Parallax by Ankur Kalra Radcliffe Cardiology

In the landmark centennial episode of Parallax, Dr Ankur Kalra welcomes a true luminary in the field of cardiology, Dr Valentin Fuster.

Dr Valentin Fuster, a renowned cardiologist, currently holds multiple roles. He serves as the Director of the Cardiovascular Institute and as the Physician-in-Chief at the Mount Sinai Medical Center in New York. Additionally, Dr Fuster is the General Director of the Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC) in Madrid. Notably, he also holds the position of Editor-in-Chief at the Journal of the American College of Cardiology (JACC).

In this candid and rich episode, Dr Fuster delves into his upbringing in Barcelona and reflects on the influential role his family played in providing him with role models and a sense of freedom during his formative years. Dr Fuster invites us to contemplate the concepts of mentorship and trust by recounting pivotal moments from his life, revealing how these principles propelled him towards a life of fulfilment.
Dr Kalra and Dr Fuster revisit one of the central questions explored in Dr Fuster's book, "The Circle of Motivation" – how can one maintain a positive outlook and prepare for life's inevitable fluctuations? Dr Fuster shares insights into his daily routine, which aids him in reflection, tuning into his intuition, and making choices that align with his true self.
While discussing his priorities, we gain insight into Dr Fuster's projects, driven by the concern that we do not intervene early enough in the treatment of individuals. Dr Kalra and Dr Fuster engage in a discussion about Dr Fuster's thoughts on JACC and Dr Fuster outlines the key principles of leadership in various contexts, accompanied by examples from his own life. Dr Kalra seeks Dr Fuster's perspective on augmentative intelligence and the future of medicine, shedding light on what Dr Fuster believes is essential for contemporary medical education in light of the transformative impact of AI.
Finally, Dr Fuster shares three influential books that have shaped his thinking, along with a message for our listeners.

Resources:
JACC Journals’ Pathway Forward With AI Tools: The Future Is Now
https://www.jacc.org/doi/10.1016/j.jacc.2023.02.030
The Circle of Motivation
https://www.amazon.com/Circle-Motivation-Valentin-Fuster-ebook/dp/B07YLVMSKH

In this week's Parallax, Dr Ankur Kalra's guest is Dr Mirvat Alasnag. Dr Alasnag is an interventional cardiologist at King Fahad Armed Forces Hospital (KFAFH) in Saudi Arabia. Additionally, she serves as the Editor-in-Chief at Current Cardiovascular Imaging Reports and is a member of the Board of Trustees at SCAI.
Dr Alasnag and Dr Kalra provide a comprehensive review of the key highlights from ESC Congress 2023. Dr Alasnag distills the background and latest evidence from key interventional trials, emphasizing their significance for patient care.
Tune in to discover the strategies that Dr Kalra and Dr Alasnag are currently employing and gain insights into how these data will shape their future decision-making in the catheterization laboratory. Don't miss this informative discussion at the forefront of interventional cardiology.

Trials included:
FIRE: Physiology-Guided Complete PCI in Older MI Patients
MULTISTARS AMI: MULTivessel Immediate Versus STAged RevaScularization in Acute Myocardial Infarction
ILUMIEN IV: Optical coherence tomography-guided coronary stent implantation compared to angiography
OCTOBER: European Trial on Optical Coherence Tomography Optimized Bifurcation Event Reduction
OCT Vs IVUS Vs Angiography Guidance
OCTIVUS: Optical coherence tomography non-inferior to intravascular ultrasound for stent guidance

What are the take-home messages from ESC 2023 for interventional cardiologists? How can we interpret the results for patient care? What new data have the power to change guidelines?

Questions and comments can be sent to “podcast@radcliffe-group.com” and may be answered by Ankur in the next episode.
Guests: @mirvatalasnag Host: @AnkurKalraMD and produced by: @RadcliffeCARDIO.

In this week's Parallax, Dr Ankur Kalra welcomes back Dr Jag Singh to discuss Dr Singh's recently published book, "Future Care," which delves into the exciting evolution of medicine over the next 5 to 10 years.

Dr Jagmeet Singh is a Cardiac Electrophysiologist and a Professor of Medicine at Harvard Medical School. He is also the Founding Director of the Resynchronization and Advanced Cardiac Therapeutics Program at Massachusetts General Hospital.

"Future Care" wasn't written overnight; it had been simmering in Dr Singh's mind for nearly a decade. The catalyst for this book was a convergence of factors, including the COVID-19 pandemic and Dr Singh’s personal health journey. Drawing from his experiences across three different countries, his role in patient care and leadership and his unique perspective as a patient himself, Dr Singh explores the crucial question of how medicine can and should evolve.
In this episode, Dr Kalra and Dr Singh delve deeply into the ideation, research, and writing process that brought "Future Care" to life. We learn more about Dr Singh's valuable tips for aspiring authors. Dr Singh unpacks the four key chapters of his book: Sensors, Virtual Care, AI, and the Establishment of a sustainable healthcare system. Looking into the future, Dr Singh paints a vivid picture of the hospital of tomorrow—a place where technology and human touch harmoniously converge. As we adapt to the changes brought about by the pandemic, Dr Singh outlines the necessary steps to foster a reality in which we can utilize these technologies to create more time for human connection.
What advice does Dr. Singh have for our listeners? What does the future of medicine look like? How can we scale high-tech solutions effectively?

