Chief’s message: Highlights and some updates on the cardiology field
Hope you all had a good week. This episode of the pulse will welcome a new CT surgery faculty member, we will have a few highlights from the week, and we will be working to get everyone excited for the Triangle Heart Walk with the American Heart Association on October 3rd. Register a team, join us for the walk.
The story dominating the cardiology conversation this week continues to be ZEUS: Novo Nordisk’s trial with ziltivekimab (IL-6 ligand inhibitor) that missed its primary endpoint in the phase 3 outcomes trial — HR 0.99 for 3-point MACE in ASCVD/CKD patients with elevated inflammation, despite confirmed target engagement (hs-CRP and free IL-6 both dropped as expected). Given the inflammatory hypothesis – with evident data around relationship – it’s forcing a real reckoning with the inflammatory hypothesis of atherosclerosis less than a year after ACC’s own scientific statement endorsed factoring inflammation into risk assessment. CANTOS gave the hypothesis its first foothold in 2017; ZEUS is arguably the cleanest, largest test of direct IL-6 blockade since, and it came back neutral. Two related trials are still live — HERMES in HFpEF and ARTEMIS post-AMI — both reading out in H1 2027, so this isn’t necessarily the final word on the target in this pathway, but it’s a gut-check moment. I also think there are some upstream targets that will be important test. We will also in this upcoming week faculty meeting be discussing some prevention and science at the start of the meeting and can discuss with faculty at that time.
Other things crossing the cardiology wire this week for me:
- TAVR at 10 years — JACC published a look-back at long-term TAVR durability data (Aug 14), reopening the durability-vs-SAVR debate for younger, lower-risk patients — relevant given our structural volume.
- Some data that under 30 minutes/day of moderate-vigorous activity may be enough to offset most inactivity-related CV risk — useful soundbite for our prevention/rehab messaging.
- Continued conversations on social media and some pushback on the 2026 AHA/ACC/Multi-society dyslipidemia guideline — worth having our groups think about how we can continue to clarify for our patients.
- Smaller items: a case report on a HYROX competitor’s cardiac arrest prompting sports cardiology warnings about ignoring prodromal symptoms during competition including this high-intensity competition; new data suggesting PREVENT risk equations outperform legacy models in Native American populations; and a study noting LLMs generate inadequate dietary plans for hypertensive patients — the latter is a cautionary note for our teams working on AI management tools and evaluation systems.
Highlights of the week:
Vigneshwar to Join Cardiothoracic Surgery Faculty
Navin G. Vigneshwar, MD, MPH, will join the Duke Department of Surgery faculty as an assistant professor in the Division of Cardiothoracic Surgery in September, following completion of his cardiothoracic surgery fellowship at Duke.
Vigneshwar’s practice will include heart and lung transplantation, mechanical circulatory support — including ventricular assist devices (VAD) and extracorporeal membrane oxygenation (ECMO) — and adult cardiac surgery.
“I’m looking forward to finally practicing cardiac surgery after 10 years of training,” Vigneshwar said. He is also eager to work with Duke residents and pursue opportunities for research collaboration across the university.
Among his early areas of focus will be helping bring a novel donor heart recovery technique to Duke known as Rapid Recovery with Extended Ultra-Oxygenated Preservation (REUP). The technique allows for recovery of hearts donated after circulatory death without reanimation before transplant and has enabled extended ischemic times. Vigneshwar is particularly interested in investigating the mechanisms underlying the approach and its potential applications in transplantation.
For Vigneshwar, remaining at Duke also means beginning his faculty career alongside the colleagues and mentors with whom he has trained.
“The mentorship from senior surgeons as I start a career in heart and lung transplant and adult cardiac surgery is the main reason I chose to stay,” he said. He also pointed to the strength of Duke’s multidisciplinary teams, including colleagues in cardiac anesthesia, heart failure and interventional cardiology, and the OR and ICU.
“I can’t imagine surrounding myself with a better group of colleagues to start my career.”
Vigneshwar earned his undergraduate degree from the University of Virginia and his medical degree from Virginia Commonwealth University School of Medicine. He completed general surgery residency at the University of Colorado, where he also earned an MPH in applied biostatistics, before coming to Duke for cardiothoracic surgery fellowship. His academic interests include heart and lung transplantation, mechanical circulatory support, and organ preservation.
Outside the hospital, Vigneshwar is an avid mountain biker and enjoys playing guitar.
Please join us in congratulating Navin on completing his fellowship and in welcoming him to the Duke Heart & Vascular faculty!
Duke Among Top Enrolling Sites for RECHARGE Trial
Duke is among the nation’s leading enrolling sites for a clinical trial designed to address an important evidence gap in coronary revascularization among women and Black and Hispanic patients.
Duke has enrolled 19 participants in the RECHARGE Trial (REvascularization CHoices Among underRepresented Groups Evaluation) and is currently the second-highest enroller among approximately 96 participating sites.
