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Duke Heart Week ending June 13th 2021

Highlights of the week:

Kisslo to Receive ASE Award for Outstanding Achievement

Joseph Kisslo

Joseph Kisslo, professor of medicine in cardiology, will receive the American Society of Echocardiography’s (ASE) Outstanding Achievement in Perioperative Echocardiography Award next weekend at the ASE 2021 Scientific Sessions Virtual Experience. The ASE award ceremony is scheduled for Saturday morning, June 19. Kisslo, who served as the fourth president of ASE (1983-1984), is the first cardiologist to be recognized with the award.

The Outstanding Achievement in Perioperative Echocardiography Award recognizes an individual who has made significant clinical, research or educational contributions to the development of the field of perioperative echocardiography. The awardee is chosen by the ASE Council on Perioperative Echocardiography.

Kisslo was the first to use phased array ultrasound imaging in the human body and the first to describe most of the disease for which the technique is now commonplace. Not only has his work shaped the field of echocardiography, it helped establish Duke Heart as one of the premier cardiovascular treatment centers in the world.

We asked Dr. Kisslo’s colleagues to submit their perspective on his work at Duke and what it has meant to them. We received a tremendous response. Without a doubt, Dr. Kisslo is among our most beloved faculty members. Here is what they shared:

Dr. Kisslo was inclusive even before the term was invented. He elevates people around him, his colleagues, anesthesiologists, sonographers. He is a friend and a teacher, and one of the founding fathers of perioperative echocardiography. Without him, our professional landscape would be different. Thank you!” — Alina Nicoara, MD

Dr. Joe Kisslo is recognized worldwide for his formative work in the field of echocardiography.  His impact on cardiac ultrasound imaging stems from his unique ability to forge lasting collaborative relationships between clinical cardiology, cardiac anesthesia and engineering at Duke resulting in meaningful contributions including phased array ultrasound imaging, Doppler color flow imaging, and transesophageal imaging.  He has been honored worldwide for his contributions to the field. I consider myself overwhelming lucky to have been one of his students and colleagues.”  – Anita Kelsey, MD

Dr. Kisslo is a legend in the field of Cardiac Ultrasound. He has been a leader and dedicated professor that has shared his wealth of knowledge and experience with the world. Learning from him has been an honor and a gift that I will cherish and apply to my students.”  — Richard A. Palma, Director of the Duke Cardiac Ultrasound Certificate Program

I feel so privileged to have the opportunity to learn from Dr. Kisslo going over cases almost daily. Thanks to Dr. Kisslo, I will always remember to calculate LV strain patterns at the onset of the QRS complex!! It’s not every day that you get to learn from not only an expert in your field but one of the few who revolutionized the entire world of cardiac ultrasound!” – Sarah H., sonographer

Vince Lombardi may have said, ‘Perfection is not attainable. But if we chase perfection, we can catch excellence.’ Dr. Kisslo has lived this adage throughout his career, and has taught all of us to not settle for mediocrity. He inspires me to work harder, not to settle for mediocrity, and therefore I believe that I am a better person, both professionally and personally.” – Jean Woolard, sonographer

Thank you for your pioneering efforts in the field of Perioperative Echocardiography. You were the first to advocate for and actually demonstrate how collaboration between cardiology, cardiac anesthesiology, and cardiac surgery would actually improve the care of our patients. And what a difference that pioneering spirit has made to the field of cardiac anesthesiology and to the generations (including me) that learned from you not just about echocardiography but also of excellence, innovation, and passionate curiosity. Congratulations on this well-deserved award, Doctor, Professor, Reverend Kisslo!” — Joseph Mathew, MD

Dr. Joseph Kisslo is a true pioneer in the field of echocardiography. While most are familiar with his contributions to the development of the technology and its use in cardiovascular care, few may be aware of his profound influence in the operating room. In the early days of perioperative echo, Joe made countless trips to the operating room to collaborate with surgeons and anesthesiologists and demonstrate the value of echo in patients undergoing cardiac surgery. Whether it was using a TEE probe with a sterile sheath for epicardial echo in pediatric cardiac surgery, or pioneering the use of TEE in adult patients, Joe had a huge impact on an entire generation of cardiac anesthesiologists. He helped us see the immediate results of heart surgery, something we had never envisioned before. As a result, the field developed and Duke has been a leader in perioperative echo ever since, including at ASE, a society he helped create in the mid ’70s. His staunch support of perioperative echo led to the first anesthesiologist leading ASE as president in 2019. I will forever be grateful for his support. Congratulations on this award, Joe!” – Madhav Swaminathan, MD

When I was in school and at my first job out of state, I was always curious about the clinical impact that the operator dependence of echo has on a patient’s care. During Hi-5, Joe is passionate and a huge advocate for the ongoing training and education of sonographers. He not only advocates for us to think as a sonographer but also as a clinician and about the clinical implications our echo will have on a patient’s care. This has made me much more diligent and helps me think critically about the role that I play in helping answer a clinical question. Through the education and training that Joe provides, I have learned so much in my short time here. I now know what sets our lab, sonographers, and echoes apart from other institutions. What makes for a good echo is not just the latest and greatest machine, but the sonographer that is able to think critically and use the appropriate tools to answer a clinical question. I have no regrets and have zero disappointments in making the move from Arizona. Thanks to Joe and his involvement, the opportunity to work at Duke has lived up to all of my expectations of what it would be like to work at a world renowned institution. Joe has made me proud to be a sonographer here at Duke and I appreciate all that he does.” – Eddy Sandoval, sonographer

Dr. Kisslo has made a career out of educating all of us in cardiology. Treating us all as brother, sisters, children and grandchildren he never misses a chance to mentor us all. The passion he shows and the high expectations to which he holds us are on the forefront each and every day, making us all better professionals. I am so thankful for the left and right SVC ladder, making 3D “Jelly Beans” and after-hours adult congenital training. Heart dissections and 3D training with experts that I have had the pleasure of working side by side with are unique and valuable opportunities. Joe, thanks so much for pushing us all to be great.” — One of your children of Echo

Dr. Kisslo, from the moment we sat in his office in 1984 asking if he would help two ignorant cardiac anesthesiologists learn about transesophageal echocardiography, has been continuously supportive of everyone involved in the use of TEE at Duke.

When our first book about TEE was published in 1987, Joe’s foreword included this prescient remark concerning the use of TEE in cardiac anesthesia: “…likely to redefine the requisite fund of knowledge and skills necessary for the practice of cardiovascular anesthesiology in the future.”

Joe’s history with the development of phased array echo transducers is the reason we got hold of HP color flow Doppler probes so early in the game.

His willingness to come to the OR to help with any questions, and his willingness to allow his expert echocardiographers, Kitty Kisslo and David Adams, to help with our education enabled our TEE skills to develop and engendered confidence amongst anesthesiologists and cardiac surgeons.

Cardiologists, not generally used to inserting gastroscope-like echo probes into awake patients, used to come along to the OR induction rooms for assistance in looking for left atrial thrombi and vegetations associated with infectious endocarditis. They were thrilled with the quality of images obtained with the esophageal window.

There again, Joe’s leadership resulted in advances in cardiology practice. His has been a remarkable career, and so many of us lucky to have learned from him.” — Fiona and Norbert (Drs. Norbert de Bruijn and Fiona Clements, now retired)

It’s hard to put together what to say about Dr. Kisslo because one feels they’ll fall short. He’s a mentor, innovator, father figure, teacher, someone who makes you want to be the best person you can be. I find myself quoting him almost daily at work, especially as I’m educating others. His hunger for knowledge and understanding is contagious. He’s one of the most supportive individuals I’ve ever met. There’s always a challenge he puts forward for us to meet, but it drives us to excel. Thank you Joe for your continual support, we all are better in our careers from it.” — Alicia Armour, Health Center Administrator, Triangle Heart Associates

“‘We are in the relentless pursuit of perfection,’ Dr. Kisslo has instilled this in all of us that have had the privilege of being his students, echo disciples, and friends. Joe has more determination than anyone I have ever met, when many of us would have given up, he just keeps going. He will be there for you in any way he can, both professionally as well as personally. When my mom was diagnosed with cancer, Joe was my first call “who should she see?” and when in the cross-roads of professional decisions, Joe was there to bounce ideas off of (and give me the hard truths). Most importantly, he taught us the 4th of the 3 Rules of Echo:Talk to each other.’” — Ashlee Davis, Chief Technologist, CDU

I am thrilled to see Dr. Kisslo recognized for his never-ending dedication to the field of Echocardiography. I have so much respect for the time and effort that Dr. Kisslo invests in educating sonographers, physicians, engineering students, and many more at Duke and across the world. His passion for the field of echo is contagious. He makes me want to be better at what I do and made me realize that I can contribute to the advancement and future of echo. Working closely with Dr. Kisslo has emphatically impacted my life both personally and professionally.” – Batina Kight, sonographer

Congratulations, Dr. Kisslo!

 

Swaminathan to Deliver Edler Lecture

Madhav Swaminathan

Congratulations to our colleague Madhav Swaminathan, cardiac anesthesiologist and immediate past president of the American Society of Echocardiography (ASE)! He has been selected to deliver the Edler Lecture next weekend at ASE 2021 Scientific Sessions Virtual Experience. The title of his presentation is Echo, Equity, and Empowerment: A Framework for the Future. The annual Edler Lecture honors the founder of echocardiography, Dr. Inge Edler; it was created in 1990.

 

Shout-out to EKG Support Unit, Daubert & Kraus

A wonderful shout-out to our Duke Heart EKG Support Unit & Diagnostics teams – including Terri DeMuro, Kim Starkey, Duke LifeFlight Event Medicine, Jim Daubert and Bill Kraus!

Hap Zarzour, of Duke Athletics wrote to us in thanks of our annual support of their freshman football player physicals, which were held on Monday, June 7 at Yoh Football Center:

“Thank you everyone for all of your help during freshman football physicals. Things went perfectly, we were able to get all the testing completed as well as an ECHO that afternoon. Amazing. Your hard work and support is so appreciated.  I’m so proud of our resources at Duke that enable us to provide care for our athletes and staff, and Duke Cardiology is at the top of the list.”Robert “Hap” Zarzour, Executive Director of Athletic Medicine

“Kudos to the Duke Heart team for their outstanding commitment and performance once again!”– Jill Engel, Associate Vice President – Heart Services

Shout-out to Team Members on 7700

Rio Landa wrote in earlier this week with a shout-out to team members on 7700. Great work, everyone!

“Big thank you to Brooke, Callie, Dr. Dennis Abraham, and Dr. Jamie Jollis for their help with a sick patient on 7700 last weekend.”Rio Landa, co-team leader of Cardiology APPs

Patient Compliments from Satisfaction Surveys

Many thanks to Lisa Clark Pickett, Chief Medical Officer, Duke University Hospital for sharing the following two great notes with us!

In the first, Pickett shared, “While reading comments on our Patient Satisfaction Survey I was delighted to read this high compliment of the excellent care provided by your team. Thank you for such outstanding teamwork and care!:

“The various teams of Doctors headed up my Drs. Wang and Milano and the stent placement team were outstanding and worked closely together to solve my blocked arteries without having to resort to open heart surgery. The nurses on floors 3 and 7 were also outstanding especially on floor three. Please give them all my heartfelt thanks!” – Name withheld for confidentiality

Nicely done, Andrew Wang, Carmelo Milano and Floors 3 & 7 Nursing teams!

Her second note stated, “While reading comments on our Patient Satisfaction Survey, I was delighted to read this lovely one about your team. Please share with the wonderful nurses, as their last names were not included. Thank you all for providing such excellent and compassionate care!:

“All of the nurses were exceptional in their card during my stay. Nurse JT in CCU was a great guy to have during a time that I did feel uncomfortable due to the fact that I never stayed in a hospital. Dr. Crawford is excellent as my Cardiologist for my Cath Lab Dr. Jollis was superb in giving me insight into my heart issues. Dr Bloomfield did a noteworthy job in giving me the information on my future Open Heart Surgery. Nurse Andreas and the rest of the RN Staff were exceptional in making sure that I was comfortable and helped me with all my needs during my stay. Duke Cardiology is most definitely a first-class operation that genuinely cares about their patients.” – Name withheld for confidentiality

Great work, Larry Crawford, Jamie Jollis, Gerry Bloomfield & Care teams!

 

Virtual Town Hall, June 14

A virtual Town Hall, Planning for the Future of Duke Health’s Clinical Enterprise will be held Monday, June 14 from 5-6 p.m. The event is open to all members of the Duke Health community. Panelists will include Eugene Washington, William Fulkerson, Mary Klotman, Thomas Owens, Theodore Pappas and John Sampson. Erica Taylor will moderate. You may submit questions in advance to DHPG@duke.edu. A recording of the town hall will be posted on dukehealthplanning.duke.edu by close of business the following day. To join the Zoom, please click here: Join the Zoom.

Note: Access to the webinar requires authenticated access with your NetID and password. If prompted to sign in, please select to ‘Sign in with SSO’ and enter ‘duke’ when prompted for the company domain. You will be directed to log in with your NetID and password.

 

Scholars Tip: Global Scholarship

Do you want your research and expertise to appear on the Duke in the World map? It’s as easy as updating your Scholars@Duke profile to reflect your global scholarship! Any global scholarship from your profile is automatically added to the map for others to explore.

Duke scholars represent more than 150 countries with their research, expertise, service, and teaching. Sharing your global scholarship is a great way to connect with other experts who share interest in a particular region.

How to indicate your Global Scholarship:

Make sure your device is connected to the internet, then follow these steps:

  1. Type duke.edu in your computer’s browser address bar.
  2. Click Edit My Profile under Update
  3. Log in using your NetID and password, and then click Manage Your Profile.
  4. Select Global Scholarship from the Scholarly Output section of the Profile Manager.
  5. Follow the instructions in the How to Edit box to designate a specific state, country, or continent that you’ve impacted with your work.
  6. Click Save to update your profile or click Cancel to discard any changes.

Remember to update your Community Outreach

Often, your Global Scholarship involves some form of community outreach, which might include activities such as field work or advocacy. If this applies to you, be sure to indicate these activities in the Outreach and Engaged Scholarship section of your Scholars profile.

 

Upcoming Opportunities/Save the Date:

Virtual PMWC: Precision Medicine in the Era of a Pandemic Recovery

June 14-18 – Precision World Medicine Conference. Registration is free and open to all. https://www.pmwcintl.com/covid/

Duke University Chancellor Emeritus Dr. Ralph Snyderman will lead a panel discussion on Personalized, Proactive Value-Based Care: Emerging New Models.

The confluence of the growth of chronic diseases, the impact of COVID, the emergence of new technologies, and the impact of value-based reimbursement are driving major innovations and changes in care delivery. Proactive, personalized, precision, population-based and digitally supported care is emerging and heralding new approaches to health care. This session will capture the elements of these changes and the dynamics of the forces that are driving them. Perspective from care innovators, large providers and payers will be discussed by the following key opinion leaders:

  • Patrick  Conway, CEO of Care Solutions, Optum
  • Jaewon Ryu, President and Chief Executive Officer, Geisinger
  • Rodney Hochman, President & CEO, Providence St. Joseph Health
  • Marc Harrison, President and CEO, Intermountain Healthcare

 

HCPLive State of the Science Summit

June 23: Institutional Perspectives in Cardiology: Cardiovascular Risk Management webinar with Manesh Patel, Schuyler Jones, Tracy Wang and Christopher Granger. 7 to 8:30 p.m. EST. Virtual. Registration is free. They’ll cover:

  • CAD/PAD: Identifying Risk & Summary of Recent Clinical Trials
  • Extended Thromboprophylaxis: What Do We Know About Scoring, Risk and Contemporary Trials?
  • Atrial Fibrillation: What Have We Learned About NOACs in Special Populations?
  • Putting This All Together: Treatment Pyramid

To learn more, please visit: HCPLive Institutional Perspectives in Cardiology.

 

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.

Duke Heart in the News:

June 4 — Cameron Wolfe

CBS17.com

Heart reaction in 7 teenagers probed as possible rare Pfizer vaccine link

https://bit.ly/3xfo0U2

June 6 — Marc Samsky

Healio/Cardiology Today

Among patients with PAD, those with HF at higher risk for poor outcomes

https://bit.ly/2TWe57o

June 7 — Christopher Granger

WECT News (Wilmington, NC)

Brunswick County EMS to participate in Duke University study

https://bit.ly/3pKgHkG

June 7 — Sunil Rao

Medscape

First Risk Score to Predict Bleeding Risk After TAVR

https://www.medscape.com/viewarticle/952580#vp_1

Division of Cardiology Publications Indexed in PubMed June 3-9, 2021

Butala NM, Makkar R, Secemsky EA, Gallup D, Marquis-Gravel G, Kosinski AS, Vemulapalli S, Valle JA, Bradley SM, Chakravarty T, Yeh RW, Cohen DJ. Cerebral Embolic Protection and Outcomes of Transcatheter Aortic Valve Replacement: Results From the Transcatheter Valve Therapy Registry. Circulation 2021;143(23):2229-2240. PM: 33619968.

Dal-Ré R, Mentz RJ, Rosendaal FR. Thoughtful selection and use of scientific terms in clinical research: the case of ‘pragmatic’ trials. J Investig Med 2021;69(5):1056-1058. PM: 33753535.

Dong R, Leung C, Naert MN, Naanyu V, Kiptoo P, Matelong W, Matini E, Orango V, Bloomfield GS, Edelman D, Fuster V, Manyara S, Menya D, Pastakia SD, Valente T, Kamano J, Horowitz CR, Vedanthan R. Chronic disease stigma, skepticism of the health system, and socio-economic fragility: Qualitative assessment of factors impacting receptiveness to group medical visits and microfinance for non-communicable disease care in rural Kenya. PLoS One 2021;16(6):e0248496. PM: 34097700.

Elliott BA, Holley CL. Assessing 2′-O-Methylation of mRNA Using Quantitative PCR. Methods Mol Biol 2021;2298:171-184. PM: 34085245.

Felker GM, Butler J, Januzzi JL, Desai AS, McMurray JJV, Solomon SD. Probabilistic Readjudication of Heart Failure Hospitalization Events in the PARAGON-HF Study. Circulation 2021;143(23):2316-2318. PM: 34097449.

Kaufman BG, Granger BB, Sun JL, Sanders G, Taylor DH, Mark DB, Warraich H, Fiuzat M, Steinhauser K, Tulsky JA, Rogers JG, O’Connor C, Mentz RJ. The Cost-Effectiveness of Palliative Care: Insights from the PAL-HF Trial. J Card Fail 2021;27(6):662-669. PM: 33731305.

Kennedy DL, Olsen MK, Yang H, Gao X, Alkon A, Prose NS, Dunbar K, Jackson LR, Pollak KI. Communication Coaching in Cardiology (CCC): A study protocol and methodological challenges and solutions of a randomized controlled trial in outpatient cardiology clinics. Contemp Clin Trials 2021;105:106389. PM: 33798730.

Lala A, Mentz RJ. Remembering the Calling – Where Patients and Caregivers Are Front and Center. J Card Fail 2021;27(6):621. PM: 34088378.

Mullan CW, Chouairi F, Sen S, Mori M, Clark KAA, Reinhardt SW, Miller PE, Fuery MA, Jacoby D, Maulion C, Anwer M, Geirsson A, Mulligan D, Formica R, Rogers JG, Desai NR, Ahmad T. Changes in Use of Left Ventricular Assist Devices as Bridge to Transplantation With New Heart Allocation Policy. JACC Heart Fail 2021;9(6):420-429. PM: 33714748.

Perez AL, Grodin JL, Chaikijurajai T, Wu Y, Hernandez AF, Butler J, Metra M, Felker GM, Voors AA, McMurray JJ, Armstrong PW, O’Connor C, Starling RC, Tang WHW. Interleukin-6 and Outcomes in Acute Heart Failure: An ASCEND-HF Substudy. J Card Fail 2021;27(6):670-676. PM: 33497809.

Pfeiffer CT, Wang J, Paulo JA, Jiang X, Gygi SP, Rockman HA. Mapping Angiotensin II Type 1 Receptor-Biased Signaling Using Proximity Labeling and Proteomics Identifies Diverse Actions of Biased Agonists. J Proteome Res 2021;20(6):3256-3267. PM: 33950683.

Rao SV. Real-World Data on the Intravascular Microaxial Left Ventricular Flow Pump (Impella) in High-Risk Patients. Korean Circ J 2021;51(6):487-494. PM: 34085421.

 

 

Duke Heart Week ending June 6th 2021

Highlights of the week:

Milano Delivers Inaugural Cohn Lectureship at Tufts

Carmelo Milano

Duke heart surgeon Carmelo Milano, MD, delivered the inaugural American Association of Thoracic Surgery (AATS) Lawrence H. Cohn Visiting Lectureship of Cardiac Surgery at Tufts Medical Center on May 27. Milano’s talk, Heart Transplantation Utilizing Donors after Circulatory Death, was held via Zoom. The Tufts team was unanimously chosen as the inaugural recipient of the AATS/AATS Foundation lectureship award.

