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Duke Heart Pulse — February 4, 2024
Highlights of the week:
February kicked off with several events that were aimed at raising awareness around heart disease and specifically cardiovascular disease in women with GoRed events on Friday February 2nd. We have several examples below of our heart center community including faculty, fellows, staff and patients engaged in Heart Month awareness events. We also highlight the ongoing work within the Heart Center around research and patient care. In upcoming weeks we will highlight the recent STS meeting and some our CT surgery and cardiology care and advances in valvular heart disease. Included below are some pictures from the GoRed – Red Dress event at the Lincoln center in NYC this week that a few of our faculty were able to attend and walk the red carpet.
Voora Appointed Exec Director of VA National Pharmacogenomics Program
Congratulations to Deepak Voora, MD, associate professor of medicine in cardiology! Voora has been appointed Executive Director for the Veterans Affairs National Pharmacogenomics Program.
Since 2019, Voora and his team have designed and implemented an end-to-end system for implementing pharmacogenomics (PGx) into routine clinical care across the VA. This includes access to PGx testing, funding, patient- and provider education, changes to the electronic medical record, clinical decision support systems, population health management tools, pharmacist consultation, and implementation workflows targeting specific patient populations most likely to benefit from PGx testing.
The VA’s National Pharmacogenomics Program currently supports PGx testing and services for the nearly 30,000 U.S. Veterans throughout the Veterans Health Administration (VHA) who are prescribed more than 60 common medications that are impacted by PGx each year. The Veterans Health Administration consists of more than 110 Veterans Affairs Health Care systems.
Heart Team Launches Use of Renal Denervation Device; 1st in VAHS & NC
Duke cardiologists Tony Gutierrez, MD, the Durham Veterans Affairs Medical Center (VAMC) Cath Lab Director, and Raj Swaminathan, MD, the Durham VAMC Chief of Cardiology, have performed the first renal denervation procedures for the treatment of hypertension in the Veterans Affairs Healthcare System (VAHS). The team used a recently FDA-approved ultrasound renal denervation device, making it the first commercial use of the device in the entire VAHS and any hospital in NC.
Hypertension, also known as ‘high blood pressure,’ puts those who have it at risk for heart disease and stroke — the leading causes of death in the U.S. Nearly half of adult Americans have the condition, but only about one in four have it under control, according to the Centers for Disease Control. The latest guidelines from the American College of Cardiology and the American Heart Association define stage 1 hypertension as a blood pressure at or above 130/80 mmHg and stage 2 hypertension as a blood pressure at or above 140/90 mmHg.
Initial treatments for hypertension are usually lifestyle interventions and medications that can help lower blood pressure. Despite those treatments, more than one-half of individuals do not achieve recommended treatment goals, according to a recent position statement from the Society for Cardiovascular Angiography & Interventions (SCAI). The statement’s team of co-authors, led by Swaminathan, cite the limitations of medical therapy as medication cost, adverse side effects, limited access, and poor adherence.
With the FDA’s approval of two renal denervation devices last year, treatment options are expanding for those with uncontrolled or resistant forms of hypertension, particularly among those at greatest cardiovascular risk.
“The prevalence of hypertension in our Veterans is anywhere from 71 to 87 percent,” Gutierrez says. “The technology that we have now is pretty advanced to go ahead and treat the nerves around the arteries.”
The renal denervation devices are used to disrupt the nerve signals going to the kidneys. The procedure treats high blood pressure and conditions related to high blood pressure, according to Swaminathan. Of the two approved devices, one uses ultrasound technology and the other utilizes radiofrequency ablation.
“Blood pressure control has plateaued over the last decade and existing treatment strategies, including lifestyle changes and medications, are often not enough,” Swaminathan adds. “Renal denervation is a new technology to treat high blood pressure that is safe, durable, and is ‘always on’.”
The patients treated at the Durham VA both had resistant hypertension and were referred to the team by cardiologist Michelle Kelsey, MD, who has built a robust cardiology prevention clinic at the Durham VAMC. The procedures were performed in December.
The renal denervation approach begins with the cardiologist identifying and targeting appropriate segments of the renal arteries with adjacent renal nerves. A catheter is then threaded carefully through blood vessels toward the renal arteries. Once the catheter reaches its target area, energy (using ultrasound or radiofrequency) is delivered and disrupts nerve signals without damaging the arteries or surrounding tissues. The interrupting of nerve signals is what can help reduce high blood pressure, says Swaminathan.
“The overall objective of renal denervation is to provide long-term reduction in blood pressure, especially to Veterans who may not respond well to medication alone,” Gutierrez adds.
Swaminathan says the Position Statement is currently being used by industry and health systems as a guide to launch renal denervation programs around the country.
Congratulations, Raj, Tony, and Michelle!
Duke Celebrates National Wear Red Day!
Thanks to everyone who joined us in wearing red on Friday to celebrate National Wear Red Day! It was terrific to see so many of our teams sporting a bit of red. Check out these pics from teammates throughout Duke University Hospital, Duke Raleigh Hospital and Duke Regional Hospital.
This was a great way for our teams to kick off Heart Month!
Next up:
Hands-Only CPR demonstration:
For team members at Duke who are not required to have BLS certification, please consider participating in the upcoming virtual AHA Triangle Hands-Only CPR demonstration, being held at Noon on Feb. 22. To register please click here. You’ll then receive a confirmation with the Zoom link. Help us reach 100+ participants from Duke Health!
Duke Heart Team Wins Family-Centered Care Award
Congratulations to Callie Tennyson, John Oliver, Dustin Tart, Karen Jooste, Kelly Kester, and their collaborators — Bradi Granger, Catie Dunn, and Kayla Brooks — for receiving the Society of Critical Care Medicine’s (SCCM) “Family-Centered Care Innovation Award” for Duke University Hospital. The award was formally presented during the SCCM’s 53rd Critical Care Congress held last week in Phoenix, AZ.
The Family-Centered Care Innovation Award is presented annually to a program that
demonstrates novel, effective methods of providing care to critically ill and injured patients and their families. The team was recognized for their project, Interprofessional Education for Family Care During Resuscitation.
Way to go!
Reminder: Tier 2 Status
We are currently in Tier 2 visitation status throughout Duke University Health System. Information is available on Duke Health Now.
Upcoming Events & Opportunities
- Duke Culture Survey: Jan. 29-Feb.17
- February is Heart Month and Black History Month.
- February 7-14 is Congenital Heart Defect Awareness Week
- February 11-17 is Heart Failure Awareness Week
- Wednesday, Feb. 14 is National Donor Day
Cardiology Grand Rounds
Feb. 6: Implementation strategies to address the burden of Heart Failure with Harriette Van Spall of McMaster University. 5 p.m., DN 2002 or via Zoom.
Feb. 13: Breaking Barriers: The future of heart transplantation with Joseph Lerman. 5 p.m., DN 2002 or via Zoom.
All Duke Cardiology Grand Rounds recordings are housed on Warpwire. To access recordings please visit:
NET ID and password are required. Enjoy!
CD Fellows Core Curriculum Conference
Feb. 7: HT/Txp Case Presentation with Ivan Nenadic Wood. Noon. DMP 2W96 (in-person only).
Feb. 9: Cardiac PET with Salvadore Borges-Neto. Noon. Zoom only.
Office of Faculty — Event with Israni of Stanford Medicine, Feb. 26
Academic Medicine, with all its complexities, naturally includes conflict amongst its crucial collaborators – trainees, faculty, staff, communities and more. 21st century leadership skills require all of us to strategically leverage components of this conflict for constructive change, with intentional and thoughtful actions. This talk will weave together themes from restorative justice and design thinking; and how they can be applied to artificial intelligence and JEDI (justice, equity, diversity, and inclusion), offering a case for new ways of leveraging conflict to advance a culture of connectedness and belonging. The featured speaker will be Sonoo Thadaney Israni of Stanford University’s Presence Center.
February 26: Leveraging Conflict for Constructive Change. 4-5:30 p.m., DN 2002. Presented by the Office for Faculty. Refreshments will follow. To learn more and register: https://duke.is/8/8d7f.
Upcoming CME Symposia for Spring, 2024
Feb 6: Stroke Management of the Future? The Potential Role of Factor XI/XIa Inhibitors in Secondary Stroke Prevention.
This is a DukeHeart/TotalCME event with Manesh Patel, et al. In-person at the Hyatt Regency Phoenix, 2nd floor, Phoenix Ballroom. Virtual: Livestream via MedEd On The Go, 8-9:30 p.m., EST. This evening symposium will be held during the International Stroke Conference 2024 in Phoenix.
Join experts to explore how factor XI/XIa inhibitors may transform secondary stroke prevention in patients with acute ischemic strokes and transient ischemic attack risk factors. This data-rich symposium reviews currently available therapeutics and how they affect the coagulation cascade, increasing the potential for serious bleeds. Experts outline new and emerging anticoagulation pharmacotherapy that may mitigate bleeding risks. Through interactive presentations, attendees gain a deep understanding of the rapidly evolving stroke prevention landscape, preparing them to implement the latest approaches, improve clinical practice and boost patient outcomes.
Faculty presenters:
- Valeria Caso, MD, PhD of the University of Perugia
- Mike Sharma, MD, MSc, FRCPC of McMaster University
- Manesh R. Patel, MD of Duke Health
- Ashkan Shoamanesh, MD of McMaster University
Supported by an educational grant from Bayer HealthCare Pharmaceuticals and jointly provided by Duke Heart, MedEd On The Go, and Total CME.
March 8: Cardio-Oncology/Amyloid Symposium
The Southeastern Cardio-Oncology Conference, The Future is Now will take place on March 8 at the JB Duke Hotel in Durham, NC. Event registration is open; the registration deadline is March 5.
Duke cardiologists Michel Khouri and Ravi Karra of Duke’s Precision Cardiomyopathy Program will be presenters during the symposium.
Keynote to be provided by Avirup Guha, director of cardio-oncology and assistant professor of medicine at Augusta University’s Georgia Cancer Center.
The symposium is presented by Duke Cancer Network (DCN) in collaboration with Duke Cancer Institute. For more information, please contact Beth Tanner of DCN.
April 12: Duke Sports Cardiology & Sudden Death in Athletes
May 4: Duke Heart Failure Symposium
Registration is not yet open for the April 12 or May 4 symposia, but if you have questions about either event, please reach out to Christy Darnell.
Have news to share?
If you have news to share with the Pulse readership, please contact Tracey Koepke, director of communications for Duke Heart at tracey.koepke@duke.edu. We would love to hear about your latest accomplishments, professional news, cool happenings, and any events or opportunities that may be of interest to our Duke Heart family. Please call with any questions: 919-681-2868. Feedback on Pulse is welcome and encouraged. Submissions by Noon, Wednesdays, to be considered for weekend inclusion.
Duke Heart in the News:
January 26 — Karen Alexander
Heart.org
What is a heart attack? Cardiologists explain the condition following death of NBA coach
January 26 — Robert Lefkowitz
Business Minds Coffee Chat (podcast)
Episode 123: From Yellow Beret to Nobel Laureate
January 27 — Nenad Bursac and Nicholas Strash
Tech Explorist (IN)
Healing hearts with skin cancer genes
January 29 — Joseph Turek and the Monroe family
The Science Times
January 29 — Robert Lefkowitz
Freedom Pact (podcast)
Episode 317: Dr Robert Lefkowitz – Nobel Prize Winner Shares The Secrets To Unlocking Your Genius
January 29 — G. Chad Hughes
Medpage Today
Cooling Technique Frowned Upon in Aortic Arch Surgery
January 30 — Duke University Hospital
Yahoo News/Insider Monkey
30 Best Cardiology Hospitals In the US
February 2 — Manesh Patel
Triangle Business Journal
Their battle: Slow the growth of heart disease
Duke Heart Pulse — January 28, 2024
Highlights of the week:
Schroder Named Surgical Director for Advanced Heart Failure
We are pleased to share that Jacob N. Schroder, MD, assistant professor of surgery, has been named Surgical Director for Advanced Heart Failure of Duke Health’s Heart and Vascular Service line and the Duke Division of Cardiovascular and Thoracic Surgery. The announcement was made Monday by Duke Surgery and Duke Heart leadership.
Dr. Schroder earned his Medical Degree from Georgetown University School of Medicine and completed both his general and cardiothoracic surgery residencies, as well as thoracic transplant surgery fellowship, at Duke University. He then joined the Duke Department of Surgery faculty in the Division of Cardiothoracic Surgery in 2012.
Since then, Dr. Schroder has helped lead transplant growth and innovation within the Duke Heart program while maintaining a deep passion for the care of advanced heart failure patients. In 2017, he accepted the role of surgical director of cardiac transplantation and has led the program to marked volume growth while maintaining outstanding survival outcomes. In 2023, Duke completed 161 heart transplants, which is the greatest annual number at any institution worldwide. In addition, the program has surpassed 2,000 total heart transplants, which has only been achieved by a handful of other programs in the U.S.
In his new role as Surgical Director for Advanced Heart Failure, he will not only oversee heart transplantation but will also oversee the Extracorporeal Membrane Oxygenation (ECMO) program, the Left Ventricular Assist Device (LVAD) program, and the Total Artificial Heart program at Duke. Additionally, Jacob will oversee conventional cardiac surgery procedures in patients with severely reduced left ventricular function. As part of his new role he will assemble a team of surgeons and multidisciplinary team members to deliver these therapies, oversee research efforts throughout these areas, and continue to drive innovation.
Dr. Schroder has been a leader in perfusion storage and was the first surgeon in North America to perform an adult heart transplant utilizing a donation after cardiac death (DCD) donor. He led the U.S. Organ Care System DCD Heart Trial, which was published last year in the New England Journal of Medicine. Importantly, the strategy of utilizing DCD donors has served to expand the donor pool by as much as 30% at adopting centers. He has also reinvigorated the combined heart–lung transplant program and facilitated increased volume in other combined heart-kidney and heart-liver transplant procedures. Jacob has also served as co-director of the 7West Cardiothoracic Intensive Care Unit (CTICU), creating an environment of enhanced patient care with collaborative surgical and intensivist oversight. He has led the application of mechanical circulatory support at Duke and performed the first successful CARMAT total artificial heart implant in North America in 2021.
In summary, he has displayed incredible dedication and passion for heart failure care and has worked tirelessly to expand our footprint in the treatment of these patients.
Congratulations, Jacob!
St. Jude Children’s Invests $13M in Duke, Columbia, and Stanford Collaboration
St. Jude Children’s Research Hospital has invested nearly $13 million toward a new collaboration with researchers at Duke, Columbia, and Stanford Universities to expand the understanding of G-protein coupled receptors (GPCR), vital proteins that have been linked to more than 100 human diseases and disorders.
The GPCR Collaborative is led by Scott Blanchard, PhD, and M. Madan Babu, PhD, of St. Jude’s. The two are partnering with Jonathan Javitch, MD, PhD, of Columbia University; Georgios Skiniotis, PhD, and Alice Ting, PhD, of Stanford University, and Robert J. Lefkowitz, MD, of Duke University School of Medicine and Duke Cardiovascular Research Center.
Lefkowitz, a cardiologist and biochemist, was awarded the Nobel Prize in Chemistry in 2012 for his studies of G-protein coupled receptors. He received the award with Brian Kobilka, MD, of Stanford.
The multi-institutional GPCR Collaborative team will integrate and improve advanced methodologies including single-molecule imaging, cryo-electron microscopy, data science, and other techniques to study GPCR biology, structure, and pharmacology. Building on insights from these studies, investigators hope to develop new therapies for many pediatric diseases, including cancer and other life-threatening conditions.
“Each group within the collaborative has a very different focus, yet there’s overlap in the methods we use in our laboratories. We each have a distinct emphasis and expertise that is lacking in the other groups,” says Lefkowitz, Chancellor’s Distinguished Professor of Medicine at Duke and member of Duke Cancer Institute. “What my lab brings to the table is, first of all, our very long history in the field. My involvement with the receptors goes back more than 50 years. So we have the long view — the history – of working with GPCRs, but we also bring a pharmacological, biochemical, and clinical perspective to the endeavor.”
The goal of the collaboration is to use the biophysical expertise of the teams to interrogate the receptors in a very deep way to try to assist in developing new strategies to develop drugs, according to Lefkowitz.
“Many of the other investigators in the collaboration bring a deep biophysical and structural orientation to the table. So the hope and expectation are for real synergy to emerge from bringing these different approaches to bear, especially from individuals who have already demonstrated successful collaborations with one another.”
St. Jude’s Children’s Research Hospital has funded six different Research Collaborative projects since 2017, including the GPCR Collaborative, with an investment of more than $80 million. By 2027, St. Jude plans to support even more collaborations focused on unanswered needs in science and medicine which will increase total investment to $160 million.
Congratulations, Bob!
Williams Receives TSF Award at STS 2024
Congratulations to cardiothoracic surgeon Adam Williams who has received the Thoracic Surgery Foundation (TSF) Every Heartbeat Matters Award for medical outreach in Honduras via our Duke Heart for Honduras program. The announcement was made during The Society of Thoracic Surgeons (STS) 60th Annual Meeting being held this weekend (Jan. 27-29) in San Antonio, TX.
The TSF, which is the philanthropic arm of the STS, offers grants of up to $35,000 for qualified surgeons who conduct charity surgical outreach work in underserved regions with underserved populations. The grant is designed to provide support for programs that educate, screen, and/or treat underserved populations to reduce the global burden of heart valve disease and other programs that advance healthcare and address underserved populations. The Every Heartbeat Matters Award is made possible through the support of Edwards Lifesciences Foundation.
Duke Heart for Honduras is an international cardiovascular surgical outreach partnership program launched in 2019 between the Division of Cardiovascular and Thoracic Surgery at Duke and the Instituto Nacional Cardiopulmonar (INCP) in Tegucigalpa, Honduras.
The socioeconomic climate of Honduras has made the provision of healthcare to its 9.5 million inhabitants difficult. There is a high rate of poverty, political instability, frequent natural disasters, and very few physicians available to diagnose and treat heart disease, let alone perform surgical cardiac interventions.
There is essentially only one cardiovascular surgeon in all of Honduras – Dr. Hugo Orellana, of the Instituto Nacional Cardiopulmonar (INCP) – with whom the Duke team collaborates. The INCP is a public hospital built roughly 75 years ago to provide specialized care for patients with tuberculosis, pulmonary, and cardiovascular diseases. The hospital has two operating rooms available. When resources permit, cardiac surgery is performed in those spaces.
“This award is key for us to continue these missions to Honduras, because it will essentially help fund all the flights we need to get the team down there,” said Williams. “That’s the biggest expense we have, so we are very excited and grateful to receive this award.”
