to find a match and offers patients a lifesaving option they would not have otherwise had. This allowed the patient to live with the device for 10 days before undergoing a heart transplant here at DUH. Thank you to our teams for your incredible commitment to this life-saving work.”

Way to go, team!

Duke Health Baxter IV Fluid Update

Thanks to all who continue to assist in our conservation strategies!

Please continue to follow all previously communicated conservation strategies.
Updates on this situation can be found on Duke’s Baxter Operational Updates page on Sharepoint.

Attend the 2024 Grief Symposium on November 20

Duke Health will hold the 2024 Grief Symposium on Wednesday, November 20. The event is hosted by the DUHS Employee Experience team. The keynote speaker will be Rebecca Feinglos, founder of Grieve Leave, who will present “Grief in Healthcare.” The symposium will also include a panel discussion on how to communicate immediately after a loss and a discussion with Dr. Tony Galanos on re-entry into the workplace after a significant loss.

Grief Symposium – Wednesday, November 20

Education Event | 8:30 – 10:30 a.m.
Grief Circles | 10:30 – 11:30 a.m.

Both in-person and virtual opportunities are available. Click here to register.

This event is being held during Grief Awareness Week (Nov. 18-22), which is designed to increase awareness of issues about grief and loss in the workplace, promote strategies for healthy grieving, and encourage staff self-care. Events and activities during the week include a staff memorial service and other events designed to normalize grief.

Election Day & Voting Resources

If you did not vote early – please plan to vote on Tuesday! Before heading out to do so, make sure to bring an acceptable form of photo identification, which can include a North Carolina driver’s license, an approved Duke ID card (students only), and others. Duke Votes is an excellent resource for non-partisan voting information and resources for voting here in North Carolina or in your home state if you are not a North Carolina resident.

To allow Duke employees flexibility in casting their vote, Duke University and Duke Health encourage supervisors to cancel nonessential meetings on November 5 and be flexible with scheduling to enable staff members who are unable to vote outside normal work hours to do so before, during, or after their assigned shifts. On Election Day, Karsh will not be a polling location, so you will need to cast a ballot at your assigned polling place.

Thank you for participating in our democracy!

Duke Health Hurricane Helene Relief Efforts

You can join our support efforts in several ways:

Check for updates on the Duke Health intranet page (NET ID required)
Sign up to volunteer with our SMAT team to deploy to provide disaster relief.
Make a financial donation to the American Red Cross.

Upcoming Events & Opportunities

Nov. 10-16: National Nurse Practitioner Week

Nov. 18-22: Grief Awareness Week

Cardiology Grand Rounds

November 5: CTA in 2024: Physiology, Plaque, and Planning PCI with Jonathan Leipsic. 5 p.m. DN 2002 or via Zoom.

November 12: Devices in Heart Failure with Marat Fudim. 5 p.m., Zoom only.

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

2024 CGR Recordings

NET ID and password are required. Enjoy!

CD Fellows Core Curriculum Conference

November 6: EP Conference with Tess and Aubrie. Noon, DN 2001.

November 8: Current AFib Management Guidelines with Jon Piccini. Noon, Zoom.

November 13: Board Review with Paula Rambarat and Nishant Shaw. Noon, DN 2001.

November 15: Fellow’s Forum with Paula Rambarat and APDs Noon, Zoom.

Cardiovascular Research Symposium

Dec. 3-4, 2024 at Weill Cornell’s Belfer Research Building, 413 East 69th Street, NYC.

The Duke Cardiovascular Research Center and the Cardiovascular Institutes of Stanford and Penn are partnering to present the Symposium, which will rotate locations each cycle.

Registration and additional information can be found here.

Have news to share?

Duke Heart in the News:

October 20 — Leanna Ross

Daily Republic

‘Weekend warriors’ may gain same health benefits as people who spread out exercise

October 21 — Annemarie Thompson

Kansas City Star*

How to manage heart and stroke risks before, during and after non-heart surgery

*appears in 30+ affiliates nationally

October 23 — Renato Lopes

Amazing Health Advances