The lectureship was established to honor the memory of the late Dr. Lawrence H. Cohn, former president of AATS and a highly-esteemed cardiovascular surgeon who spent the majority of his career in Boston. Cohn died in 2016 at the age of 78. He was the former chief of the Division of Cardiac Surgery at Brigham and Women’s Hospital and held the Virginia and James Hubbard Chair in Cardiac Surgery at Harvard Medical School. Across his career, Cohn performed more than 11,500 cardiac surgical operations and was world-renowned in the field of valve repair and replacement surgery and minimally invasive heart surgery. He was a member of the team that completed the first heart transplant in New England in 1984.

“In a nutshell, Dr. Cohn was the consummate academic cardiac surgeon leader and trainer of academic surgeons,” said Frederick Y. Chen, MD, PhD, chief of the Division of Cardiac Surgery at Tufts University School of Medicine and a mentee of Cohn’s. “He wanted to train surgeons who would change and move the field forward.”

The American Association of Thoracic Surgery and AATS Foundation opened applications a year ago to apply for the Cohn Lectureship. As part of the application process, the Tufts team identified Milano as their choice of lecturer if they were to win the award.

Earlier this year, Tufts was approved to begin use of the technology that makes DCD heart transplantation possible. They were eager to hear directly from a surgeon with a high level of expertise in DCD who is also a leader within AATS.

“When I surveyed the field, I felt there really is no other surgeon with the expertise of Dr. Milano in the U.S. who performs DCD transplants,” added Chen. “Moreover, I’ve known about Dr. Milano for a very long time. He, too, is a consummate academic cardiac surgeon. He has an R01; he operates, and he’s a teacher – so he really is the traditional triple threat surgeon. We felt, as an internationally known senior AATS member and a highly-regarded educator and mentor, that he would be a great fit for this.”

As part of the lectureship, the Tufts team held a tribute to Dr. Cohn and a meet-and-greet so that all members of their cardiovascular and thoracic surgery teams, including PAs, perfusionists, and anesthesiologists, as well as members of leadership and their administration could participate. The tribute and lecture were attended by family members of the late Dr. Cohn.

 

McGarrah, Southerland Receive Strong Start awards

Kevin Southerland

Congratulations to Rob McGarrah, assistant professor of medicine in cardiology, researcher in the Cardiovascular Research Center (CVRC) and member of the Duke Molecular Physiology Institute; and to Kevin Southerland, assistant professor of surgery in the division of vascular and endovascular surgery, who has done considerable research in the CVRC lab of Christopher Kontos. They are two of six physician scientists in the Duke School of Medicine who were selected to receive Strong Start Awards.

McGarrah’s research has made strides in answering the question of how a disease in the liver can affect a distant organ like the heart. He and his collaborators have found that obesity turns off a certain metabolism pathway in the liver, leading to non-alcoholic fatty liver disease and also increasing the levels of specific amino acids (building blocks of proteins) in the blood. When these amino acids are delivered to the heart, they cause the heart to store more fat, which is unhealthy, and to make more protein, which can cause unhealthy heart muscle thickening. This liver-heart cross talk might explain why non-alcoholic fatty liver disease causes abnormal heart function.

The overall goal of the Kontos lab is to understand how blood vessels grow and remodel in response to both pathological and physiological stimuli as well as how they maintain normal tissue function, a process known as vascular homeostasis. The work that Dr. Southerland did in the Kontos lab focused specifically on how genetics influence muscle injury following ischemia in a mouse model.

The Strong Start Award program is designed to nurture the careers of junior, laboratory-based physician-scientists at Duke. By offering substantive mentoring and financial resources, the award supports junior faculty during a critical period of their career — the transition to research independence. Each award is for $75,000 per year, renewable up to three consecutive years ($225,000 total). The funds are to be used at the discretion of the individual recipient to support their research program.

Congratulations Rob and Kevin!

Katz, Arps & Sullivan Receive Year-End Medicine Awards

Jason Katz

 

Congratulations to Jason Katz; third-year cardiology fellow Kelly Arps; and incoming fellow Lonnie Sullivan! Katz was awarded the Internal Medicine residency program’s Eugene Stead Faculty Teaching Award given to the faculty who best exemplifies the principles of teach from Dr. Steads time at Duke; Arps received the Fellow Teaching Award and Sullivan received the Haskell Schiff Award for Excellence, which is peer-selected and given to the house staff member who best represents the ideal of the program. The awards, presented annually by Duke’s Internal Medicine Chief Residents, were presented on Friday, June 4 during Medicine Grand Rounds. We are so proud of you!

McKee Retiring from Heart Center Communications

Vickie McKee, a transitional care nurse with Heart Center Communications, will retire from Duke University Health System at the end of June. She has been working at Duke for 43 years. A certified Basic Life Support Instructor and Heart Failure Nurse, McKee was one of the first recipients of Duke’s Friends of Nursing Award, receiving it in 1989 and again in 1999. She has co-authored several poster presentations related to heart failure, and shepherded a number of projects to advance education for patients, including iPad Technology for Heart Failure Education that involved a collaboration between the Duke Transitional Nursing Institute and DCRI/Duke Center for Learning Health Care. Another such project was Heart at Home, Transition in Care where she assisted in the development of a DVD used to educate heart failure patients transitioning from the hospital to home and back to clinic.

Vickie’s last official day with us will be Wednesday, June 30. Please offer her your warm congratulations this month. We know she will be missed!

Members of the HCC team shared these thoughts with us:

“I was thrilled when Vickie joined the Heart Center Communications team as a cardiology transitional care nurse, where we provide our inpatient cardiology patients with post discharge follow up telephone calls. She has brought a wealth of cardiac nursing knowledge and skill to our team, and it has been an honor to work with Vickie and to learn from her. She has served in many nursing roles during her years here at Duke, and each of these roles have played a part in the nursing expertise that she has brought to our team. I have seen her provide such genuine and exemplary care to her patients; she has truly had a positive impact on so many lives. I am so proud to call her my friend and colleague, and I wish her all the best as she enters into the next chapter in her life. I will miss her!” — Cheryl Swartz, Cardiology Transitional Care Nurse, HCC

“Vickie is a great nurse, coworker, and friend. She is compassionate with patients and their families. I wish her the best in this next phase of her life.” — Ruth B. Cavales, Transitional Care Nurse, HCC

“Vickie’s compassion and experience will be greatly missed.” — Michael Blazing, Medical Director; Greg Shelton, Administrative Director; and Gina Nesmith, Nurse Program Manager; HCC.

 

Wegermann Closes Out CGR

Zach Wegermann was the closer for the 2020-21 Cardiology Grand Rounds season on Tuesday, June 1. Wegermann presented research that utilized several different registries to gain insights on various questions related to interventional cardiology. His work showed that patients receiving MitraClip had larger improvements in quality of life outcomes, as measured by Kansas City Cardiomyopathy Questionnaire (KCCQ) scores, when they had lower baseline KCCQ score prior to the procedure.  Another project highlighted that intraoperative TEE during CABG frequently reveals worse-than-expected valvular disease, leading to unplanned valve repair or replacement. Notably, there is wide variance across centers in the usage of intraoperative TEE for CABG, raising the question of whether a more standardized approach is needed. The lecture was not recorded for potential PHI reasons, but we are sure that Dr. Wegermann would be happy to field any follow-up questions. You can read the published results here.

Looking forward, CGR will be on summer break until September 14, when we will kick off the 2021-22 academic year with Dr. Robert Lefkowitz as our guest speaker.

Krasuski Grand Rounds Presentation, Mass General

Rich Krasuski, director of our Adult Congenital Heart Disease Center, was the guest presenter for Cardiology Grand Rounds at Mass General Hospital (MGH) on June 2. A recorded presentation of his talk, The Complexities of Managing Pulmonary Hypertension in Congenital Heart Disease, can be found here; a pre-grand rounds interview with Krasuski, conducted by Mostafa Al-Alusi, a first-year cardiovascular disease fellow at MGH, can be found here.

Fast Track Extubation Article in AACN

Congratulations to our 7W research team, including Myra Ellis, Heather Pena, Allen Cadavero, Debra Farrell, Mollie Kettle, Alexandra Kaatz, Tonda Thomas, Bradi Granger and Kamrouz Ghadami! Their article, Reducing Intubation Time in Adult Cardiothoracic Surgery Patients With a Fast-track Extubation Protocol is the cover article in the June 2021 issue of Critical Care Nurse (CCN), one of the journals of the American Association of Critical-Care Nurses. The publication is available online and can be found here. Be sure to check out the associated article appearing in HealthLeaders below in “Duke Heart in the News.”

 

Heart Center Leadership Council Spring Meeting Held

The Heart Center Leadership Council held their spring meeting on Friday, May 21 via Zoom. The Council has welcomed four new members over the past year: Kathy Finley, Brad Branch, Chuck Swoboda and Dennis Wicker.

Manesh Patel and Edward Chen, co-directors of Duke Heart Center, provided a general overview of our programs, an update on our latest research and how the pandemic impacted us. The Council then heard a great presentation on the Heart Transplant program from Jacob Schroder and Chet Patel, who covered major milestones from across the past year.

Some comments from the meeting:

“I just wanted to say how blessed I think we are to have Duke and Duke Heart in our neighborhood as well as southeast United States. I am impressed and proud of what is being done — thank you!” — Robb Teer, member, Heart Center Leadership Council

“So impressed by the energy, innovation and courage it takes to do things differently.” Donna Childress, member, Heart Center Leadership Council

The HCLC will meet again in October.

 

Duke Health Closes COVID-19 Command Centers

At the beginning of the COVID-19 pandemic, Duke established Hospital Incident Command Structure (HICS) command centers that allowed for close monitoring and quick adjustments to every part of our operations across the health system. Due to the significant decrease in the spread of infection, Duke has closed all COVID-19 command centers as of June 1. DUHS leadership will continue to monitor COVID-19 and keep safe practices in place. However, the command center closures represent the end of Duke Health’s official emergency response efforts.

COVID Hotline Hours as of June 1

As of June 1, the COVID hotline hours of operation for patients, Duke employees and students are as follows:

Employee Hotline: 8 a.m. – 6 p.m., daily. For urgent after-hours concerns, call the Blood and Body Fluids Hotline at 919-684-8115.

Vaccine Hotline: 8 a.m. – 6 p.m., Monday – Saturday.

Patient Hotline:  8 a.m. – 6 p.m., Monday – Saturday. There will remain an option to reach Nurse Triage from 6 p.m. – 8 p.m. and Sundays from 8 a.m. – 8 p.m. for symptomatic and exposed patients.

Student Hotline: 8 a.m. – 8 p.m. daily.

Asymptomatic Testing Hotline: 8 a.m. – 5 p.m., Monday – Saturday.

 

Scholars Tip: Showcase Your Presentations

Did you know your Scholars@Duke profile has a spot for all of your important invited talks and keynotes? Your Scholars profile is the ultimate tool to demonstrate your contributions to the Duke community and enable discovery of your work. Be sure to list any notable presentations (conferences, lectures, interviews, invited talks, keynotes, etc.) you want others to notice.

How to display notable appearances on your Scholars profile

Make sure your device is connected to the internet, then follow these steps:

  1. Type scholars.duke.edu in your computer’s browser address bar.
  2. Click Edit My Profile under Update
  3. Log in using your NetID and password, and then click Manage Your Profile.
  4. Select Global Scholarship from the Scholarly Output section of the Profile Manager.
  5. Scroll down to the Professional Activities section, expand the Recognition heading, then click Presentations & Appearances.
  6. Click Add and complete the required fields to describe your presentation and provide a link to any related materials, then click save. Repeat this step for every presentation you wish to display on your profile.

Information contained in your Scholars@Duke profile feeds into other websites at Duke, so it’s good to keep your Scholars profile as up to date as possible.

 

Upcoming Opportunities/Save the Date:

Virtual PMWC: Precision Medicine in the Era of a Pandemic Recovery

June 14-18 – Precision World Medicine Conference. Registration is free and open to all. https://www.pmwcintl.com/covid/

Duke University Chancellor Emeritus Dr. Ralph Snyderman will lead a panel discussion on Personalized, Proactive Value-Based Care: Emerging New Models.

The confluence of the growth of chronic diseases, the impact of COVID, the emergence of new technologies, and the impact of value-based reimbursement are driving major innovations and changes in care delivery. Proactive, personalized, precision, population-based and digitally supported care is emerging and heralding new approaches to health care. This session will capture the elements of these changes and the dynamics of the forces that are driving them. Perspective from care innovators, large providers and payers will be discussed by the following key opinion leaders:

  • Patrick  Conway, CEO of Care Solutions, Optum
  • Jaewon Ryu, President and Chief Executive Officer, Geisinger
  • Rodney Hochman, President & CEO, Providence St. Joseph Health
  • Marc Harrison, President and CEO, Intermountain Healthcare

 

HCPLive State of the Science Summit

June 23: Institutional Perspectives in Cardiology: Cardiovascular Risk Management webinar with Manesh Patel, Schuyler Jones, Tracy Wang and Christopher Granger. 7 to 8:30 p.m. EST. Virtual. Registration is free. They’ll cover:

  • CAD/PAD: Identifying Risk & Summary of Recent Clinical Trials
  • Extended Thromboprophylaxis: What Do We Know About Scoring, Risk and Contemporary Trials?
  • Atrial Fibrillation: What Have We Learned About NOACs in Special Populations?
  • Putting This All Together: Treatment Pyramid

To learn more, please visit: HCPLive Institutional Perspectives in Cardiology.

 

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.

 

Duke Heart in the News:

May 26 — Manesh Patel

Weather.com/TWC India

Individuals Advised to Look Out for Symptoms of Heart Problems After COVID-19 Vaccine Shot

https://bit.ly/3g1Uv0M

May 27 — W. Schuyler Jones

TheDoctorWillSeeYouNow.com

Aspirin for Heart Disease? Less May Be More

https://www.thedoctorwillseeyounow.com/content/heart/art6404.html

May 27 — Manesh Patel

PennLive.com/Patriot News

CDC investigates a potential link between COVID-19 vaccines and heart problem seen in young people

https://bit.ly/3wSA650

May 30 — Harry Severance

CNBC.com

Covid has made it harder to be a health-care worker. Now, many are thinking of quitting

https://cnb.cx/34Hmwpk

*carried by 26 other news outlets

May 31 — Daniel Mark

PhysiciansWeekly.com

Dapagliflozin Is Cost-Effective in HFrEF, But Is It Affordable?

https://bit.ly/2RlEbzO

June 3 — Daniel Mark and Derek Chew

MDEdge.com

Dapagliflozin’s cost-effectiveness ‘intermediate’ for HFrEF

https://bit.ly/3vVI90V

June 3 — Myra Ellis

HealthLeaders

Nursing Researchers Safely Decrease Ventilation Time for Cardiac Surgery Patients

https://bit.ly/2Sc2xfx

Division of Cardiology Publications Indexed in PubMed May 27-June 2, 2021

Bernstein RA, Kamel H, Granger CB, Piccini JP, Sethi PP, Katz JM, Vives CA, Ziegler PD, Franco NC, Schwamm LH. Effect of Long-term Continuous Cardiac Monitoring vs Usual Care on Detection of Atrial Fibrillation in Patients With Stroke Attributed to Large- or Small-Vessel Disease: The STROKE-AF Randomized Clinical Trial. JAMA 2021;325(21):2169-2177. PM: 34061145.

Bihlmeyer NA, Kwee LC, Clish CB, Deik AA, Gerszten RE, Pagidipati NJ, Laferrère B, Svetkey LP, Newgard CB, Kraus WE, Shah SH. Metabolomic profiling identifies complex lipid species and amino acid analogues associated with response to weight loss interventions. PLoS One 2021;16(5):e0240764. PM: 34043632.

Chow C, Mentz RJ, Greene SJ. Update on the Impact of Comorbidities on the Efficacy and Safety of Heart Failure Medications. Curr Heart Fail Rep 2021;18(3):132-143. PM: 33835396.

Garza MY, Rutherford MW, Adagarla B, Eisenstein E, Kumar KR, Zimmerman KO, Topaloglu U, Zozus M. Evaluating Site-Level Implementations of the HL7 FHIR Standard to Support eSource Data Exchange in Clinical Research. Stud Health Technol Inform 2021;281:397-401. PM:

34042773

Gutierrez JA, Samsky MD, Schulteis RD, Gu L, Swaminathan RV, Aday AW, Rao SV. Venous thromboembolism among patients hospitalized with COVID-19 at Veterans Health Administration Hospitals. Am Heart J 2021;237:1-4. PM: 33745899.

Jones WS, Mulder H, Wruck LM, Pencina MJ, Kripalani S, Muñoz D, Crenshaw DL, Effron MB, Re RN, Gupta K, Anderson RD, Pepine CJ, Handberg EM, Manning BR, Jain SK, Girotra S, Riley D, DeWalt DA, Whittle J, Goldberg YH, Roger VL, Hess R, Benziger CP, Farrehi, et al. Comparative Effectiveness of Aspirin Dosing in Cardiovascular Disease. N Engl J Med 2021;384(21):1981-1990. PM: 33999548.

Lowenstern A, Sheridan P, Wang TY, Boero I, Vemulapalli S, Thourani VH, Leon MB, Peterson ED, Brennan JM. Sex disparities in patients with symptomatic severe aortic stenosis. Am Heart J 2021;237:116-126. PM: 33722584.

Mentz RJ, Pulungan Z, Kim S, Yang M, Teigland C, Hilkert R, Djatche LM. Quality outcomes, healthcare resource utilization and costs in Medicare patients with chronic heart failure with reduced ejection fraction with and without a worsening event. J Med Econ 2021;24(1):698-705. PM: 33900874.

Pagidipati NJ, Svetkey LP. Time for a Renewed Focus on the DASH-Low Sodium Diet. J Am Coll Cardiol 2021;77(21):2635-2637. PM: 34045019.

Rymer JA, Webb L, McCall D, Hills MT, Wang TY. Differences in Preferences Between Clinicians and Patients for the Use and Dosing of Direct Oral Anticoagulants for Atrial Fibrillation. J Am Heart Assoc 2021;10(11):e020697. PM: 33998252.

Sliwa K, Singh K, Raspail L, Ojji D, Lam CSP, Thienemann F, Ge J, Banerjee A, Newby LK, Ribeiro ALP, Gidding S, Pinto F, Perel P, Prabhakaran D. The World Heart Federation Global Study on COVID-19 and Cardiovascular Disease. Glob Heart 2021;16(1):22. PM: 34040935.

Southwell BG, Wood JL, Navar AM. Función de los profesionales de la salud de rectificar la información errónea que tienen los pacientes más allá de corregir los hechos. Rev Panam Salud Publica 2021;45:e60. PM: 34035798.

Turakhia M, Sundaram V, Smith SN, Ding V, Michael Ho P, Kowey PR, Piccini JP, Foody J, Birmingham MC, Ianus J, Rajmane A, Mahaffey KW, et al. Efficacy of a centralized, blended electronic, and human intervention to improve direct oral anticoagulant adherence: Smartphones to improve rivaroxaban ADHEREnce in atrial fibrillation (SmartADHERE) a randomized clinical trial. Am Heart J 2021;237:68-78. PM: 33676886.

 

Duke Heart Updates – May 30th 2021

Chief’s message: Memorial Day Weekend

It’s a traditional start to the summer, Memorial Day weekend with the Indianapolis 500 and many end of the academic year festivities coming up including graduating medical school students, residents going to fellowships or jobs, and fellows finishing to start their careers as cardiologists. Some of the weekend is also spent remembering the tremendous sacrifices of the women and men in the armed services that allow us the freedoms that we have today. This Memorial Day, we reflect on their sacrifice and the debt we owe our fallen service members and their families.

It would also be hard not to remember our ongoing battle with the COVID-19 pandemic where one year ago today we were trying to keep the COVID related deaths under 100,000 and thinking of ways in which we could continue to safely care for our patients and each other.  One year has made a tremendous difference, and we are blessed to have kept our fellows, faculty, and staff healthy with continued focus on serving our local community and the broader missions of academic discovery and training.  So, as our health system, faculty, and school are working to determine an aligned way forward in which we can better meet the needs of our community, our clinical and academic missions, I am encouraged by the resiliency and teamwork of all of you at Duke Heart.  Together we are stronger and the mission to improve Heart Health remains our true north. You will see in the updates this week that we have kept pushing to develop new ways to educate, innovate, and care for our patients.

Highlights of the week:

Cardiac Ultrasound Certificate Program Receives CAAHEP Accreditation

Congratulations to our Duke Cardiac Ultrasound Certificate Program team led by Richie Palma and Anita Kelsey! They have been granted initial accreditation by the Board of Directors of the Commission on Accreditation of Allied Health Education Programs (CAAHEP). The CAAHEP Board acted upon the accreditation recommendation of the Joint Review Committee on Education in Cardiovascular Technology (JRC-CVT). The decision was made during the CAAHEP board meeting held May 21.