Williams says the funding will be used to support the team’s next medical mission to Honduras, which is planned for May 11-18, 2024.
Congratulations, Adam — we are thrilled for you and the Duke Heart for Honduras team! Note: We’ll have more coverage from STS next weekend.
ICYMI: Latest Duke Publication on Diversity in Cardiology Fellowships
Congratulations to Sarah Snow, Pamela Douglas, and Brooke Alhanti for their latest publication in JAMA Cardiology. Recruiting a Diverse Cardiology Physician Workforce was published online Jan. 24, 2024.
The team reports their findings on changes in the representation of women and underrepresented racial and ethnic populations in cardiovascular disease and cardiovascular subspecialty fellowships. Using data from the Accreditation Council for Graduate Medical Education the team found percentages of women trainees in cardiovascular disease and interventional cardiology fellowships significantly increased from 2008 to 2022. While percentages of Black and Hispanic trainees in these fellowships have increased in recent years, the change is not yet statistically significant, according to the authors.
Great job on an incredibly important topic, Sarah, Pam, and Brooke!
Loring, Piccini Appear in Latest Episode of Heart Rhythm TV
Congrats to Zak Loring and Jon Piccini for appearing in a great episode of Heart Rhythm TV. The episode, The Natural History of AF – An Echocardiographic Study was posted to the Heart Rhythm channel on YouTube yesterday.
The two were interviewed by host Roderick Tung about their latest publication, Natural history of echocardiographic changes in atrial fibrillation: A case-controlled study of longitudinal remodeling, appearing in the January 2024 issue of Heart Rhythm Journal.
Nicely done – great interview, Jon and Zak!
Jule Named ANM, 6 East
We are excited to share that Annette Jule, BSN, RN, MPH, MSN, has been named the new 6 East assistant nurse manager (ANM), effective Jan. 2, 2024. Annette was born and raised in New York City and obtained her BSN from Long Island University Brooklyn Campus. She has nursing experience in transplant, med/surg, and critical care. She relocated to Florida and while there was promoted to leadership roles in nursing both at Baptist Hospital of Miami and HCA Kendall. During this time she obtained her MPH at George Washington University and MSN in nursing leadership at Nova Southeastern University.
Please join us in congratulating and welcoming Annette in her new role!
Kudos to Keenan & CT Surgery Team!
We received a warm note from DUH chief medical officer David Gallagher letting us know about patient feedback on Jeffrey Keenan and members of the CT Surgery team.
“Jeff, we received this nice feedback (from Press Ganey HCAHPS) about the great care you and your team gave to a patient at Duke Hospital. Thank you for the high quality and compassionate care you provide to patients! Jill, thanks to all the heart surgery staff who helped this patient! Great team!” — David Gallagher, MD, chief medical officer
“I can’t say enough on how grateful I am towards my doctor Jeffrey Keenan and all staff that helped me recover from my heart surgery.” — grateful patient, name withheld for privacy
Kudos to Parker & CTICU Team!
Kudos to Phillip Parker, nurse manager of the CTICU, and the whole CTICU team for their amazing partnership and floating ICU nurses to the OTC at Duke Hospital last week.
Their teamwork is helping capacity rise to 150 in the next few weeks. Great job!
Latest Duke Heart/Med-IQ CME Course Now Available
Managing Mitral Regurgitation Based on the Mechanism of Disease, a Med-IQ CME course with Andrew Wang is now live. To learn more, please click here.
Duke Research and Innovation Week
Starting Monday, Jan. 29, Duke is hosting its annual Research and Innovation Week–this time, with a Centennial twist. Join the Office for Research & Innovation for a week of exciting events, panels, and showcases to celebrate the past, present, and future of research and innovation at Duke.
It will include discussions on:
- Depolarizing Political Toxicity on Social Media
- Duke and NCCU’s Ongoing Partnerships and Collaboration
- Race, Ethnicity and Politics Research
- Many more great topics!
Consider attending the Research Town Hall on Jan. 31 featuring Brian McAdoo, Ross McKinney, Michael Pencina, Geeta Swamy, and Kanecia Zimmerman speaking on Integrity in Scholarship: The Next 100 Years. Or, on Feb. 1, check out the session on Duke Research in 2124 with panelist Muath Bishawi, or Duke and the FDA with Lesley Curtis, Mark McClellan, and Ehsan Samei.
A great week is planned! Learn more here.
National Wear Red Day is Friday
On Friday, Feb. 2, please join us in celebrating National Wear Red Day! This annual event is a visible means of showing your support and enthusiasm for working with cardiovascular patients and heart disease survivors. No need to don a completely crimson outfit! Red accessories such as socks, shoes, ties, or earrings are a great way to show you are participating in Wear Red Day! (Note: If your work area at Duke Health requires a uniform of specific color, you must adhere to that dress code policy.)
Kick-off Heart Month by wearing some red on Friday. Another event to consider is:
- 22 – AHA Triangle Hands-Only CPR demonstration, Noon, via Zoom. To register please click here.
Reminder: Tier 2 Status
We are currently in Tier 2 visitation status throughout Duke University Health System. Information is available on Duke Health Now.
Upcoming Events & Opportunities
- Duke Culture Survey: Jan. 29-Feb.17
- Duke Centennial Research & Innovation Week: Jan. 29-Feb.2
- National Wear Red Day: 2
- February is Heart Month and Black History Month.
Transplant Grand Rounds
Jan. 30: Partial Heart Transplantation – Emergence of a New Paradigm with Joseph Turek. Noon. DN2003 or via Zoom.
Cardiology Grand Rounds
Jan. 30: Unraveling ketone metabolism in the failing heart with Senthil Selvaraj. 5 p.m., DN 2002 or via Zoom.
Feb. 6: Implementation strategies to address the burden of Heart Failure with Harriette Van Spall of McMaster University. 5 p.m., DN 2002 or via Zoom.
All Duke Cardiology Grand Rounds recordings are housed on Warpwire. To access recordings please visit:
Your NET ID and password are required. Enjoy!
Cardiology Grief Debrief Session
Jan. 29. Noon, In-person only: DMP 2W96
CD Fellows Core Curriculum Conference
Jan. 31: HT/Txp Case Presentation with Eric Xie. Noon. DMP 2W96 (in-person only).
Feb. 2: Introduction to SPECT with TBD. Noon. Zoom only.
Office of Faculty — Event with Israni of Stanford Medicine, Feb. 26
Academic Medicine, with all its complexities, naturally includes conflict amongst its crucial collaborators – trainees, faculty, staff, communities and more. 21st century leadership skills require all of us to strategically leverage components of this conflict for constructive change, with intentional and thoughtful actions. This talk will weave together themes from restorative justice and design thinking; and how they can be applied to artificial intelligence and JEDI (justice, equity, diversity, and inclusion), offering a case for new ways of leveraging conflict to advance a culture of connectedness and belonging. The featured speaker will be Sonoo Thadaney Israni of Stanford University’s Presence Center.
February 26: Leveraging Conflict for Constructive Change. 4-5:30 p.m., DN 2002. Presented by the Office for Faculty. Refreshments will follow. To learn more and register: https://duke.is/8/8d7f.
Upcoming CME Symposia for Spring, 2024
Feb 6: Stroke Management of the Future? The Potential Role of Factor XI/XIa Inhibitors in Secondary Stroke Prevention.
This is a DukeHeart/TotalCME event with Manesh Patel, et al. In-person at the Hyatt Regency Phoenix, 2nd floor, Phoenix Ballroom. Virtual: Livestream via MedEd On The Go, 8-9:30 p.m., EST. This evening symposium will be held during the International Stroke Conference 2024 in Phoenix.
Join experts to explore how factor XI/XIa inhibitors may transform secondary stroke prevention in patients with acute ischemic strokes and transient ischemic attack risk factors. This data-rich symposium reviews currently available therapeutics and how they affect the coagulation cascade, increasing the potential for serious bleeds. Experts outline new and emerging anticoagulation pharmacotherapy that may mitigate bleeding risks. Through interactive presentations, attendees gain a deep understanding of the rapidly evolving stroke prevention landscape, preparing them to implement the latest approaches, improve clinical practice and boost patient outcomes.
Faculty presenters:
- Valeria Caso, MD, PhD of the University of Perugia
- Mike Sharma, MD, MSc, FRCPC of McMaster University
- Manesh R. Patel, MD of Duke Health
- Ashkan Shoamanesh, MD of McMaster University
Supported by an educational grant from Bayer HealthCare Pharmaceuticals and jointly provided by Duke Heart, MedEd On The Go, and Total CME.
March 8: Cardio-Oncology/Amyloid Symposium
The Southeastern Cardio-Oncology Conference, The Future is Now will take place on March 8 at the JB Duke Hotel in Durham, NC. Event registration is open; the registration deadline is March 5.
Duke cardiologists Michel Khouri and Ravi Karra of Duke’s Precision Cardiomyopathy Program will be presenters during the symposium.
Keynote to be provided by Avirup Guha, director of cardio-oncology and assistant professor of medicine at Augusta University’s Georgia Cancer Center.
The symposium is presented by Duke Cancer Network (DCN) in collaboration with Duke Cancer Institute. For more information, please contact Beth Tanner of DCN.
April 12: Duke Sports Cardiology & Sudden Death in Athletes
May 4: Duke Heart Failure Symposium
Registration is not yet open for the April 12 or May 4 symposia, but if you have questions about either event, please reach out to Christy Darnell.
Angels Among Us Walk & 5K, April 27
Our friends and colleagues at the Preston R. Tisch Brain Tumor Center (BTC) will hold their 31st annual Angels Among Us Walk on April 27 at the corner of Erwin Road and Flowers Drive on the Duke Medical Center campus. The Angels Among Us 5K and Walk of HOPE will begin with a 5K run followed by great entertainment, children’s activities, delicious food, and fun for the entire family.
A ceremony will begin the walk of hope through the Duke Medical Campus and the Sarah Duke Gardens. Proceeds from the event support the Preston Robert Tisch Brain Tumor Center at Duke. Visit www.angelsamongus.org to learn more.
Please consider supporting our Duke BTC colleagues and their annual event!
Have news to share?
If you have news to share with the Pulse readership, please contact Tracey Koepke, director of communications for Duke Heart at tracey.koepke@duke.edu. We would love to hear about your latest accomplishments, professional news, cool happenings, and any events or opportunities that may be of interest to our Duke Heart family. Please call with any questions: 919-681-2868. Feedback on Pulse is welcome and encouraged. Submissions by Noon, Wednesdays, to be considered for weekend inclusion.
Duke Heart in the News:
January 12 — Nishant Shah
Healthcentral.com
January 19 — Robert Lefkowitz
Memphis Business Journal
January 19 — Jonathan Piccini
Cardiovascular Business
January 19 — Duke Heart study
Woman’s World
Doctors Reveal the Best Sleeping Position to Outsmart Nighttime Leg Pain
*refers to this Duke study
January 20 — Brittany Zwischenberger
The New York Times
The Heart Surgery That Isn’t as Safe for Older Women
January 23 — Stephen Greene
Medscape
Deaths Linked to Substance Use, CVD on the Rise
January 23 — Kristin Newby
Consumer Reports
El mejor chequeo para tu corazón
January 24 — Sarah Snow
Healio/Cardiology Today
Women in CV fellowships on the rise; not so among other underrepresented groups
January 24 — Duke University Hospital
Becker’s ASC Review
The top 317 cardiology facilities for Medicare members, per Aetna
January 24 — Duke Heart study
Today’s Geriatric Medicine
Statins: Reducing Racial Disparities
*references this Duke study.
January 25 — Nenad Bursac
Genetic Engineering & Biotechnology News
Cancer Mutation That Spurs Cell Division Helps Heart Models Run at Full Gallop
January 25 — Nenad Bursac
WPTF/680 News Radio
Mutation in skin cancer may help recovery from heart attacks
*clip begins @ 12:12:48
Duke Heart Pulse — January 21, 2024
Highlights of the week:
Bloomberg Grant Funds Innovative Partnership for Early College High School in Durham
A partnership between Duke Health, Durham Technical Community College, and Durham Public Schools has been awarded a transformative $29.5 million grant from Bloomberg Philanthropies to establish an early college for high school students interested in pursuing healthcare careers upon graduation.
The grant is one of 10 awarded nationally through Bloomberg Philanthropies’ “Student-centered, Market-driven Healthcare Education Initiative.” The initiative’s goal is to address critical healthcare workforce needs while preparing young adults for successful careers in the field.
“For too long, our education system has failed to prepare students for good jobs in high-growth industries,” said Michael R. Bloomberg, founder of Bloomberg Philanthropies and Bloomberg LP and 108th mayor of New York City. “By combining classroom learning with hands-on experience, these specialized healthcare high schools will prepare students for careers with opportunities for growth and advancement. America needs more health care workers, and we need a stronger, larger middle-class – and this is a way to help accomplish both goals.”
The Durham partnership will provide the preparation needed for careers in nursing, allied health, surgical tech, and clinical research. The key elements of the partnership are:
- Interested Durham Public Schools (DPS) students in grades 9-12 will attend the early college high school and simultaneously earn both a high school diploma and an associate degree or workforce credential for aligned healthcare occupations.
- The Middle College at Durham Tech will expand to an early college high school and will be housed at Durham Tech (DTCC) in a newly renovated space, with the school opening in the fall of 2025.
- Upon graduation, students will have an immediate pathway to jobs or research roles at Duke Health.
“This partnership is about much more than an innovative educational approach,” said J.B. Buxton, president of Durham Tech. “It’s about creating a high-quality pathway to some of the most important jobs in our community. It’s about making sure our healthcare workforce looks like the patients it serves. It’s about improving the quality of patient care and the health outcomes for all. It’s about the role of education and health in improving people’s lives.”
The program is expected to open in the fall of 2025 with an initial class of 100 ninth graders, then enroll additional classes of 100 students for each of the next three years.
The Bloomberg Philanthropies grant will allow Durham Public Schools to further increase Durham’s talent pipeline in the healthcare sector. The district currently offers medical career-focused courses and experiences through its City of Medicine Academy.
“This innovative partnership marks a significant milestone in our collective commitment to provide students with unparalleled opportunities and prepare them for successful futures in the dynamic health sciences sector,” said Pascal Mubenga, superintendent of Durham Public Schools. “This will also help us keep qualified talent right here in Durham to strengthen our network of care.”
Students will graduate with one or more credentials required to fill high-demand positions, including certified nursing assistant, emergency medical technician, phlebotomist, and central sterile processing technician.
Duke University Health System (DUHS), which comprises Duke’s hospitals, clinics, and other patient care services, is expected to hire at least 60 students directly after graduation from the early college high school, fulfilling a critical need for a diverse and skilled workforce. To promote retention and career advancement, the health system will provide mentoring, flexible scheduling, and assistance with other support services such as transportation or childcare.
“This exciting new partnership encompasses education, research, patient care, and community enhancement to advance a bold and innovative healthcare education model for Durham,” said Vincent E. Price, president of Duke University. “We are grateful to Bloomberg Philanthropies for supporting this vital work, and thankful for our innovative regional partners as we create compelling new opportunities for Durham students and address critical workforce shortages.”
This initiative reflects Duke’s broad commitment to forging partnerships to support strategic community priorities such as college and career readiness. Through Bloomberg Philanthropy’s generosity, this innovative model of collaboration will provide significant opportunities for young people to be prepared as the next generation of leaders in health care as well as advance the overall well-being of communities.
“Through this collaboration, we will advance economic stability and economic mobility within our communities by expanding educational and career opportunities while addressing critical workforce shortages,” said Craig T. Albanese, chief executive officer of Duke University Health System. “Duke Health’s engagement in this partnership, led by Debra Clark Jones, our associate vice president for Community Health, is one of many DUHS initiatives aimed at improving the overall health, both clinically and socially, of the communities we serve.”
“Duke Health is committed to health equity where everyone in our community has a fair and just opportunity to be their healthiest,” said Debra Clark Jones, associate vice president for Community Health at Duke Health. “Working collaboratively with our community partners to remove barriers to education and good jobs is critical to advancing health equity. I cannot be prouder of leading this important effort on behalf of Duke Health. This initiative is a great example of how we improve overall community health by partnering with intention and leveraging our respective strengths and assets.”
In addition to providing a direct pathway to healthcare jobs, an apprenticeship program through the Duke University School of Medicine will offer a direct route for students to pursue clinical research.
“We are delighted by this opportunity to extend and deepen our work with local education partners,” said Mary E. Klotman, Duke University’s executive vice president for health affairs and dean of Duke University School of Medicine.
“Duke brings strength to this partnership not only as the lead employer for this program but also because we are especially well-positioned to support learners,” Klotman said. “This initiative’s innovative apprenticeship program will offer a more direct pathway for talented young people to enter the profession in clinical research units across Duke. This helps address acute talent shortages while allowing students to gain professional experience in a supportive learning environment.”
The early college high school could help ensure that a significant percentage of new frontline healthcare workers reflect the Durham communities served by DUHS. Because Durham Public Schools is one of the most diverse districts in the region, with approximately 81% non-white students, the graduates of the early college who join DUHS could help improve healthcare access, patient care and engagement, and equity in health outcomes.
“The Bloomberg grant provides a unique opportunity for Durham Public Schools, Duke Health, and Durham Tech to create a transformative educational partnership that will be a “win” for everyone in our community,” said Tara Fikes, Durham Tech Board of Trustees chairwoman. “As a result, DPS students will have a pathway through Durham Tech to well-paying jobs in health care, helping to address the shortage of workers in the field while providing greater access to health care for all residents.”
Administratively, the early college high school will be part of the DPS system, operated jointly by the public school system and Durham Tech. DPS will provide high school teachers, a principal, support staff, student services, and curricular resources. Students will also be dually enrolled at DTCC, which will begin renovating a building on-site to house the new school.
DUHS will also contribute employee time to engage with students in classroom projects, co-teach, and supervise work-based learning opportunities. In addition, the health system will evaluate the program and calculate its overall value and measures of success.
“The plans and aspirations of our partnerships align with the Bloomberg initiative’s vision,” said Bettina Umstead, chair of the Durham Public Schools Board of Education. “Together, we will create innovative education models, prepare young adults for successful career opportunities, and address critical shortages in health care talent, ultimately ensuring our DPS students connect with health care career opportunities in their home, the City of Medicine.”
