Duke Heart Pulse — November 3, 2024 – The Pulse

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.

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 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 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, and Sudarshan Rajagopal.

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?

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:

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

Wearable Heart Monitor Increases Diagnosis of Irregular Heart Rhythm

October 23 — Manesh Patel