Through the accreditation process, which includes a thorough review of the program, curriculum, resources, faculty and staff, as well as a site visit, the Duke program was determined to be in substantial compliance with the nationally-approved Standards and Guidelines for educational programs. The CAAHEP Standards by which the program was measured has been developed primarily by Cardiovascular Technology professionals, are approved by each profession’s sponsoring organizations, and are intended to reflect required knowledge and skills that a person needs to be able to successfully function within the Cardiovascular Technology profession. CAAHEP Standards focus on quality outcomes, assuring that educational programs are preparing competent Cardiovascular Technology professionals.

CAAHEP accredits more than 2,200 educational programs that prepare health professionals in 32 different disciplines. Accreditation is a critical step in a process that is meant to protect the public and ensure a supply of qualified health care professionals.  For more information about CAAHEP and accreditation, visit www.caahep.org.

The Duke Cardiac Ultrasound Certificate Program will graduate its first class in August. The team will be adding a six-month pediatric training program this fall.

 

Cath Team Performs Duke’s 1st Coronary Angiogram Using Transmedics System

Congratulations to Jennifer Rymer, Angela Lowenstern, Robyn Strong, Meghan Ronn, Michaela Fahn and Shawna Walker (not pictured) – the team completed Duke’s first coronary angiogram using the Transmedics Organ Care System (OCS) to assess the coronary arteries of a donor heart in the catheterization lab.

“We now have one of the largest experiences with the Transmedics OCS in the world, but have not – until this week—had to assess the coronary arteries of the donor heart once it was on the device,” said Chet Patel. “We had discussed the need for doing this on a few occasions in the past, but this was the first time we had to complete one.”

Very few such procedures have been done worldwide among medical centers currently using the Transmedics OCS, according to Patel. Congratulations, team!

 

Chen Named to JTCVS Editorial Board; Klapper, Andersen Earn Ed Board Awards

Edward Chen

Congratulations to Edward P. Chen, chief of the division of Cardiovascular and Thoracic Surgery – he has been named to the editorial board of the Journal of Thoracic and Cardiovascular Surgery (JTCVS). He joins a number of Duke colleagues there, including Tom D’Amico, Nick Andersen, Don Glower, Matt Hartwig, Jacob Klapper, Jerrold Levy, Andrew Lodge, Betty Tong and Joe Turek.

“For me, this is a tremendous honor.  JTCVS is arguably the leading CT surgery journal in North America and to be asked to serve in this capacity is a tremendous privilege,” said Chen. “Getting a manuscript accepted into this journal has always been recognized as very difficult and I hope to continue to uphold these high publication standards as a member of the Editorial Board. I am extremely pleased that we have such robust representation of our Duke CT faculty on this Board which is reflective of the emphasis we put on discovery and academic pursuits in our Division.”

Congratulations also to Jacob Klapper and Nick Andersen who were both recognized by the JTCVS with 2021 Editorial Board Awards – which are based on overall average ratings as a reviewer. The average is calculated from the number of papers that reviewers accept for review, the percentage of those completed on time, and the number of reviews that score higher than 70%.  “I find reviewing the papers a vital part of continuing to read and assess the medical literature critically as well an opportunity to gain new and valuable insights into my field,” said Klapper.

Excellent work!

 

Bishawi, Randles Honored with Novim AJN Award

Muath Bishawi, a cardiothoracic surgery resident in our Integrated Thoracic Surgery Residency Program, and Amanda Randles, the Alfred Winborne and Victoria Stover Mordecai Assistant Professor of Biomedical Sciences at Duke, have been honored by Novim with an Alexandra Jane Noble Award. AJN awards are given for innovations contributing to world health, social impact, increasing awareness and new discovery. The awards, now in their fourth year, honor efforts to communicate complex topics in innovative, engaging ways to stimulate higher awareness of scientific issues, particularly in young adults.

Bishawi and Randles were given the 2021 Science Inspiration Award; the colleagues made fundamental contributions to engineering with their split ventilator prototype. With ventilators in high demand during the COVID-19 pandemic, Dr. Randles and Dr. Bishawi created a ventilator splitter and resistor system (VSRS) which enables one ventilator to support two or more patients. A full article about their ventilator system can be found here. Don’t miss this Microsoft Inspire video about the computational models used in development: https://www.youtube.com/watch?v=B55viclEWLc&t=640s

A full listing of all 2021 Novim awardees can be found here. The awards, announced earlier this year, were presented on Wednesday, May 26.

Congratulations, Muath! We are so proud of you!

UPDATE: Risk Capture & HCC Coding: CV Disease

Clinical providers, please review this updated PowerPoint we have sent from Drs. Momen Wahidi and Dev Sangvai on the importance of Risk Adjustment Factor (RAF) documentation. Please take time to review slides 12-18 that highlight documentation tips with patients for the following cardiovascular related conditions: Specified Heart Arrhythmias, Vascular Disease, Angina Pectoris, and Opportunities in Cardiovascular Disease. For additional information, please contact: Momen Wahidi. Thank you!

All Three Duke Hospitals among Top Performing for Treatment of MI

Congratulations to our teams at Duke Raleigh Hospital, Duke University Hospital and Duke Regional Hospital – all three hospitals are recipients of the American College of Cardiology’s NCDR Chest Pain  ̶  MI Registry Platinum Performance Achievement Award for 2021. Only 212 hospitals nationwide have received the honor.

To receive the Chest Pain  ̶  MI Registry Platinum Performance Achievement Award, hospitals must demonstrate sustained achievement in the Chest Pain  ̶   MI Registry for two consecutive years (2019 and 2020), and perform at the highest level for specific performance measures. Full participation in the registry engages hospitals in a robust quality improvement process using data to drive improvements in adherence to guideline recommendations and overall quality of care provided to heart attack patients.

This award is evidence of the hard work and commitment it takes to deliver the highest quality in cardiovascular care to transform heart health. Congratulations to all involved in our Chest Pain – MI Registry!

 

AACN NTI Poster Presentation

Congratulations to members of the Duke Cardiac Catheterization Lab! They had a poster presentation at the American Association of Critical Care Nurses 2021 National Teaching Institute & Critical Care Exposition. Their poster, Improving Adoption of Evidenced-Based Chlorohexidine Skin Prep Prior to Cardiac Catheterization, authored by Robyn Strong and Cassidy Johnson, demonstrated results of how the cath lab team worked together to improve scrub time, scrub technique and prep dry time to >95% compliance. Great job, everyone!

 

 

 

High Five: Clinic 2F/2G

Our 2F/2G Duke South Clinic team was nominated for a “high five” recently by Carolyn Lekavich. In her nomination, she wrote, “I want to recognize the exceptional team that we have at 2F/2G. I can’t say enough about the exceptional care, compassion, and humanistic style that the entire team provides, every day, for our patients and each other!”

Nicely done, team!

 

COVID-19 Updates:

All the latest official DUHS information regarding coronavirus/COVID-19 response at the following locations:

 

Upcoming Opportunities/Save the Date:

Virtual PMWC: Precision Medicine in the Era of a Pandemic Recovery

June 14-18 – Precision World Medicine Conference. Registration is free and open to all. https://www.pmwcintl.com/covid/

Duke University Chancellor Emeritus Dr. Ralph Snyderman will lead a panel discussion on Personalized, Proactive Value-Based Care: Emerging New Models.

The confluence of the growth of chronic diseases, the impact of COVID, the emergence of new technologies, and the impact of value-based reimbursement are driving major innovations and changes in care delivery. Proactive, personalized, precision, population-based and digitally supported care is emerging and heralding new approaches to health care. This session will capture the elements of these changes and the dynamics of the forces that are driving them. Perspective from care innovators, large providers and payers will be discussed by the following key opinion leaders:

  • Patrick  Conway, CEO of Care Solutions, Optum
  • Jaewon Ryu, President and Chief Executive Officer, Geisinger
  • Rodney Hochman, President & CEO, Providence St. Joseph Health
  • Marc Harrison, President and CEO, Intermountain Healthcare

 

HCPLive State of the Science Summit

June 23: Institutional Perspectives in Cardiology: Cardiovascular Risk Management webinar with Manesh Patel, Schuyler Jones, Tracy Wang and Christopher Granger. 7 to 8:30 p.m. EST. Virtual. Registration is free. They’ll cover:

  • CAD/PAD: Identifying Risk & Summary of Recent Clinical Trials
  • Extended Thromboprophylaxis: What Do We Know About Scoring, Risk and Contemporary Trials?
  • Atrial Fibrillation: What Have We Learned About NOACs in Special Populations?
  • Putting This All Together: Treatment Pyramid

To learn more, please visit: HCPLive Institutional Perspectives in Cardiology.

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.

Duke Heart in the News:

May 18 — Harry Severance, Jr.

ACEPNow.com

Unintended Consequences of Vaccine “Passports”

https://bit.ly/34j3fds

May 21 — Harry Severance, Jr.

CNBC/Travel

Unvaccinated Americans are less worried about traveling than vaccinated Americans are, study says

https://cnb.cx/3ugD95v

May 21 — Sunil Rao

tctMD

Transradial PCI Bests Femoral Access in Complex Cases: COLOR

https://bit.ly/3hXAJ98

May 24 — Manesh Patel

NBCNews.com

CDC looking into possible link between heart problem and Covid vaccines in young people

https://nbcnews.to/3voTsi7

May 25 — W. Schuyler Jones

WebMD

‘Baby’ Aspirin As Effective As High-Dose for Heart

https://wb.md/3fNmcdB

Division of Cardiology Publications Indexed in PubMed May 20-26, 2021

Aktaş MK, Younis A, Zareba W, Kutyifa V, Klein H, Daubert JP, Estes M, McNitt S, Polonsky B, Goldenberg I. Survival After Implantable Cardioverter-Defibrillator Shocks. J Am Coll Cardiol 2021;77(20):2453-2462. PM: 34016257.

Barnett AS, Kiefer T, Kim HW, Mitchell M, Jackson KP, Piccini JP, Koontz JI, Sun AY. Ablation of Ventricular Tachycardia Storm With Coronary Venous Ethanol. JACC Clin Electrophysiol 2021;7(5):682-683. PM: 34016399.

Chiamvimonvat N, Frazier-Mills C, Shen ST, Avari Silva JN, Wan EY. Sex and Race Disparities in Presumed Sudden Cardiac Death: One Size Does Not Fit All. Circ Arrhythm Electrophysiol 2021;14(5):e010053. PM: 33993706.

Chouairi F, Pacor J, Miller PE, Fuery MA, Caraballo C, Sen S, Leifer ES, Felker GM, Fiuzat M, O’Connor CM, Januzzi JL, Friedman DJ, Desai NR, Ahmad T, Freeman JV. Effects of Atrial Fibrillation on Heart Failure Outcomes and NT-proBNP Levels in the GUIDE-IT Trial. Mayo Clin Proc Innov Qual Outcomes 2021;5(2):447-455. PM: 33997640.

Chrispin J, Frazier-Mills C, Sogade F, Wan EY, Clair WK. Pandemic Highlights Disparities in Health Care. Circ Arrhythm Electrophysiol 2021;14(5):e009908. PM: 33993701.

Forrest CB, Xu H, Thomas LE, Webb LE, Cohen LW, Carey TS, Chuang CH, Daraiseh NM, Kaushal R, McClay JC, Modave F, Nauman E, Todd JV, Wallia A, Bruno C, Hernandez AF, O’Brien EC. Impact of the Early Phase of the COVID-19 Pandemic on US Healthcare Workers: Results from the HERO Registry. J Gen Intern Med 2021;36(5):1319-1326. PM: 33694071.

Gargiulo G, Cannon CP, Gibson CM, Lopes RD, Vranckx P, Valgimigli M. The multiplication of loaves and fishes approach: a critic to double anti-thrombotics or to double number of ischaemic events? Eur Heart J Cardiovasc Pharmacother 2021;7(3):e29-e30. PM: 33340322.

Huang HI, Jewell ML, Youssef N, Huang MN, Hauser ER, Fee BE, Rudemiller NP, Privratsky JR, Zhang JJ, Reyes EY, Wang D, Taylor GA, Gunn MD, Ko DC, Cook DN, Chandramohan V, Crowley SD, Hammer GE. Th17 Immunity in the Colon Is Controlled by Two Novel Subsets of Colon-Specific Mononuclear Phagocytes. Front Immunol 2021;12:661290. PM: 33995384.

Lopes RD, Alexander KP, Hochman JS, Maron DJ. Response by Lopes et al to Letter Regarding Article, “Initial Invasive Versus Conservative Management of Stable Ischemic Heart Disease Patients With a History of Heart Failure or Left Ventricular Dysfunction: Insights From the ISCHEMIA Trial”. Circulation 2021;143(20):e961-e962. PM: 33999666.

Mentz RJ, Ambrosy AP, Ezekowitz JA, Lewis GD, Butler J, Wong YW, De Pasquale CG, Troughton RW, O’Meara E, Rockhold FW, Garg J, Samsky MD, Leloudis D, Dugan M, Mundy LM, Hernandez AF. Randomized Placebo-Controlled Trial of Ferric Carboxymaltose in Heart Failure With Iron Deficiency: Rationale and Design. Circ Heart Fail 2021;14(5):e008100. PM: 34003690.

Nelson AJ, Pagidipati NJ, Granger CB. The SAMSON trial: using a placebo to improve medication tolerability. Eur Heart J Cardiovasc Pharmacother 2021;7(3):e13. PM: 33638980.

Ohman EM, Zwischenberger BA, Thiele H. Left Ventricular Support for the Management of Cardiogenic Shock: Sooner May Be Better. JACC Cardiovasc Interv 2021;14(10):1120-1122. PM: 34016409.

Patel PA, Green CL, Lokhnygina Y, Christensen J, Milano CA, Rogers JG, Patel CB, Koweek LM, Daubert MA. Cardiac computed tomography improves the identification of cardiomechanical complications among patients with suspected left ventricular assist device malfunction. J Cardiovasc Comput Tomogr 2021;15(3):260-267. PM: 32891544.

Tai A, Ambrosy AP, Fudim M. Making the case for sacubitril/valsartan in patients with heart failure with a preserved ejection fraction. Eur Heart J Cardiovasc Pharmacother 2021;7(3):e5-e6. PM: 33537712.

Teerlink JR, Felker GM, McMurray JJV. Omecamtiv Mecarbil in Systolic Heart Failure. Reply. N Engl J Med 2021;384(20):1967-1968. PM: 34010541.

Wang L, Balmat TJ, Antonia AL, Constantine FJ, Henao R, Burke TW, Ingham A, McClain MT, Tsalik EL, Ko ER, Ginsburg GS, DeLong MR, Shen X, Woods CW, Hauser ER, Ko DC. An atlas connecting shared genetic architecture of human diseases and molecular phenotypes provides insight into COVID-19 susceptibility. Genome Med 2021;13(1):83. PM: 34001247.

Yoneshiro T, Kataoka N, Walejko JM, Ikeda K, Brown Z, Yoneshiro M, Crown SB, Osawa T, Sakai J, McGarrah RW, White PJ, Nakamura K, Kajimura S. Metabolic flexibility via mitochondrial BCAA carrier SLC25A44 is required for optimal fever. Elife 2021;10:10.7554/eLife.66865. PM: 33944778.

Younis A, Goldberger JJ, Kutyifa V, Zareba W, Polonsky B, Klein H, Aktas MK, Huang D, Daubert J, Estes M, Cannom D, McNitt S, Stein K, Goldenberg I. Predicted benefit of an implantable cardioverter-defibrillator: the MADIT-ICD benefit score. Eur Heart J 2021;42(17):1676-1684. PM: 33417692.

 

Duke Heart Week ending May 23rd 2021

Highlights of the week:

Duke Highlights, ACC 2021 – part 2!

We closed out ACC.21 earlier this week with lots of great presentations, including:

Melissa Daubert had a poster presentation: Impact of Postpartum BP Screening on Clinical Outcomes in Women with Hypertensive Disorders of Pregnancy

Key findings:

  • Early postpartum BP screening was performed in a minority of women with HDP, but was associated with greater detection of CV risk factors and CV disease.
  • Over 1/3 of women with HDP developed ≥ 1 new CV risk factor within 5 years of delivery.
  • Further study is needed to optimize preventive Figure 2 CV care in high-risk women with HDP.

 

Adam DeVore presented Effect of a Hospital and Post-discharge Quality Improvement Intervention on Clinical Outcomes and Quality of Care for Patients With Heart Failure With Reduced Ejection Fraction on behalf of the CONNECT-HF investigators and committees. Their conclusion: “In this cluster-randomized trial of hospitals treating patients after a hospitalization for HFrEF, a hospital and post-discharge quality improvement intervention that focused on clinician education and audit and feedback of HF quality of care did not meaningfully improve HF outcomes or care above current quality improvement efforts.”

Clinical implications:

  • Major gaps in guideline-directed care remain
    • Low rates of ACEI/ARB/ARNI, evidence-based beta-blocker, and MRA
  • New approaches are needed to improve care above current quality improvement efforts for patients with HFrEF
    • HF rehospitalization or death: 39% over 12 months of follow-up
    • Fragmented nature of HF care in the US apparent during the study

Renato Lopes presented The Coalition ACTION Trial, a Randomized Clinical Trial To Evaluate a Routine Full Anticoagulation Strategy In Patients With Coronavirus Infection (SARS-CoV-2) Admitted To Hospital. The presentation received a good amount of news coverage (see below). Lopes and colleagues conducted the ACTION trial to determine whether a therapeutic anticoagulation strategy based on rivaroxaban improved outcomes in patients with elevated D-dimer levels hospitalized with COVID-19 compared with a prophylactic anticoagulation strategy.

 

 

Neha Pagidipati presented Caring for Women With Familial Hypercholesterolemia Through Pregnancy during the Applying the Guidelines for Lipid Management in Special Populations session.

Key findings:

  • As screening for FH increases, clinicians will increasingly encounter women with FH who become pregnant
  • Lipids normally increase in pregnancy; in FH, the absolute increase is greater
  • Pregnancy is not associated with risks to mothers with FH, however may be associated with risks to fetus
  • Statins are NOT recommended during pregnancy
    • Need more studies on what the risks actually are
  • Colsevelam is approved during pregnancy, but use is limited by side-effects
  • This area is woefully understudied — need more data to drive evidence-based practice for both mothers and their children

 

J.D. Serfas, a fellow in our Adult Congenital Heart Disease Program, served on the ACC.21 planning committee for the Adult Congenital and Pediatric Cardiology section and primarily designed the section, “Controversies in Interventional and Surgical Management of Congenital Heart Disease.”

Serfas was involved in the planning of several Fellows-in-Training sessions, and helped facilitate the FIT Mix-and-Mingle and Fellows-in-Training Networking Events. He also co-designed and co-moderated the session Art with Heart: Tales of Creativity in Cardiology, a podcast-style session that included conversations with Doug Zipes, Suzie Brown Sacks, Nazanin Moghbeli, and Kedar Sankholkar, all of whom have integrated careers in the arts or entertainment with active cardiology careers.

Serfas presented the case of a patient with d-transposition of the great arteries after atrial switch repair with advanced heart failure requiring LVAD support in the session “Challenges of Transplantation in Congenital Heart Disease Patients: Ethics, Listing Strategy & MCS.”

 

Additionally, he had a poster presentation: Racial and Ethnic Disparities in Location of Death Among Adult Congenital Heart Disease Patients.

Key findings:

  • Minority patients with ACHD are less likely to die at home or with hospice and more likely to die in a hospitalized setting than non-Hispanic White patients, and that structured programs to address these racial disparities in end-of-life care in ACHD are needed.

 

Olivia Dong, a post-doctoral research fellow working with Deepak Voora, earned first place in the ACC.21 Young Investigator Competition in Outcomes Research. She presented, One-year cost-effectiveness of CYP2C19-guided P2Y12 inhibitors de-escalation and escalation in Veterans undergoing percutaneous coronary intervention.

Key takeaway:

  • In Veterans with acute coronary syndromes who have undergone percutaneous coronary intervention, CYP2C19-guided P2Y12 inhibitor selection can improve cardiovascular outcomes and lower costs for the Veterans Health Administration within 12 months of implementation.

“I’m very grateful I had the opportunity to share this research at the ACC.21 conference,” said Dong. “This achievement would not have been possible without the unwavering support from my primary mentor, Dr. Deepak Voora, and my amazing research collaborators– Dr. Kevin Friede (Duke Cardiology Fellow), and Dr. Catherine Chanfreau-Coffinier (Veterans Affairs PHASER Data Core Director).”

Dong is currently completing a post-doctoral T32 NHGRI fellowship in genomic medicine research through the Duke Center for Applied Genomics and Precision Medicine and the Durham VA Health Care System. She will graduate in June. Well done, Olivia – congratulations!

Congratulations to all faculty and fellows who participated in ACC.21 this year – you’re doing remarkable work!

 

Shout-out to Respiratory Care Services

We were delighted and not at all surprised to learn of the generosity of our Respiratory Care Services team, led by Charlotte Reikofski, in helping support Duke Health by preparing supplies for India. The team gathered resuscitators, oxygen masks, filters and more for shipment to New Delhi – an effort spearheaded by anesthesiologist Madhav Swaminathan, clinical director of CT Anesthesia and Critical Care Medicine.