RECHARGE is a Patient-Centered Outcomes Research Institute (PCORI)-funded research program comparing coronary artery bypass grafting (CABG) with multivessel percutaneous coronary intervention (PCI) in two parallel randomized trials: one enrolling women of any race or ethnicity and another enrolling Black or Hispanic patients of any sex. These populations have historically been underrepresented in randomized trials comparing coronary revascularization strategies.
The study is designed to help fill that evidence gap by examining survival and health-related quality of life following CABG or PCI. Participants are followed for a minimum of three years.
At Duke, RECHARGE is led by site co-principal investigators Brittany A. Zwischenberger, MD, MHSc, associate professor in the Division of Cardiothoracic Surgery, and Andres M. Pineda Maldonado, MD, assistant professor of medicine in the Division of Cardiology.
Potential participants must be at least 18 years old and have multivessel or left main coronary artery disease for which revascularization is intended, and the care team determines that either CABG or PCI would be an appropriate treatment option.
The national study is led by Mario Gaudino, MD, of Weill Cornell Medicine, and Gregg Stone, MD, of the Icahn School of Medicine at Mount Sinai. Recruitment is expected to continue for at least two more years or until the study’s overall enrollment goal is reached.
Help Duke keep the momentum going: Clinicians who identify a potentially eligible patient can contact Zwischenberger or Pineda, or reach out to study research coordinator Camryn Black.
Join Us at the 2026 Triangle Heart Walk
At Duke Health, nothing unites us like doing good together! It’s what each one of you does each and every day, and for that, we are so grateful.
We want to thank all those who served as Heart Walk coaches and walkers in our 2025 walk. It was a terrific event! Together, we raised more than $123,000 for the American Heart Association, with 1,013 Duke Health team members participating.
We are pleased to share that Duke Health is serving as a lead sponsor of the 2026 Triangle Heart Walk. On Saturday, October 3, please join us again as we walk alongside our colleagues, family members, friends, and many of our cardiovascular patients to celebrate our community.
We are honored to support this fun, family-friendly event again and look forward to your participation this fall. The Heart Walk is the American Heart Association’s premier fundraising event, drawing communities together from across the U.S. to raise funds and celebrate progress in the fight against heart disease and stroke. This year’s Triangle Heart Walk will unite us in our commitment to living heart-healthy lifestyles and raising lifesaving funds, all while having a fun time together!
This year, we have set a goal for Duke Health to register 250 teams, with 10 people per team, and to raise $170,000. We need your help to accomplish this. Please consider signing up as a team captain to lead a Heart Walk team or simply join one as a walker.
The American Heart Association is one of the largest non-federal funding sources of cardiovascular research in the country. AHA-supported research informs the guidelines, treatments, and prevention efforts our teams use every day, so the dollars we raise come back to our own patients, our colleagues, and our community.
Register for the Heart Walk by Wednesday, Aug. 19, to receive a Duke Health Heart Walk T-shirt. Shirts will be distributed in advance of the Walk through Duke Health team captains.
We hope you’ll join us on Saturday, October 3, at Coastal Credit Union Music Park at Walnut Creek as we walk together in support of healthier hearts and healthier communities.
Let’s make this year the most successful showing for Duke Heart & Vascular yet!
Heart Ma’am, AHA Torch Back at Duke This Week
The AHA mascot (“Heart Ma’am”) and the AHA Triangle Torch will be at Duke this week – so be on the lookout! Heart Ma’am will be at Duke North and the Duke Medicine Pavilion on Tuesday, Aug. 18, for visits to Heart & Vascular units. There will be treats, a lot of AHA spirit, and opportunities for photos. The Torch will also arrive Tuesday and spend the week on the 8th floor of the HAFS building.
The visits are part of generating enthusiasm and participation ahead of the 2026 Triangle Heart Walk, set for Saturday, Oct. 3. Register for the Triangle Heart Walk by Aug. 19 to be guaranteed a Duke Heart Walk T-shirt.
Let’s go, team!!!
Luggage Donations Needed for Duke Heart for Honduras
The Duke Heart for Honduras team is seeking donations of old or gently used suitcases and luggage to help transport medical supplies and equipment during its upcoming mission trip to Tegucigalpa, Honduras, in September.
Duke Heart for Honduras is a volunteer cardiac surgery mission led by Duke physicians, trainees, and staff in partnership with local healthcare providers. This year, the team plans to perform approximately 15 lifesaving cardiac surgeries at no cost to patients while also providing education and training opportunities for Honduran healthcare colleagues.
Donated luggage will be used to transport needed medical supplies and equipment to Honduras and will remain there for continued use by local healthcare providers and hospitals. Donated luggage will not be returned.
Have a suitcase to spare? Please bring donations to Lauren Parker in CARL Room 250 by Aug. 30. Those for whom CARL is not convenient may contact Lauren at 804-332-4723 or lep52@duke.edu to coordinate an alternate pick-up time and location.
Thank you for helping Duke Heart for Honduras prepare for another important mission!