ICYMI: The Heart Surgery That Isn’t as Safe for Older Women
We want to draw your attention to an excellent consumer news article on an important topic published in Saturday’s issue of The New York Times. ‘The Heart Surgery That Isn’t as Safe for Older Women’ features the experiences of several women who underwent coronary artery bypass grafting (CABG) procedures; the piece includes a quote from Duke cardiothoracic surgeon, Brittany Zwischenberger, MD, and references two 2023 publications – one a retrospective cohort study published in JAMA Surgery, the other is the accompanying editorial to that study. Zwischenberger, along with Jennifer Lawton of Hopkins, is a co-author of the editorial.
A Call to Action to Improve Outcomes in Women Undergoing Surgical Coronary Revascularization, by Zwischenberger and Jennifer S. Lawton, MD.
Operative Outcomes of Women Undergoing Coronary Artery Bypass Surgery in the US, 2011 to 2020, by Mario Gaudino, MD, PhD, MSCE (Weill Cornell Medicine), et al.
Duke Culture Survey Launching Jan. 29
In his 2020 Juneteenth address, Duke University president, Vincent E. Price committed to surveying all faculty, students, and staff to assess and inform Duke’s progress in addressing bias and promoting respect, meaningful inclusion, and true equity in our community.
As a result, Duke University staff, faculty, and students were asked to respond to an April 2021 Duke Campus Survey. Nearly 13,000 of us did so. That effort helped identify areas of concern and priorities as we moved forward in our racial equity work. That first survey was an essential step to document where we were.
On Jan. 29, the second Duke Campus Survey will launch — this and all surveys to follow — will ensure we are continuing to move toward equity. The survey will be repeated every three years to track our progress.
If you would like Duke to be a place where everyone has an equal chance to thrive, please take the survey. By sharing your experience, you will help Duke leaders understand our progress as we strive to create a more equitable Duke. The survey is anonymous and will be open between Jan. 29 and Feb. 16.
Keep an eye out on your email for further information. Thank you!
Shout-out to Conway
A big shout-out to cardiology clinical pharmacist, Monique Conway!
“Monique is amazing—consistently helping to make sure our patients are on appropriate therapies and teaching the house staff (and sometimes the attendings!) about new studies and evidence. Her support and participation are an essential part of providing excellent care to our inpatients.
What truly inspired me this week is that she also goes out of her way to care for the patients by making sure they can purchase their medications, and she even helped one of our patients find clothes to wear home on a cold day. We are very grateful to have her as part of our team!” – Cary Ward, MD
Nice job, Monique!
Kudos to Gaca & Zwischenberger!
We received terrific feedback on Drs. Jeff Gaca and Brittany Zwischenberger via the Patient & Visitor Relations monthly report this week.
“Patient stated that despite the busy unit Dr. Gaca and Dr. John help saved patient’s life.”
“Patient stated that Dr. Brittany Zwischenberger is one of the best doctors he has ever had. She is very knowledgeable and has a good personality. She made him and his wife feel confident.”
Well done, Jeff and Zwisch!
Shout-outs to Members of Duke’s Heart Failure Team!
We wanted to share a large group of shout-outs regarding team member efforts in clinical research trial recruitment! Congratulations to Lacey Taylor and Stephen Greene for enrolling the first patient into GOALS-HF and to Kim Biever, Aferdita Spahillari, and Marat Fudim for enrolling a patient into FASTR!
Additional gratitude from Kim Biever: “To Tracy DeWald for approaching the patient for the FASTR trial and filling multiple furosemide syringes over the course of a few days- most impressively, the last one on Sunday evening; to Isha Amin, Shelley Thompson, John Lazzari, Jaime McDermott, Aferdita Spahillari and Stephen Greene for coordination of care, chart documentation and for answering my endless questions about fluid volume; to Marat Fudim for promptly signing what seemed to be at least a hundred orders, and last, but not least, to Ashley Frazier, Laura Dickerson and the nursing staff for ensuring proper staffing levels and for going above and beyond their clinical duties to ensure that our research efforts went smoothly. I appreciate your assistance more than you could ever know! Thank you!”
Way to go, team!!!
Duke My Chart is Now My Duke Health
Last week, Duke My Chart transitioned to My Duke Health. Neither patients nor staff need to make any changes – login information will remain the same. However, accessing My Duke Health via smartphone or tablet will require downloading the new app which is now available in Google Play and in the Apple App Store, or by visiting MyDukeHealth.org.
Reminder: Tier 2 Status
We are currently in Tier 2 visitation status throughout Duke University Health System. Information is available on Duke Health Now.
Upcoming Events & Opportunities
- Duke Culture Survey: Jan. 29-Feb.17
- National Wear Red Day is Friday, Feb. 2!
- February is Heart Month
Cardiology Grand Rounds
Jan. 23: All you need to know about the new AF guidelines in the new year! with Jonathan Piccini. 5 p.m., DN 2002 or via Zoom.
Jan. 30: Unraveling ketone metabolism in the failing heart with Senthil Selvaraj. 5 p.m., DN 2002 or via Zoom.
Feb. 6: Implementation strategies to address the burden of Heart Failure with Harriette Van Spall of McMaster University. 5 p.m., DN 2002 or via Zoom.
All 2023 Duke Cardiology Grand Rounds recordings are housed on Warpwire. To access recordings please visit: https://duke.is/DukeCGR; NET ID and password required. Enjoy!
CD Fellows Core Curriculum Conference
Jan. 24: EP Case Presentation with Andrew Andreae, MD and Damarcus Ingram, MD. Noon. DMP 2W96 (in-person only).
Jan. 26: Cath Lab Math with Thomas Bashore, MD. Noon. Zoom only.
Office of Faculty — Event with Israni of Stanford Medicine, Feb. 26
Academic Medicine, with all its complexities, naturally includes conflict amongst its crucial collaborators – trainees, faculty, staff, communities, and more. 21st century leadership skills require all of us to strategically leverage components of this conflict for constructive change, with intentional and thoughtful actions. This talk will weave together themes from restorative justice and design thinking; and how they can be applied to artificial intelligence and JEDI (justice, equity, diversity, and inclusion), offering a case for new ways of leveraging conflict to advance a culture of connectedness and belonging. The featured speaker will be Sonoo Thadaney Israni of Stanford University’s Presence Center.
February 26: Leveraging Conflict for Constructive Change. 4-5:30 p.m., DN 2002. Presented by the Office for Faculty. Refreshments will follow. To learn more and register: https://duke.is/8/8d7f.
Upcoming CME Symposia for Spring, 2024
March 8: Cardio-Oncology/Amyloid Symposium
The Southeastern Cardio-Oncology Conference, The Future is Now will take place on March 8 at the JB Duke Hotel in Durham, NC. Event registration is open; the registration deadline is March 5.
Cardiologists Drs. Michel Khouri and Ravi Karra of Duke’s Precision Cardiomyopathy Program will be presenters during the symposium.
Keynote to be provided by Dr. Avirup Guha, director of cardio-oncology and assistant professor of medicine at Augusta University’s Georgia Cancer Center.
The symposium is presented by Duke Cancer Network (DCN) in collaboration with Duke Cancer Institute. For more information, please contact Beth Tanner of DCN.
April 12: Duke Sports Cardiology & Sudden Death in Athletes
May 4: Duke Heart Failure Symposium
Registration is not yet open for the April 12 or May 4 symposia, but if you have questions about either event, please reach out to Christy Darnell.
Have news to share?
If you have news to share with the Pulse readership, please contact Tracey Koepke, director of communications for Duke Heart at tracey.koepke@duke.edu. We would love to hear about your latest accomplishments, professional news, cool happenings, and any events or opportunities that may be of interest to our Duke Heart family. Please call with any questions: 919-681-2868. Feedback on Pulse is welcome and encouraged. Submissions by Noon, Wednesdays, to be considered for weekend inclusion.
Duke Heart in the News:
January 12 — Amanda Craig
Cardiovascular Business
Heart transplant recipients face increased risk of maternal complications when giving birth
January 12 — Brian Duscha
Healio/Cardiology Today
Each cardiac rehab session attended cuts readmission, death risk by 2%
January 12 — Joseph Turek
Univision
Un trasplante parcial de corazón salva la vida de una bebé: te explicamos cómo es este procedimiento
January 15 — Kristin Newby
Consumer Reports
January 16 — Joseph Turek and the Monroe family
El Pais
January 16 — Adrian Hernandez
Heart.org
Beyond breathing: How COVID-19 affects your heart, brain and other organs
January 16 — Cynthia Shortell
Vascular News
We still have a lot more work to do
January 17 — Duke Health
Becker’s Hospital Review
13 major health systems partner with high schools in $250M Bloomberg initiative
January 17 — Duke Health
Healthcare Innovation
Bloomberg Workforce Initiative Connects Health Systems, Public Education
January 17 — Adrian Hernandez
Associated Press/Sinembargo.mx
La COVID no es “vencer el resfrío” y ya. Deja daños en corazón, cerebro y más órganos
January 17 — Pamela Douglas
tctMD
Doctors on Overdrive: Fewer Breaks Equal More Burnout
January 17 — Joseph Turek
La Nacion (Argentina)
“El hito de Owen”. El tejido de corazón trasplantado que crece con el bebé que lo recibió
January 17 — Adrian Hernandez
NPR/1A
* carried by WUNC and 480+ affiliated stations nationally
Duke Heart Pulse — January 14, 2024
Highlights of the week:
Shah Named Associate Dean for Translational Research
Svati H. Shah, MD, MS, MHS, has been named associate dean for translational research, effective immediately.
In this role, Shah will serve in an expanded capacity from her previous role as associate dean of genomics. She will provide strategic vision, development, and oversight of translational research initiatives within the School of Medicine. Specifically, she will be responsible for overseeing biobanking service centers and the integration of large biologic datasets including storage and computer environments. Her leadership portfolio will also include the OneDukeBio Integrated Biospecimen Network. She will collaborate closely with associate and vice deans in related disciplines to ensure program alignment across the School of Medicine.
Shah has been a member of the Department of Medicine’s cardiology faculty since 2005. Currently, she is Ursula Geller Distinguished Professor of Research in Cardiovascular Disease, professor of bioinformatics and biostatistics, director of the Duke Center for Precision Health within the Duke Clinical and Translational Science Institute (CTSI), director of the Duke School of Medicine Precision Genomics Collaboratory, director of the Adult Cardiovascular Genetics Clinic, and a member of the Duke Molecular Physiology Institute and Duke Clinical Research Institute. She is the founding director of the Duke Center for Precision Health, chair of the research committee for the Board of Directors of the American Health Association, and a member of the Board of Directors of the Sarnoff Foundation.
Shah is a physician-scientist and practicing cardiologist who sees patients and families with cardiovascular genetic disorders. Upon completing her internal medicine residency at the Brigham and Women’s Hospital, she came to Duke for a cardiology fellowship in 2001, where she also completed a master’s degree in medical genomics and a postdoctoral fellowship in genetic epidemiology.
Congratulations, Svati!
Selvaraj Selected for 2024 ASCI Award
We are thrilled to share that Senthil Selvaraj, MD has been selected as a recipient of an American Society for Clinical Investigation (ASCI) 2024 Young Physician-Scientist Award (YPSA). The ASCI award is a significant early-career achievement and highly competitive; there were 172 nominations this year for 52 awards.
Selvaraj, an assistant professor of medicine in cardiology (Advanced Heart Failure and Transplant) at Duke and a faculty member in the Duke Molecular Physiology Institute is a past recipient of ASCI’s inaugural Emerging-Generation Awards in 2022 while he was at the University of Pennsylvania Perelman School of Medicine.
This is the second consecutive year that a faculty member from Duke Heart has earned one of ASCI’s YPSAs. Jennifer Rymer, MD, MBA, received a 2023 ASCI YPSA.
Way to go, Senthil! Congratulations!!
Duke Centennial Kick-off Features Easton Sinnamon, Joe Turek of Duke Heart
Duke University’s Centennial Celebration Kickoff was held Tuesday, Jan. 9 in Cameron Indoor Stadium. It was a fantastic event with hosts (and alums!) Ken Jeong, comedian and
actor, and Lisa Borders, former president of the Women’s National Basketball Association, along with a special appearance by Mike Krzyzewski. The trio helped highlight the many contributions the faculty, staff, students, and alumni have made over the years. Notable VIPs included Drs. Joseph Turek and Louise Markert who appeared as part of a special segment featuring the story of Easton Sinnamon, the now 3-year-old boy who received the world’s first combination heart transplant-thymus procedure here at Duke in 2021. Sinnamon is doing great, and his story stole the show!
If you did not get the opportunity to attend in person or to view the livestream, we have links for you! To see an overview and editor selection of key moments, visit https://100.duke.edu/story/start-of-a-centennial/
To get all the details regarding Duke’s Centennial and associated events, please visit the Centennial web page.
Kudos to Cox!
Kudos to Gail Cox for her assistance with a patient of Bill Kraus’ who was having anemia and dyspnea in a post-operative period. The patient and their family, who live in Western Virginia, reached out to whomever they knew at Duke to handle this difficult and frightening situation.
During their emergency, they had pulled their car over on the road after getting someone to take the call at Duke — that amazing person turned out to be Gail Cox. Cox listened to their description of the issue and then arranged for a Duke admission.
In gratitude, they sent a card to their care team – the card states:
“Dear Gail, We are so appreciative for your help and advocacy. We were struggling to get the help (for patient/name withheld) needed after surgery. You were there to get them the care they needed at Duke. They were able to come home and begin healing. Forever grateful.”
Nicely done, Gail!!!
Duke MyChart Transitioning to My Duke Health
On January 17, Duke MyChart will transition to My Duke Health, a sleek new online portal – app and website – with improved functionality and visual appeal.
My Duke Health is expected to provide a tailored, Duke-specific online experience for Duke Health patients, and puts all the convenient features of Duke MyChart into one place. By logging into the portal patients can:
- Make in-person appointments for provider visits, lab work, imaging, and other tests like screening mammograms and sleep studies.
- Schedule and attend virtual appointments with primary care providers and specialists.
- Check-in for appointments up to 5 days ahead of time to save time on the day of an appointment.
- Communicate with providers, view after-visit notes and test results.
- Pay bills and view documents
Patients will be able to easily access urgent care virtual visits and view urgent care wait times. There is an option to read Duke Health news and learn about upcoming events, view articles related to the topic of the month, and search through an educational health library. The My Duke Health library contains hundreds of educational materials including short videos and other resources.
Soon, patients will be able to chat with a virtual assistant, view personalized resource pages based on their health needs, and connect with Duke Health Listens, an online community in which patients can offer direct feedback about their healthcare experience, and help us advance better health together.
NOTE: Accessing My Duke Health via smartphone or tablet will require downloading the new app which will be available on Jan. 17 at 10 a.m. in Google Play and in the Apple App Store, or by visiting MyDukeHealth.org.
Cardio-Oncology/Amyloid Symposium Announced
The Southeastern Cardio-Oncology Conference, The Future is Now will take place on March 8 at the JB Duke Hotel in Durham, NC. Event registration is open; the registration deadline is March 5.
Duke cardiologists Drs. Michel Khouri and Ravi Karra will be presenters during the symposium. Keynote to be provided by Dr. Avirup Guha, director of cardio-oncology and assistant professor of medicine at Augusta University’s Georgia Cancer Center.
The symposium is presented by Duke Cancer Network (DCN) in collaboration with Duke Cancer Institute. For more information, please contact Beth Tanner of DCN.
New Visitor Restrictions In Effect
Duke Health has updated visitation restrictions as of Wednesday, January 3.
- Visiting hours are from 8 a.m. to 9 p.m.
- Visitors must check in at the hospital information desk to receive a visitor badge to enter inpatient areas.
- All visitors must be age 12+. (Visitors in some clinical areas must be age 18+.)
- Minors are required to be attended by an adult age 18+ at all times.
- A maximum of two visitors are allowed per patient.
- Visitors must check out upon departure at a kiosk or with information desk staff.
- Visitors with fever, cough, or other flu-like symptoms should not visit.
For more details, refer to the Tier 2 visitation standard work document. Updated signage is posted.
Please note: Additional visitation and masking precautions may apply to certain patient populations, including COVID-19/Special Airborne Contact, oncology, end-of-life, and overnight visitors. Please follow all unit guidelines. Exceptions to visitation restrictions may be granted based on special circumstances, including without limitation, to permit Compassionate Care Visitors.
Upcoming Events & Opportunities
- National Wear Red Day is Friday, Feb. 2!
- February is Heart Month
Cardiology Grand Rounds
Jan. 16: No CGR today.
Jan. 23: All you need to know about the new AF guidelines in the new year! with Jonathan Piccini. 5 p.m., DN 2002 or via Zoom.
Jan. 30: Unraveling ketone metabolism in the failing heart with Senthil Selvaraj. 5 p.m., DN 2002 or via Zoom.
Feb. 6: Implementation strategies to address the burden of Heart Failure with Harriette Van Spall of McMaster University. 5 p.m., DN 2002 or via Zoom.
All 2023 Duke Cardiology Grand Rounds recordings are housed on Warpwire. To access recordings please visit: https://duke.is/DukeCGR; NET ID and password required. Enjoy!
CD Fellows Core Curriculum Conference
Jan. 17: DHP Case Presentation with Aarti Thakkar, MD. Noon. DMP 2W96 (in-person only).
Jan. 19: Hypertrophic Cardiomyopathy with Andrew Wang, MD. Noon. Zoom only.
Office of Faculty Announces Event with Israni of Stanford Medicine, Feb. 26
Academic Medicine, with all its complexities, naturally includes conflict amongst its crucial collaborators – trainees, faculty, staff, communities and more. 21st century leadership skills require all of us to strategically leverage components of this conflict for constructive change, with intentional and thoughtful actions. This talk will weave together themes from restorative justice and design thinking; and how they can be applied to artificial intelligence and JEDI (justice, equity, diversity, and inclusion), offering a case for new ways of leveraging conflict to advance a culture of connectedness and belonging. The featured speaker will be Sonoo Thadaney Israni of Stanford University’s Presence Center.
February 26: Leveraging Conflict for Constructive Change. 4-5:30 p.m., DN 2002. Presented by the Office for Faculty. Refreshments will follow. To learn more and register: https://duke.is/8/8d7f.
Upcoming CME Symposia for Spring, 2024
Heads up on some CME dates you might want to put on the calendar for next year. Our Duke Sports Cardiology & Sudden Death in Athletes symposium will be held at the Trent Semans Center on Friday, April 12, 2024. And our Duke Heart Failure Symposium will be held at the Durham Hilton on Saturday, May 4, 2024.
Registration won’t be open for a while, but if you have any questions about either event, please reach out to Christy Darnell.
As soon as registration opens, we’ll have that listed here in Pulse.
Have news to share?