To read more about the effort, please visit: Duke Health Sends Supplies to India to Assist with Covid-19 Crisis.

Way to go, Respiratory Care team!!!

 

Moments to Movement – May 25th

Recently, Chancellor Washington shared an update with all Duke Health staff regarding the upcoming anniversary of our Moments to Movement initiative. Locations across Duke Health are planning time for all to stand together in observance of this important day and reflect upon our progress and prepare us for the work to come. Here are a few ways you can participate in the Stand for Peace this week.

Across Duke Health, many of us will take a one-day pause from non-essential meetings to allow our faculty and staff extra space and time to have conversation or to participate in one of the planned observances.

Stand for Peace: 7 a.m. – 9 a.m. and 2 p.m. – 4 p.m.; Duke Medicine Circle (grassy area in front of Duke South Clinics). This event is for all Duke Health faculty, staff and students working on campus; Create individual signs for display; sign the Duke Health Anti-racism Pledge

M2M Virtual Tea for the Soul: 7 a.m., 10 a.m., and 2 p.m., via Zoom. Guided reflection, relaxation for all Duke Health faculty, staff and students; each session will last 15 minutes. Participants are encouraged to bring their own tea. Click here to join. Hosted by Chaplain Services.

Revisiting Black Man in a White Coat: 3:00 p.m. – 3:45 p.m.; Register or read more here. All are invited to join Chancellor A. Eugene Washington and Associate Professor Damon Tweedy for a special conversation as they revisit Black Man In A White Coat — Tweedy’s 2015 bestselling book examining the difficult and often contradictory terrain of race and medicine.

Collective Breath for Justice:  4 p.m. – 4:45 p.m.; via Zoom. The Duke School of Medicine Office of Diversity & Inclusion will lead a virtual event to reflect, connect and share in a collective breath for justice. It will include a nine minute and 29 second silent vigil. Join here.

Senior leadership for Duke University Hospital and DUHS are committed to supporting everyone who wants to participate in one of these events. They ask that you please coordinate with your manager so that as many team members as possible are able to join in these activities while maintaining patient safety.

Thank you for everything you do every day to care for our communities. We are proud of each of you for your commitment to eliminating health disparities and standing against racial inequality and injustice.

 

COVID-19 Updates:

All the latest official DUHS information regarding coronavirus/COVID-19 response at the following locations:

Upcoming Opportunities/Save the Date:

Virtual PMWC: Precision Medicine in the Era of a Pandemic Recovery

June 14-18 – Precision World Medicine Conference. Registration is free and open to all. https://www.pmwcintl.com/covid/

Duke University Chancellor Emeritus Dr. Ralph Snyderman will lead a panel discussion on Personalized, Proactive Value-Based Care: Emerging New Models.

The confluence of the growth of chronic diseases, the impact of COVID, the emergence of new technologies, and the impact of value-based reimbursement are driving major innovations and changes in care delivery. Proactive, personalized, precision, population-based and digitally supported care is emerging and heralding new approaches to health care. This session will capture the elements of these changes and the dynamics of the forces that are driving them. Perspective from care innovators, large providers and payers will be discussed by the following key opinion leaders:

  • Patrick  Conway, CEO of Care Solutions, Optum
  • Jaewon Ryu, President and Chief Executive Officer, Geisinger
  • Rodney Hochman, President & CEO, Providence St. Joseph Health
  • Marc Harrison, President and CEO, Intermountain Healthcare

 

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. 

Duke Heart in the News:

May 15 — W. Schuyler Jones

Associated Press

Heart study: Low- and regular-dose aspirin safe, effective

https://bit.ly/3bARUtt

*story carried by 425 news outlets

May 15 — W. Schuyler Jones

Medpage Today

Baby Aspirin on Par With Full Dose to Prevent Repeat Heart Events

https://bit.ly/3wgN2BE

May 15 — W. Schuyler Jones

tctMD

High- and Low-Dose Aspirin Equivalent in ASCVD: ADAPTABLE

https://bit.ly/3fxOkl3

May 17 — Renato Lopes

tctMD

ACTION: Full-Dose Rivaroxaban Doesn’t Help in Hospitalized COVID-19

https://www.tctmd.com/news/action-full-dose-rivaroxaban-doesnt-help-hospitalized-covid-19

May 17 — W. Schuyler Jones

HealthDay

ACC: 81-mg, 325-mg Aspirin Similarly Effective in ASCVD

https://bit.ly/3yklkFV

May 17 — Renato Lopes

Healio/Cardiology

ACTION: Rivaroxaban-based anticoagulation strategy fails to improve outcomes in COVID-19

https://bit.ly/2S421QC

May 17 — Adam DeVore

Medpage Today

Stubborn Gaps in Heart Failure Persist Despite Clinician Education, Feedback

https://bit.ly/3hBG7yT

May 17 — Adam DeVore

Healio/Cardiology

Hospital, post-discharge quality improvement intervention failed to improve HFrEF outcomes

https://bit.ly/3u3TSbU

May 17 — Manesh Patel and W. Schuyler Jones

HCPLive

VOYAGER PAD with Manesh Patel, MD, and Schuyler Jones, MD

https://bit.ly/3fu7QP9

May 18 — W. Schuyler Jones

WNDU-NBC-16 (South Bend, IN)

Study finds low-dose and regular-dose aspirin perform the same for heart health

https://bit.ly/3eVWTqG

*carried by 17 additional news outlets

May 18 — W. Schuyler Jones and Renato Lopes

Medical Dialogues

Study Cautions Against Use of Oral Anticoagulants in Admitted COVID Patients, ACC 2021

https://bit.ly/3foK86M

May 18 — Adam DeVore

AJMC

Hospital Quality Program for Heart Failure Patients Fails to Improve Outcomes

https://bit.ly/3wgCVg0

May 18 — W. Schuyler Jones

USNews.com

Low- or High-Dose, Aspirin Brings Similar Protection Against Heart Disease: Study

https://bit.ly/3bGIuMT

May 18 — Renato Lopes

HCP Live

Rivaroxaban Linked to Increased Bleeding Among Hospitalized COVID-19 Patients

https://bit.ly/3u6M9tD

May 18 — Manesh Patel

Medium.com

The Extra Extra Life Conversations, Part Two

https://bit.ly/3hDFQLH

Division of Cardiology Publications Indexed in PubMed May 6–19, 2021

Caughey MC, Vaduganathan M, Arora S, Qamar A, Mentz RJ, Chang PP, Yancy CW, Russell SD, Shah SJ, Rosamond WD, Pandey A. Racial Differences and Temporal Obesity Trends in Heart Failure with Preserved Ejection Fraction. J Am Geriatr Soc 2021;69(5):1309-1318. PM: 33401338.

Daubert MA, Yow E, Barnhart HX, Piña IL, Ahmad T, Leifer E, Cooper L, Desvigne-Nickens P, Fiuzat M, Adams K, Ezekowitz J, Whellan DJ, Januzzi JL, O’Connor CM, Felker GM. Differences in NT-proBNP Response and Prognosis in Men and Women With Heart Failure With Reduced Ejection Fraction. J Am Heart Assoc 2021:e019712. PM: 33955231.

Gaeta S, Bahnson TD, Henriquez C. High-Resolution Measurement of Local Activation Time Differences From Bipolar Electrogram Amplitude. Front Physiol 2021;12:653645. PM: 33967825.

Greene SJ, Butler J, Spertus JA, Hellkamp AS, Vaduganathan M, DeVore AD, Albert NM, Duffy CI, Patterson JH, Thomas L, Williams FB, Hernandez AF, Fonarow GC. Comparison of New York Heart Association Class and Patient-Reported Outcomes for Heart Failure With Reduced Ejection Fraction. JAMA Cardiol 2021;6(5):522-531. PM: 33760037.

Greene SJ, Mentz RJ, Limkakeng AT, Irons T, Truong T, Green CL, Nowak C, Blumer V, Pang PS. Comparison of Dyspnea Measurement Instruments in Acute Heart Failure: The DYSPNEA-AHF Pilot Study. J Card Fail 2021;27(5):607-609. PM: 33091609.

Harris Walker G, Gonzalez-Guarda R, Yang Q, Shah S, Prvu Bettger J. Socio-ecological perspective on factors influencing acute recovery of younger stroke survivors: A mixed methods study. J Adv Nurs 2021:10.1111/jan.14778. PM: 33650219.

Hurst JH, Liu Y, Maxson PJ, Permar SR, Boulware LE, Goldstein BA. Development of an electronic health records datamart to support clinical and population health research. J Clin Transl Sci 2020;5(1):e13. PM: 33948239.

Kelsey MD, Granger CB. LOW-HARM score predicted mortality in patients hospitalized with COVID-19 in Mexico. Ann Intern Med 2021:10.7326/ACPJ202105180-059. PM: 33939489.

Lala A, Mentz RJ. Reaping from Reciprocity: the Mentor-Mentee Relationship. J Card Fail 2021;27(5):507-508. PM: 33962740.

Lopes RD, Thomas L, Di Fusco M, Keshishian A, Luo X, Li X, Masseria C, Friend K, Mardekian J, Pan X, Yuce H, Jones WS. Clinical and Economic Outcomes Among Nonvalvular Atrial Fibrillation Patients With Coronary Artery Disease and/or Peripheral Artery Disease. Am J Cardiol 2021;148:69-77. PM: 33667438.

Mann DL, Felker GM. Mechanisms and Models in Heart Failure: A Translational Approach. Circ Res 2021;128(10):1435-1450. PM: 33983832.

Parikh PB, Bhatt DL, Bhasin V, Anker SD, Skopicki HA, Claessen BE, Fonarow GC, Hernandez AF, Mehran R, Petrie MC, Butler J. Impact of Percutaneous Coronary Intervention on Outcomes in Patients With Heart Failure: JACC State-of-the-Art Review. J Am Coll Cardiol 2021;77(19):2432-2447. PM: 33985688.

Peri-Okonny PA, Wang J, Gosch KL, Patel MR, Shishehbor MH, Safley DL, Abbott JD, Aronow HD, Mena-Hurtado C, Jelani QU, Tang Y, Bunte M, Labrosciano C, Beltrame JF, Spertus JA, Smolderen KG. Establishing Thresholds for Minimal Clinically Important Differences for the Peripheral Artery Disease Questionnaire. Circ Cardiovasc Qual Outcomes 2021:120007232. PM: 33947205.

Povsic TJ, Sanz-Ruiz R, Climent AM, Bolli R, Taylor DA, Gersh BJ, Menasché P, Perin EC, Pompilio G, Atsma DE, Badimon L, DeMaria AN, Hare JM, Henry TD, Janssens S, Kastrup J, Torella D, Traverse JH, Willerson JT, Fernández-Avilés F. Reparative cell therapy for the heart: critical internal appraisal of the field in response to recent controversies. ESC Heart Fail 2021;8(3):2306-2309. PM: 33652498.

Prado GM, Mahfoud F, Lopes RD, Moreira DAR, Staico R, Damiani LP, Ukena C, Armaganijan LV. Renal denervation for the treatment of ventricular arrhythmias: A systematic review and meta-analysis. J Cardiovasc Electrophysiol 2021;32(5):1430-1439. PM: 33724602.

Rao VN, Kelsey MD, Kelsey AM, Russell SD, Mentz RJ, Patel MR, Fudim M. Acute cardiovascular hospitalizations and illness severity before and during the COVID-19 pandemic. Clin Cardiol 2021;44(5):656-664. PM: 33682157.

Rettmann ME, Holmes Iii DR, Monahan KH, Breen JF, Bahnson TD, Mark D, Poole J, Ellis AM, Silverstein A, Al-Khalidi HR, Lee KL, Robb RA, Packer DL. Treatment-Related Changes in Left Atrial Structure in Atrial Fibrillation: Findings from the CABANA Imaging Substudy. Circ Arrhythm Electrophysiol 2021:10.1161/CIRCEP.120.008540. PM: 33848199.

Sharma G, Douglas PS, Hayes SN, Mehran R, Rzeszut A, Harrington RA, Poppas A, Walsh MN, Singh T, Parekh R, Blumenthal RS, Mehta LS. Global Prevalence and Impact of Hostility, Discrimination, and Harassment in the Cardiology Workplace. J Am Coll Cardiol 2021;77(19):2398-2409. PM: 33985685.

Sun H, Hodgkinson CP, Pratt RE, Dzau VJ. CRISPR/Cas9 Mediated Deletion of the Angiotensinogen Gene Reduces Hypertension: A Potential for Cure? Hypertension 2021;77(6):1990-2000. PM: 33813849.

 

 

 

 

Duke Heart Week Ending March 16th 2021

Chief’s message: American College of Cardiology Meeting 2021 and Spring Events:

This weekend highlighted the spring virtual American College of Cardiology Presentations. At the time of this email we have had several of our Faculty and fellows present.  This year Duke Cardiology, DCRI, and Duke Heart with many of our collaborators will account for 87 presentations at the ACC 2021 meeting, with several late breaking clinical trials, young investigator awards, and overview of hot topics.  We also have our heart center leadership council meeting coming up this week and will share updates from that next week.  Finally, with some of the CDC and some of the School of Medicine policy changes, we are planning some outdoor graduation events for our wonderful fellows.  I was fortunate enough to see some of the ACC and still make it to my daughter’s Indian Dance Performance in Midtown Raleigh and son’s track meet.  One of few benefits of virtual conferences is that they have allowed us to balance clinical work, scientific meetings, and family life. Hopefully, you all got some time to enjoy the weekend and potentially catch up on some of the great science being presented.

Highlights of the week:

Duke Highlights, ACC 2021

We are pleased to share information on two late-breaking clinical trials presented this weekend at the American College of Cardiology’s Scientific Sessions. Congratulations to Schuyler Jones and the ADAPTABLE team and Rob Mentz and the REHAB-HF team! Renato Lopes is presenting the ACTION trial evaluating anticoagulation in SARS-COV2 today and we will have information on that in upcoming weeks. Further below, we highlight Marat Fudim and the Doug Zipes Distinguished Young Investigator award… although we have previously reported on this, now that the time has finally arrived, we’re celebrating once again! We will have more ACC.21 coverage next weekend.

ACC.21: Lower- and Higher-dose Aspirin Achieve Similar CVD Protection, Safety

Schuyler Jones

People with cardiovascular disease (CVD) taking aspirin to lower their chances of suffering a heart attack or stroke experienced similar health benefits, including reduced death and hospitalization for heart attack and stroke, whether they took a high or low dose of aspirin, according to a study presented at ACC.21, the American College of Cardiology’s 70th Annual Scientific Session and published in the New England Journal of Medicine.

CVD—and atherosclerosis, in particular, which is a narrowing and hardening of the arteries—is a leading cause of death for men, women, and most racial and ethnic groups in the United States, with estimated direct costs of $214 billion, according to the American Heart Association. Millions of Americans with CVD take recommended aspirin therapy to help reduce their risk of heart attack and stroke, a decades-long practice that has, until now, lacked definitive research studying the doses that work best for patients and minimize potentially serious side effects, such as major bleeding.

“We found that both doses had similar effectiveness and safety, and while there were differences in dose switching between the groups, generally patients with heart disease should take low-dose aspirin given its tolerability and no clear benefit with higher doses of daily aspirin,” said Schuyler Jones, MD, associate professor of medicine in cardiology and the study’s principal investigator at the Duke Clinical Research Institute (DCRI).

The study, called ADAPTABLE, is the first large-scale study of aspirin dosing to be embedded in real-world practice and the first randomized controlled trial to be conducted using PCORnet®, the National Patient-Centered Clinical Research Network. PCORnet is a national resource developed with funding support from the Patient-Centered Outcomes Research Institute (PCORI) to enable more efficient patient-centered clinical research by tapping into real-world health data collected during routine care. PCORI funded ADAPTABLE both to demonstrate the capacities of PCORnet and to fill an important evidence gap regarding cardiovascular care.

Researchers followed 15,076 people with CVD who were identified via electronic health records and randomized to self-administer either 81 mg or 325 mg of daily aspirin for a median of 26.2 months. Participants were engaged at 40 health centers across the nation and a health plan engaged in the PCORnet network. Most follow-up to obtain patient-reported information occurred via a patient portal, with the rest occurring via telephone calls.

While the researchers found no significant difference between the two doses in safety or effectiveness, they noted the higher dose group was much more likely to switch doses during the study. The patients in this group also were slightly more likely to discontinue the use of aspirin, for reasons including tolerability and participant and clinician preferences, among others.

“ADAPTABLE provides useful evidence to inform patients and clinicians who advise them on aspirin dosing decisions,” noted PCORI Executive Director Nakela L. Cook, MD, MPH. “Sometimes health care is based on years of routine practice and when rigorous studies are conducted, we can evolve that practice from common sense to evidence based. That is why PCORI funds studies like ADAPTABLE that aim to enhance decision making with useful evidence.”

Cook added, “ADAPTABLE demonstrated the capacities that PCORnet offers to conduct large-scale patient-centered research more efficiently utilizing a rich data infrastructure and provides valuable lessons learned as the first randomized controlled trial conducted via the network. The generation of real-world evidence to enhance and extend beyond the evidence generated through studies conducted in specialized research settings is so important to improving health outcomes for all populations in all settings around the nation.”

According to the researchers, ADAPTABLE provides a demonstration that randomized trials can leverage electronic health data, direct-to-participant methods and participant-reported outcomes to address important, patient-centered questions.

“ADAPTABLE provides a blueprint for how research can be improved in the future,” added Jones. “The pragmatic structure of the PCORnet network enabled remote follow-up and streamlined processes and made it easier for sites and participants to take part. We also benefited from continuous engagement with patient partners who raised questions at every touchpoint that made us all think how ADAPTABLE and future research could be done differently.”

More information on ADAPTABLE can be found at theaspirinstudy.org, which includes a plain-language summary of the results and a town hall discussion on lessons learned through the study. More information on PCORnet is available at pcornet.org.

ACC.21: Tailored Cardiac Rehab Program Improves Function and Quality of Life in Older Heart Failure Patients

Robert Mentz

Older patients hospitalized with acute heart failure who participated in a novel 12-week cardiac rehabilitation (rehab) program tailored to address their specific physical impairments had significant gains in physical functioning, quality of life and depression compared with those receiving usual care, regardless of their heart’s squeezing ability (ejection fraction), according to a new study presented at the American College of Cardiology’s 70th Annual Scientific Session. Participation in the program, however, did not significantly reduce rehospitalizations during the six-month follow up.

Heart failure, which happens when the heart can’t pump blood the way it should because it is too weak or stiff, is the leading cause of hospitalizations in people 65 and older. Many of these patients are never able to return to their previous level of functioning—resulting in reduced independence and increased risk of returning to the hospital or dying.

“These patients have persistently poor outcomes with frequent rehospitalizations, poor quality of life, high rates of dying and high health care costs,” said Dalane W. Kitzman, MD, professor of cardiovascular medicine and geriatrics/gerontology at Wake Forest School of Medicine and the study’s lead author. “Despite many efforts to improve outcomes in these patients, most studies testing a wide range of medications, devices and strategies have been negative. This suggested to us that we were overlooking an important factor contributing to these poor outcomes, and we suspected the missing factor might be severe physical dysfunction, which is generally not addressed in heart failure management.”

In an earlier pilot study, Kitzman and colleagues found that older patients admitted to the hospital with acute heart failure had profound deficits in all domains of physical function, including their balance, mobility and strength, not just in endurance, which would have been expected. Nearly all of these patients (97 percent) were considered frail or prefrail.

“Even before they are hospitalized, these patients already have lower physical functioning due to both aging and their chronic heart failure, and when their heart failure worsens, their physical function deteriorates further and this can then be exacerbated by the hospital experience and bed rest,” Kitzman said. “This sequence of events leading to marked impairments in all domains of physical function and its impact on patient outcomes has been largely overlooked.”

With these insights, the REHAB-HF rehabilitation intervention was developed and designed to correct deficits in balance, mobility and strength. REHAB-HF seeks to enhance effectiveness and avoid injuries that can occur when frail older persons undertake traditional cardiac rehab programs that are more focused on endurance. The program was tailored to each patient’s specific needs and adjusted to their ability level as they progressed. Unlike traditional cardiac rehab programs that typically start six weeks after a hospitalization, the REHAB-HF program started early—during the patient’s hospital stay if possible—and transitioned to three outpatient sessions per week for 12 weeks following hospital discharge. The aim of the current REHAB-HF trial was to evaluate whether this novel rehabilitation program could improve physical function (primary outcome) and rehospitalizations (secondary outcome) compared to usual care which could include physician-ordered physical therapy or traditional cardiac rehab.

A total of 349 patients across seven different hospitals, including four community hospitals, were enrolled in the study. Patients ranged in age from 60-99 years; over half were women and 49 percent were from underrepresented racial or ethnic minority groups. Notably, 53 percent had heart failure with preserved ejection fraction (HFpEF). Overall, they had an average of five comorbidities, most commonly high blood pressure, diabetes, obesity, lung disease and kidney disease, which may also contribute to declines in physical function.