Kudos to Shah, Team for Outstanding Patient Care
Kudos to Nishant Shah, MD, and a multidisciplinary Duke Heart team for their exceptional teamwork and dedication to patient care during a recent unexpected situation.
A patient with stable but sustained ventricular tachycardia (VT) was scheduled for a transesophageal echocardiogram (TEE) and direct-current cardioversion (DCCV), but the procedure could not be completed during regular operating hours. When notified, Shah and team quickly coordinated to perform the procedure after hours, successfully cardioverting the patient.
Janny Sweetow, DNP, recognized the team for their initiative, professionalism, and collaboration, noting that their response exemplified Duke University Hospital’s core values.
Team members recognized include:
- Nishant Shah, MD
- Jordan Franklin, MD, Cardiology fellow
- Hedva Katz, RN
- Emily Luis, RN
- Caroline Burchett, RN
- Jeff Mills, CRNA
- Anne Cherry, MD, Anesthesiology
- Crosby Culp, MD, Anesthesiology
- Danielle McCarthy, Sonography
Thank you to the entire team for going above and beyond to ensure this patient received the care they needed. Great job!
Kudos to CVICU Team for Exceptional Care
A heartfelt shout-out to members of our Cardiovascular Intensive Care Unit (CVICU) and Heart teams for the exceptional care they recently provided to a patient and her family during a frightening and uncertain time.
The patient’s family member, who is also a nurse, shared her gratitude for a team that not only provided outstanding clinical care, but also recognized and supported her needs as both a loved one and a healthcare professional.
She particularly recognized Clara, her family member’s primary nurse, who patiently answered questions, talked through assessments and other aspects of care, and understood her need to remain involved.
“She spoke with me as though I was a colleague and a family member,” she shared. “Her allowing me to ask questions and talk with her gave me a sense of purpose and control in a time where I had no control and felt helpless.”
She also recognized Taylor for her confident and compassionate care and for helping make transitions in care feel seamless, and Cheryl, whose “wit and humor” and comforting confidence came at just the right time.
She expressed gratitude to Dr. Etter and team for keeping the family involved in care and decision-making, listening to concerns and making themselves available to answer questions. She also thanked Jason Koontz, MD, and the EP team, as well as the many others who cared for her family member during the hospitalization.
“I cannot thank the team enough,” she wrote.
Thank you to everyone involved for providing this patient and family with skillful, compassionate care — and for demonstrating how much communication, kindness, and inclusion matter during some of our patients’ and families’ most difficult moments.
Way to go!
Upcoming CME Events & Opportunities
Cardiology Grand Rounds
Sept. 8: ESC Updates with Christopher Granger, MD. 5 p.m. DN2002 and via Zoom.
Sept. 15: Powering Genomics with Health IT with Jeffrey Balser, MD, PhD, President and CEO, Vanderbilt University Medical Center. 5 p.m. DN2002 and via Zoom.
Sept. 22: Cardiology, Immunology and Rheumatology with Antonio Abbate, MD, PhD, of UVA Health. 5 p.m., DN2002 and via Zoom.
Sept. 23: A Primate Genetic Model Organism for Cardiovascular Disease with Stephen Chang, MD, PhD of Stanford Medicine. 5 p.m. HAFS 7683. This special CGR session will be in person only.
Until then, please enjoy past recordings. All Duke CGR Recordings (except for those containing PHI) can be found on Duke Warpwire by year: 2026, 2025, 2024. Questions about recordings? Contact Tracey Koepke.
2026 Symposia
The dates for the following 2026 Duke Heart symposia have been set. We will announce others as they are added.
- September 26: Duke Case-Based Multimodality Imaging Symposium – Registration is now open. Course directors are Sreekanth Vemulapalli and Anita Kelsey. Location: Trent Semans Center, Great Hall.
- October 30: 18th Annual NC Research Triangle Pulmonary Vascular Symposium – Course directors are Terry Fortin, Sudar Rajagopal, and Jimmy Ford. Location: Durham Convention Center, Durham, NC.
- January 9: Duke EP Symposium. Course director is Jon Piccini. Location: JB Duke Hotel.
Please save the dates!
Hitting with Heart Softball Tournament
The 10th Annual Hitting with Heart Softball tournament will be held on Saturday, August 22 at Valley Springs Park, 3805 Valley Springs Road, in Durham. The tournament raises funds that will, in part, support the American Heart Association’s 2026 Triangle Heart Walk.
Triangle Heart Walk
The American Heart Association’s 2026 Triangle Heart Walk will take place on Saturday, October 3, 2026, at Coastal Credit Union Music Park at Walnut Creek, 3801 Rock Quarry Road, Raleigh.
The Walk is expected to start around 9:30 a.m., but that may change. Stay tuned for a more formal announcement from the AHA. Meanwhile, registration for team captains and walkers is open!
Have news to share?
If you have news to share with the Pulse readership, please 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 me with any questions: 919-681-2868. Feedback on Pulse is welcome and encouraged. Submissions by Noon on Wednesdays will be considered for weekend inclusion.
