November 2022 Newsletter
Cardiovascular Institute Nov 17, 2022
Cardiovascular InstituteOne, diverse academic health enterprise where people come to receive the highest quality heart and vascular care in their community while also enabling relentless innovation that fuels better health for Indiana and beyond. Read on to learn about recent advances in realizing this vision.
Connect to Purpose
The IU Health CV Risk and Prevention Quality & Clinical Effectiveness Council is bringing innovations like virtual cardiac rehabilitation to improve patients experiences. Thanks to the leadership of Katrina Riggin in the East Central Region for bringing Virtual Cardiac Rehabilitation to IU Health. Hear directly from a patient on the impact of this program on his life.
"I just wanted to drop you a note and tell you how well the virtual cardiac rehab is going. Cara, Gary and Leroy have been great to work with! Everyone has been on time, personable, efficient and professional.
The program itself works very well for someone like me who would have difficulty scheduling three sessions a week at a specific time to come to the hospital for rehab. Being able to log my exercise sessions on the app and have the community paramedics come out once a week has worked really great, along with the other information that is provided in the app, such as nutrition, food shopping, exercise tips, etc.
This program could be a real asset for individuals who need to exercise on their own and still being held accountable.
Have a great day."
- A quote from Brian (graduated from IU Ball Cardiac Rehab Program)
• A multi-institution study led by Dr. Rohan Dharmakumar, recently published in "Nature Communications", identifies that iron drives the formation of fatty tissue in the heart and leads to chronic heart failure in about fifty percent of heart attack survivors. This study paves the way for treatments that have the potential to prevent heart failure in nearly half a million people a year in the United States, and many millions more worldwide.
• The increasing use of endovascular aneurysm repair (EVAR) to treat abdominal aortic aneurysm (AAA) mandates solutions to the limitations of this operation including patients' needs for additional procedures. Kudos to Drs. David Peterson, Duangnapa Cuddy and team on their patient's successful innovative endovascular repair highlighted in their recent case report published in the "Journal of Vascular Surgery Cases, Innovations and Techniques".
• The study, recently accepted for publication in the "American Journal of Cardiology", showed that patients with familial dilated cardiomyopathy have a significantly higher risk for reaching the composite primary endpoint of death, need for left ventricular assist device implant, or heart transplantation, as compared to patients with nonfamilial dilated cardiomyopathy. Patients with familial dilated cardiomyopathy were also at a significant risk of ventricular arrhythmia events than those with nonfamilial cardiomyopathy. This study highlights the value of family and genetic screening to identify the high risk-group of patients with dilated cardiomyopathy. The study was performed in collaboration of our heart failure team (Dr. Roopa Rao and Dr. Maya Guglin), electrophysiology team (Dr. Mithilesh Das), and involved internal medicine residents including Dr. Elie Kozaily.
• According to new research recently published in the journal "Circulation: Heart Failure", cannabis users could be candidates for heart transplants. Lead author, Dr. Onyedika Ilonze, said heart transplantation can be life-saving in patients with end stage heart failure. Substance abuse has prevented patients from being candidates for heart transplantation. Increasing medical and recreational cannabis use, clinician bias and lack of standard ways of addressing cannabis use all serve to limit standardized decision making and worsen disparities in heart transplantation. This paper reviews the factors that need to be considered before and after heart transplant, compares attitudes between opiates and cannabis, and concludes by listing research priorities that will enable standardized decision making for patients with cannabis use who may require heart transplantation.
• The Affordable Care Act Medicaid Expansion policy was associated with greater likelihood of White patients receiving cardiac resynchronization therapy +/- defibrillator based upon the study published in the "Journal of the American Heart Association" by Dr. Khadijah Breathett and team. Benefits were not observed among Hispanic nor Black patients. This study illustrates that additional strategies are needed to achieve equitable delivery of life saving therapies.
• Dr. Abhishek Khemka has secured the competitive national American College of Cardiology's Clinical Trial Research Award for his research proposal, Cardiometabolic Risk in African American Patients with Prostate Cancer. The ultimate goal of this project is to improve health outcomes in prostate cancer patients and specifically bring parity to African American patients with cancer. Dr. Khemka and his team will use the risk prediction algorithm to develop an electronically integrated tool that clinicians can use quickly and easily to identify high-risk patients and offer interventions (referrals to dietician, adjust medications for blood pressure/cholesterol, refer to cardiology, etc.). The team will use the data for an RO1 to help develop the tool and do a prospective study to evaluate its benefit. If successful, it would be able to be expanded to other IU Health facilities as well as other institutions.
• Through the National Comprehensive Cancer Network Oncology Research Program and in collaboration with Myovant Sciences and Pfizer, Dr. Balaji Tamarappoo has secured a new award titled, Personalized Medical Treatment of Coronary Atherosclerosis in Prostate Cancer Patients Guided by Plaque Assesment with Quantitative Coronary CT Angiography. This research program seeks to improve cardiovascular management of patients with prostate cancer being treated with androgen-deprivation therapy (ADT).