At the three-month follow-up, compared with participants randomized to receive usual care, those in the intervention group had notable and significant improvements in physical functioning and quality of life across all the assessments used. For example, the Short Physical Performance Battery, a standard measure of physical function in older adults, improved by 1.6 units—more than twofold greater than the minimum amount that is meaningful to patients. On the six-minute walk test, they were able to walk 34 meters farther, a large improvement compared to very low function at baseline. Participant scores on the Kansas City Cardiomyopathy Questionnaire, which measures the patient’s perception of their health status, and a separate depression survey also showed large improvements. The improvements in physical function in the REHAB-HF intervention group were even greater when compared to the subset of usual care patients who had received traditional physical therapy and/or cardiac rehab as part of their physician’s orders, further supporting the effectiveness of the REHAB-HF intervention.

At six months, 83 percent of patients were still doing their exercises, which Kitzman said bodes well for long-term adherence. However, there were no statistically significant differences in clinical events, including rates of readmission for any reason, with 194 and 213 rehospitalizations occurring in the intervention group and usual care control group, respectively. Heart failure-related hospitalizations were also no different (94 vs. 110) at six months. There were numerically more deaths among people in the rehab group (21 vs. 16), but this was not statistically significant; researchers said this result may have been due to chance.

“The study was not large enough to really look at clinical events. But patient preference surveys show that older patients often value improved function and quality of life independently of rehospitalization and death,” Kitzman said. “By improving quality of life and physical functioning, the patient feels better, which is a positive outcome for patients.”

Kitzman and his collaborators, including David Whellan, Pamela Duncan, Amy Pastva, Robert Mentz, Gordon Reeves, M. Benjamin Nelson, Haiying Chen, Bharathi Upadhya, Shelby Reed, Mark Espeland, LeighAnn Hewston and Christopher O’Connor are now investigating whether certain subgroups of patients (for example, those with HFpEF) saw more benefits, which could inform a subsequent larger trial powered to definitively examine effects on clinical events.

This study was simultaneously published online in the New England Journal of Medicine at the time of presentation. It was funded by the National Institute on Aging.

 

ACC.21: Fudim Presented with Zipes Award

Marat Fudim received the 2021 Douglas P. Zipes Distinguished Young Scientist Award. He is the first Duke nominee to receive the honor. The Zipes award is presented annually at the ACC Scientific Sessions to recognize a young scientist who has made outstanding contributions to the field of cardiovascular medicine and who has amassed an impressive body of scientific research in either the clinical or basic domain. The pre-recorded award session featured Doug Zipes and JoAnn Lindenfeld; it ran this morning during the Sessions.

Congratulations, Marat!

Samsky CGR presentation

Marc Samsky was our presenter for Cardiology Grand Rounds on Tuesday. Samsky discussed cardiogenic shock and the difficulties in conducting clinical trials for these patients. His research has focused on developing new ways to streamline research on patients with shock, leading to the design of two studies: an AHA Cardiogenic Shock Registry, and the BEST-SHOCK Trial. The trial, which has been submitted as a PCORI grant, would be an RCT to study Impella CP vs vasopressors/IABP. Marc also highlighted the fact that most of the work in cardiogenic shock has focus on patients with AMI and not those with acute on chronic heart failure, so it is difficult or impossible to apply the results from the AMI population to our HF pts.

You can find his recorded presentation here: https://bit.ly/3ybyuFd.

 

Heart Center Communications Updates

Since the start of COVID, the Heart Center Communications (HCC) volume of communications and the length of calls have increased while staffing has been down, at times, during staff transitions. Additionally, the majority of HCC staff have been working effectively from home in order to maintain social distancing requirements.

Over the last year, the HCC team has experienced employee turnover for a variety of reasons ranging from retirements to the passing of a beloved team member in September. For those familiar with the team, turnover is quite rare – this is a group that has forged close connections and operates more like a family in the way they care for one another.

The HCC now has four new nurses who are actively learning their roles: Kendell Hill, Carroll Enterkin, MJ Chapman and Alicia Snyder. We are very glad to have them on the team!

HCC has two talented financial analysts supporting charge capture processes for DUH cardiology invasive labs: Pat Clarke and Jon Boylan. They truly have a heart for service and continually look for ways to best support patient, provider and clinical staff needs. Heart Center Financial Administration (HCFA) supports DUH cardiac invasive labs by monitoring WQ’s, performing regular audits, reconciliations, financial reporting, charge corrections and communicating with clinical staff and medical providers as needed. By providing financial support, this allows the clinical team to focus more time on patients. The HCFA team has partnered with the cardiology invasive labs at DRH and DRAH, to provide them with this high level of support.

Finally, about a year ago, Duke Heart Center partnered with PRMO to add a dedicated Service Access Manager (SAM) to support Cath/EP, CDU and CMRI. The HCC was able to recruit the highly talented La Chandra Chavis, who role models our Duke Values and demonstrates great leadership. She has been a true asset to the team.

Great work, HCC! Hat tip to Greg Shelton for providing us with this update!

McKinney, NTI Poster Submission

Congratulations to Heather McKinney, MSN, RN, NE-BC! Her poster entitled MenTIR: Mentoring to Improve Retention Study will be exhibited at the National Teaching Institute Conference sponsored by the American Association of Critical Care Nurses, May 24-27, 2021. The poster highlights the successful outcomes, including a reduction in nurse turnover, achieved by implementation of a mentorship program on Duke North Unit 3100.

Way to go, Heather!

 

Celebrating Nurses!

Congratulations to Missy Sturdevant, RN and Kamie Pedler, NCA of the Duke Heart 3100 Unit in Duke University Hospital who were both nominated during the Department of Medicine’s Celebrate Nursing Campaign! Their nominator(s) had this to say:

 

“Kamie is one of the hardest working, most compassionate coworkers I have had the honor of working with. She cares deeply about working with patients and exemplifies all of the Duke Values. She deserves all the praise in the world!” – Name withheld

“Missy has been such a dependable, integral and inspiration of a nurse on 3100. She goes above and beyond to share her knowledge and provide the best possible care for her patients. I learned so much from her and hope that Duke realizes how lucky it is to have her caring for our patients.” – Name withheld

Congrats, Missy & Kamie!

Shout-out to Yankey, Loriaux & Flores Rosario!

More great feedback on members of our fellowship program was received this week – in a note to Anna Lisa Crowley, we learned:

“I am writing to recognize three of your outstanding fellows: Dr. George Sipa Yankey, Dr. Daniel Loriaux, and Dr. Karen Flores Rosario. These three fellows volunteered several hours of their time to teach first-year Duke medical students basic cardiac ultrasound. I had the privilege of teaching alongside them, and I was so impressed with their educational skills. The students LOVED learning from them and are still raving about the experience.

We are so lucky to have such gifted educators willing to volunteer their time for our students.” — Julian Hertz, Assistant Professor of Surgery & Global Health, Course Director, Longitudinal Point-of-care Ultrasound Curriculum

Great job, Sipa, Daniel and Karen!

Nursing Gala Held; Celebration of FON Awards

The 32nd Gala Celebration of Excellence, hosted by the Duke Friends of Nursing Board of Advisors was held last night, May 15. The online event honored all Duke nurses and celebrated the nominees and winners of the FON Excellence Awards. A very special congratulations to the following Duke Heart nurses who were recognized: Stephanie Barnes, Allison Dimsdale, Mollie Kettle, Elaine Milton, Brenda Smith, Courtney Stierwalt and Katie Toy. We are so happy for each of you!

 

Duke Box Update

Good news for those of us who use Box, Duke’s cloud-based storage and collaboration service. Starting Monday, May 17, Box will have new and improved features. The new features include:

  • Infinite scroll – Scroll down to view files and folders rather than clicking through pages of content
  • Collections – Organize files and folders in ways that make sense to you

You may also notice a slight branding change on the Box interface. This short video provides an overview of the changes: https://warpwire.duke.edu/w/taIFAA/

If you would like to learn more about Box, please visit box.duke.edu.

COVID-19 Updates:

All the latest official DUHS information regarding coronavirus/COVID-19 response at the following locations:

Upcoming Opportunities/Save the Date:

Proctors Needed: MaryAnn Black Virtual Summer Internship Program

The MaryAnn Black Virtual Summer Internship Program is in need of volunteer proctors to cover about 12 hours during the virtual program. Coverage times are as small as one hour between June 15 and June 30. Proctors will provide active supervision, listen during sessions, and observe to ensure minor participants (ages 15-18) are behaving appropriately. If you’re interested and willing to help out, please contact Darla Wohlfarth.

To learn about the program, please visit: https://community.duke.edu/program/duke-internships/

This year’s program will be completely virtual and will highlight dozens of healthcare careers and healthcare supportive careers. The internship will begin June 7 and end June 30, 2021. The first week will be devoted to structured training and orientation. The remaining weeks will give the student an overview of the many career opportunities that make up the fabric of Duke Health.

Thank you for considering!

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.

Duke Heart in the News:

May 6 — Cameron Prigge (neurobiology)

AAMC.org

Basic medical research took a hit during the pandemic. It might take years to recover

https://bit.ly/3o9y11F

May 6 — Brigit Carter (Duke SON)

health.usnews.com

Why Representation in Nursing Matters

https://bit.ly/3eFdz5u

May 9 — general interest

The Washington Post

An app that swiftly sends CPR volunteers to heart attack sufferers has made a big difference in Denmark. Could this be copied in the U.S.?

https://wapo.st/3w8QlL7

May 10 — Adrian Hernandez

WRAZ/Fox 50

There’s one side-effect to watch for when children receive the COVID-19 vaccine

https://bit.ly/3y0Pxtv

Note: clip begins at 10:04:10

May 10 — E. Magnus Ohman

Medscape

Patient-Focused Revisit of ISCHEMIA Bolsters Conservative Message in Stable CAD

https://www.medscape.com/viewarticle/950875https://bit.ly/3es0tZr

 

Duke Heart Week ending May 9th 2021

Chief’s message: Happy Mother’s Day

Hopefully you all got some time to spend celebrating mother’s day either with your mother, or with family remembering your mothers.  Springtime in the triangle is notable for a good weather and school graduations, many of which are appropriately on mother’s day weekend.  Graduations serve as a reminder of all the hard work and love, compassion, and grace that mothers have in raising and supporting their kids and families.  At graduations commencement speakers frequently ask our young colleagues to often look forward and look at the opportunity they will have to shape the world, and it is fitting that doing that with thoughts of the ways in which our mothers helped us all will serve as a continued guiding light.

Highlights of the week:

Celebrating National Nurses Week, May 6-12

It’s National Nurses Week! As we take time to celebrate our nurses, we also pause to consider the sacrifices and losses many nurses and frontline workers have endured due to Covid-19. At Duke Heart and across the Health System, we have seen remarkable dedication and courage from all of our teams over the past year. It hasn’t been easy and there are still challenges ahead. Yet we know that our nurses will continue to help lead the way through their outstanding care for patients and through their commitment to excellence, education, compassion, and to one another. Thank you to all Duke nurses – especially those on each of our Heart units, in each of our clinics and those in the research space and elsewhere. Thanks for all that you do!

Reminder: The Department of Medicine Well-Being Committee is hosting Celebrating Our Nurses. Through May 12, all members of the Department of Medicine can use this link to nominate nurses for their contributions and describe how they emulate the Duke Health values of Excellence, Integrity, Teamwork, Respect, and Innovation.

There is no limit to the number of nurses one person can nominate, and you can nominate a nurse from any location (i.e. clinic, inpatient, research).

This year more than any other, it is important to recognize the inspiring work done by our nursing colleagues and their important role in the care of our patients.

 

Women in the Heart of Cardiology Symposium Held

The first “Women in the Heart of Cardiology” international symposium was held virtually on Wednesday, May 5th.

The program was organized by the Brazilian Clinical Research Institute (BCRI) in partnership with the Duke Clinical Research Institute and Stanford University with the goal of promoting discussion around gender disparities in cardiology, in cardiovascular health outcomes and quality of care around the world, and strategies to minimize them. The symposium featured discussions on the still low representation of women participating in clinical trials and as well as the paucity of women selected to lead clinical trials.

The symposium featured male and female thought-leaders from across the cardiovascular space. The presentations and discussions were informative, engaging and featured a number of current and former Duke faculty members including Tracy Wang, Renato Lopes, Jennifer Rymer, Adrian Hernandez, Manesh Patel, Robert Harrington, Lesley Curtis and Robert Califf, as well as Duke cardiology fellow, Vanessa Blumer.

To learn more about the event, the topics covered, and to see a full list of all presenters, please visit: https://wihc.online. Congratulations to co-chairs Renato Lopes, Robert Harrington, Tracy Wang and Ariane Macedo for planning a very successful and well-attended event. We hope to see more sessions on these critical topics in the future. Great job!

 

 

 

Swaminathan to Serve as Track Director for SCAI 2022

Rajesh Swaminathan has been appointed the Cath Lab Bootcamp Track Director for the 2022 Society for Cardiovascular Angiography and Interventions (SCAI) Annual Scientific Sessions, which is scheduled for May 19-22, 2022 in Atlanta. SCAI is the only professional medical society in the U.S. dedicated solely to interventional cardiology.

Duke is well represented on the SCAI Sessions planning team. In addition to Raj, former Fellow Connie Hess is part of the planning committee for the Peripheral Track of the meeting and Sunil Rao became President-Elect of SCAI as of April 28; Rao has most recently served as SCAI vice president.

Congrats, Raj!!

 

D’Amico, Tong Named to AATS Committees

Betty Tong

Please join us in congratulating surgeons Tommy D’Amico and Betty Tong for their appointments to the following American Association for Thoracic Surgery (AATS) committees:

  • D’Amico has been appointed to the AATS Board of Directors, the governing body of the AATS, in recognition of his dedication and service.
  • Tong has been appointed to the IT committee, the group charged with modernizing the AATS digital universe and its online presence.

The AATS, founded in 1917, promotes scholarship, innovation, and leadership in the field of thoracic and cardiovascular surgery; it is an international organization whose members have a proven record of distinction within the specialty and have made significant contributions to the care and treatment of cardiothoracic disease.

“These appointments are not only significant individual accomplishments, but also are extremely important for our entire Division as well as our individual faculty and residents,” said Edward P. Chen, chief of the Division of Cardiovascular and Thoracic Surgery. “I am absolutely thrilled for them and ask that you join me in congratulating Tommy and Betty for their achievements.”

 

Perfusion Services Team Recognized with JECT Award

Congratulations to Travis Siffring, Amy Evans, William Dauch, Greg Smigla and David Kaemmer – all members of the Duke Perfusion Services pediatric specialty team — and to Duke medical student, Neel Prabhu. Their manuscript, Sustained Total All-Region (STAR) Perfusion: An Optimized Perfusion Strategy for Norwood Reconstruction, has been selected for the JECT Technique Article Award for 2021. The Journal of ExtraCorporeal Technology (JECT) is the official publication of the American Society of ExtraCorporeal Technology (AmSECT) and is the longest continuously published periodical in the field of perfusion.

STAR perfusion is a new technique being used at Duke during Norwood reconstruction. It combines continuous coronary perfusion, cerebral perfusion and lower body perfusion at mild hypothermic temperature for the duration of surgery to reconstruct the aorta. Norwood reconstruction is generally performed in the first weeks of life on infants born with a congenital heart defect called hypoplastic left heart syndrome – a condition where the left side of the heart has not fully developed, rendering the heart unable to pump oxygen-rich blood throughout the body.

“Before this technique we had to cool the patients and use hypothermic circulatory arrest with cerebral perfusion only in order to allow the surgeons to perform a big portion of the surgery — creation of the neoaorta,” Siffring said. “Now we can stay closer to normothermia and can perfuse the brain, the heart and the rest of the body while the surgeons are operating on the aorta.”

The perfusion team presented on this technique at the AmSECT 58th International Conference, held in March, 2020. Their manuscript describing the technique was published in the December 2020 issue of JECT.

This award is presented annually to a perfusionist who has published an exceptional technique article in JECT. The award consists of a certificate and a modest honorarium. The JECT Award was presented last weekend during AmSECT’s 59th International Conference, which was held virtually from May 1-4.

ICYMI: Members of our pediatric heart surgery team published recently on the development and use of the STAR perfusion technique during Norwood. A manuscript by surgeons Nick Anderson and Joe Turek with medical student Neel Prabhu, Sustained Total All-Region (STAR) Perfusion for Norwood Reconstruction was published online last May in the journal Operative Techniques in Thoracic and Cardiovascular Surgery; it appears in the autumn 2020 print issue.

Congratulations to all!

 

Passings: Carl M. Voyles, Jr., MD

We were saddened this week to learn that Dr. Carl M. Voyles, Jr., a Duke cardiology alum, died on Dec. 31, 2020. He was 98. His obituary reads, in part, “Carl was part of an accelerated medical program at Duke University Medical School during the war (WW2). He interned at Johns Hopkins and then was drafted. As part of his military training, he became a flight surgeon. After his military service, Carl returned to Duke and completed advanced medical training in Cardiology/Internal Medicine under the infamous Dr. Eugene Stead. When his specialized medical training was complete, he moved to St. Petersburg, Florida, and opened a cardiology practice with fellow Duke graduate, Dr. Charlie Rast.”

A wonderful tribute to his life can be found here. Our condolences to his wife Joan, their family and friends and his former colleagues. We know he is missed.

 

Shout-out to CT Surgery Team

We received the following note from Andrew Wang: “I would like to express my gratitude and awe for remarkable collaboration during a high risk TAVR case this past week. During the procedure being performed by Dr. Jeff Gaca and myself, there was a rare, unexpected complication that required rapid problem-solving and eventual conversion to open surgery. In addition to the prompt response from the OR staff, perfusion team and CT anesthesia, both Drs. Jacob Schroder and Ben Bryner quietly appeared and assisted in the emergent surgery which was successfully completed. In observing the many of parts of our heart center team work together at a moment’s notice, running toward the fire, it provided a real-time example that “culture eats strategy for breakfast.”  Thanks for everyone’s dedication and help.” – Andrew Wang, Vice Chief for Clinical Affairs, Division of Cardiology.

Nicely done, team!!!

 

Shout-out to Corley

We’re pleased to share the following message of praise for first year fellow Ali Corley. In a note to Anna Lisa Crowley from Durham VAMC cardiology physician assistant Kim Jones, we learned:

“Ali is the best. I told her today about the snafu with the VA ID badges here so no incoming fellows in July. She asked who would be covering her patients. I told her I would, and she said she would be available to help with any questions I had.

What impressed me was not that she said she’d help with any questions (hopefully all the fellows would) but that her first comment was “who will be taking care of my patients?” … that, priceless.

Her future patients should count themselves lucky!!!” –Kimberly Jones, PA, Durham VAMC Cardiology

We completely agree — Great work, Ali!

 

Kudos to Tong

In a note from Lisa Clark Pickett, Chief Medical Officer for Duke University Hospital, we learned of warm feedback for Betty Tong and the thoracic care team.

“Every nurse was extremely nice to me and my visitor. Dr. Tong was awesome.” – A grateful patient (name withheld)

Pickett wrote, “Betty, while reading comments on our Patient Satisfaction Survey I was just delighted to read this lovely compliment about you and your team! Thank you for always providing such excellent and compassionate care.”

 

Photo of the Week: Nafissi Wedding

Congratulations to Duke cardiology fellow Navid Nafissi and his wife, Haley, who were married April 17! The couple, along with their friends and family, celebrated at the Daniel Stowe Botanical Garden in Belmont, NC. It was a beautiful day for a beautiful couple! Congratulations, Navid and Haley!

Newly published!

Carolyn Lekavich

Congratulations to Carolyn Lekavich and her co-authors, Dennis Abraham, Marat Fudim, Cynthia Green, Robert Mentz, Karol Harshaw-Ellis, Margaret Bowers, Anita Kelsey, Kishan Parikh, Tracy Truong, Debra Barksdale (Virginia Commonwealth University), and William Kraus – their manuscript, Early Identification of Patients At-Risk for Incident Heart Failure with Preserved Ejection Fraction (HFpEF):  Novel Approach to Echocardiographic Trends was published online yesterday in the Journal of Cardiac Failure. Great job!

 

 

 

 

Triangle Go Red Luncheon – Register Now

The American Heart Association’s 2021 Triangle Go Red for Women Luncheon digital celebration will be held on Friday, May 14th from 11:30 a.m. – 1 p.m. Join us as we celebrate the impact of Go Red for Women in the Triangle, learn tips to structure self-care into your day, participate in a series of health and wellness breakout sessions, and hear from inspiring survivors who are “Living Fierce” and not letting cardiovascular disease stand in their way. If interested, please visit https://events.bizzabo.com/301164. Registration is still open for those who would like to join. The event is free and open to all.

Registration Open for Friends of Nursing Gala, May 15

The Duke Friends of Nursing Board of Advisors cordially invites you to attend the 32nd Gala Celebration of Excellence! Hundreds of nurses, friends, supporters and community members attend the Gala each year to honor all Duke Nurses, and to recognize the nominees and winners of the Excellence Awards. While we can’t celebrate in-person this year, we are preparing for a very special virtual celebration. Join us for a virtual program celebrating our spirit of innovation, unwavering compassion, clinical excellence, and significant impact across Duke Health. We hope you will attend. There is no fee for this event. To learn more or to register, please visit: https://www.dukefriendsofnursing.org.