If you have news to share with the Pulse readership, please contact Tracey Koepke, director of communications for Duke Heart at tracey.koepke@duke.edu. We would love to hear about your latest accomplishments, professional news, cool happenings, and any events or opportunities that may be of interest to our Duke Heart family. Please call with any questions: 919-681-2868. Feedback on Pulse is welcome and encouraged. Submissions by Noon, Wednesdays, to be considered for weekend inclusion.
Duke Heart in the News:
January 4 — Joseph Turek
Le Monde (France)
January 4 — Joseph Turek
Scripps News
Baby thriving a year after world’s first partial-heart transplant
January 4 — Joseph Turek
Medical Design & Development
‘World’s First’ Partial Heart Transplant Forms Functioning Valves and Arteries
January 4 — Joseph Turek, Lillian Kang, Douglas Overbey, and Michael Carboni
Nature
A record-setting transplant heals a baby’s broken heart
January 5 — Joseph Turek and Michael Carboni
Healio/Cardiology Today
Valves from world’s first partial heart transplant growing with child recipient
January 5 — Robert Mentz
tctMD
Top Heart Failure News of 2023
January 7 — Harry Severance
KevinMD.com/Medpage Today
Leaders advise us to accept it as a job norm: violence and abuse in the health care workplace
January 8 — Brian Duscha and William Kraus
Knowridge (Australia)
Cardiac rehab is a lifesaving choice for people with heart disease
January 8 — Duke University Hospital
Press Ganey
2023 recipients of the Human Experience Pinnacle of Excellence Award
January 8 — Brian Duscha
WPTF (Raleigh)
Rehab helpful for recovering heart patients
*clip begins @ 15:41:27
January 9 — Carolina Tennyson
U.S. News & World Report
Why Nurse Practitioner Is the No. 1 Job of 2024
January 10 — Joseph Turek
Noticias del Mundo
El corazón trasplantado del bebé Owen crece con él por primera vez en el mundo
Duke Heart Pulse — January 7, 2024
Pulse – January 7, 2024
Highlights of the week:
Study of Duke Heart Attack Patients Finds Definitive Benefit of Cardiac Rehab
The benefits of doing cardiac rehabilitation after a heart attack might seem obvious, but studies have provided surprisingly underwhelming findings.
Now an analysis from Duke Health offers definitive evidence for heart attack patients or those who have had procedures to clear blockages: Cardiac rehab saves lives and keeps people out of the hospital — no matter their age, sex, education level, income level, or race.
Publishing in the Journal of Cardiopulmonary Rehabilitation and Prevention, the researchers showed that fewer than 10 percent of patients with cardiovascular disease who can do so participate in cardiac rehab; and those who do have a 43 percent reduction in either mortality or readmission compared to those who do not.
“Our study shows that no matter who your patient is, what clinical characteristics they have, what type of intervention they have to clear blockages — if you send them to cardiac rehab, the benefit is far greater than what previous studies have shown,” said lead author Brian Duscha, an exercise physiologist at Duke.
Duscha and colleagues — including senior author William Kraus, MD, professor of cardiology in Duke’s Department of Medicine – said previous studies about the impact of cardiac rehab had limitations that skewed the findings. Notably, studies often included all discharged heart patients, including those with frailties or conditions that required them to live in a facility without access to rehab, or those who lived too far away from an available rehabilitation center that ruled out participation in a rehab program.
The Duke team analyzed the health records of 2,641 patients in Duke Health hospitals with coronary artery disease; all were considered able to do cardiac rehab at the Duke facility given distance or rehab location. Included patients were those with myocardial infarction and/or who had blockages requiring stenting or bypass surgery.
Among those who were ruled out were patients heading to skilled nursing care, those with valve replacements and heart transplant recipients, or those living more than 50 miles from the Duke rehab center. The researchers accounted for demographics, comorbidities, medical therapies, and demographics in their analysis.
“Not controlling for all these factors may explain the inconsistent findings from other studies assessing cardiac rehab’s impact on clinical outcomes,” Duscha said.
The researchers found that only about 8 percent (214) of the eligible discharged patients actually participated in at least one session of cardiac rehab; 93 percent of those who participated, however, attended five or more sessions.
“Importantly, attending even five sessions equated to a 10 percent significantly reduced risk of readmission or mortality,” Duscha said.
Kraus added that for every session attended, the risk of death or rehospitalization declined by 2 percent. 
“Bottom line – cardiac rehabilitation is effective. It keeps people out of the hospital, saving both money and lives. Why wouldn’t you do that?” Kraus said.
In addition to Kraus and Duscha, study authors include Leanna M. Ross, Andrew L. Hoselton, Lucy W. Piner, and Carl F. Pieper.
The study received funding support from Duke research funds and the Johnston Distinguished Professorship.
First Barostim Implant Performed at Duke
Duke’s first Barostim implant was performed last month by vascular surgeon Chandler Long, MD, as part of a cross-departmental collaboration. Barostim is an implantable device now being used in heart failure patients with reduced ejection fraction.
Duke is currently offering this to patients referred to the Heart Failure Device Clinic for screening. The providers there, including Leilani Gomez, Todd McVeigh, and Marat Fudim, will screen, follow, and titrate the devices for patients in parallel to their routine care at Duke.
“This therapy will provide an alternative and complementary approach to medications for patients with symptomatic HFrEF (over 35 or less) and NYHA 2-3 symptoms despite GDMT,” according to Fudim.
In the future, the team plans to have providers manage the screening and referrals for implants themselves, but titration of devices will remain with the HF Device Clinic.
161 Hearts Transplanted at Duke in 2023
A final count has revealed that our team transplanted 161 hearts in 2023. To celebrate this record, and for reaching our 2000th heart transplant milestone, our team shared special cookies throughout the units last week. We will have our final total thoracic support (Transplant / VAD / Temporary VAD) data in the upcoming weeks. Again Duke Heart is leading the country in many of these areas
Kudos to all!
World’s First Partial Heart Transplant Proves Successful in First Year
The world’s first partial heart transplant has achieved what researchers have spent more than a year hoping for — functioning valves and arteries that grow along with the young patient, as hypothesized by the pioneering team behind the procedure at Duke Health.
The procedure was performed in the spring of 2022, in an infant who needed heart valve replacement. The previous standard of care — using valves that were non-living — would not grow along with the child, requiring frequent replacement, entailing surgical procedures that carry a 50 percent mortality rate.
A study led by Duke Health physicians, appearing online Jan. 2 in the Journal of the American Medical Association, found that the new manner of valve procurement used during the partial heart transplant led to two well-functioning valves and arteries that are growing in concert with the child as if they were native vessels.
“This publication is proof that this technology works, this idea works and can be used to help other children,” said Joseph W. Turek, MD, PhD, first author of the study and Duke’s chief of pediatric cardiac surgery, who led the landmark procedure.
The study also found the procedure requires about a quarter of the amount of immunosuppressant medication than a full heart transplant, potentially saving patients from detrimental side effects that might compound over decades.
Turek said the innovation has paved the way for a domino heart transplant, where one heart can save two lives. During a domino heart transplant, a patient who has healthy valves but needs stronger heart muscle receives a full heart transplant; their healthy valves are then donated to another patient in need, creating a domino effect.
“You could potentially double the number of hearts that are used for the benefit of children with heart disease,” Turek said. “Of all the hearts that are donated, roughly half meet the criteria to go on to be used for full transplant, but we believe there’s an equal number of hearts that could be used for valves.”
“If you introduce the donated hearts that weren’t being put to use into the supply chain and add the valves from domino heart transplants, that can create a substantial change,” Turek said.
The partial heart transplant procedure has been performed 13 times at four centers around the world, including nine at Duke, several of which have been domino heart transplants.
Turek said bringing this innovation to a clinical trial would be the next step to achieving the volume in procedures that would change the availability of hearts by a large amount.
“This innovation adds a lot to the whole donation community,” Turek said, “because it’s treating more kids, while also honoring the wishes of selfless donor parents who’ve given the ultimate gift. It allows them to offer hope to another child in the process.”
Preclinical data was supported by the Brett Boyer Foundation.
In addition to Turek, study authors include Lillian Kang, Douglas Overbey, Michael P. Carboni, and Taufiek K. Rajab.
Sports Performance Coach Takes the Lead Against Sarcoidosis Thanks to Expert Care at Duke
In Fall 2019, William Stephens learned he had cardiac sarcoidosis, a rare autoimmune disease that causes inflammation in the heart. A team of Duke doctors helped Stephens continue to work as a sports performance coach for Duke basketball players. Years later, he experienced a life-threatening sarcoidosis “flare” that sent him to the emergency department. Duke sarcoidosis experts stabilized Stephens quickly and established a more aggressive treatment regimen. Today, his sarcoidosis is in full remission, and the 58-year-old is happy to feel better. “This disease will kill you if you don’t get on top of it,” Stephens said. “I’m very blessed.” 
Something’s Not Right
William Stephens prioritized health from a young age. After spending more than a decade in law enforcement, winning a handful of high-profile powerlifting championships, and becoming a certified strength and conditioning specialist, Stephens joined Duke basketball in 1998. He prioritized living a healthy lifestyle at home and work so when he started noticing fatigue and chest pressure in the summer of 2019, he knew something wasn’t right.
Cardiac Sarcoidosis Diagnosis
Stephens’ primary care doctors ordered a battery of tests, which showed his heart rate was dangerously low and inconsistent, and imaging scans showed scarring on his heart. Both signs indicated Stephens could have sarcoidosis. Its cause unknown, sarcoidosis encourages the immune system to form clumps of inflammatory cells that can attack organs including the heart (doctors call this cardiac sarcoidosis). Common sarcoidosis risk factors include age (between 20 and 60 years old) and African American descent, both of which applied to Stephens.
Recognized Sarcoidosis Clinic
Stephens’ doctors referred him to Duke’s Sarcoidosis Clinic, which is recognized by international organizations like the World Association for Sarcoidosis and Other Granulomatous Disorders (WASOG). The clinic’s specially trained providers work together to treat people with sarcoidosis and related complications. Stephens met advanced heart failure specialist Ravi Karra, MD; electrophysiologist James Daubert, MD; and rheumatologist Jayanth Doss, MD.
“Our multidisciplinary providers have expertise in different areas of sarcoidosis, and we work as a team,” Dr. Karra said. He likened it to legendary Duke men’s basketball Coach Mike Krzyzewski’s well-known teamwork analogy: a fist is much more powerful than five individual fingers.
Treatment Plan Includes Heart Device
To address Stephens’ immune response, decreased heart function, and heart rhythm issues, Drs. Karra, Daubert, and Doss recommended medications as well as a combination pacemaker/implantable cardioverter defibrillator (ICD).
“I’ll never forget that phone call when Dr. Daubert told me I had to get a pacemaker. It was a shock,” Stephens said. “Your mind goes a lot of places when someone says, ‘You need something to help your heart do what it’s supposed to do.’ That was hard to digest.”
A Dangerous Flare
Stephens’ pacemaker/ICD was surgically implanted in October 2019. He felt better, returned to work, and had regular check-ups with his doctors. In Spring 2022, Stephens was driving by Duke University Hospital when he felt like someone hit his car from behind. When it happened again, he realized he was being shocked by his ICD. That meant his heart was in a dangerous rhythm. He called his Duke care team, who immediately sent him to the emergency room. “By the time I got to the ER, they took me right back and got everything under control,” Stephens said.
According to Dr. Karra, Stephens was experiencing unstable ventricular tachycardia, a dangerous arrhythmia, or irregular heartbeat that doctors call a “VT storm.” PET scans showed increased inflammation in Stephens’ heart, indicating a sarcoidosis flare — a sudden worsening of an otherwise stable condition. His doctors recommended more aggressive treatment with a different combination of medications. Quick, expert treatment at Duke probably saved his life that day, Stephens said. Four days later, he returned home.
Looking Forward
Since then, follow-up PET scans have shown no evidence of sarcoidosis activity. Stephens is now in his 26th year with Duke athletics and said he’s grateful for how in-tune Duke providers are with their patients.
“We are a very patient-centered program,” Dr. Karra said. “And for Mr. Stephens, we considered things very carefully. What does it mean for him to go back to work? How can he be productive in his role and his job? We want to help people not only prolong their lives but also to enjoy it and have fulfilling experiences.”
Dr. Karra emphasized that Duke can offer the full range of sarcoidosis treatment options, including heart and other organ transplants for the most severe cases. “We can help people at all stages of their disease, including very complex sarcoidosis that’s no longer responding to treatment,” he said. “That’s not true anywhere else in North Carolina.”
Stephens’ story was published last week on DukeHealth.org.
Selvaraj Receives FSR Research Grant Award
Congratulations to Senthil Selvaraj!
The Foundation for Sarcoidosis Research (FSR) announced last month that Selvaraj was one of two $50,000 grant award winners in support of research aimed at improving the diagnosis, management, and treatment of cardiac sarcoidosis.
Selvaraj, an assistant professor of medicine in the Section of Advanced Heart Failure and Transplant at Duke University Medical Center and faculty member at the Duke Molecular Physiology Institute was selected for his innovative project, “Diagnostic Utility of SGLT2 Inhibition to Facilitate Myocardial Glucose Suppression During Evaluation of Cardiac Inflammation on FDG-PET,”
“We are absolutely delighted to receive this funding support from the FSR,” says Selvaraj. “With this grant, we aim to improve the specificity of cardiac sarcoidosis diagnosis with FDG-PET using a novel strategy incorporating combined SGLT1/2 inhibition with sotagliflozin. Further, we leverage a strong academic collaboration between Duke University and the University of Pennsylvania with co-PI Dr. Paco Bravo.”
“FSR is thrilled to support this extraordinary project through our cardiac sarcoidosis-specific grant,” says Mary McGowan, FSR’s CEO. “The learnings from this research could be groundbreaking in improving diagnosis, prognosis assessment, and treatment management of not only those living with cardiac sarcoidosis but for many other inflammatory diseases.”
The FSR’s second grant award goes to Daniela Čiháková, MD, PhD, of Johns Hopkins University School of Medicine and Department of Molecular Microbiology and Immunology for her project, “3D Morphological and Spatial Transcriptomic Analysis of Cardiac Sarcoidosis.”
To learn more about FSR’s Research and Grant Programs, please visit www.stopsarcoidosis.org/fsr-grants/.
1st DUH BEE Award Recognizes Simpson
We are pleased to share that Danielle Simpson, Health Unit Coordinator for 3100, received the very first BEE Award at Duke University Hospital the week of Dec. 19, 2023. The Being Exceptional Everyday (BEE) award is presented to unlicensed personnel who patients and their loved ones nominate for going above and beyond to make a difference in their or their loved one’s care.
There will be 6 winners announced quarterly across DUH for this award.
Congratulations to Danielle for her exceptional work in caring for our patients and their loved ones!
ICYMI: Duke Heart Contributes to Cardiovascular Manual for the Advanced Practice Provider
Congratulations to the following members of the Duke Heart team for their contributions to the recently published Cardiovascular Manual for the Advanced Practice Provider. 
Allen Stephens, Todd McVeigh, and Cary Ward along with Elisabeth A. Powell (Banner University) and Larry Watts (Atrium Health) co-authored chapter 19 on Infective Endocarditis; Carolina Tennyson author of chapter 21 on Heart Failure with Preserved Ejection Fraction; and Allison Dimsdale who co-authored chapter 30 on Prevention of Cardiometabolic Disease with Christopher Kelly of UNC.
The book was published last month by Springer (eBook ISBN 978-3-031-35819-7, Print ISBN 978-3-031-35818-0).
Great work! Congratulations to all!
New Visitor Restrictions In Effect, Jan. 3, 2024
Due to the increase in respiratory illness throughout our communities and after consulting with our Infectious Disease and Infection Prevention experts, Duke has updated visitation restrictions as of Wednesday, January 3.
- Visiting hours are from 8 a.m. – 9 p.m.
- Visitors must check in at the hospital information desk to receive a visitor badge to enter inpatient areas.
- All visitors must be age 12+. (Visitors in some clinical areas must be age 18+.)
- Minors are required to be attended by an adult age 18+ at all times.
- A maximum of two visitors are allowed per patient.
- Visitors must check out upon departure at a kiosk or with information desk staff.
- Visitors with fever, cough, or other flu-like symptoms should not visit.
For more details, refer to the Tier 2 visitation standard work document. Updated signage is posted.
These changes are being implemented at Duke University Hospital, Duke Regional Hospital, and Duke Raleigh Hospital, as well as Duke Ambulatory Surgery Center, Duke Health Center Arrington, Duke North Pavilion, and the James E. Davis Ambulatory Surgical Center.
We realize that these changes may be challenging to patients, visitors, and team members. We appreciate your support as we continue to implement practices that ensure we provide a safe place for healing.
Please note: Additional visitation and masking precautions may apply to certain patient populations, including without limitation, COVID-19/Special Airborne Contact, oncology, end-of-life, and overnight visitors. Please follow all unit guidelines. Exceptions to visitation restrictions may be granted based on special circumstances, including without limitation, to permit Compassionate Care Visitors.
Upcoming Events & Opportunities
- Happy 100th Birthday, Duke University! 2024 marks the centennial anniversary of the
founding of Duke University. The Centennial Celebration Kickoff will take place at 4 p.m. in Cameron Indoor Stadium on Tuesday, Jan. 9, followed by a ‘Winter Chill’ reception outside in K-ville at 5:30 p.m. The Kickoff requires a ticket for entry, but the reception is open to all Duke faculty, staff, students, alumni, and guests. To get all the details, please visit the Centennial web page. Stay tuned for a full year of celebratory events!
Cardiology Grand Rounds
Jan. 9: All you need to know about the new AF guidelines in the new year! with Jonathan Piccini. 5 p.m., DN 2002 or via Zoom.
All 2023 Duke Cardiology Grand Rounds recordings are housed on Warpwire. To access recordings please visit: https://duke.is/DukeCGR; NET ID and password required. Enjoy!
CD Fellows Core Curriculum Conference
Jan. 10: EP Case Presentation with Belal Suleiman, MD, and Aubrie Carroll, MD. Noon. DMP 2W96 (in-person only).
Jan. 12: PAD-Aorta with Jennifer Rymer, MD. Noon. Zoom only.
MDEpiNet: RAPID PASSION CV Virtual Think Tank, Jan. 9
Predictable And SuStainable Implementation Of National CardioVascular Registries: PASSION CVR — Registry-Supported Infrastructure Development for Prospective Trials: Pathways for DEI and “Long, Long” Term Vital Status Use Cases
Tuesday, January 9, 2024, 12:00 p.m. – 4:00 p.m. EST
Meeting Objectives:
- Pragmatic aspects of CV device research approaches to DEI issues.
