Putting Her Spin on Heart Health

AS A GRADUATE student studying electrical engineering, Subha Raman, MD, MSEE, never imagined that her research would foreshadow her future. It involved basic artificial intelligence tools to understand magnetic resonance images. “I was pretty sure I’d never use it again,” Raman said.

It turns out, the knowledge came in handy. As Raman wrapped up medical school and residency at The Ohio State University, she began considering cardiology. As she did, a mentor suggested she build on her prior research to contribute to a new area in cardiology using noninvasive magnetic resonance imaging to better diagnose and treat cardiovascular disease.

Her master’s degree, earned as a National Science Foundation fellow, now seemed the perfect foundation for her to advance cardiovascular care in a way she hadn’t even considered at that point. “With so many things, you have some initial plans,” Raman said, “but doors open with greater possibilities, beyond what you ever could have envisioned.”

In February, Raman walked through another door, assuming roles as Chief of the Division of Cardiology at IU School of Medicine and Vice President of IU Health Cardiovascular Services. Raman also leads the newly created Cardiovascular Institute, a joint effort with IU Health to enhance collaboration between the school and health system.

We caught up with Raman to chat about her background, vision for the division, and what it means for medical education and research.

What drew you to cardiology?

I was not sure about my career path after residency. On outdoor walks with my mom, she asked, ‘What do you see as a vocation that will make you happy many years from now?’ I pictured myself helping people in the throes of an acute issue, while also connecting with individuals and families over time to prevent acute disease. That broad spectrum was attractive to me.

How does your training as an engineer influence your view of clinical care?

On the one hand, it brings a rigorous approach to understanding and fixing a problem. But you need to complement it with an ability to connect with people, and provide care in sync with their life goals. How do our tools and treatments support someone’s aspirations? What do they want to get back to in life? That’s the ideal combination.

What proved enticing about the opportunity at IU School of Medicine?

The ability to make an impact statewide and beyond. We have a statewide medical school, and IU Health also spans Indiana. That partnership was compelling. If we do this right, we can impact lives in a way that serves as a model for organizations across the country on how to align patient care, research, education and service to evolve and transform cardiovascular health.

How would you describe your mission overseeing the division and the Cardiovascular Institute?

Consider the analogy of how MRI makes clear pictures with a magnetic field that aligns the constant rotation of hydrogen atoms, or ‘spins’ in many directions throughout your body. We have an opportunity to align our collective clinical, educational, scientific and administrative ‘spins’, so that together we are more effective in finding clear ways to reduce cardiovascular disease and improve overall health.

In what ways can the institute align with the school’s research and educational mission?

We hear from practitioners across the state about what they see on the frontline and recognize what works well and where we have room for improvement. Research helps us do better. For example, too many Hoosiers suffer from various forms of unhealthy metabolism, including diabetes, which accelerate heart and vascular disease. Our unique statewide research environment positions us to make significant strides at the intersection between metabolic and cardiovascular health.

There are also students–undergraduate, graduate and medical–plus residents, fellows, and trainees across many disciplines whose questions help illuminate assumptions in health care that need to be challenged. We have an environment where we hold ourselves to the highest standards in clinical care while being attuned to where we need to do better for both patients as well as for each other. This may involve basic research to find new solutions, or translational and clinical research to make solutions at hand more accessible to those who could benefit. All of that only happens if a health system and medical school are aligned.

What example would you give to a patient of the research’s impact?

We can do better in preventing heart attacks, the leading killer of Hoosiers and many people around the world. Too often, those suffering heart attacks had no idea before the event that they had a progressive condition called coronary artery disease—the cause of most heart attacks. And sometimes it’s too late, as over half a million Americans each year die or become disabled with their first heart attack. We have the technology to detect early plaque buildup and predict the risk for an individual’s heart; but we need to make it accessible, and integrate it with preventive strategies tailored to a person’s lifestyle and preferences. Doing so moves us from treating risk factor targets alone, such as cholesterol numbers, to more directly tracking and treating disease and preventing potentially tragic events.

How does it affect a place like the Krannert Institute of Cardiology?

It’s taking the best of what’s been done and building on it. Krannert has a great legacy of advances in arrhythmia research and ultrasound imaging of the heart. Now, we have even better non-invasive ways to more accurately diagnose heart and vascular conditions in their earliest stages to guide more effective interventions. It’s thinking in terms of how to deliver care in an integrative way, grounded by an understanding of how each person’s heart is connected to everything else in one’s life.