 

COVID-19 Updates:

All the latest official DUHS information regarding coronavirus/COVID-19 response at the following locations:

Upcoming Opportunities/Save the Date:

Cardiology Grand Rounds

May 11:  Cardiogenic Shock: An Outlook on the Past, Present, and Future with Marc Samsky. 5 p.m. Webex.

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.

Duke Heart in the News:

May 1 — Robert Lefkowitz

Endocrine News (April issue)

My Accidental Path Into Research and Thoughts on Grooming the Next Generation of Physician-Scientists

https://bit.ly/3es0tZr

May 2 — Robert Lefkowitz

Newsweek

‘I’m A Nobel Laureate, But I Still Have Regrets’

https://bit.ly/3eYveUT

Division of Cardiology Publications Indexed in PubMed April 29 – May 5, 2021

Badhwar V, Vemulapalli S, Mack MA, Gillinov AM, Chikwe J, Dearani JA, Grau-Sepulveda MV, Habib R, Rankin JS, Jacobs JP, McCarthy PM, Bloom JP, Kurlansky PA, Wyler von Ballmoos MC, Thourani VH, Edgerton JR, Vassileva CM, Gammie JS, Shahian DM. Volume-Outcome Association of Mitral Valve Surgery in the United States. JAMA Cardiol 2020;5(10):1092-1101. PM: 32609292.

Blumer V, Greene SJ, Wu A, Butler J, Ezekowitz JA, Lindenfeld J, Alhanti B, Hernandez AF, O’Connor CM, Mentz RJ. Sex Differences in Clinical Course and Patient-Reported Outcomes Among Patients Hospitalized for Heart Failure. JACC Heart Fail 2021;9(5):336-345. PM: 33714746.

Breeze CE, Batorsky A, Lee MK, Szeto MD, Xu X, McCartney DL, Jiang R, Patki A, Kramer HJ, Eales JM, Raffield L, Lange L, Lange E, Durda P, Liu Y, Tracy RP, Van Den Berg D,  , Evans KL, Kraus WE, Shah S, Tiwari HK, Hou L, Whitsel EA, Jiang X, Charchar FJ. Epigenome-wide association study of kidney function identifies trans-ethnic and ethnic-specific loci. Genome Med 2021;13(1):74. PM: 33931109.

Califf RM, Hernandez AF, Landray M. Weighing the Benefits and Risks of Proliferating Observational Treatment Assessments: Observational Cacophony, Randomized Harmony. JAMA 2020;324(7):625-626. PM: 32735313.

Cavalier JS, Klem I. Using Cardiac Magnetic Resonance Imaging to Evaluate Patients with Chest Pain in the Emergency Department. J Cardiovasc Imaging 2021;29(2):91-107. PM: 33938167.

Dayoub EJ, Eberly LA, Nathan AS, Khatana SAM, Adusumalli S, Navar AM, Giri J, Groeneveld PW. Adoption of PCSK9 Inhibitors Among Patients With Atherosclerotic Disease. J Am Heart Assoc 2021;10(9):e019331. PM: 33904340.

Douglas PS. Functional vs Anatomical Testing for Patients With Stable Chest Pain-Binary or Directional Thinking? JAMA Cardiol 2020;5(8):868-870. PM: 32492103.

Figueroa JF, Wadhera RK, Frakt AB, Fonarow GC, Heidenreich PA, Xu H, Lytle B, DeVore AD, Matsouaka R, Yancy CW, Bhatt DL, Joynt Maddox KE. Quality of Care and Outcomes Among Medicare Advantage vs Fee-for-Service Medicare Patients Hospitalized With Heart Failure. JAMA Cardiol 2020;5(12):1349-1357. PM: 32876650.

Garza MY, Rutherford M, Myneni S, Fenton S, Walden A, Topaloglu U, Eisenstein E, Kumar KR, Zimmerman KO, Rocca M, Gordon GS, Hume S, Wang Z, Zozus M. Evaluating the Coverage of the HL7  FHIR  Standard to Support eSource Data Exchange Implementations for use in Multi-Site Clinical Research Studies. AMIA Annu Symp Proc 2021;2020:472-481. PM: 33936420.

Greene SJ, Velazquez EJ, Anstrom KJ, Eisenstein EL, Sapp S, Morgan S, Harding T, Sachdev V, Ketema F, Kim DY, Desvigne-Nickens P, Pitt B, Mentz RJ.Pragmatic Design of Randomized Clinical Trials for Heart Failure: Rationale and Design of the TRANSFORM-HF Trial. JACC Heart Fail 2021;9(5):325-335. PM: 33714745.

Kirtane AJ, Mehran R, Navar AM, Bonow RO. Heroism in the Face of the COVID-19 Pandemic. JAMA Cardiol 2020;5(10):1163-1164. PM: 32558909.

Klein LW, Anderson HV, Rao SV. Performance Metrics to Improve Quality in Contemporary Percutaneous Coronary Intervention Practice. JAMA Cardiol 2020;5(8):859-860. PM: 32374347.

Lowenstern A, Alexander KP, Douglas PS. Should We Simplify Computed Tomography Angiography Reporting as Black or White vs Describing All Shades of Gray?-Reply. JAMA Cardiol 2020;5(12):1450-1451. PM: 32902566.

Malik AO, Spertus JA, Patel MR, Dehmer GJ, Kennedy K, Chan PS. Potential Association of the ISCHEMIA Trial With the Appropriate Use Criteria Ratings for Percutaneous Coronary Intervention in Stable Ischemic Heart Disease. JAMA Intern Med 2020;180(11):1540-1542. PM: 32955575.

Mentz RJ, Rao VN. Worsening Heart Failure Events in HFpEF: Underlying Biology Not Treatment Location. JACC Heart Fail 2021;9(5):383-385. PM: 33839077.

Nanna MG, Chen ST, Nelson AJ, Navar AM, Peterson ED. Representation of Older Adults in Cardiovascular Disease Trials Since the Inclusion Across the Lifespan Policy. JAMA Intern Med 2020;180(11):1531-1533. PM: 32897289.

Okoro PC, Schubert R, Guo X, Johnson WC, Rotter JI, Hoeschele I, Liu Y, Im HK, Luke A, Dugas LR, Wheeler HE. Transcriptome prediction performance across machine learning models and diverse ancestries. HGG Adv 2021;2(2):100019. PM: 33937878.

Pagani FD, Mehra MR, Cowger JA, Horstmanshof DA, Silvestry SC, Atluri P, Cleveland JC, Lindenfeld J, Roberts GJ, Bharmi R, Dalal N, Kormos RL, Rogers JG. Clinical outcomes and healthcare expenditures in the real world with left ventricular assist devices – The CLEAR-LVAD study. J Heart Lung Transplant 2021;40(5):323-333. PM: 33744086.

Roth GA, Emmons-Bell S, Alger HM, Bradley SM, Das SR, de Lemos JA, Gakidou E, Elkind MSV, Hay S, Hall JL, Johnson CO, Morrow DA, Rodriguez F, Rutan C, Shakil S, Sorensen R, Stevens L, Wang TY, Walchok J, Williams J, Murray C. Trends in Patient Characteristics and COVID-19 In-Hospital Mortality in the United States During the COVID-19 Pandemic. JAMA Netw Open 2021;4(5):e218828. PM: 33938933.

Shahid I, Nizam MA, Usman MS, Khan MS, Fudim M, Michos ED. Meta-Analysis Comparing the Safety and Efficacy of Dual Versus Single Antiplatelet Therapy After Transcatheter Aortic Valve Implantation. Am J Cardiovasc Drugs 2021 May;21(3):373-376. PM: 33634434.

Spahillari A, Zhu J, Ferket BS, Hunink MGM, Carr JJ, Terry JG, Nelson C, Mwasongwe S, Mentz RJ, O’Brien EC, Correa A, Shah RV, Murthy VL, Pandya A. Cost-effectiveness of Contemporary Statin Use Guidelines With or Without Coronary Artery Calcium Assessment in African American Individuals. JAMA Cardiol 2020 Aug 1;5(8):871-880. PM: 32401264.

Steinberg BA, Li Z, O’Brien EC, Pritchard J, Chew DS, Bunch TJ, Mark DB, Nabutovsky Y, Greiner MA, Piccini JP. Atrial fibrillation burden and heart failure: Data from 39,710 individuals with cardiac implanted electronic devices. Heart Rhythm 2021 May;18(5):709-716. PM: 33508517.

Stone AT, Carlson KM, Douglas PS, Morris KL, Walsh MN. Assessment of Subspecialty Choices of Men and Women in Internal Medicine From 1991 to 2016. JAMA Intern Med 2020 Jan 1;180(1):140-141. PM: 31545349.

van Diepen S, Hochman JS, Stebbins A, Alviar CL, Alexander JH, Lopes RD. Association Between Delays in Mechanical Ventilation Initiation and Mortality in Patients With Refractory Cardiogenic Shock. JAMA Cardiol 2020 Aug 1;5(8):965-967. PM: 32432650.

Yang S, Starks MA, Hernandez AF, Turner EL, Califf RM, O’Connor CM, Mentz RJ, Choudhury KR. Corrigendum to “Impact of baseline covariate imbalance on bias in treatment effect estimation in cluster randomized trials: Race as an example” [Contemporary Clinical Trials volume 88 (2020) 105775]. Contemp Clin Trials 2021 Apr;103:106298. PM: 33578196.

 

 

Duke Heart Week ending May 2nd 2021

Chief’s message: Transitions and Accomplishments

It’s understandable that great institutions produce faculty and fellows that garner national attention and eventually leave to lead and areas of importance in medicine around the world.  However, this fact does not make it any less bittersweet when we have one of great colleagues leave to pursue other opportunities.   This was the case this week as we had a celebration grand rounds for Joe Rogers, someone who has been a clinician scientist for Duke Heart, and a leader for our institution on many fronts including cardiovascular medicine, the department of medicine, the PDC, and most recently as CMO of the health system.  The grand rounds we had reminded me of the times we as faculty and fellows could tell stories, share accomplishments, and most importantly thank each other for the roles that we play in each other’s lives.  Hopefully as we move towards more in person interaction, we can have grand rounds and get togethers where some of that can be done again.  Joe has certainly played an important role in many lives at Duke Heart will be missed by many.

I wanted to also highlight for all of our faculty, fellows, and friends of Duke Heart that this week we will have the national American College of Cardiology meeting (virtually).  We have an enormous number of scientific presentations by our faculty and fellows, and we will ensure that next Sunday that we have a mothers’ day edition of the pulse with updates of all the great science our group is playing a role in developing and discovering.

Highlights of the week:

Rogers Celebrated During Special CGR

A special Cardiology Grand Rounds was held via Zoom on Thursday, April 29 to celebrate Joe Rogers and all he has meant to us in Duke Heart – including his many accomplishments across his 16 year career at Duke. Rogers was celebrated as an extraordinary mentor, leader, clinician, researcher, and as someone who exemplifies the very best of Duke. He was recognized as dedicated to inclusivity – as someone who helped everyone to feel welcome and that their voice mattered. We are truly blessed to have worked with him and he will be deeply missed. Stories and anecdotes from across the years were shared by Carmelo Milano, Jacob Schroder, Chet Patel, Adam DeVore, Bradi Granger, Jennifer Lewis, Mona Fiuzat, Chris O’Connor, Robert Mentz, Marc Samsky, Mike Felker, Adrian Hernandez and several others.

Joe is heading to Texas Heart Institute this month to join their team as President and Chief Executive Officer. We wish him all the best!

Perfusion Team Recognized with AmSECT’s Inaugural Pillar Award

Duke Perfusion Services has been named one of the inaugural recipients of the Pillar Award for Perfusion Excellence by the American Society of Extracorporeal Technology (AmSECT). Awardees are being recognized for their programmatic dedication to excellence as well as professional standards across four categories or “pillars” — quality, community, responsibility, and education.

“We are so fortunate at Duke to have such an outstanding team of perfusionists who support our cardiothoracic faculty at the highest level possible all while embracing the core values encompassing this award,” said Edward P. Chen, MD, Chief of the Division of Cardiovascular and Thoracic Surgery. “It is a true privilege to have them on the Duke Heart Team.”

With thirty-four perfusionists, Duke Heart offers one of the largest and best trained perfusion teams in the U.S. Each member of the team is certified by the American Board of Cardiovascular Perfusion, licensed by the North Carolina Medical Board, and most hold advanced degrees and credentials. In addition to proficiency in cardiopulmonary bypass (operating the heart-lung machine during cardiothoracic surgery), Duke perfusionists specialize in order to support a variety of needs across the hospital. Duke offers a dedicated team of pediatric perfusionists, as well as a team to support heart surgery at Duke Regional Hospital. There is a team that specializes in Extra-Corporeal Life Support (ECLS) assisting with cannulating and retrieving patients from referring hospitals; there is a team that provides apheresis in the OR, and a team trained in use of the Transmedics Organ Care System, increasing the donor pool for Duke’s Heart Transplant program.

“Perfusionists have a distinct role,” says Desiree Bonadonna, chief of Perfusion Services at Duke. “I don’t think many people are aware of the full scope of our practice. In the operating room we run cardiopulmonary bypass which is quite complex and responsible for the patient’s circulation, respiratory function, and anesthesia and drug delivery while the surgeon is operating on the heart or lung. We have expertise in ventricular assist devices, extracorporeal membrane oxygenation (ECMO), really anything that involves pumping blood or perfusing organs, such as specialized chemo delivery systems used in surgical oncology cases. We are invested in education, research and quality improvement work and we are doing it in the high volume, high performance space of Duke Heart. We are very excited to be one of the first programs recognized with a Pillar award.”

Members of the Duke Perfusion team are regularly invited to present at national conferences, and a number of perfusion schools send their students here to learn from the Duke team.

“On behalf of the Cardiothoracic Anesthesiology and Critical Care faculty, I would like to extend a big round of applause and heartfelt congratulations to our Duke Perfusion family on their receipt of the inaugural 2021 AmSECT Pillar Award, said Mihai V. Podgoreanu, MD, chief of Cardiothoracic Anesthesiology. “Founded on a tradition of excellence, this program has continued to expand and perform outstandingly in supporting the ever-increasing clinical needs of extracorporeal technology both in the operating rooms and intensive care units. Through leadership, patient-centeredness, innovation, ownership, meticulous attention to quality improvement and collaboration, this talented and passionate group of professionals is contributing 24/7 to life-changing procedures, shaping the next generations of perfusionists and cardiovascular physician trainees through education and simulation, and generating new research knowledge. Bravo!”

Criteria for the award included demonstration of a clear management structure; well-developed protocols and procedures; an onboarding and orientation process; quality assurance standards and processes, and a professional commitment to the field. At Duke, each member of the perfusion team is also a member of a professional organization or society for the advancement of the field of perfusion – this way they are always learning and contributing.

“The value of our perfusion team to patient care at Duke cannot be underestimated or overstated,” adds Andrew J. Lodge, MD, Medical Director of Quality and Safety for Children’s Surgery. “I have been saying for years that the Duke Perfusion team is consistently the best group of individuals with whom I have had the pleasure to work. Their various sections have been characterized by excellent leadership and outstanding clinical skills.

“To a person, the perfusionists with whom I’ve worked, particularly on the pediatric and ECMO teams, have been exemplary colleagues. Additional words I would use to describe them are compassionate, dedicated, professional, driven, and ambitious. Not only are they great educators, they are always striving to learn themselves. They are on the cutting edge of technology, and allow us to offer the best available treatments for our patients. They are tireless workers and always up for a challenge. It comes as no surprise to me that the Duke Perfusion team has received a national award for excellence. It is surely well-deserved.”

Please join us in congratulating our entire team of perfusionists on their Pillar Award for Perfusion Excellence, particularly since today launches National Perfusion Appreciation Week (May 2-8). Congratulations and keep up the great work! 

Coniglio to Serve as Chief Cardiology Fellow, 2021-2022

Amanda Coniglio has been elected by her peers to serve as Duke’s chief cardiology fellow for 2021-2022. The announcement was made Friday evening by Anna Lisa Crowley, program director for the cardiology fellowship program.

As some of you may know, Amanda grew up in Richmond, Virginia before moving to upstate New York for high school. She attended Elon University here in North Carolina for her undergraduate degree. She returned to New York for medical school at the University of Rochester. There, she met her now husband, Andrew, and they couples-matched at the University of North Carolina Chapel Hill for residency. After completing residency, we were fortunate that Amanda switched to the darker blue for her cardiovascular disease fellowship training at Duke. She is completing advanced heart failure and transplant fellowship training this year before rejoining cardiovascular disease fellowship for a year of research in July. She is interested in familial cardiomyopathy and is planning to spend her research year working with Svati Shah and learning clinical genetics. Amanda is very honored to be elected as the chief fellow and is excited to work with all the fellows!

Please join us in congratulating and welcoming Amanda to this new role!

 

Shout-out to Friede!

The following message from Anna Lisa Crowley was shared with the fellows and faculty on Friday evening:

“As Amanda Coniglio transitions to her new role as chief cardiology fellow during May, I want to take an opportunity to give a big THANK YOU to Kevin Friede who has been spectacular this year during unprecedented challenges.  Kevin helped us implement new virtual lectures, end of year fellows’ banquet, recruitment, and a holiday talent show! In addition, Kevin was a clear and calm voice for the fellows. He helped us re-imagine the CICU fellow experience, arranged COVID and overnight coverage, and many other things I have not listed here.

He navigated all these new challenges while working in the lab, studying and passing the ever-shifting CV ABIM exam, and welcoming a new daughter, Celia, to his family.

We are fortunate that Kevin will stay on at Duke next year as an interventional fellow.

Please join me in thanking Kevin for his dedication to the fellowship! Attached is a photo of Kevin, his wife, Dr. Schell Bressler, and daughters Elizabeth and Celia, taken after Celia was born last fall.”

Well done, Kevin!

Kudos to Harrison, Hughes & Glower

Chad Hughes

 

In a note from Lisa Clark Pickett, Chief Medical Officer for Duke University Hospital, we learned of recent patient compliments for three of our faculty members. The compliments were submitted to Duke via recent Patient Satisfaction Surveys.

“I thank God for Dr. Glower— he saved my life. Everything about my stay was excellent. Everyone had my best interests at heart.” – Grateful patient, name withheld

“Excellent facility & hospital – best decision to use Duke.  Doctors were great and very thankful for them*.” – Grateful patient, name withheld (*Dr. Robert Harrison & *Dr. Chad Hughes)

Pickett added, “You and your team clearly made an impact on this person. Thank you for your dedication to excellence!”

Medicine Grand Rounds with Lefkowitz

For anyone who missed Bob Lefkowitz’s terrific presentation “A Tale of Two Callings” during last week’s Medicine Grand Rounds, you can view a recording of the event here: https://warpwire.duke.edu/w/tasFAA/.

 

Picture of the Week – Mike Sketch’s pen found in the Duke Cath lab

I was in the Duke Cath Lab on Friday and found this pen in the duke cath lab.  On inquiring, I learned it was Mike Sketch’s unicorn to-do list pen.  It’s a pretty cool pen and we have it kept for Mike in the lost and found.

Celebrating Our Nurses: Nominations Are Open!

In recognition of National Nurses Week (May 6-12) the Department of Medicine Well-Being Committee hosts “Celebrating Our Nurses.” From today until May 12, all members of the Department of Medicine can use this link to nominate nurses for their contributions and describe how they emulate the Duke Health values of Excellence, Integrity, Teamwork, Respect, and Innovation.

The Committee will communicate each nomination to the individual nurse and their manager, display nominations on a virtual bulletin board, and feature the campaign on the Department of Medicine Twitter feed. There is no limit to the number of nurses one person can nominate, and you can nominate a nurse from any location (i.e. clinic, inpatient, research).

This year more than any other, it is important to recognize the inspiring work done by our nursing colleagues and their important role in the care of our patients.

Registration Open for Friends of Nursing Gala, May 15

The Duke Friends of Nursing Board of Advisors cordially invites you to attend the 32nd Gala Celebration of Excellence! Hundreds of nurses, friends, supporters and community members attend the Gala each year to honor all Duke Nurses, and to recognize the nominees and winners of the Excellence Awards. While we can’t celebrate in-person this year, we are preparing for a very special virtual celebration. Join us for a virtual program celebrating our spirit of innovation, unwavering compassion, clinical excellence, and significant impact across Duke Health. We hope you will attend. There is no fee for this event. To learn more or to register, please visit: https://www.dukefriendsofnursing.org.

 

COVID-19 Updates:

All the latest official DUHS information regarding coronavirus/COVID-19 response at the following locations:

 

Upcoming Opportunities/Save the Date:

Virtual Town Hall

Do you have questions regarding the new clinical practice model that is being formed by the PDC, SOM, and DUHS? Join us for a virtual town hall for all members of the Duke Health community on May 3, from 5 to 6 p.m. Leaders will answer your questions about the planning process for this new clinical practice model. Panelists will include Ted Pappas, Tom Owens, and John Sampson who will share their perspectives on why change is needed now and their expectations for the path forward.