- Pragmatic aspects of developing a streamlined, high quality, “long, long” (> 5 yr) vital status profile that could be predictably and reliably accessed by clinical trial sponsors and sufficient for public health safety assessments going forward.
Office of Faculty Announces Event with Israni of Stanford Medicine, Feb. 26
Academic Medicine, with all its complexities, naturally includes conflict among its crucial collaborators – trainees, faculty, staff, communities, and more. 21st century leadership skills require all of us to strategically leverage components of this conflict for constructive change, with intentional and thoughtful actions. This talk will weave together themes from restorative justice and design thinking; and how they can be applied to artificial intelligence and JEDI (justice, equity, diversity, and inclusion), offering a case for new ways of leveraging conflict to advance a culture of connectedness and belonging. The featured speaker will be Sonoo Thadaney Israni of Stanford University’s Presence Center.
February 26: Leveraging Conflict for Constructive Change. 4-5:30 p.m., DN 2002. Presented by the Office for Faculty. Refreshments will follow. To learn more and register: https://duke.is/8/8d7f.
Upcoming CME Symposia for Spring, 2024
Heads up on some CME dates you might want to put on the calendar for next year. Our Duke Sports Cardiology & Sudden Death in Athletes symposium will be held at the Trent Semans Center on Friday, April 12, 2024. And our Duke Heart Failure Symposium will be held at the Durham Hilton on Saturday, May 4, 2024.
Registration won’t be open for a while, but if you have any questions about either event, please reach out to Christy Darnell.
As soon as registration opens, we’ll have that listed here in Pulse.
Have news to share?
If you have news to share with the Pulse readership, please contact Tracey Koepke, director of communications for Duke Heart at tracey.koepke@duke.edu. We would love to hear about your latest accomplishments, professional news, cool happenings, and any events or opportunities that may be of interest to our Duke Heart family. Please call with any questions: 919-681-2868. Feedback on Pulse is welcome and encouraged. Submissions by Noon, Wednesdays, to be considered for weekend inclusion.
Duke Heart in the News:
December 11 — Harry Severance
ACEP Now
December 18 — Jonathan Piccini
Medical Dialogues (India)
Cold weather may raise the risk of heart problems, say researchers
December 19 — Harry Severance
Becker’s ASC Review
10 ASC leaders’ thoughts that rocked 2023
December 19 — Manesh Patel
WRAL-TV Raleigh
Family raises awareness about severity of flu in children after death
(*clip begins @ 16:31:08)
December 26 — Manesh Patel
Fox News (national)
December 26 — Joseph Turek & the Hobby family
WNCN-TV Raleigh
A NC baby was able to both give and receive the gift of life
(*clip begins @ 18:12:40)
December 27 — Manesh Patel
WRAZ/WRAL-TV Raleigh
Cardiac deaths spike during holidays. Why?
December 27 — Joseph Turek & the Monroe family
Star News (Wilmington, NC)
After receiving the world’s first partial heart transplant, a Leland toddler is thriving
December 27 — Manesh Patel
Arab Times
Innovative procedure offers hope for treatment-resistant blood pressure
December 29 — Manesh Patel
American Talk
‘Game-changing’ procedure could have major impact on heart disease by treating this ‘silent killer’
December 31 — Adrian Hernandez
Medpage Today/Opinion
‘It Is a Horrifying Prospect’: What We Heard This Year
January 2 — Joseph Turek, Nick & Owen Monroe
CNN
Groundbreaking procedure allows heart repairs to grow with children, new study shows
*carried by 35+ CNN affiliates and CNN Panorama Mundial
January 2 — Joseph Turek
Medpage Today
Donated Heart Valves Still Growing a Year After World’s 1st Partial Heart Transplant
January 2 — Joseph Turek
Becker’s Hospital Review
Duke reports success in world’s 1st partial heart transplant
January 2 — Joseph Turek, Lillian Kang, Douglas Overbey, Michael P. Carboni, and Taufiek K. Rajab
WRAL news
Duke breakthrough: Transplanted parts of heart are growing along with child
January 4 — Svati Shah
HFMA.org
Tailoring care to the patient’s needs presents an opportunity for hospitals and physicians.
Duke Heart Pulse — December 17, 2023
Chief’s message:
Happy holidays! This is our final Pulse of 2023 – so, as we close out the calendar year, thank you for all the terrific work you have done this year and for your many good-news submissions to us. We look forward to 2024 where we will continue to focus on the difference we can make in each others lives, our community, and the future leaders of cardiovascular medicine.
We are taking the next two weekends off. We’ll return with the latest news and shout-outs on Sunday, Jan. 7. On behalf of the Duke Heart leadership team, we wish each of you and your loved ones a safe and joyous New Year.
Please find some photos from the Duke Heart Center Holiday Party Photo Booth at the end of the pulse this week.
Highlights of the week:
Heart Team Clears 150 Transplants for 2023; Surpasses 2000 Total
We are thrilled to share that our Heart Transplant team has set a new record! The team has now transplanted more than 150 hearts this year – a feat we believe no other U.S. institution has achieved. They also surpassed a program milestone: transplanting our 2000th recipient one week ago today. The numbers include pediatric and adult transplant cases.
“I am really proud of the work the team did this year,” says advanced heart failure specialist Adam DeVore, MD, medical director of Duke’s Heart Transplant Program. “The volume and the numbers we have reached are a big deal, but when you think about what they represent — the number of lives we have impacted, it’s pretty amazing. Just think about how many kids went on to grow up, and parents who were able to continue raising their kids, and grandparents who were able to see their families grow. We’ve helped a remarkable number of people and that is what it’s all about.”
Cardiovascular and thoracic surgeon Jeff Keenan, MD, performed Duke’s 2000th heart transplant last weekend. Keenan, who did his surgical residency and training at Duke, recently returned to Duke after two years on the faculty of the University of Washington Medical Center in Seattle.
“I think for our entire team and program, this is a great accomplishment,” says Keenan. “This reflects a great commitment to our patients with advanced heart failure from the institution and the whole team. It reflects a whole lot of hard work from a lot of people over a long period.”
DeVore’s pride in the team is palpable.
“This is a really remarkable achievement, and I am proud to be part of it. I cannot overstate how important this success is overall for Duke Heart Center. This is not a transplant achievement,” says DeVore, “This is a result of the entire Duke Heart team. These patients are cared for within the Heart Center for a long time before they need a heart transplant. Then, even afterward, our patients continue to be touched by all the different areas within Heart services – from cardiac imaging to the cardiac catheterization lab and electrophysiology, and all of the care units – this is a huge testament to what we’re able to do here, together, within Duke Heart.”
Reaching this number of successful transplants goes beyond just a handful of people, DeVore and Keenan both say. The success is due to the efforts of literally hundreds of people contributing over many years.
“Contributions come from across the spectrum. From everyone who takes care of these patients,” Keenan says. “This includes cardiology, our transplant coordinators, the support teams, social workers, our cardiothoracic anesthesiology team, our OR and CTICU support teams, and then all of the staff and support coming through Duke Hospital – and I’m sure there are a lot of people who do things to support us that I have no idea about that make everything ultimately work.”
DeVore notes the energy and dedication of Jacob Schroder, MD, surgical director of the Heart Transplant program. “Jacob has been like the engine for this team. He really has been a driving force and has done so much for the program. We have a great team, we’re doing great work, and love working together.”
Duke’s heart transplant program, established in 1985, has experienced annual growth for nearly a decade, according to DeVore. “It has grown every year since 2015, which is remarkable. Year over year, growth like this is difficult to sustain, but there are no signs of letting up. He says the growth has come through partnering with other great heart failure programs throughout the southeast, and also through innovation and research.
“Any time we’re a part of new discovery, that’s a great thing,” DeVore adds. “But to be able to do it and immediately impact care and see results like this is really, really rewarding and certainly a great thing. Hopefully, we can take this and educate other centers on how to do this so we can keep expanding transplant across the globe, too.”
Congratulations to all for a great year!
Ngeno Among Five Recipients of Inaugural Corey Legacy Award
Congratulations to cardiologist Titus Ngeno, MD, MSc-GH, assistant professor of medicine! Ngeno is among five inaugural recipients of the Dr. G. Ralph Corey Legacy Award. The awardees were announced last week by the Hubert-Yeargan Center and Duke Clinical Research Institute, the partnering organizations that created the award and established a research fund to carry on Dr. Corey’s vision of “developing the next generation of globally educated, socially responsible clinician educators and scientists dedicated to improving health equity at home and abroad.”
Ngeno and Neelima Navuluri, MD, MPH, assistant professor of medicine in the division of pulmonary, allergy, and critical care, together were named awardees for their collaborative research project, Validation of Cardiopulmonary Rehabilitation Patient Related Outcome Measures among Adults in Kenya” which will be conducted at Moi Teaching and Referral Hospital in Eldoret, Kenya.
Cardiopulmonary diseases are the leading cause of death globally and exert a disproportionate burden of morbidity in low income regions of the world such as Sub-Saharan Africa. One effective intervention for treatment of cardiopulmonary disease is cardiopulmonary rehabilitation. Such rehabilitation involves a comprehensive set of patient-tailored treatments such as aerobic exercise, endurance training, strength exercises, education, and behavior change designed to improve physical and psychological well-being among patients with chronic cardiac and pulmonary disease. It improves exercise tolerance, functional status, respiratory symptoms, depressive symptoms and quality of life among patients with chronic cardiovascular and respiratory diseases such as heart failure, chronic obstructive lung disease and post-tuberculosis lung disease.
However, cardiopulmonary rehabilitation is not widely available in most of sub-saharan Africa, including in Kenya, according to the team’s project proposal. Thus, there is a critical need for further implementation studies to increase evidence for and availability of rehab programs.
Ngeno and Navuluri’s co-principal investigators include Neil MacIntyre, professor of medicine in the division of pulmonary, allergy, and critical care; Dr. David Lagat of Moi University School of Medicine, and Dr. Carolyne Lusweti, Moi Teaching and Referral Hospital.
Ngeno and Navuluri’s project aims to assess which cardiopulmonary functional assessment and quality of life measures are most appropriate for the Kenyan setting. The study will enroll 102 participants comprising healthy controls, patients with pulmonary disease (chronic obstructive lung disease, post-tuberculosis lung disease), and patients with cardiac disease (valvular and non-valvular disease, heart failure). Functional capacity and quality of life assessments will be compared across groups. The project findings will yield insight into which metrics would be most appropriate for routine clinical assessments as well as establish reference ranges for future research studies.
Additional inaugural recipients are Hutton Chapman, MD, Sharla Rent, MD, and Sweta Patel, MD. To learn more about the Corey Legacy Award, visit https://duke.is/6/dm83; to read about the other research projects funded this year, please see the lead story in the Hubert-Yeargan Center for Global Health’s latest quarterly newsletter: HYC Happenings – Fall 2023
Congratulations, Titus!
Kudos to Melissa Williams!
Congratulations to Duke Heart Center of Excellence team member Melissa Williams! Williams graduated from Duke Management Academy’s year-long
program on Wed., Dec. 13. The program, created for mid-level managers, is part of Duke’s commitment to develop leaders at all levels within Duke University and Health System. Williams is clinical manager of our registry team in CV Informatics and Quality Improvement.
Her team (comprised of Williams, Keith Holder, Aris Marton, Katherine Fox, and Danielle Wiggins) received the best presentation and paper award for their project, “Help at Students’ Fingers: A Mobile App to Navigate Well-being Resources”.
Way to go, Melissa!
Duke Heart continuing innovation with Impella RP Flex
Imran and Jeff worked together placing the first RP Flex Impella this week. Some pictures included. This is gratifying after our team worked to help with some of the first RP trial patients in the OR and cath labs. Great work team!
New publications from the Duke Heart Team
Congratulations to Bill Kraus, MD and his co-authors on their latest publication!
The Science of Precision Prevention: Research Opportunities and Clinical Applications to Reduce Cardiovascular Health Disparities was published online this week in JACC: Advances.
Duke Health Signs Pledge for Ethical, Responsible AI in Health Care
Duke Health is among a leading group of health systems and payers from across the U.S. to sign a pledge advancing ethical and responsible use of Artificial Intelligence technology in health care.
The pledge announced today at the annual conference hosted by the Office of the National Coordinator for Health Information Technology, is a voluntary commitment to the principles of safety, security and trust that are fundamental to the future of AI.
“AI presents unequalled potential for advancing health with new scientific discoveries, improved diagnoses and treatment of diseases and better systems that free our workers to dedicate their expertise to patient care rather than administrative chores,” said Craig T. Albanese, MD, chief executive officer of Duke University Health System.
“But we recognize that AI also has the potential to be misused,” Albanese said. “By signing this pledge, we are publicly stating our commitment to work toward the better good.”
Mary Klotman, MD, executive vice president for health affairs at Duke University and dean of Duke University School of Medicine, said establishing Duke’s role as a leader in trustworthy AI has been an institutional priority for years and is foundational to advancing better health.
“This pledge actually reflects many years of work that Duke Health has already undertaken to establish the infrastructures we need to pursue AI with integrity,” Klotman said. “It puts us on record with our commitment.”
In addition to signing the pledge, Duke Health has been a founding member of the Coalition for Health AI, or CHAI, established to develop guidelines and guardrails for fair and credible applications of AI in health care.
Duke Health has also built a framework for the governance and evaluation of clinical algorithms used throughout the organization. Duke’s Algorithm-Based Clinical Decision Support framework is designed to foster innovative, safe, equitable, and high-quality patient care. This is achieved with human oversight throughout the use of an AI program to ensure that transparency, quality, and ownership are maintained.
“First and foremost, AI should serve humans,” said Michael Pencina, PhD, Duke Health’s chief data scientist and director of Duke AI Health. “It’s imperative that AI is developed and applied in a trustworthy manner, and we have been engaged in establishing that foundation for the last few years, as evidenced by our role in CHAI and recent publications. We are not catching up on this — it’s something that has been a differentiator in terms of being careful and proactive — and our signature on the pledge is a further confirmation of our commitments.”
ICYMI: December Leadership Town Hall
The latest Duke University Health System Leadership Town Hall video from Tuesday, Dec. 12, is now available on Leadership Café. Check it out when you get some time. Leadership Town Hall is held via Zoom on the 4th Tuesday of each month from 12-12:45 p.m.
Upcoming Events & Opportunities
- Masking is strongly recommended throughout all clinical areas during respiratory virus season, from now through early March. It is currently mandatory in 7E/CICU through 12/21.
- Lots of holiday fun in-house throughout the holiday season! Be sure to check out Season’s Greetings Bingo; pop-up Cheer Stations (13th-18th); and Tribute Snowflakes: An Act of Remembrance in the corridor from DMP to Duke Central Tower throughout December. Details on the DUH SharePoint site.
- Everyone working at DUH on Monday, Dec. 25 is invited to enjoy a complementary holiday meal.
Cardiology Grand Rounds
Dec. 19: AHA Recap, part 2 with Manesh Patel and Kristin Newby. 5 p.m., DN 2002 or via Zoom.
All 2023 Duke Cardiology Grand Rounds recordings are housed on Warpwire. The AHA Recap, Part 1 from Dec. 12 has been uploaded. To access recordings please visit: https://duke.is/DukeCGR; NET ID and password required. Enjoy!
CD Fellows Core Curriculum Conference
Dec. 20: EP Case Presentation with Ivan Nenadic Wood and Husam Salah. DMP 2W96 (in-person only).
Dec. 22: No CD Fellows Core Curriculum conference today. Happy holidays!
MDEpiNet: RAPID PASSION CV Virtual Think Tank, Jan. 9
Predictable And SuStainable Implementation Of National CardioVascular Registries: PASSION CVR — Registry-Supported Infrastructure Development for Prospective Trials: Pathways for DEI and “Long, Long” Term Vital Status Use Cases
Tuesday, January 9, 2024, 12:00 p.m. – 4:00 p.m. EST
Meeting Objectives:
- Pragmatic aspects of CV device research approaches to DEI issues.
- Pragmatic aspects of developing a streamlined, high quality, “long, long” (> 5 yr) vital status profile that could be predictably and reliably accessed by clinical trial sponsors and sufficient for public health safety assessments going forward.
Office of Faculty Announces Event with Israni of Stanford Medicine, Feb. 26
Academic Medicine, with all its complexities, naturally includes conflict amongst its crucial collaborators – trainees, faculty, staff, communities and more. 21st century leadership skills require all of us to strategically leverage components of this conflict for constructive change, with intentional and thoughtful actions. This talk will weave together themes from restorative justice and design thinking; and how they can be applied to artificial intelligence and JEDI (justice, equity, diversity, and inclusion), offering a case for new ways of leveraging conflict to advance a culture of connectedness and belonging. The featured speaker will be Sonoo Thadaney Israni of Stanford University’s Presence Center.
February 26: Leveraging Conflict for Constructive Change. 4-5:30 p.m., DN 2002. Presented by the Office for Faculty. Refreshments will follow. To learn more and register: https://duke.is/8/8d7f.
Call for Abstracts: Duke’s Annual Quality & Safety Conference
Save the date for Duke’s Annual Quality and Safety Conference scheduled for April 11 in the Trent Semans Center. Click here to view Abstract Guidelines. Abstracts are due by 5 p.m. on Dec. 31, 2023. Late submissions will not be accepted. Contact cynthia.gordon@duke.edu or kyle.rehder@duke.edu with any questions.
Upcoming CME Symposia for Spring, 2024
Heads up on some CME dates you might want to put on the calendar for next year. Our Duke Sports Cardiology & Sudden Death in Athletes symposium will be held at the Trent Semans Center on Friday, April 12, 2024. And our Duke Heart Failure Symposium will be held at the Durham Hilton on Saturday, May 4, 2024.
Registration won’t be open for a while, but if you have any questions about either event, please reach out to Christy Darnell.
As soon as registration opens, we’ll have that listed here in Pulse.
Have news to share?
If you have news to share with the Pulse readership, please contact Tracey Koepke, director of communications for Duke Heart at tracey.koepke@duke.edu. We would love to hear about your latest accomplishments, professional news, cool happenings, and any events or opportunities that may be of interest to our Duke Heart family. Please call with any questions: 919-681-2868. Feedback on Pulse is welcome and encouraged. Submissions by Noon, Wednesdays, to be considered for weekend inclusion.