• In collaboration with Dr. Jordan Alexander Holmes with Radiation Oncology, Dr. Balaji Tamarappoo and team have secured a 1 year community engagement pilot program grant by Indiana University Simon Comprehensive Cancer Center. To date, passive physician centered interventions to address cardiovascular screening and care for patients with prostate cancer have not been effective. This novel pilot study aims to measure health literacy and behavior among men who were treated for prostate cancer with androgen deprivation. Through partnership with Eskenazi Health, the team will oversample African American (AA) men to specifically explore differences in CVD health literacy and behavior between white and AA men. This study will inform future extramural funding applications to test the efficacy of patient or community-based interventions aimed at improving cardiovascular knowledge and care, and ultimately reduce CVD mortality among prostate cancer survivors.
In the Media
Dr. Khadijah Breathett discussed Stepping Up To Achieve Health Equity in Heart Failure in her recent editorial collaboration between Medscape and the American College of Cardiology.
Kudos to Dr. Pantila Bateman and Dr. Richard Kovacs for working across interdisciplinary teams to develop the Endocarditis Due to Injection Drug Use Mini power plan. This first of its kind care pathway was stemmed from the 2nd Annual IUH/IUSM CVI Institute Summit on High Value Cardiovascular Care: Opioid-Related Valvular Heart Disease in August 2021 and went live in Cerner on September 12th.
First AngelMed Implantation at IU Health Bloomington Hospital
The first AngelMed Guardian implantation procedure was successfully completed on October 10th by Dr. John Strobel and team at IU Health Bloomington Hospital - the first in the state of Indiana!
The AngelMed Guardian System is an implantable cardiac monitor with patient alerting capability and an additional external alarm device. The Guardian System is indicated for use in patients who have had prior acute coronary syndrome (ACS) events and who remain at high risk. The system detects potential ongoing ACS events, characterized by sustained ST segment changes, and alerts the patient to seek medical attention for those potential ACS events.
IU Health Ball Memorial Hospital Reaches 7,000 Open-Heart Cases
Since its creation in 1977, the open-heart surgery program at IU Health Ball Memorial Hospital has reached a huge milestone: 7,000 open-heart cases. These cases include everything from coronary artery bypass grafts (CABG) to valve repairs and replacements, and the specialty cases in between.
"These cases are life altering, and our team is so rightfully honored to have changed so many lives through this program", says Dr. Glenn Carlos.
Welcome to Our Team
Erin Shin, MD, an Interventional Cardiologist, has joined our team covering STEMI call for IU Methodist Hospital and West Hospital, as well as Eskenazi Hospital. At the Richard L. Roudebush VA Medical Center in Indianapolis, he is focusing on restarting the Interventional Program with the assistance of our Interventional Cardiology faculty. Dr. Shin completed his undergraduate at Northwestern with a BS in Biomedical Engineering and completed his Doctor of Medicine at Indiana University. His Residency, Post-Doctoral Research, Clinical Cardiology Fellowship, Interventional and Structural Heart and Valve Disease Fellowships were all completed at Emory University School of Medicine.
Our faculty educators including Drs. Upasana Jarori, Katsiaryna Tsarova, and Pantila Bateman recently spent time at the Simulation Center at Fairbanks Hall teaching 150 second-year medical students heart sounds and valvular heart disease. Cheers to the transmission of excellence through education!
Douglas and Joan Zipes Visiting Professorship
Dr. Douglas and Mrs. Joan Zipes established the Visiting Professorship that this year brought Dr. Emelia Benjamin, MD, ScM from Boston to Indiana. Her Zipes Visiting Professorship lecture entitled, "Time to Double Down on Preventing Atrial Fibrillation and Its Complications" offers a state-of-the-art roadmap to preventing AF.
Time of Celebration
Members of the IU Health Heart Failure/Transplant team saved a patient's life after 5 long months in the hospital. The patient's wedding that followed was conducted at the IU Health Methodist Chapel - the couple's choice for their special day so that their care team could be present.
IU Health's Day of Service
Members of IU Health Physicians Cardiology's administrative leadership team participated in IU Health's Day of Service. As a team, they partnered with Groundwork Indy whose mission is to bring about the sustained regeneration, improvement, and management of the physical environment by developing community based partnerships which empower people, businesses, and organizations to promote environment, economic, and social well-being. They loaded and spread mulch at a local community garden which was a great way to grow as a team while benefiting the community.
Do you have a story that reflects the strength of our statewide system for cardiovascular care? Please email OneIUCV so we can share with the team!
Cardiovascular disease is the number one cause of death worldwide—and in Indiana. Cardiovascular diseases claim more lives each year than the next three leading causes combined. To meet this challenge, the Cardiovascular Institute brings together highly skilled caregivers, researchers, and educators into close collaboration to improve the health of patients and communities across Indiana.