Monday, May 3rd from 5 to 6 p.m. Join the Zoom here

The Zoom link is one-click entry, however if prompted to enter a passcode it is 505478. Access to the webinar series requires authenticated access with your NetID and password. If prompted to sign in, please select to ‘Sign in with SSO’ and enter ‘duke’ when prompted for the company domain. You will be directed to log in with your NetID and password.

Add to Calendar

Submit questions in advance to DukeFP@duke.edu. A recording of the town hall will be posted on the website the next day.

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.

 

Duke Heart in the News:

April 22 – Rob Califf

Club Industry

COVID-19 Patients Could Develop Chronic Health Conditions, Causing Possible Onslaught For U.S.

https://bit.ly/3gP52i5

April 27 — Duke University Hospital

WRAL

Colorful mural captures contributions of health care heroes at Duke Hospital

https://bit.ly/3vrpEkh

April 27 — Yuichiro Yano (Family Medicine)

Medpage Today

USPSTF Prioritizes Office Measurements in Hypertension Screening

https://bit.ly/3sZjMNB

April 30 — Duke Hospitals are mentioned

News & Observer

Which Triangle hospitals are the safest? Watchdog group releases latest report cards

https://bit.ly/3gQ1c86

April 30 — W. Schuyler Jones

Healio/Endocrinology

Predictive model identifies risk factors for major adverse limb events in diabetes

https://bit.ly/3xBicF3

Duke Heart Week Ending April 25th 2021

Chief’s message: Spring Days

Spring days long days of sunlight are good for all of us.  It is notable in North Carolina that there is a yellow covering on all things – the season of pollen.  This week was notable for some more important announcements around change (see the announcement below around Dr. Fulkerson), continued teamwork by groups of faculty, fellows and staff in caring for our patients (see the photo from cath lab on Friday), and continue involvement in changing how we care for patients (ISHLT meeting 2021- lead by Joe Rogers).  We are blessed to at any given time at Duke Heart to be surrounded by great colleagues, partners, fellows, and staff, many of whom are shaping the field of cardiovascular medicine.   As we move through the ongoing change in healthcare, we will have trust and lean into working with each other to shape our future.  As I have often said, the people we get to work with make Duke Heart special.

Updates from the week:

Dr. Wiliam Fulkerson to Step Down from EVP of Duke Health December 21st  2021

Dr. Bill Fulkerson announced this week that he will be stepping down as the Executive Vice President of Duke Health system at the end of this year.  He noted that he will be continuing to support the health system, but wanted the next person who will be shaping our future to engage in this time of transition.

Dr. Eugene Washington provide the following statement around the tremendous impact Dr. Fulkerson has had on Duke Health.

“Dr. Fulkerson’s transition as EVP will be a great loss for Duke, but we will benefit from the fruits of his superb leadership for many years to come. When Dr. Fulkerson became the second EVP of the health system back in July 2010, he was already a seasoned leader, as well as an accomplished academician. He had served as Senior Vice President of Clinical Affairs for DUHS, CEO of Duke University Hospital, Vice President of DUHS, Chief Medical Officer for both DUHS and the Private Diagnostic Clinic (PDC), and Professor of Medicine in the Duke University School of Medicine. Throughout his leadership trajectory, Dr. Fulkerson has amassed a reputation of being an outstanding physician and administrator of integrity who cares deeply, is an award-winning teacher, has a passion for excellence, and is truly committed to championing DUHS to be the best in the industry.

As EVP over the past decade-plus, he has amply demonstrated his exceptional dedication and abilities as an executive administrator, a creator of innovative programs, a builder of state-of-the-art facilities, a respected colleague and mentor, and a collaborative broker of strategic partnerships across Duke Health, Duke University, Durham and beyond.

Dr. Fulkerson’s career has not only had a substantial positive impact on Duke, but also has improved hundreds of thousands of lives, in part due to the tremendous growth that DUHS has experienced under his leadership. Today, we are 24,000 people strong compared to approximately 15,000 when he started as EVP. Scores of individuals in DUHS have been recruited and have thrived under his tutelage. Our reach in touching lives has extended locally, regionally and nationally. The number of patients we cared for across Duke Health increased nearly 50% – from approximately 550,000 in 2010 to nearly 820,000 last year. Groundbreaking multidisciplinary, multisector programs and ventures have advanced and excelled with Dr. Fulkerson at the helm of DUHS. Our DUHS and broader Duke Health Clinical Enterprise footprint and facilities have also expanded impressively with Dr. Fulkerson as a driving force.

During this period of unprecedented growth, we continued to lead in the delivery of highest-quality, patient-centered care, deservedly receiving multiple professional accolades to affirm our high standards. DUHS’ financial performance has been stellar during Dr. Fulkerson’s EVP tenure, with revenue increasing 85% – from $2.1 billion in 2010 to $3.9 billion in 2020 and an average operating margin of approximately 8%. Importantly, DUHS’ success over this period has enabled $1.5 billion in support for our academic missions, principally the Duke University School of Medicine.”

We look forward to continuing to partner with Dr. Fulkerson and work with the Health system as we engage in our future state to discover deliver health to our community.

 

Shout-Out to Samsky

Together with Aimee Zaas, the Program Director of the Duke IM residency, and Sunil Rao, we want to give a HUGE thank you to Marc Samsky who covered the VA Cardiology Consult service for multiple days last week when a significant number of residents were out sick with food poisoning.

Thank you Marc!! – Anna Lisa Crowley

Nicely done, Marc!

 

Kudos to Loungani

We’re pleased to share the following note received last week by Anna Lisa Crowley – more great teamwork shown by cardiology fellow Rahul Loungani!

My housestaff and I responded to a nursing call that our patient had SVT. Rahul was walking by and saw the tachycardia and our interventions and stepped in to help. Over the next 1.5 hours, he hung out with us at bedside as we managed (the patient’s) arrhythmias. Ultimately he also helped us arrange transfer to the CCU. We were all at bedside until close to 8 pm.

“I really appreciate the way he saw an opportunity to help colleagues and a patient and jumped in, even if it wasn’t his responsibility. These little acts of kindness and professionalism always fill me with happiness.

“FYI- the patient did great and is coming back out of the CCU, so the story also has a good ending.” — Joanna Kipnes, MD

Great job, Rahul!

 

Esther Kim CGR SCAD Presentation

Cardiology Grand Rounds this past week was presented by Duke alumnae Dr. Esther Kim, who is Associate Professor of Medicine and Medical Director of the Vascular Labs at Vanderbilt University Medical Center. She is an expert in vascular medicine and her wonderful presentation focused on spontaneous coronary artery dissection (SCAD), with particular attention to the recognition and treatment of SCAD events, as well as the links between SCAD and other systemic diseases like fibromuscular dysplasia. To see the recorded presentation of her CGR presentation, please visit: https://bit.ly/2QRDQ73.  Shown here is a screenshot of her take-home points.

Photo of the Week

A rare together at-work sighting of the Hernandez family! Photo of Adrian Hernandez and Tracy DeWald courtesy of Jon Piccini.

Triangle Go Red Luncheon – Registration Open

The American Heart Association’s 2021 Triangle Go Red for Women Luncheon digital celebration will be held on May 14th from 11:30 a.m. – 1 p.m. Join us as we celebrate the impact of Go Red for Women in the Triangle, learn tips to structure self-care into your day, participate in a series of health and wellness breakout sessions, and hear from inspiring survivors who are “Living Fierce” and not letting cardiovascular disease stand in their way. Registration is free and open to all. If interested, please visit https://events.bizzabo.com/301164.

 

COVID-19 Updates:

All the latest official DUHS information regarding coronavirus/COVID-19 response at the following locations:

Upcoming Opportunities/Save the Date:

Cardiology Grand Rounds

April 27: Cardio-Oncology: Moving Forward in 2021 with Daniel J. Lenihan, Director, Cardio-Oncology Center of Excellence, Washington University in St. Louis. 5 p.m., Webex.

April 29: A Special celebration of Joe Rogers with Duke faculty, alumni & friends. 5 p.m., Zoom.

 

Upcoming (Virtual) 2021 Duke Heart CME

We have dates set for two upcoming virtual symposia; registration is not yet available.

October 8: Duke Advanced Heart Failure Symposium. Course director is Richa Agarwal

November 5:  13th Annual NC Research Triangle Pulmonary Hypertension Symposium. Course directors are Terry Fortin and Jimmy Ford (UNC).

 

Final Mental Health Webinar in Series

Apr. 27: Mental Health in Children of Color. Noon-12:30 p.m. Led by Erikka Dzirasa, MD, MPH, consulting associate in Psychiatry & Behavioral Sciences (Link below).

This is the final webinar of a six-part series, “Taking Care of Yourself and Your Loved Ones,” for all Duke University and Duke Health community members and their families. The 30-minute topical webinars provide practical expert advice on topics including emotional wellness, substance misuse, suicide prevention, and mental health for children, adolescents and teens.

The webinar series runs through April 27. Learn more, watch past webinars and join upcoming webinars:  http://bit.ly/DukeMHSeries.

 

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.

 

Duke Heart in the News:

April 13 — Harry Severance

Chattanoogatrend.com

The COVID-19 Vaccine and Reopening the World: What might it look like?

https://bit.ly/3tJE8f4

April 15 — TransPop, MURDOCK Study mentioned

WBTV.com (Charlotte, NC)

Duke CTSI launches kidney disease study in Kannapolis for people with African ancestry

https://bit.ly/3xj2qi0

April 20 — William Kraus

EatThis.com

Genius Little Ways You Can Move More Every Single Day

https://www.eatthis.com/exercise-more-every-day/

May 2021 issue — John Alexander

Scientific American

COVID Has Pushed Medical Research into Remote Trials, Benefiting Patients and Scientists

https://bit.ly/3sIINfK

Division of Cardiology Publications Indexed in PubMed April 15-21, 2021

Birati EY, Najjar SS, Tedford RJ, Houston BA, Shore S, Vorovich E, Atluri P, Urgo K, Molina M, Chambers S, Escobar N, Hsich E, Estep JD, Alexander KM, Teuteberg JJ, Chaudhry SP, Ravichandran A, DeVore AD, Margulies KB, Hanff TC, Zimmer R, Kilic A, Wald JW. Characteristics and Outcomes of COVID-19 in Patients on Left Ventricular Assist Device Support. Circ Heart Fail 2021;14:e007957. PM: 33813838.

Blumer V, Mentz RJ, Sun JL, Butler J, Metra M, Voors AA, Hernandez AF, O’Connor CM, Greene SJ. Prognostic Role of Prior Heart Failure Hospitalization Among Patients Hospitalized for Worsening Chronic Heart Failure. Circ Heart Fail 2021;14:e007871. PM: 33775110.

Desai NR, Sciria CT, Zhao X, Piccini JP, Turakhia MP, Matsouaka R, Fonarow GC, Lewis WR. Patterns of Care for Atrial Fibrillation Before, During, and at Discharge From Hospitalization: From the Get With The Guidelines-Atrial Fibrillation Registry. Circ Arrhythm Electrophysiol 2021;14:e009003. PM: 33724875.

Giarraputo J, Giamberardino S, Arvai S, Maichle S, Eckstein C, Newby LK, Gregory S. Profiling serum neurofilament light chain and glial fibrillary acidic protein in primary progressive multiple sclerosis. J Neuroimmunol 2021;354:577541. PM: 33725477.

Julien HM, Stebbins A, Vemulapalli S, Nathan AS, Eneanya ND, Groeneveld P, Fiorilli PN, Herrmann HC, Szeto WY, Desai ND, Anwaruddin S, Vora A, Shah B, Ng VG, Kumbhani DJ, Giri J. Incidence, Predictors, and Outcomes of Acute Kidney Injury in Patients Undergoing Transcatheter Aortic Valve Replacement: Insights From the Society of Thoracic Surgeons/American College of Cardiology National Cardiovascular Data Registry-Transcatheter Valve Therapy Registry. Circ Cardiovasc Interv 2021;14:e010032. PM: 33877860.

Kansal A, Green CL, Peterson ED, Newby LK, Wang TY, Sendak M, Balu S, Patel MR, Fanaroff AC. Electronic Health Record Integration of Predictive Analytics to Select High-Risk Stable Patients With Non-ST-Segment-Elevation Myocardial Infarction for Intensive Care Unit Admission. Circ Cardiovasc Qual Outcomes 2021;14:e007602. PM: 33757310.

Khan MS, Sreenivasan J, Lateef N, Abougergi MS, Greene SJ, Ahmad T, Anker SD, Fonarow GC, Butler J. Trends in 30- and 90-Day Readmission Rates for Heart Failure. Circ Heart Fail 2021;14:e008335. PM: 33866827.

Lee CL, Lee JW, Daniel AR, Holbrook M, Hasapis S, Wright AO, Brownstein J, Da Silva Campos L, Ma Y, Mao L, Abraham D, Badea CT, Kirsch DG. Characterization of cardiovascular injury in mice following partial-heart irradiation with clinically relevant dose and fractionation. Radiother Oncol 2021;157:155-162. PM: 33545252.

Lekavich CL, Allen JD, Bensimhon DR, Bateman LA, Slentz CA, Samsa GP, Kenjale AA, Duscha BD, Douglas PS, Kraus WE. Aerobic Versus Resistance Training Effects on Ventricular-Arterial Coupling and Vascular Function in the STRRIDE-AT/RT Trial. Front Cardiovasc Med 2021;8:638929. PM: 33869303.

Nguyen AH, Lefkowitz RJ. Signaling at the endosome: cryo-EM structure of a GPCR-G protein-beta-arrestin megacomplex. FEBS J 2021;288:2562-2569. PM: 33605032.

Sawant AC, Rizik DG, Rao SV, Pershad A. Algorithms for challenging scenarios encountered in transradial intervention. Indian Heart J 2021;73:149-155. PM: 33865510.

Shah AH, Puri R, Krasuski RA. Transcatheter Closure of Patent Foramen Ovale: Not Always an “Open or Shut” Case. Circulation 2021;143:1539-1541. PM: 33872078.

Sherwood MW, Gupta A, Vemulapalli S, Li Z, Piccini J, Harrison JK, Dai D, Vora AN, Mack MJ, Holmes DR, Rumsfeld JS, Cohen DJ, Thourani VH, Kirtane AJ, Peterson ED. Variation in Antithrombotic Therapy and Clinical Outcomes in Patients With Preexisting Atrial Fibrillation Undergoing Transcatheter Aortic Valve Replacement: Insights From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve. Circ Cardiovasc Interv 2021;14:e009963. PM: 33877866.

Varma N, Cygankiewicz I, Turakhia M, Heidbuchel H, Hu Y, Chen LY, Couderc JP, Cronin EM, Estep JD, Grieten L, Lane DA, Mehra R, Page A, Passman R, Piccini J, Piotrowicz E, Piotrowicz R, Platonov PG, Ribeiro AL, Rich RE, Russo AM, Slotwiner D, Steinberg JS. 2021 ISHNE/HRS/EHRA/APHRS collaborative statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals: From the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm. J Arrhythm 2021;37:271-319. PM: 33850572.

Updates – Duke Heart Week Ending April 18th 2021

Chief’s message: Global Health

This past year, more than most years over the last quarter century has made all of the public and those of us in medicine look carefully at our relationship with global health and health care, and specifically at how we deliver care and train the next generation.  With this background, we were blessed to have one of our former Duke Cardiology Faculty, Zainab Samad, now the Chair of Medicine at Aga Khan University in Pakistan, virtually give our cardiology grand rounds this week as our visiting Global Health Lecture.  Gerry Bloomfield has led the Duke Cardiovascular Global Health group partnering on work with Zainab and also colleagues at Moi Teaching and Referral Hospital in Kenya with bilateral educational exchanges with Duke and Kenyan Faculty and Students.  Zainab’s grand rounds was notable for her own journey from Pakistan to Duke for residency, fellowship, and early faculty life, and now returning to lead the Department of Medicine at Aga Khan.  Additionally, she highlighted measuring the clinical outcomes, building programs, and most notably developing specific pathways to reduce health inequities for women in Pakistan and worldwide.  This included the work she and others have instituted around training, where now over 50% of the medical students are women.  In addition to the inspiring talk and work, it was wonderful to see a colleague and friend working to make the world a healthier and more equitable place.

Highlights of the week:

Thomas to Receive Excellence in Professionalism Award

Kevin Thomas

Congratulations to Kevin Thomas, MD, Associate Dean for Underrepresented Faculty Development at Duke and associate professor of medicine in the Division of Cardiology, who has been selected as the 2021 recipient of the Duke School of Medicine’s Excellence in Professionalism Award. The award recognizes a faculty member who exemplifies professionalism and personifies Duke’s guiding principles of respect, trustworthiness, diversity, teamwork and learning.

“I am incredibly honored to receive this award,” said Thomas.

The Excellence in Professionalism award is normally given during the Spring Faculty Celebration, but due to the continuing pandemic, an alternate virtual event is being planned. Since we’re unsure of when that will take place, we thought we’d share some of the comments made by colleagues in support of his nomination.

One faculty member shared, “Kevin is one of Duke’s most stalwart champions of professional equity and fairness. Work on the anti-racism committee is often emotional and requires faculty members to bring a certain amount of vulnerability ‘to the table’ in order to advance a meaningful dialogue. Kevin is tremendously adept at helping individuals share this vulnerability while creating a safe professional space for the intellectual and emotional growth that anti-racism work requires.”

Another wrote, “He leads with integrity, compassion, empathy and a palpable respect for both dismantling racism and for those with whom he labors to do so. As a respected leader, I have confided in Dr. Thomas on countless occasions over the years. His private words and actions mirror those made in public; a testament to his consistent character and a model of professionalism for the faculty at large.”

Yet another added, “In these difficult times, it has never been more important to have colleagues who embody principles of compassion, grace, and professionalism. The struggle to redefine our approach to systemic racism will particularly require engagement of faculty members with deep knowledge and commitment coupled with the ability to engage in hard conversations in a respectful manner. Kevin Thomas has all of these attributes. Moreover, at this moment where addressing racial inequality effectively is paramount for the survival of our university, I believe that Kevin is among a very small set of the most important and impactful faculty members that we have. He is richly deserving of this award, and he has my deepest support.”

Kevin, your contributions to Duke are seen, valued and deeply appreciated and will undoubtedly have a transformative and lasting impact at Duke. We congratulate you on this well-deserved recognition!

School of Medicine Awards Duke Cardiology Winners 2021:
Kevin Thomas, MD – Excellence in Professionalism

Rob Mentz, MD – Early Career Mentoring Award in Clinical – Population Science

Terry Fortin, MD – Master Clinician Award

Brock Elected Associate of the ACC

Gail Brock

Gail Brock, one of our wonderful nurse practitioners, has been elected to Associate of the American College of Cardiology. She will take the official oath during the Convocation ceremony at the 70th Annual ACC Scientific Sessions taking place May 15-17. The Sessions will be held virtually this year due to the ongoing pandemic.

Her nominators, Kristen Bova Campbell and Rebecca Yapejian, noted that they are pleased to see Gail receive the professional validation she deserves for her contributions to cardiology and electrophysiology. We agree! Gail, we are very happy for you – congratulations!

 

 

Butler Honored During TBJ Virtual Celebration

Kiersten Butler was honored on Thursday, April 15 during the Triangle Business Journal‘s virtual 2021 Health Care Heroes Award Ceremony. Butler is a nurse on the 7E/Cardiac Intensive Care Unit. We are so proud of you, Kiersten! Congratulations.

NC Walk for Victory Held

The North Carolina Walk for Victory to support families of Marfan patients was held yesterday at Laurel Hills Park in Raleigh. Duke Heart and the Duke Center for Aortic Disease served as the presenting sponsor with Dr. G. Chad Hughes as the medical chair for the walk. We had a great time cheering on and supporting the families who attended – from those with Marfan syndrome to those with Loeys-Dietz (LDS), Vascular Ehlers-Danlos (VEDS), and related conditions.

Thanks to all who helped support this event!

Triangle Go Red Luncheon – Registration Open

The American Heart Association’s 2021 Triangle Go Red for Women Luncheon digital celebration will be held on May 14th from 11:30 a.m. – 1 p.m. Join us as we celebrate the impact of Go Red for Women in the Triangle, learn tips to structure self-care into your day, participate in a series of health and wellness breakout sessions, and hear from inspiring survivors who are “Living Fierce” and not letting cardiovascular disease stand in their way. Registration is free and open to all. If interested, please visit https://events.bizzabo.com/301164.

 

COVID-19 Updates:

All the latest official DUHS information regarding coronavirus/COVID-19 response at the following locations:

 

Upcoming Opportunities/Save the Date:

Cardiology Grand Rounds

April 20: Spontaneous Coronary Artery Dissection with Esther (Soo Hyun) Kim of Vanderbilt University Medical Center. 5 p.m., Webex.