Duke Heart in the News:
December 5 — Nishant Shah and Neha Pagidipati
Medscape
Meet the Newest Acronym in Primary Care: CKM
December 6 — Stephen Greene
HCP Live
Semaglutide: The Drug of Today and a Steppingstone to Tomorrow
December 7 — Joseph Turek, Paul Martin, and the Nolasco family
Texas Tribune
How one family carved out Medicaid coverage for a rare treatment
December 9 — Jonathan Piccini
The Washington Post
Cold weather may raise the risk of this heart problem
December 11 — Marat Fudim
HealthCentral
The Four Stages of Congestive Heart Failure
December 11 — Svati Shah
American Heart Association Newsroom
Scholars named for research leadership program to increase diversity in clinical trials
December 11 — Jacob Schroder
The Hearty Soul
Doctors Brought Dead Heart ‘back to life’ For Groundbreaking Transplant**
**originally published in Jan. 2020; this is an updated version
Duke Heart Pulse — December 10, 2023
Highlights of the week:
MUSIC-HFpEF1 Trial Launches at Duke
We are excited to announce a new clinical trial taking place at Duke and led by advanced heart failure specialist Marat Fudim, MD. The Modulation of SERCA2a In Cardiomyopathy – Heart Failure with Preserved Ejection Fraction (MUSIC- HFpEF1) clinical trial launched in early November with the dosing of our first enrolled patient at Duke University Hospital. Our second patient was enrolled last week.
MUSIC-HFpEF1 is a first-in-human trial using gene therapy to modify the pathophysiology of heart failure with preserved ejection fraction. Half of all heart failure patients are diagnosed with HFpEF, characterized by abnormal ventricular relaxation and elevated filling pressures. The trial, led by Fudim along with interventional cardiologist Manesh Patel, MD, as sub-investigator, presents a true multidisciplinary effort as it includes the expertise of members of the Duke Early Phase Research Unit (DEPRU), the cardiac catheterization lab, and the Cardiac Diagnostic Unit (CDU).
The study drug is an adeno-associated virus (AAV)-based gene therapy that is directly delivered to cardiac ventricular muscle cells via a proprietary intracoronary infusion system for enhancing the protein expression and functional activity of the SERCA2a gene.
“We believe this should, at least in theory, reduce the stiffness of the heart, which is the key problem in HFpEF,” Fudim said.
The trial will enroll patients with HFpEF confirmed by rigorous exercise hemodynamics and gas exchange in an open-label, dose-escalation, 52-week Phase 1b/2a clinical trial. The trial is being conducted at two sites, Duke and the University of Texas Southwestern.
While the initial primary goal is to assess safety following intra-coronary SRD-001 infusion, clinical efficacy will also be assessed with cutting-edge approaches.
If you have patients you think might be suitable and interested in participating, or if you have additional questions about the study, please contact Marat Fudim.
Visiting Moi CV Faculty Update
We received thoughtful feedback this week from our recent visitors from Moi University and Teaching Hospital in Eldoret, Kenya. Thanks to everyone who helped support Titus Ngeno, our Duke-Kenya cardiovascular lead, in hosting Drs. Joan Kiyeng and David Lagat, members of the Moi cardiology faculty who visited us in October.
Kiyeng and Lagat spent time observing and learning some of Duke Heart’s best clinical practices and learning more about our care delivery and management systems. Additionally, they were able to get to know members of our faculty better.
Of note, they spent time with Terry Fortin and Nishant Shah in the Cardiac ICU, where they observed the care of our LVAD patients and advanced heart failure population; and time in the cardiac catheterization lab with Andrew Wong, David Kong, Jenn Rymer, Marat Fudim, Schuyler Jones, and Rich Krasuski and were able to observe the watchman procedure, TAVI, complex caths, and post-transplant biopsies. They spent time with members of our electrophysiology team, including Larry Jackson, Camille Frazier-Mills, Zak Loring, Rob Lewis, and James Daubert, and observed several ablations for atrial fibrillation, as well as device implantations. They even had the opportunity to practice using an intracardiac ultrasound stimulator.
During their visit to the PAC and our Consult Services team, they spent time with Gerald Bloomfield, Titus, Cary Ward, and Michelle Kelsey, and more time with both Jerry and Titus, as well as Sreek Vemulapalli while visiting the CDU, and with Igor Klem to observe patients undergoing cardiac MRI.
In their follow-up report to Duke about their visit, the team noted our “excellent atmosphere” for mentorship, learning, and patient care with dedicated and motivated staff, along with excellent teamwork and support systems with highly trained personnel that make clinical care seamless.
“Thank you for the immense support, and engagement with our cardiology colleagues from Kenya during their recent trip to Duke,” said Ngeno. “Joan and David had very productive interactions and great conversations exploring future growth opportunities. They also got to watch a (winning) Duke football home game, courtesy of Duke alums John H. Lawrence & John E. Lawrence.”
Thanks again to all who made this site visit possible and successful, and for taking the time to share your knowledge with Joan and David.
Great job!
DUSON, CTSI Collaborate to Advance Research in Health Equity
Through a collaboration designed to advance research in health equity and social drivers of health, the Duke Clinical and Translational Science Institute (CTSI) and the Center for Precision Health have partnered with the Center for Nursing Research at the Duke University School of Nursing (DUSON) to bring more than 20,000 biological samples and linked data from a community-based registry at Duke Kannapolis to investigators at DUSON.
The new DUSON-MURDOCK Biorepository includes de-identified samples and associated data from nearly 12,000 racially and ethnically diverse participants in the Kannapolis Population Based Cohort, a longitudinal cohort based at CTSI’s research site in Kannapolis.
“We are thrilled to make thousands of biospecimens and associated clinical and outcome data available to the School of Nursing through this science-forward collaboration,” said Svati Shah, MD, MHS, who directs Duke Kannapolis and the Center for Precision Health. “This partnership is exactly what we envisioned when we created our biorepository initiative with the intention to share this powerful resource with more Duke collaborators.”
The Biorepository Transformation Initiative is available to all Duke researchers, who can complete this brief interest form as a first step toward accessing samples. DUSON is well and uniquely positioned to tap into this initiative to create a local biorepository to facilitate biomarker research to support their strategic priorities in health equity, social drivers of health, and nurse-led models of care.
“We are excited to test hypotheses exploring how social and contextual experiences can be embedded in our biology and thus our health. Understanding how these experiences impact health is a key piece of our strategic plan for research,” said Sharron L. Docherty, PhD, PNP, RN, FAAN, vice dean for research at DUSON. “Thanks to the sample size, diversity, and the number of chronic health conditions present across this data set, we can explore vital questions related to how the environment influences biology.”
Researchers at DUSON will use their DUSON-MURDOCK Biorepository in two relatively new areas of research: social epigenetics, or how social experiences become embodied in humans and can impact health in positive and negative ways, and social genomics, or how fixed biological traits underpin health outcomes that are influenced by social factors, such as stress.
“Duke Kannapolis will be a valuable collaborator as we explore ways to use these biospecimens to better understand how a genetic predisposition for a health outcome may be modified by social factors, and in turn, how social factors may become genetically embedded in humans, changing biological function,” said Julia K.L. Walker, PhD, director of the DUSON-Biomarker Laboratory. “The database is a remarkable resource.”
Data generated from the project will be returned to the Kannapolis database for other investigators to use for continued population-based research.
Kais Gadhoumi, PhD, assistant research professor at DUSON, will lead informatics and data management on the project. Duke Kannapolis leadership on the project includes Julie Eckstrand, RPh, executive director for scientific programs, and Douglas Wixted, MMCi, research program leader.
Shout-out to Tcheng!
Congrats to interventionalist Jimmy Tcheng! He has been acknowledged as one of NC’s most respected doctors, as selected by his peers. Check out the Business News article below (under “Duke Heart in the News”.
Bowers Earns FACC
We are thrilled to share with the Duke Heart team that Midge Bowers, DNP, has been elected to Fellowship by the American College of Cardiology. Bowers, a nurse practitioner with our Heart Failure Same Day Access Clinic, is — we believe – the first APP at Duke University Hospital to receive the honor.
As a newly elected Fellow, Bowers has been invited to attend the ACC’s prestigious Convocation ceremony which will be held during the ACC’s Annual Scientific Sessions in Atlanta this coming April.
Congratulations, Midge! This is a wonderful achievement and well deserved!
Cox Earns DNP, Post-Grad Certification
Congratulations to Kevin Cox who graduated from the Duke University School of Nursing this weekend! Kevin graduated with a Doctorate in Nursing Practice and a Post-Graduate Certificate in Nursing Education. His project entitled “Implementation of Educational Intervention in Duke Left Ventricular Assist Device Department by Adding STOP-BANG Sleep Apnea Screening” was implemented at Duke University Hospital.
Congratulations, Kevin!
Filming for ARTEMIS Launch
This week we had the pleasure of hosting a small film crew as part of the collaborative effort between Duke Clinical Research Institute (DCRI) and Novo Nordisk for the ARTEMIS trial, which is expected to launch in mid-2024.
The ARTEMIS trial is a global cardiovascular outcomes study that aims to evaluate the effects of a study medicine versus placebo on cardiovascular outcomes in patients with acute myocardial infarction. This double-blind, randomized trial will follow 10,000 eligible adults for two years. It is a large-scale study to investigate the potential of the study medicine, an IL-6 inhibitor administered once monthly as a subcutaneous injection, to reduce the risk of major adverse cardiovascular events (MACE) in patients with acute myocardial infarction (AMI).
The crew filmed with Adrian Hernandez, MD, MHS, Vice Dean and Executive Director of DCRI and Principal Investigator for ARTEMIS, and interventional cardiologist, Jenn Rymer, MD, MBA, who will serve as the site PI for Duke.
The video will be released early next year as part of a meeting invitation to site investigators. To learn more about the trial, please visit https://duke.is/j/cydp.
New publications from the Duke Heart Team
Congratulations to the following team members on their latest publications!
Role of Advanced Practice Providers in the Cardiac Intensive Care Unit Team, was published online this week in the Journal of the American College of Cardiology. Callie Tennyson, Midge Bowers, Allison Dimsdale, Jordan McKenzie-Solis, and Jason Katz are the Duke representatives among the co-authors.
And Impact and Sustainability of a Palliative Care Education Module in Patients With Heart Failure published in the American Journal of Hospice and Palliative Medicine, published online Dec. 4, 2023. Duke authors are Shelley Thompson, Allison Lindgren, Jaime McDermott, Stephanie Barnes, Carolina Tennyson, and Bradi Granger.
Congrats to all!
Upcoming CME Symposia for Spring, 2024
Heads up on some CME dates you might want to put on the calendar for next year. Our Duke Sports Cardiology & Sudden Death in Athletes symposium will be held at the Trent Semans Center on Friday, April 12, 2024. And our Duke Heart Failure Symposium will be held at the Durham Hilton on Saturday, May 4, 2024.
Registration won’t be open for a while, but if you have any questions about either event, please reach out to Christy Darnell.
As soon as registration opens, we’ll have that listed here in Pulse.
Upcoming Events & Opportunities
- Masking is strongly recommended throughout all clinical areas during respiratory virus season, from now through early March.
- Lots of holiday fun in-house throughout the holiday season. Friday, Dec. 15 is CozyFest: Holiday Sweater Spectactular!, sponsored by Duke University Hospital. Also, be sure to check out Season’s Greetings Bingo; pop-up Cheer Stations (13th-18th); and Tribute Snowflakes: An Act of Remembrance in the corridor from DMP to Duke Central Tower throughout December. Details on the DUH SharePoint site.
- And, everyone working at DUH on Monday, Dec. 25 is invited to enjoy a complementary holiday meal.
Transplant Grand Rounds
Dec. 12: Perioperative Anesthetic Management for Patients Undergoing Solid Organ Transplantation with Adam J. Milam. Noon, DN 2001 or via Zoom.
Cardiology Grand Rounds
Dec. 12: AHA Recap with Manesh Patel and Kristin Newby. 5 p.m., DN 2002 or via Zoom.
All 2023 Duke Cardiology Grand Rounds recordings are housed on Warpwire. The most recent CGRs with Dr. Holger Thiele of the University of Leipzig, Dr. Daniel Friedman of Duke, and Dr. Eric Secemsky of Beth Israel Deaconess Medical Center can all be found there. To access them, please visit: https://duke.is/DukeCGR; NET ID and password required. Enjoy!
CD Fellows Core Curriculum Conference
Dec. 13: HF/Txp Case Presentation with Joshua Rushakoff. Noon, DMP 2W96 (in-person only).
Dec. 15: Diseases of the Pericardium with Andrew Wang. Noon, Zoom only.
MDEpiNet: RAPID PASSION CV Virtual Think Tank Announced
Predictable And SuStainable Implementation Of National CardioVascular Registries: PASSION CVR — Registry-Supported Infrastructure Development for Prospective Trials: Pathways for DEI and “Long, Long” Term Vital Status Use Cases
Tuesday, January 9, 2024, 12:00 p.m. – 4:00 p.m. EST
Meeting Objectives:
- Pragmatic aspects of CV device research approaches to DEI issues.
- Pragmatic aspects of developing a streamlined, high quality, “long, long” (> 5 yr) vital status profile that could be predictably and reliably accessed by clinical trial sponsors and sufficient for public health safety assessments going forward.
Office of Faculty Announces Event with Israni of Stanford Medicine, Feb. 26
Academic Medicine, with all its complexities, naturally includes conflict amongst its crucial collaborators – trainees, faculty, staff, communities and more. 21st century leadership skills require all of us to strategically leverage components of this conflict for constructive change, with intentional and thoughtful actions. This talk will weave together themes from restorative justice and design thinking; and how they can be applied to artificial intelligence and JEDI (justice, equity, diversity, and inclusion), offering a case for new ways of leveraging conflict to advance a culture of connectedness and belonging. The featured speaker will be Sonoo Thadaney Israni of Stanford University’s Presence Center.
February 26: Leveraging Conflict for Constructive Change. 4-5:30 p.m., DN 2002. Presented by the Office for Faculty. Refreshments will follow. To learn more and register: https://duke.is/8/8d7f.
Call for Abstracts: Duke’s Annual Quality & Safety Conference
Save the date for Duke’s Annual Quality and Safety Conference scheduled for April 11 in the Trent Semans Center. Click here to view Abstract Guidelines. Abstracts are due by 5 p.m. on Dec. 31, 2023. Late submissions will not be accepted. Contact cynthia.gordon@duke.edu or kyle.rehder@duke.edu with any questions.
Final Week for A&H Winterfest
The final Thursday of Winterfest Marketplace 2023, will be this week: December 14. The annual holiday art show and sale hosted by Arts & Health at Duke features local North Carolina-based artisans who are displaying and selling their work to Duke Health employees, visitors, and patients in the main concourse of Duke Hospital.
Art will be available for purchase from 11 a.m. to 2 p.m. Featured artisans include Beth Ann Taylor, Chapel Hill Woodturners, Bonnie Toney, and Justin Leitner.
A portion of the proceeds from Winterfest will go back to Arts & Health at Duke, which provides support to patients through music, visual art activities and journaling. This is a great opportunity to support local artists, and the Arts & Health programming at Duke Health, and to score some beautiful holiday gifts for loved ones!
Have news to share?
If you have news to share with the Pulse readership, please contact Tracey Koepke, director of communications for Duke Heart at tracey.koepke@duke.edu. We would love to hear about your latest accomplishments, professional news, cool happenings, and any events or opportunities that may be of interest to our Duke Heart family. Please call with any questions: 919-681-2868. Feedback on Pulse is welcome and encouraged. Submissions by Noon, Wednesdays, to be considered for weekend inclusion.
Duke Heart in the News:
December 1 — James Tcheng
Business North Carolina
2023 Top Doctors: A report on the state’s most respected doctors as selected by their peers
December 5 — David Harpole
OncLive
December 7 — Neha Pagidipati, Jennifer Green, Susan Spratt, Jashalynn German, Matthew Crowley, Ryan Jeffrey, Ranee Chatterjee, and Bryan Batch
AJMC
Inspiring Clinicians to Take Action on Closing Diabetes Care Gaps
Duke Heart Pulse — December 3, 2023
Highlights of the week:
Pauly Named to Duke Health Leadership Roles, Effective Jan. 31
Duke Health has named Gregory Pauly, currently executive vice president and chief operating officer for Massachusetts General Hospital and the Massachusetts General Physicians Organization, to three key leadership roles: group president of Acute Care Services for Duke University Health System; president of Duke University Hospital; and Vice Dean for Clinical and Academic Integration at Duke University School of Medicine. Pauly will join the Duke Health team on Jan. 31, 2024.
In these roles, Pauly will provide oversight of the strategic direction, fiscal management, and program development for all acute care services across DUHS, including Duke University Hospital, Duke Regional Hospital, and Duke Raleigh Hospital campuses.
“Greg is an accomplished health care executive with proven experience in hospital operations, ambulatory practice management, strategic business planning, and clinical program development,” said Thomas A. Owens, MD, executive vice president and chief operating officer of Duke University Health System.
“With his vast experience in the operations and administration of a large academic medical center and ambulatory care network, Greg brings a wealth of knowledge and visionary leadership to his new role as group president for Acute Care Services and president of Duke University Hospital,” Owens said.
“As vice dean, Pauly will collaborate closely with clinical chairs, vice deans, IT leaders and other leaders in the School of Medicine and the health system, as well as other relevant Duke schools, to further strengthen the link between clinical and academic missions,” said Mary Klotman, MD, executive vice president for Health Affairs, Duke University and dean of the School of Medicine.
During his more than 20-year career at Mass General, Pauly led development of multiple system-wide service lines, the launch of an ambulatory care transformation program, and extensive work to reduce barriers to discharge and length of stay.
Pauly was instrumental in enhancing the integration with system physicians through new employment and compensation models as well as developing new plans for provider growth.
He was also directly responsible for all administrative and clinical operations of both the hospital and the physician’s organization, enhancing the integration with system physicians through new employment and compensation models as well as developing new plans for provider growth.
We look forward to working with him!
Fellowship Matches Announced
We’re excited to share our fellowship matches for 2024! Matches were announced on November 29 as part of National Fellowship Match Day.
Congratulations to the following ten fellows who are joining our Cardiology Fellowship training program:
- Tess Allan will join us from the University of Chicago
- Cosette Champion will join us from Washington University, St. Louis
- Vincent Delgado will join us from the University of Texas, Southwestern
- Jemi Galani will join us from Emory
- Mugdha Joshi will join us from Stanford
- Hubie Haywood, Jonathan Kusner, Hannah Schwennesen, and Nishkala Shivakumar will all join us from Duke
- Josh Sink will join us from Northwestern University
Congratulations to our new Advanced Heart Failure fellows:
- Haya Aziz will join us from the University of Pennsylvania, where she is completing her training in cardiac imaging.