Order Dr Singh's book today: https://mcpress.mayoclinic.org/product/future-care/

In the finale of our series "Conversations about Hypertrophic Cardiomyopathy", Dr Ankur Kalra welcomes, Dr Anjali Tiku Owens, for a dynamic and practical discussion.

Dr Owens is Medical Director of the Center for Inherited Cardiac Disease and Associate Professor of Medicine at the Hospital of the University of Pennsylvania.

This series is supported by an unrestricted educational grant from Bristol Myers Squibb. Please see www.camzyosrems.com for important safety information.

In this week’s episode, Dr Kalra and Dr Owens take us on a journey through the complexities of hypertrophic cardiomyopathy (HCM), with focus on the diagnostic challenges and breakthroughs in this field.
Emphasising with the critical importance of making accurate diagnoses, Dr Owens shares her insights into identifying the common mimickers of HCM through a structured approach starting with taking the patients history.
As the conversation delves deeper, Dr Owens discusses the various diagnostic tools and tests used to rule out other conditions and uncover the underlying aetiology. She navigates us through the algorithm for interpreting genetic test results, differentiating pathogenic variants, benign variants and variants of uncertain significance (VUS). Dr Owens talks about the wider implications for family members and the cases in which she recommends screening.
Dr Kalra asks Dr Owens about her approach to exercise in HCM patients. Additionally, they cover the debated topic of defibrillator therapy and the use of HCM Risk-SCD risk calculator.
Dr Owens provides an overview of the treatment paradigms for HCM, touching on haemodynamic classifications, symptomatology and the evaluation of sudden death risk.

What are the most common mimickers of HCM? What is Dr Owens and her heart team approach to decision making? What is the role of genetic testing in patients with HCM?

This content is intended for US-based physicians.

In the second episode of our series "Conversations about Hypertrophic Cardiomyopathy", Dr Ankur Kalra sat down with Dr Ahmad Masri to have a deep-dive into the management paradigms of hypertrophic cardiomyopathy (HCM), considering the evolution of medical therapy in recent years. Dr Ahmad Masri is a Cardiologist and the Director of OHSU Hypertrophic Cardiomyopathy Center.

This series is supported by an unrestricted educational grant from Bristol Myers Squibb. Please see www.camzyosrems.com for important safety information.

Dr Kalra invites Dr Masri to guide us through his decision-making process in evaluating medical and surgical options in patients with obstructive hypertrophic cardiomyopathy. Dr Masri delves into first and second-line treatment strategies while exploring the significance of FDA-approved cardiac myosin inhibitors in the management of hypertrophic cardiomyopathy. Dr Kalra asks Dr Masri about the practical office-based clinical course for patients deemed suitable candidates to receive mavacamten. Dr Masri provides a clear and practical outline of what it entails to opt for this second-line medical therapy including the REMS programme required for therapy (www.camzyosrems.com). Dr Masri highlights the importance of looking at HCM patients holistically to find the treatment which best fits their circumstances and preferences in choosing surgical and medical therapy options.

What are the available management options for patients with HCM? How does Dr Masri approach shared decision-making in the management of HCM? What are some of the practical considerations regarding the cardiac myosin inhibitor, mavacamten?

This content is intended for US-based physicians.

Join Dr Ankur Kalra in this episode of our mini-series, "Conversations about Hypertrophic Cardiomyopathy", as he engages in an in-depth discussion with Dr Carolyn Yung Ho. Together, they explore the journey from symptoms to diagnosis and management options for hypertrophic cardiomyopathy (HCM).

This series is supported by an unrestricted educational grant from Bristol Myers Squibb. Please see www.camzyosrems.com for important safety information.

Dr Ho is Medical Director of the Cardiovascular Genetics Center and an Associate Professor at Harvard Medical School.

Dr Ho offers a comprehensive examination of HCM, providing valuable insights on diagnosing the condition and distinguishing it from other conditions. The discussion addresses important questions, such as when to refer patients suspected of having HCM.

The episode explores the significance of cardiac MRI in diagnosing and distinguishing HCM, with a focus on the distinctive features that aid in assessment. The differentiation between sarcomeric and non-sarcomeric forms of HCM is examined for its clinical relevance, with an emphasis on identifying individuals at risk.

Dr Ho sheds light on the diagnostic tools used for risk stratification in both obstructive and non-obstructive cases of HCM. The conversation delves into management strategies for non-obstructive HCM patients, including additional approaches to alleviate symptoms such as exertional dyspnoea.

The episode concludes by discussing cardiac myosin inhibition as a potential therapy, covering important considerations and providing a comprehensive checklist for initiating treatment. Additionally, the latest evidence on exercise training in HCM patients is highlighted.

Tune in to gain insights into the diagnosis and management of HCM as Dr Ankur Kalra and Dr Carolyn Yung Ho illuminate this intricate cardiovascular condition.

This content is intended for US-based physicians.