April 23: A Tale of Two Callings with Robert J. Lefkowitz. Noon, Zoom. All Medicine Grand Rounds attendees will have the chance to win a signed copy of Dr. Lefkowitz’s book, “A Funny Thing Happened on the Way to Stockholm.”

April 27: Cardio-Oncology: Moving Forward in 2021 with Daniel J. Lenihan, Director, Cardio-Oncology Center of Excellence, Washington University in St. Louis. 5 p.m., Webex.

April 29: A celebration of Joe Rogers with Duke faculty, alumni & friends. 5 p.m., TBD.

 

Upcoming (Virtual) 2021 Duke Heart CME

We have dates set for two upcoming virtual symposia; registration is not yet available.

October 8: Duke Advanced Heart Failure Symposium. Course director is Richa Agarwal

November 5:  13th Annual NC Research Triangle Pulmonary Hypertension Symposium. Course directors are Terry Fortin and Jimmy Ford (UNC).

 

Final Mental Health Webinar in Series

Apr. 27: Mental Health in Children of Color. Noon-12:30 p.m. Led by Erikka Dzirasa, MD, MPH, consulting associate in Psychiatry & Behavioral Sciences (Link below).

This is the final webinar of a six-part series, “Taking Care of Yourself and Your Loved Ones,” for all Duke University and Duke Health community members and their families. The 30-minute topical webinars provide practical expert advice on topics including emotional wellness, substance misuse, suicide prevention, and mental health for children, adolescents and teens.

The webinar series runs through April 27. Learn more, watch past webinars and join upcoming webinars:  http://bit.ly/DukeMHSeries.

 

AGS/NIA Conference on Cancer & CV Disease – Application Available

The American Geriatrics Society has announced that “Cancer and Cardiovascular Disease”– the third in a three-part series of U13 Bench-to-Bedside Conferences — will be held at the Heart House – American College of Cardiology in Washington, DC on Monday, October 18 and Tuesday, October 19, 2021. A preliminary agenda for the conference can be accessed HERE.

The conference, sponsored by the National Institute on Aging (NIA) and the American Geriatrics Society (AGS), will provide attendees the opportunity to learn about cutting edge research developments, participate in the creation of recommendations for future research, and network with colleagues and leaders in the field. Learn more here.

The application for the conference is now available; applications are due by MONDAY, JUNE 14, 2021 and applicants will be notified if they are invited to participate by the end of July. Please review the following eligibility criteria before applying.

Applicants must meet the following criteria:

  1. At least 1-2 years of research experience in a related field.
  2. Hold an MD, PhD, PharmD or equivalent degree (e.g., DO, OD, DPT, DDS, Psy.D).
  3. Have an academic appointment as a research fellow, instructor or faculty member.

If you are interested in participating or learning more about the conference please contact Elisha Medina-Gallagher, AGS Manager for Special Projects, egallagher@americangeriatrics.org or 212-308-1414.

 

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.

Duke Heart in the News:

April 7 — Sunil Rao

tctMD

Radial Superior to Femoral Access in Patients With Prior CABG

https://bit.ly/3wTTDmt

April 9 — Theresa Bayless; heart patient wedding

The New York Times

A Final Celebration of Their Life Together

April 9 — Nishant Shah

Cardiology Advisor

Managing the Interplay of Familial Hypercholesterolemia and COVID-19

https://bit.ly/3uQNBRY

April 12 — Mollie Kettle and Kelly Kester

Healthcare NOW Radio (podcast)

iPad workarounds for COVID visitation restrictions

https://bit.ly/32jAb4o

April 13 — Cary Ward

Spectrum News

Pregnancy Complications & Heart Disease

https://bit.ly/3wW2wvM

Division of Cardiology Publications Indexed in PubMed April 8-14, 2021

Carnicelli AP, Al-Khatib SM, Xavier D, Dalgaard F, Merrill PD, Wojdyla DM, Lewis BS, Hanna M, Alexander JH, Lopes RD, Wallentin L, Granger CB. Premature permanent discontinuation of apixaban or warfarin in patients with atrial fibrillation. Heart 2021;107:713-720. PM: 32938772.

Gargiulo G, Cannon CP, Gibson CM, Goette A, Lopes RD, Oldgren J, Korjian S, Windecker S, Esposito G, Vranckx P, Valgimigli M. Safety and efficacy of double vs. triple antithrombotic therapy in patients with atrial fibrillation with or without acute coronary syndrome undergoing percutaneous coronary intervention: a collaborative meta-analysis of non-vitamin K antagonist oral anticoagulants. Eur Heart J Cardiovasc Pharmacother 2021;7:f50-f60. PM: 33119069.

Gaudino M, Di Franco A, Bhatt DL, Alexander JH, Abbate A, Azzalini L, Sandner S, Sharma G, Rao SV, Crea F, Fremes SE, Bangalore S. The association between coronary graft patency and clinical status in patients with coronary artery disease. Eur Heart J 2021;42:1433-1441. PM:33709098.

Kochav JD, Kim J, Judd R, Kim HW, Klem I, Heitner J, Shah D, Shenoy C, Farzaneh-Far A, Polsani V, Kalil R, Villar-Calle P, Nambiar L, Sultana R, Parker M, Cargile P, Khalique OK, Leon MB, Karmpaliotis D, Ratcliffe M, Levine R, Zoghbi WA, Devereux RB, et al. Ischemia-Mediated Dysfunction in Subpapillary Myocardium as a Marker of Functional Mitral Regurgitation. JACC Cardiovasc Imaging 2021;14:826-839. PM: 33744130.

Malik J, Loring Z, Piccini JP, Wu HT. Interpretable morphological features for efficient single-lead automatic ventricular ectopy detection. J Electrocardiol 2021;65:55-63. PM: 33516949.

Povysil G, Chazara O, Carss KJ, Deevi SVV, Wang Q, Armisen J, Paul DS, Granger CB, Kjekshus J, Aggarwal V, Haefliger C, Goldstein DB. Assessing the Role of Rare Genetic Variation in Patients With Heart Failure. JAMA Cardiol 2021;6:379-386. PM: 33326012.

Sullivan K, Doumouras BS, Santema BT, Walsh MN, Douglas PS, Voors AA, Van Spall HGC. Sex-Specific Differences in Heart Failure: Pathophysiology, Risk Factors, Management, and Outcomes. Can J Cardiol 2021;37(4):560-571. PM: 33383166.

Urban P, Gregson J, Owen R, Mehran R, Windecker S, Valgimigli M, Varenne O, Krucoff M, Saito S, Baber U, Chevalier B, Capodanno D, Morice MC, Pocock S. Assessing the Risks of Bleeding vs Thrombotic Events in Patients at High Bleeding Risk After Coronary Stent Implantation: The ARC-High Bleeding Risk Trade-off Model. JAMA Cardiol. 2021;6:410-419. PM: 33404627.

Weissler EH, Aboyans V, Bauersachs R, Brodmann M, Nikol S, Debus S, Patel MR, Jones WS. The Role for Combined Antithrombotic Therapy With Platelet and Coagulation Inhibition After Lower Extremity Revascularization. JACC Cardiovasc Interv 2021;14:796-802. PM: 33826501.

 

The Pulse: Duke Heart Week Ending April 11th 2021

Chief’s message: Good Outcomes

Like most health systems, we have discussed at great length both in our clinics and hospital rounds what are desired clinical outcomes.  Focused on delivering patient centered care that leads to improved patient health and experiences is not a new consideration, and in fact in the era of big data, public reporting, and registries there is importantly more transparency on the care we provide.  I believe a remaining large hurdle in providing more patient centered care and reducing health inequity is the science around shared decision making and understanding patient preferences.  Despite tremendous work in some parts of cardiovascular medicine, the art of medicine is still critical to shared decision making in which understandable best available information on medical care is provided to the patient, and the patient provides back their preferences based their values informed by their cultural, social, and religious beliefs. Although this construct sounds straight forward, the actual practice is often complicated with wonderful and knowledgeable patients asking what we would recommend if they were our family member.  It is with this background, that many were struck by the story in the New York Times this weekend  https://nyti.ms/3uUoBcD  of Jeffrey Benesch, a person with advanced congestive heart failure, who got married while receiving palliative care at Duke Hospital.  The story highlights the couple’s relationship and wishes, and is a testament to the Duke Staff and teams that cared for him.  As with many Heart Centers we focus on our mortality rates, the number of patients that get transplants, left ventricular support devices, and the critical care and teams-based CV procedures for our advanced heart patients.  However, in the coming years we will also continue to work to measure the  ‘good outcomes’ that our patients and their families want by investing in the ways in which we can better capture their preferences, values, and decisions on the care we provide.

Highlights of the week:

Mentz to Receive SOM Research Mentoring Award

Robert Mentz

Congratulations to Robert Mentz, MD, chief of the Heart Failure Section in the Division of Cardiology, who has been selected as the 2021 recipient of the School of Medicine’s Early Career Mentoring Award in Clinical/Population Health Science. The Research Mentoring Awards honor outstanding research mentors in the Duke SOM. Winners of the award demonstrate excellence in numerous aspects of mentoring, including accomplishments of individual mentees, programs implemented by the mentor, or by exceptional creativity in mentoring.

The award was announced by Dr. Ann Brown, Vice Dean for Faculty, who shared the news in an email to Mentz, Dr. Kathleen Cooney, Chair of the Department of Medicine, and Dr. Mary Klotman, Dean of the SOM. The award is typically given during the Spring Faculty Celebration, but due to the continuing pandemic, an alternate virtual celebration is being planned.

“I am very honored by this recognition,” said Mentz. “I appreciate the nomination and support I’ve received from the division.”

Congratulations, Rob, this is well deserved!

Greene Selected for DOM Chair’s Award

We are pleased to share that the review committee for the Department of Medicine Chair’s Awards has selected

Stephen Greene

Stephen Greene’s research proposal, “Use and Effectiveness of Outpatient Intravenous Diuretics for Worsening Heart Failure” for funding. The Chair’s Award is a one-year award for $95,000 and will begin on July 1, 2021. Dr. Kathleen Cooney, Chair of the Department of Medicine and the George Barth Geller Distinguished Professor of Medicine, formally announced the award in a letter to Greene earlier this week.

“I’m very honored to receive this award and truly appreciate the Department’s support,” said Stephen Green, MD, assistant professor in the division of cardiology. “I look forward to a productive and rewarding year.”

Congratulations, Steve!

 

Granger & SON Study Team Receive Alpha Phi Foundation Award

Congratulations to Bradi Granger and the Duke School of Nursing study team who were selected as the recipient of the Alpha Phi Foundation Heart to Heart award for their proposal, “Improving the Visibility of Women: Patients as Partners in Management of Uncontrolled Hypertension.”

The research project, led by Dr. Bradi Granger and Dr. Holly Biola, in conjunction with Awanya Caesar, RN at Lincoln Community Health Center, will use a community-based intervention that will identify and reduce disparities and inequities among women with high blood pressure, resulting in an increase in the proportion of women with hypertension under control.

“Community-based interventions using peer partners and existing social-cultural infrastructure, such as barbershops, have been effective for reducing blood pressure in [Black] men,” says Granger. According to the principal investigators, 43 percent of all women in the United States are affected by uncontrolled blood pressure, which is a significant contributor to heart attack, heart failure, stroke, and death. Duke University School of Nursing seeks to tailor a similar intervention to women, especially Black women who make up 42.9 percent of the affected population.

Hypertension disproportionately affects women of differing racial and socioeconomic backgrounds, and proper support in health education is essential to preventing further cardiovascular disease. Looking closely at disparate populations in the Raleigh-Durham area, specifically among women of color, the team at Duke is focusing on teaching local women how to integrate heart-healthy care into their everyday activities through their peers.

Granger, Biola, and Caesar will be training “Hypertension Heroes,” a group of volunteers who will serve as community health workers aiding in patients’ hypertension treatment and maintenance. Volunteers will be paired with members of their local communities who need assistance in maintaining healthy blood pressure. Using skills-based training with blood pressure cuffs, physician-prescribed medications, and other interventions, these women will help one another gain control over their health.

Awarded annually, the Heart to Heart Grant of $100,000 funds research and educational programs that support the advancement of women’s heart health and cardiac care.

Congratulations, Bradi and team!

Bradi and Team have also been invaluable partners in our AHA Life is Why campaign in which Duke Heart has partnered with community members to raise awareness and measure Blood Pressure across our community.

 

Heart Bedflow Update

As you know, Paul Clausing retired officially on March 31, 2021.  We wanted everyone to know that his duties have a seamless transition to a core group of charge nurses in 7E CICU who covered for Paul in the past. The day shift CICU bedflow CN is ONLY covering bedflow and does not have any additional responsibilities. To ensure a smooth transition to the night shift CICU CN, the day shift bedflow coverage has expanded to 7 p.m. There have been NO changes to any processes or job duties; all duties have transitioned to the CICU bedflow CN. The pager and phone number remain the same:

  • Mobile: 919-812-6340
  • Pager: 919-970-2508

If you have any delays in response, please notify Kelly Kester, COD, at 919-812-0331 or Pager 919-970-6517. You can also escalate to Mary Lindsay, pager 919-970-6575 or Jill Engel at 919-407-9753.

 

Marfan NC Walk for Victory, April 17

The North Carolina Walk for Victory to support families of Marfan patients is coming up next weekend. The event will be held from Noon to 3 p.m. at Laurel Hills Park on Edwards Mill Road in Raleigh on Saturday, April 17. Duke Heart is the presenting sponsor and Dr. G. Chad Hughes is the medical chair.

Help us support all Marfan families as well as those with Loeys-Dietz (LDS), Vascular Ehlers-Danlos (VEDS), and related conditions. We’d like to also show our full support for the Howell family of Greensboro, who are serving as the community chairs of the event.

Walk for Victory is The Marfan Foundation global walk program. The event is non-athletic and family oriented to focus on fun! To learn more about The Marfan Foundation, please visit marfan.org.

To register for our event, please visit: https://give.marfan.org/event/2021-north-carolina-walk-for-victory/e303480

DukeHeart On The Go: Latest PAD/CAD CME Modules Now Available

The fourth and final program in our CAD/PAD educational series has launched on the DukeHeart On The Go and MedEd On The Go educational platforms. Take a look and learn: Improving Clinical Outcomes in Patients with CAD/PAD – A Case-based Review on Discharge Planning, Compliance and Adherence in the Ambulatory Patient. The CME/CNE certified program, developed in collaboration with the Society for Vascular Medicine and Society for Vascular Surgery, aggregates up-to-the-minute perspectives on important milestones in PAD/CAD patient care.

Please share widely. The courses are available for free.

AGS/NIA Conference on Cancer & CV Disease – Application Available

The American Geriatrics Society has announced that “Cancer and Cardiovascular Disease”– the third in a three-part series of U13 Bench-to-Bedside Conferences — will be held at the Heart House – American College of Cardiology in Washington, DC on Monday, October 18 and Tuesday, October 19, 2021. A preliminary agenda for the conference can be accessed HERE.

The conference, sponsored by the National Institute on Aging (NIA) and the American Geriatrics Society (AGS), will provide attendees the opportunity to learn about cutting edge research developments, participate in the creation of recommendations for future research, and network with colleagues and leaders in the field. Learn more here.

The application for the conference is now available; applications are due by MONDAY, JUNE 14, 2021 and applicants will be notified if they are invited to participate by the end of July. Please review the following eligibility criteria before applying.

Applicants must meet the following criteria:

  1. At least 1-2 years of research experience in a related field.
  2. Hold an MD, PhD, PharmD or equivalent degree (e.g., DO, OD, DPT, DDS, Psy.D).
  3. Have an academic appointment as a research fellow, instructor or faculty member.

If you are interested in participating or learning more about the conference please contact Elisha Medina-Gallagher, AGS Manager for Special Projects at egallagher@americangeriatrics.org or 212-308-1414.

 

COVID-19 Updates:

All the latest official DUHS information regarding coronavirus/COVID-19 response at the following locations:

 

Upcoming Opportunities/Save the Date:

Cardiology Grand Rounds

April 13: Advancing Gender Equity in Global Cardiovascular Health Outcomes with Zainab Samad of Aga Khan University. 7:15 a.m., Webex.

April 20: Spontaneous Coronary Artery Dissection with Esther (Soo Hyun) Kim of Vanderbilt University Medical Center. 5 p.m., Webex.

April 23: A Tale of Two Callings with Robert J. Lefkowitz. Noon, Zoom.

April 27: Cardio-Oncology: Moving Forward in 2021 with Daniel J. Lenihan, Director, Cardio-Oncology Center of Excellence, Washington University in St. Louis. 5 p.m., Webex.

April 29: A celebration of Joe Rogers with Duke faculty, alumni & friends. 5 p.m., TBD.

 

Upcoming (Virtual) 2021 Duke Heart CME

We have dates set for three upcoming virtual symposia; registration is not yet available.

May 14: Duke Sports Cardiology & Sudden Death in Athletes Symposium*. Course directors are Jim Daubert and Bill Kraus. (*PUSHED TO 2022)

October 8: Duke Advanced Heart Failure Symposium. Course director is Richa Agarwal

November 5:  13th Annual NC Research Triangle Pulmonary Hypertension Symposium. Course directors are Terry Fortin and Jimmy Ford (UNC).

 

Six-Part Mental Health Webinar Series Available Through April

Apr. 14: Understanding and Preventing Youth Suicide. 4-4:30 p.m. Led by assistant professor Angela Tunno, PhD, MS (Link below).

This is the fifth in a six-part webinar series, “Taking Care of Yourself and Your Loved Ones,” for all Duke University and Duke Health community members and their families. The 30-minute topical webinars provide practical expert advice on topics including emotional wellness, substance misuse, suicide prevention, and mental health for children, adolescents and teens.

The webinar series runs through April 27. Learn more, watch past webinars and join upcoming webinars:  http://bit.ly/DukeMHSeries.

 

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.

 

Duke Heart in the News:

April 2 — Duke University Hospital/Heart patient wedding

WSOC-TV 9 (Charlotte, NC)

Final wish: Patient marries fiancee at North Carolina hospital week before his death

https://bit.ly/3uCCRXb

April 5 — Duke University Hospital/Heart patient wedding

WSET.com/ABC-13 (Lynchburg, VA)

Martinsville woman mourns loss of husband days after wedding at hospital

https://bit.ly/2OC7WLi

April 5 – Piers Barker and Joe Turek

DukeStories

At the Heart of Research and Medicine

https://bit.ly/39Trgek

April 6 — Robert Califf

SciTechDaily.com

Tsunami of Chronic Health Conditions Expected as a Result of COVID-19 Pandemic – Will Affect Society for Decades

https://bit.ly/3d51ypc

April 6 — J. Antoinio Gutierrez

Healio/Cardiology

COVID-19 confers elevated VTE risk in veterans

https://bit.ly/3fX5Fpm

April 7 — Vanessa Blumer

Cardiovascular Business

How prior hospitalizations affect a heart failure patient’s chances of survival

https://bit.ly/2QbsXNn

Division of Cardiology Publications Indexed in PubMed April 1-7, 2021

Alenezi F, Rajagopal S. The right atrium, more than a storehouse. Int J Cardiol 2021;331:329-330. PM: 33548383.

Anastasius M, Maggiore P, Huang A, Blanke P, Patel MR, Nørgaard BL, Fairbairn TA, Nieman K, Akasaka T, Berman DS, Raff GL, Hurwitz Koweek LM, Pontone G, Kawasaki T, Rønnow Sand NP, Jensen JM, Amano T, Poon M, Øvrehus KA, Sonck J, Rabbat MG, Mullen S, De B. The clinical utility of FFR stratified by age. J Cardiovasc Comput Tomogr 2021;15:121-128. PM: 33032976.

Chan AT, Dinsfriend W, Kim J, Yum B, Sultana R, Klebanoff CA, Plodkowski A, Perez Johnston R, Ginsberg MS, Liu J, Kim RJ, Steingart R, Weinsaft JW. Risk stratification of cardiac metastases using late gadolinium enhancement cardiovascular magnetic resonance: prognostic impact of hypo-enhancement evidenced tumor avascularity. J Cardiovasc Magn Reson 2021;23:42. PM: 33814005.

Cunningham LC, Fonarow GC, Yancy CW, Sheng S, Matsouaka RA, DeVore AD, Jneid H, Deswal A. Regional Variations in Heart Failure Quality and Outcomes: Get With The Guidelines-Heart Failure Registry. J Am Heart Assoc 2021;10(7):e018696. PM: 33759546.

Fudim M, Patel MR, Boortz-Marx R, Borlaug BA, DeVore AD, Ganesh A, Green CL, Lopes RD, Mentz RJ, Patel CB, Rogers JG, Felker GM, Hernandez AF, Sunagawa K, Burkhoff D. Splanchnic Nerve Block Mediated Changes in Stressed Blood Volume in Heart Failure. JACC Heart Fail 2021;9(4):293-300. PM: 33714749.

Goldstein SA, Sorenson L, Chapa JB, Krasuski RA. Pregnancy in a woman with congenitally corrected transposition of the great arteries. Cleve Clin J Med 2021;88(4):228-236. PM: 33795247