- David Elliot will join us from our cardiology fellowship program
- Joseph Lerman will join us from our advanced training in cardiology program
Congratulations to our new Clinical Cardiac Electrophysiology Fellow:
- Ilya Shadrin will join us from our cardiology fellowship program
Congratulations to our Adult Congenital Heart Disease fellow:
- Nina Morgan will join us from the University of Florida
The Department of Medicine released a celebratory Match Day video, to celebrate our Duke internal medicine residents and their matches; a full list of all where Duke residents matche can be found here: https://duke.is/4/hjc9.
A big shout-out to all of our program leaders, current fellows, and faculty members who took time to interview candidates and to showcase all that our programs at Duke have to offer. We’re looking forward to working with our newest team members when they join us in July.
Well done, everyone!
Latest AF Treatment Guidelines Released; Piccini, Thomas among co-authors
Congratulations to Duke electrophysiologists Jonathan Piccini and Kevin Thomas, Duke fellowship graduates Paul Hess and Anne Marie Valente, and to each of their co-authors on the publication of the latest atrial fibrillation treatment guidelines! 
The 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines provides recommendations to guide clinicians in the treatment of patients with atrial fibrillation. It was published this week in Circulation.
Way to go!
Duke Fellows Represent Duke Heart for STEM Goes Red
A big shout out to our amazing fellows, Sarah Snow and Kiki Osude, who generously gave their time to be mentors at the American Heart Association’s “STEM Goes Red” event for middle school girls in Wake and Durham counties on Thursday, November 9. The event hosted 110 girls chosen from local Title I schools to promote interest and increase exposure to the STEM fields.
Kiki and Sarah conducted speed mentoring sessions where they met with 4-5 girls every 7 minutes to discuss STEM opportunities, and in particular, key mentors and role models, obstacles that had to be overcome, and why they decided to pursue medicine/cardiology. The students were really engaged and excited. Neha Pagidipati and Melissa Daubert also participated in the event as expert panelists.
To learn more about the event, you can see a short report here from ABC-11, WTVD, or by visiting the AHA’s website: https://duke.is/2/bd3g
Great work, Sarah and Kiki!!
Shout-outs to Andreae, Lerman, and Sullivan!
We received a shout-out to several cardiology fellows this week:
“A shout out and huge THANK YOU to the following fellows who went above and beyond to cover CICU and night shifts on short notice in the past week: Andrew Andreae, Joe Lerman and Lonnie Sullivan.” — Anna Lisa Chamis, MD
Solid teamwork!
Upcoming Events & Opportunities
- Masking is strongly recommended throughout all clinical areas during respiratory virus season, from now through early March.
Cardiology Grand Rounds
Dec. 5: The Wild, Wild West of Peripheral Intervention: Innovations and Evidence Formation to Standardize Practice with Eric Secemsky of Beth Israel Deaconess Medical Center. 7 a.m., DN2001 or via Zoom. Please note time change!
All 2023 Duke Cardiology Grand Rounds recordings are uploaded to Warpwire. Recordings can be accessed via this link: https://duke.is/DukeCGR; NET ID and password required.
CD Fellows Core Curriculum Conference
Dec. 6: DHP Case Presentation with Jawan Abdulrahim. Noon. In-person only, DMP 2W96.
Dec. 8: EKG Review with Thomas Bashore. Zoom only.
Office of Faculty Announces Event with Israni of Stanford Medicine, Feb. 26
Academic Medicine, with all its complexities, naturally includes conflict amongst its crucial collaborators – trainees, faculty, staff, communities and more. 21st century leadership skills require all of us to strategically leverage components of this conflict for constructive change, with intentional and thoughtful actions. This talk will weave together themes from restorative justice and design thinking; and how they can be applied to artificial intelligence and JEDI (justice, equity, diversity, and inclusion), offering a case for new ways of leveraging conflict to advance a culture of connectedness and belonging. The featured speaker will be Sonoo Thadaney Israni of Stanford University’s Presence Center.
February 26: Leveraging Conflict for Constructive Change. 4-5:30 p.m., DN 2002. Presented by the Office for Faculty. Refreshments will follow. To learn more and register: https://duke.is/8/8d7f.
Call for Abstracts: Duke’s Annual Quality & Safety Conference
Save the date for Duke’s Annual Quality and Safety Conference scheduled for April 11 in the Trent Semans Center. Click here to view Abstract Guidelines. Abstracts are due by 5 p.m. on Dec. 31, 2023. Late submissions will not be accepted. Contact cynthia.gordon@duke.edu or kyle.rehder@duke.edu with any questions.
A&H Winterfest 2023
The dates for Winterfest Marketplace 2023, the annual holiday art show and sale hosted by Arts & Health at Duke, will take place across six Thursdays in November and December, local North Carolina-based artisans will display and sell their work to Duke Health employees, visitors and patients in the main concourse of Duke Hospital.
The event begins November 2 and runs until December 14. During Winterfest, art will be available for purchase on Thursdays from 11 a.m. to 2 p.m. Featured artisans will include Beth Ann Taylor, Chapel Hill Woodturners, Bonnie Toney, and Justin Leitner.
A portion of the proceeds from Winterfest will go back to Arts & Health at Duke, which provides support to patients through music, visual art activities and journaling. This is a great opportunity to support local artists, the Arts & Health programming at Duke Health, and to score some beautiful holiday gifts for loved ones!
Have news to share?
If you have news to share with the Pulse readership, please contact Tracey Koepke, director of communications for Duke Heart at tracey.koepke@duke.edu. We would love to hear about your latest accomplishments, professional news, cool happenings, and any events or opportunities that may be of interest to our Duke Heart family. Please call with any questions: 919-681-2868. Feedback on Pulse is welcome and encouraged. Submissions by Noon, Wednesdays, to be considered for weekend inclusion.
Duke Heart in the News:
November 17 — Duke University
Cardiology Advisor
Older Age, More Comorbidities Predict Favorable BMI Outcomes Among Youth
November 28 — Marat Fudim
Health Central
Are Swollen Feet a Sign of Congestive Heart Failure?
November 28 — Sarah Snow
Health Central
What Is Peripartum Cardiomyopathy?
November 29 — Marat Fudim
Health Central
Duke Heart Pulse — November 26, 2023
Chief’s message:
Happy Thanksgiving to all — I wanted to send a brief note expressing gratitude and appreciation for all the things you do for our patients and our Duke Heart Team. Over the last several years we have spent time focusing on ensuring we keep our patients and each other safe and healthy. At the same time, we have had an unwavering commitment to train the next generation of leaders in cardiovascular medicine while refocusing our energies on making meaningful discoveries. This has all been on the backdrop of ever-changing landscape in healthcare, where we are fortunate to be part of a system like Duke. This work has been hard and at times difficult to accomplish our missions, leaving us feeling stressed and out of energy.
The Thanksgiving holiday is a time to spend with friends and family catching up and reflecting on the past year, with gratitude for all the things we have. Reflecting on the last year, I am in awe of the amazing effort by so many, the impact of the discoveries and research we conduct, and the care we have provided – at times through silent acts, often in the service of others. Personally, the relationships we have with each other, and the example that you all set for our patients, colleagues, and our teams helps in part provide the fuel and energy to accomplish our missions.
I hope you all get some time with your family and loved ones over the upcoming weeks. I also want to thank those of you that are helping cover our clinical services so we can continue to help all of the patients and our community that need care during these times.
As we continue forward in service and purpose of our missions and patients, we hope you have some time to focus on your own health and can recharge for the upcoming year.
Highlights of the week:
Latest STS Star Ratings for Thoracic Surgery Released
Congratulations to our outstanding thoracic surgery team! The Society of Thoracic Surgeons (STS) has posted the General Thoracic Surgery Database Fall 2023 Analysis that includes results for cases between July 1, 2020 and June 30, 2023. The Star Ratings for both Duke University Hospital and Duke Raleigh Hospital continue to excellent!
The Star Ratings for both DUH and DRaH for the previous and current harvest are represented in the chart shown here.
Way to go!
Annual Turkey Bowl Matchup
The tradition continues! Many thanks to all who participated as players and officials in the annual Turkey Bowl on Thanksgiving Day – and thanks to all our fans who came to cheer the teams on. The annual Duke vs. VA matchup resulted in a 21-21 tie!
Kudos to Regan!
We received a note of kudos for cardiology fellow Jessica Regan this week.
“Hi Anna Lisa, I just wanted to send kudos to Jess R. for outstanding work on her overnight shift last night. She helped with a complex post-procedure patient with grace and total professionalism. I am so proud of her as a young doctor and former Duke chief. Hope you pass along how thankful we were in the lab that she helped us care for this patient.” – Jenn Rymer, MD
Nicely done, Jess!
Shout-out to Salah!
We received a shout-out to cardiology fellow Husam Salah this week. 
“First-year cardiology fellow Husam Salah stepped up to cover two CICU shifts this week at the last minute for unanticipated illnesses. Much appreciated Husam!” – Anna Lisa Chamis, MD
Thanks, Husam!!!
Domino Heart Transplant Success for Children with Congenital Heart Disease
When three-month-old Asher Hobby needed a heart transplant, his parents eagerly agreed to help save another life at the same time. In June 2023 at Duke Health, Asher received a new heart from a deceased donor — then the healthy valves and arteries from Asher’s old heart were transplanted into another infant with heart disease.
Months later, both children are growing stronger and healthier every day.
The innovation, known as a domino heart transplant, builds on the technique of partial heart transplantation pioneered at Duke in 2022 and may increase the number of hearts available for children in need. Instead of using mechanical valves that require multiple revision surgeries over time, the partial heart transplant uses human valves that will grow along with the child.
“It’s probably one of the biggest advances in congenital heart surgery in the last 40 years,” said Duke pediatric heart surgeon Joseph Turek, MD, who led both surgeries. “It’s a wonderful setup where two children can benefit from one initial gift.”
Greensboro, NC residents Kayle Cooper and Drew Hobby became concerned when their newborn son Asher stopped eating normally. Local doctors discovered Asher’s heart muscle was damaged beyond repair. Cooper and Hobby brought Asher to Duke, where he was hospitalized and placed on the national heart transplant waitlist.
Several months later, Asher’s parents got the news they’d been waiting for; Asher had been matched with a donor heart. The opportunity came with a chance to help another child with heart disease, one who needed new heart valves. Although Asher’s heart muscle was damaged, his heart valves were healthy. “When we were asked if we would like for Asher’s heart valves to be donated, we immediately said ‘yes, of course we would!’” Cooper said.
First, Asher’s heart was removed and replaced with the donor’s heart. Then, instead of discarding Asher’s old heart, surgeons harvested its healthy valves and arteries and transplanted them into the other child at Duke the next day. Four months later, both children are growing and meeting important developmental milestones.
Turek hopes more pediatric heart centers will adopt the domino heart transplant approach to save more babies’ lives.
“Twenty percent of infants waiting for a heart transplant won’t get one,” he said. “Finding a way to double the number of patients who can receive the gift of organ donation is going to help so many children who may have otherwise died waiting on a heart transplant. My mission is to spread this idea to other institutions and make it available for kids across the country and hopefully across the world.”
*This story is also featured in a Duke Health video, which can be viewed on YouTube: https://youtu.be/E7roMzDCeAU
Ginsburg to Receive PMWC Luminary Award
Congratulations to Duke adjunct professor of medicine in cardiology, Geoffrey S. Ginsburg, MD, Chief Medical and Scientific Officer for the NIH All of Us Research Program. Ginsburg has been selected to receive the Precision Medicine World Conference (PMWC) Luminary Award! He was selected by the PMWC for his pioneering work in personalized and genomic medicine.
Through Ginsburg’s research efforts and collaborations, he has made significant contributions to the fields of oncology, infectious diseases, cardiovascular disease, and metabolic disorders. He has also served as an outstanding leader in the field — as co-chair of the National Academies Roundtable on Genomic and Precision Health and as founder and inaugural president of the Global Genomics Medicine Consortium (G2MC), as well as co-chair of the International 100K+ Cohorts Consortium.
The award will be presented to Ginsburg in January when the 2024 PMWC convenes at the Santa Clara Convention Center in Silicon Valley, CA.
Congratulations, Geoff!
This week! 5th Annual Invented at Duke Celebration
Duke’s Office for Translation & Commercialization (OTC) will hold its 2023 ‘Invented at Duke’ celebration next week on Tuesday, November 28, 2023, from 4:30-7 p.m. at Duke’s Penn Pavilion. Their annual showcase of Duke inventors and inventions will include remarks from Vincent Price, president of Duke University, Robin Rasor, head of OTC, and Jungsang Kim, the Schiciano Family Distinguished Professor of Electrical and Computer Engineering, and co-founder of IonQ.
Whether you’re already part of the Duke entrepreneurial and innovation ecosystem or you’re just starting to explore how to bring your research out to the public – or perhaps you’re a member of the wider Triangle technology commercialization ecosystem – there will be something to learn and celebrate.
The event is free, but registration is required. You’ll receive an e-ticket to present at the door. The attire is business casual. Parking can be found at the Bryan Center Parking Garage – follow event signs and tell the attendant at the entrance and exit that you’re there for Invented at Duke and you will receive free parking.
Upcoming Events & Opportunities
- November is Native American Heritage Month; Men’s Health month, and Lung Cancer Awareness month.
- Masking is strongly recommended throughout all clinical areas during respiratory virus season, from now through early March.
Cardiology Grand Rounds
Nov. 28: Topic TBD, presenter TBD. 5 p.m., DN2002 or via Zoom.
All 2023 Duke Cardiology Grand Rounds recordings are uploaded to Warpwire. Recordings can be accessed via this link: https://duke.is/DukeCGR; NET ID and password required.
CD Fellows Core Curriculum Conference
Nov. 29: Match Day Review. Zoom only.
Dec. 1: Stress Testing with Anna Lisa Chamis. Noon, Zoom only.
Call for Abstracts: Duke’s Annual Quality & Safety Conference
Save the date for Duke’s Annual Quality and Safety Conference scheduled for April 11 in the Trent Semans Center. Click here to view Abstract Guidelines. Abstracts are due by 5 p.m. on Dec. 31, 2023. Late submissions will not be accepted. Contact cynthia.gordon@duke.edu or kyle.rehder@duke.edu with any questions.
A&H Winterfest 2023
The dates for Winterfest Marketplace 2023, the annual holiday art show and sale hosted by Arts & Health at Duke, will take place across six Thursdays in November and December, local North Carolina-based artisans will display and sell their work to Duke Health employees, visitors and patients in the main concourse of Duke Hospital.
The event begins November 2 and runs until December 14. During Winterfest, art will be available for purchase on Thursdays from 11 a.m. to 2 p.m. Featured artisans will include Beth Ann Taylor, Chapel Hill Woodturners, Bonnie Toney, and Justin Leitner.
A portion of the proceeds from Winterfest will go back to Arts & Health at Duke, which provides support to patients through music, visual art activities and journaling. This is a great opportunity to support local artists, the Arts & Health programming at Duke Health, and to score some beautiful holiday gifts for loved ones!
Have news to share?
If you have news to share with the Pulse readership, please contact Tracey Koepke, director of communications for Duke Heart at tracey.koepke@duke.edu. We would love to hear about your latest accomplishments, professional news, cool happenings, and any events or opportunities that may be of interest to our Duke Heart family. Please call with any questions: 919-681-2868. Feedback on Pulse is welcome and encouraged. Submissions by Noon, Wednesdays, to be considered for weekend inclusion.
Duke Heart in the News:
November 17 — Duke University
Cardiology Advisor
Older Age, More Comorbidities Predict Favorable BMI Outcomes Among Youth
November 20 — Kunal Patel
Medical Product Outsourcing
Paragonix Achieves First-in-Human Use of BAROguard Donor Lung Preservation
November 20 — Manesh Patel
Medscape
Asundexian Phase 3 AF Study Halted for Lack of Efficacy
November 21 — Duke Raleigh Hospital
Triad City Beat
Violence against doctors and nurses is rising. A new NC law aims to help protect them
November 21 — Suresh Balu
STAT
How the shakeup at OpenAI underscores the need for AI standards in health care
Duke Heart Pulse — November 19, 2023
Highlights of the week:
Happy Thanksgiving!
In advance of the Thanksgiving holiday, we hope each of you – whether you’re staying close to home or traveling to see loved ones — has a safe and wonderful holiday! Thank you for all you do each day to care for our patients and to advance our collective understanding of cardiovascular disease and treatments. We all contribute in myriad ways to the success of Duke Heart and to the relationships we have with our patients and our community. We are truly blessed to have a terrific team. Enjoy the holiday!
AHA Scientific Sessions Recap
The American Heart Association’s Annual Scientific Sessions held in Philadelphia last weekend saw terrific representation by Duke faculty and fellows! We had two Late-Breaking sessions, 21 presentations, 19 moderated sessions, and more than 38 poster presentations by Duke team members. Impressive!
Our Duke team included the following authors, presenters, and moderators/discussants:
Kevin Thomas, Larry Jackson, Emily Obrien, Svati Shah, Jason Katz, Joseph Lerman, Brittany Zwischenberger, Nishant Shah, Schuyler Jones, Stephen Greene, Jennifer Rymer, Vishal Rao, Christopher Granger, Marat Fudim, William Kraus, Dennis Narcisse, Fawaz Alenezi, Leanna Ross, Melissa Daubert, Bradi Granger, Josephine Harrington, Andrew Landstrom, Jonathan Piccini, Manesh Patel, Sana Al-Khatib, Renato Lopes, Sudarshan Rajagopal, Camille Frazier-Mills, Sean Pokorney, Sarah Snow, Zak Loring, Robert Mentz, Jessica Duran, Dan Friedman, Balim Senman, and Alina Nicoara.
Highlights from across the weekend included:
Jason Katz, participated in the Contemporary Debates in STEMI. This education session was planned by the Committee on Scientific Sessions Program and was moderated by Chris Granger. The pro/con debates addressed controversial areas of management in ACS. Particularly, this debate addresses an important issue in ICU care. Katz reviewed a few case studies that suggest implementing a risk-based triage strategy could be a better alternative to the current strategy where patients with STEMI are typically admitted to the CICU.
In summary, the CICU admission decision for STEMI patients will continue to be based on individual judgment and traditional protocols rather than robust and evidence-based risk prediction models.
As part of a Saturday morning session examining controversies in high-risk PCI procedures focusing on calcium modification and bifurcation lesions, Jennifer Rymer participated in a debate on a one-stent vs. two-stent strategy for Bifurcation Disease, detailing scenarios in which a one-stent approach would be appropriate.
Rymer emphasized that her position in favor of a provisional, one-stent strategy should be the default for many, but not all bifurcation lesions.
Pointing first to a meta-analysis of nine randomized controlled trials co-authored by her debate opponent Margaret McEntegart, Rymer noted that the one-stent strategy showed reduced mortality compared to a two-stent strategy over a longer-term follow-up.
Rymer reviewed further evidence from the Nordic bifurcation study, EBC Two, and EBC main trials, among others, showing that the provisional single-stent strategy was more favorable than a two-stent strategy. Still, Rymer acknowledged that the one-stent strategy is not the definitive answer in every case.
“There’s significant evidence that a provisional stent strategy with often one stent can be a viable strategy for many bifurcation lesions,” Rymer said. “However, it’s key to assess and examine the anatomy and features of the bifurcation lesions, particularly within the left-main bifurcation. There isn’t always a one-size-fits-all approach in any aspect of medicine and certainly in these lesions there’s not.”
In rebuttal, McEntegart largely agreed that a one-stent strategy is best when treating simple bifurcations, while highlighting the exceptions — when treating more complex bifurcations — in which a two-stent strategy is a better approach.
As a discussant for the late-breaking science session “Heart Failure – VADS, Kids, and Money,” Stephen Greene shared details of recent heart failure trials and reflected on how patient outcomes can be improved by treating heart failure with a greater sense of urgency, more efficient trial enrollment, and a focus on implementation.
He shared examples of innovative trial designs such as the CHIEF-HF study and TRANSFORM-HF trial that reduced the burden on patients and sites and then emphasized a focus on implementation as the missing link in heart failure outcomes.
“Even when we know what is quote-unquote best for patients — we know the answer, what makes them live longer, stay out of the hospital, feel better, spend more time at home with their families — history has told us that we do not routinely act on this information,” Greene said. “And, as a result, the grim reality is that every day in this country, many patients with heart failure are dying and being hospitalized without ever having the opportunity to receive medicines definitively proven to prevent these events, despite the patient being eligible for them.”
Greene cited “persistent and pervasive” gaps in the use of guideline-directed medical therapy, including less than one in 10 eligible patients being discharged on quadruple medical therapy, and less than one in three eligible patients going home on triple therapy.
“While of course quadruple therapy should be our goal for HFrEF patients, just think how much better off it would be for the heart failure community if we did complete, equitable, and timely initiation of even just three generic heart failure medications,” Greene said.
“Traditional scientific investment in heart failure is largely focused on discovery science, and thankfully we’ve gotten enormous therapeutic advancements, but with these advancements comes the responsibility to get these therapies to our patients. … Regardless of any specific implementation strategy, there’s an overarching need to change the culture of care from therapeutic hesitancy to one of therapeutic urgency.”
Marat Fudim shared predictions for the future of treatment for patients with heart failure with preserved ejection fraction (HFpEF) during an afternoon session packed with attendees eager to better understand what’s next. A more tailored approach with endo- and phenotyping, he said, is what will advance treatment for these patients, and machine learning may be able to help.
First outlining the need for more specialized research in HFpEF, Fudim noted that the subgroup makes up more than half the heart failure population and continues to grow. Yet the most helpful research for this subgroup has largely come by happenstance.
“In the past, we have applied therapeutic successes from the HFrEF space, which is much easier to diagnose and conceptualize, and applied that to the heart failure preserved ejection fraction space,” Fudim said. “We’ve really seen no positive trials over the two decades that we’ve been testing it until we started getting lucky with therapies which are actually primarily not cardio-centric — cardiometabolic drugs such as SGLT2s, GLP1RAs.”
But that approach will not be sustainable moving forward, he said.
“The future of HFpEF, I believe, will be looking as follows — we will have to do phenotyping,” Fudim said. “You can call it endotyping or phenotyping, and it will have to involve some form of superficial or deep phenotyping looking at clinical variables as well as biopsies or blood work that might tell us a little bit more about the patient, and then apply specific mechanisms of treatment to the diagnostically identified mechanism of pathology.”
Fudim provided the example of a case where spironolactone was found to be more therapeutically beneficial when matched to the proper phenotypical group.
“Certain groups will simply benefit more from certain interventions, even possible interventions found not to be significantly beneficial,” he said.
Machine learning is already applied with screening echocardiograms, Fudim noted, and could also be useful in identifying specific disease processes and matching with specific drugs, as well as identifying patients for future clinical trials where specific endotypes or phenotypes could be matched to a specific drug.
During an early morning Sunday session highlighting the pros and cons of controversial therapies for arrhythmia management in special and vulnerable patient populations, Sana Al-Khatib, shared evidence against catheter ablation for supraventricular tachycardia (SVT) in pregnant patients.
Following Kamala Tamirisa who took the “pro” position in favor of catheter ablation for SVT to avoid drug therapy, Al-Khatib argued that ablation should be avoided in these patients. Despite the presentation title, Al-Khatib cited guidelines and an expert consensus statement recommending that medications can and should be used to safely manage these patients. Al-Khatib went on to recommend that ablation could be considered either before or after pregnancy.
“Of course, I completely agree with my friend Dr. Tamirisa that we have to optimize safety, we have to make sure that we know about the properties of these medications that we use, when we can use them, when we cannot use them, dose them appropriately, see if we can get away with lower doses,” Al-Khatib said. “In fact, many of us have been able to manage pregnant women with lower doses of these medications.”
A lot has changed since the 2002 AFFIRM study showed a rhythm-control strategy offered no survival advantage over a rate-control strategy, according to Jonathan Piccini. On the contrary, data from more recent observational and randomized trials demonstrate that early initiation of rhythm control in patients with atrial fibrillation (AFib) can improve outcomes, Piccini said.
Presenting as part of a learning studio session on treating patients with AFib, Piccini reviewed recent evidence on early rhythm control such as the EAST-AFNET 4 trial, and discussed the applications of early rhythm control among different types of patients.
Which patients benefit most from early rhythm control?
“Some of the greatest benefit may be in patients who have more comorbidities,” Piccini said.
“I’d argue that we have good data that early rhythm control improves outcomes in persons with Afib and there appears to be a pretty durable 20% relative risk reduction in cardiovascular events. Persons with heart failure, left ventricular dysfunction, high degrees of comorbidity, and who have AFib progression or who are at risk for developing AFib progression are particularly important candidates for early rhythm control.”
Renato Lopes detailed how randomized controlled trials (RCTs) and real-world evidence can help inform clinical practice and shared examples of successful RCTs for atrial fibrillation.
“We always ask this question, what is the best type of study?” Lopes said. “Is it randomized trials, or is it the real-world type of study? …The right answer should be another question, ‘What is the question that I will answer?’ Because depending on the answer that I want to have from a clinical perspective, I might have different types of studies that might be the best.”
Randomized controlled trials are the gold standard for determining treatment effect, he added. “I really need randomization to be able to define cause and effect relationships.”
However, for determining real-world application and understanding patterns of care — such as what dose people are using of a particular drug — real-world evidence studies are a better approach. So, a combination of the two types of studies is helpful to support clinical decisions, he continued.
Lopes summarized two pivotal trials on atrial fibrillation with Apixaban — ARISTOTLE and AVERROES. Both RCTs, ARISTOTLE compared Apixaban to Warfarin, and AVERROES compared Apixaban against Aspirin. ARISTOTLE was able to show that Apixaban was not only non-inferior to Warfarin, but superior to it in terms of reducing stroke, risk of bleeding, and all-cause mortality.
“We couldn’t believe when we saw that we were able to meet every single endpoint of the trial. That’s what we call a home run,” Lopes said. “To hit every single endpoint, preserving your alpha was a really unique moment.”
During a session on heart failure guidelines and implementation of therapies, Stephen Greene advocated for rapid titration of quadruple therapy for every eligible heart failure patient. Greene outlined the extreme risk associated with heart failure and emphasized the need for a more urgent therapeutic response. The status quo approach of introducing medications slowly using a one-move-at-a-time, serial, and selective approach, he said, has substantial risks associated as it can take 28 to 58 weeks before guideline-directed medical therapy (GDMT) is fully implemented at the targeted doses.
Simultaneous or rapid-sequence initiation of GDMT, on the other hand, treats heart failure with the urgency that it deserves, he said, and the clinical benefits become noticeable within days to weeks.
“If you delay therapy, even a couple of weeks in an eligible patient, you’re exposing them to excess clinical risk,” Greene said. “And when you remember that the benefits of all four of these drugs are completely additive to each other, and when you further remember that we’re talking about an extreme risk condition that needs all the help it can get, we need to fully take advantage of these medicines ASAP.”
In rebuttal, University of Kentucky Healthcare’s Craig Beavers presenting on behalf of Alanna Morris, argued that while the rapid titration approach is ideal, it wasn’t rooted in real-world thinking. Beavers outlined barriers to quadruple guideline-directed medical therapy for heart failure, including lack of provider knowledge, side effects, administrative burden, Medicare prescription drug coverage, high out-of-pocket costs, and clinical inertia. He also outlined barriers to rapid titration therapy, including polypharmacy, side effects, financial toxicity, and patients failing to understand the rationale for changes.
Beavers concluded that while he agrees that an approach of rapid titration of quadruple therapy is needed for eligible heart failure patients, the current system is not set up to achieve it.
Presenting as part of an afternoon session on arrhythmia treatment, electrophysiologist Jonathan Piccini acknowledged that catheter ablation will not be needed by every patient. Most patients, though, will benefit from catheter ablation — “Absolutely yes, beyond a shadow of a doubt,” he said.
Piccini went on to outline reasons to ablate — it can suppress atrial fibrillation, improve quality of life, and reduce symptoms in patients.
“It’s not a cure, but it’s a highly effective form of suppressing active episodes of AFib,” Piccini said. “This forms the foundational pathophysiology and rationale on which catheter ablation is built.”
The EAST trial showed a 20 percent risk reduction in cardiovascular mortality, stroke, and hospitalization for both heart failure and coronary syndrome over five years, Piccini shared. In CABANA, the procedure showed similar risk reduction in deaths and cardiovascular hospitalization.
Like any procedure or drug prescribed in patients or intervention, applying it to the appropriate patients is critically linked to effectiveness and safety, he noted.
“Does every (AFib patient) need an ablation? No. But most people will probably benefit from ablation because at some point they will have symptoms. Or at some point they are going to benefit from rhythm control,” Piccini said. “EAST shows us that’s probably the beginning of their journey. … If we diagnosed it upfront and implemented early rhythm control, there is a very large role for catheter ablation in their health.”
In additional AHA news, Lesley Curtis, chief of the Department of Population Health Sciences at Duke was selected to receive the QCOR Outstanding Lifetime Achievement Award by the American Heart Association’s Council on Quality of Care and Outcomes Research (QCOR). Congratulations, Lesley!
Jay Lusk, a resident physician at Duke, was named a finalist in the American Heart Association’s Lp(a) Data Challenge. His project, titled “A Random Survival Forest Model for Cardiovascular Risk Prediction from Electronic Health Record Data” was presented Nov. 12. Way to go, Jay!
Congratulations to all!
Duke Heart Faculty Among World’s Most Influential
Congratulations to Chris Granger, Renato Lopes, and Adrian Hernandez! They, along with 27 other Duke faculty members, made Clarivate‘s Most Highly Cited Scientists list of most cited researchers for 2023. Nearly 7,000 were named to this year’s list. Hernandez has been named to the list for each of the last five years, while Granger has been included each year since 2014. This year marks Lopes’ first appearance on the list.
Data used to evaluate and select the honorees are procured from Clarivate’s Web of Science citation index and analysis by bibliometric experts and data scientists at the Clarivate’s Institute for Scientific Information.
Nicely done!
ICYMI: Editorials in JAMA
Adrian Hernandez and Christopher Lindsell as well as Mike Felker and Joe Rogers have editorials in the November 11, 2023 online issue of JAMA. Hernandez, director of the DCRI and Lindsell, professor of Biostatistics & Bioinformatics are coauthors of The Future of Clinical Trials: Artificial to Augmented to Applied Intelligence, while Felker, professor of medicine in Cardiology and head of cardiovascular research at DCRI, and Rogers, president and CEO of the Texas Heart Institute are coauthors of Addition by Subtraction in Mechanical Cardiac Support. Both are worth checking out!
Duke Heart Grows by One!
We are thrilled to share Duke Heart’s latest addition with you. Miguel Yaport, one of our cardiac anesthesia fellows, and Allie Levin, a cardiology fellow, welcomed their daughter, Noa Yaport, on August 15th. Miguel and Allie ask for your forgiveness for this delayed announcement, and hope to make up for it with cute photos! 
Despite only being three months old, Noa can calculate EROAs like a pro (thanks to dad’s nightly TEE textbook reading with her, as depicted below). When she is not learning about valve pathologies, she loves tummy time, strolls in the neighborhood, and brunch with her co-fellow Willard. 
Welcome, Noa! Congratulations, Allie & Miguel!!!
Duke Heart Celebrates Nurse Practitioners
This past week, we celebrated National Nurse Practitioner Week (Nov. 12-18), in recognition of the NP profession and the many contributions NPs make to Duke Heart and Duke Health. There are more than 355,000 certified NPs in the U.S. caring for patients of all ages. We are deeply grateful for the efforts and contributions these vital Duke Heart team members make each and every day.
As highly skilled team members and healthcare leaders, NPs provide exceptional patient care in virtually all healthcare specialties and settings. NPs are pivotal in the health care delivery of Duke Heart and Duke Health, serving in critical roles throughout clinical care, education, health administration, leadership, and research.
A very special thank you to all NPs in Duke Heart and throughout Duke Health. We hope all of you had a great week!
5th Annual Invented at Duke Celebration
Duke’s Office for Translation & Commercialization (OTC) will hold its 2023 ‘Invented at Duke’ celebration next week on Tuesday, November 28, 2023, from 4:30-7 p.m. at Duke’s Penn Pavilion. Their annual showcase of Duke inventors and inventions will include remarks from Vincent Price, president of Duke University, Robin Rasor, head of OTC, and Jungsang Kim, the Schiciano Family Distinguished Professor of Electrical and Computer Engineering, and co-founder of IonQ.
Whether you’re already part of the Duke entrepreneurial and innovation ecosystem or you’re just starting to explore how to bring your research out to the public – or perhaps you’re a member of the wider Triangle technology commercialization ecosystem – there will be something to learn and celebrate.
The event is free, but registration is required. You’ll receive an e-ticket to present at the door. Attire is business casual. Parking can be found at the Bryan Center Parking Garage – follow event signs and tell the attendant at the entrance and exit that you’re there for Invented at Duke and you will receive free parking.
Upcoming Events & Opportunities
- November is Native American Heritage Month; Men’s Health month, and Lung Cancer Awareness month.
- Masking is strongly recommended throughout all clinical areas during respiratory virus season, from now through early March.
Cardiology Grand Rounds
Nov. 21: There will be no CGR this week.
All 2023 Duke Cardiology Grand Rounds recordings are uploaded to Warpwire. Recordings can be accessed via this link: https://duke.is/DukeCGR; NET ID and password required. Our newest recording is of Dr. Holger Thiele of the Heart Center Leipzig at University of Leipzig, Germany, who presented Cardiogenic shock treatment: Between clinical practice and current evidence on Nov. 14.
CD Fellows Core Curriculum Conference
Nov. 22: Journal Club with Ivan Nenadic Wood. DMP 2W96.
Nov. 24: No CD Fellows Core Curriculum Conference today.
Call for Abstracts: Duke’s Annual Quality & Safety Conference
Save the date for Duke’s Annual Quality and Safety Conference scheduled for April 11 in the Trent Semans Center. Click here to view Abstract Guidelines. Abstracts are due by 5 p.m. on Dec. 31, 2023. Late submissions will not be accepted. Contact cynthia.gordon@duke.edu or kyle.rehder@duke.edu with any questions.
A&H Winterfest 2023
The dates for Winterfest Marketplace 2023, the annual holiday art show and sale hosted by Arts & Health at Duke, will take place across six Thursdays in November and December, local North Carolina-based artisans will display and sell their work to Duke Health employees, visitors and patients in the main concourse of Duke Hospital.
The event begins on November 2 and runs until December 14. During Winterfest, art will be available for purchase on Thursdays from 11 a.m. to 2 p.m. Featured artisans will include Beth Ann Taylor, Chapel Hill Woodturners, Bonnie Toney, and Justin Leitner.
A portion of the proceeds from Winterfest will go back to Arts & Health at Duke, which provides support to patients through music, visual art activities, and journaling. This is a great opportunity to support local artists, and the Arts & Health programming at Duke Health, and to score some beautiful holiday gifts for loved ones!
Have news to share?
If you have news to share with the Pulse readership, please contact Tracey Koepke, director of communications for Duke Heart at tracey.koepke@duke.edu. We would love to hear about your latest accomplishments, professional news, cool happenings, and any events or opportunities that may be of interest to our Duke Heart family. Please call with any questions: 919-681-2868. Feedback on Pulse is welcome and encouraged. Submissions by Noon, on Wednesdays, to be considered for weekend inclusion.
Duke Heart in the News:
November 10 — Michael Pencina and Nicoleta Economou (Duke AI Health)
Healthcare IT News
Vanderbilt and Duke awarded $1.25M to study HCO AI maturity
November 11 — G. Michael Felker
Medpage Today
No Aspirin Needed After LVAD, ARIES-HM3 Trial Says
November 12 — Manesh Patel
Medpage Today
DOAC Cuts Stroke Risk From Subclinical Afib
November 12 — Manesh Patel and Jonathan Piccini
tctMD
AZALEA-TIMI 71: Bleeds Plunge With Abelacimab vs Rivaroxaban in AF, but Stroke Impact Unclear
November 13 — Renato Lopes
Mirage News (Au)
Apixaban Proves Effective in Stroke Prevention for Atrial Fibrillation Patients
November 13 — Renato Lopes
Drug Today Online
November 13 — Susan Spratt (Endocrinology)
Today Show (NBC)
Ozempic sister drug Wegovy reduces risk of heart attack and stroke by 20%, study finds
November 13 — Renato Lopes
Medical Dialogues (In)
Apixaban may substantially prevent strokes in patients with device-detected AF
November 14 — Katherine Young (Pulmonary, Allergy & Critical Care)
Physician’s Weekly
Social Frailty Linked With Poorer Health in Patients With COPD
November 14 — Pamela Douglas
Healio/Cardiology Today
Pitavastatin lowers plaque volume, progression in lower-risk patients with HIV
November 15 — G. Michael Felker
MedTech Dive
Abbott study links aspirin-free regimen to better outcomes in heart pump patients
November 15 — Stephen Greene
HCP Live
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