Category Archives: Cardiology

Cardiology

March 19 Doctors on Call Will Focus on Cardiology – KRSL

Local

Written By: Press Release Posted by David Elliott Published Date: 03-18-2024

Doctors on Call, a local production of Smoky Hills PBS, will feature Dr. David Battin with the Heart Center at Salina Regional Health Center on Tuesday, March 19 at 7 PM and will focus on cardiology.

Doctors on Call is a program that provides medical information on a variety of different topics. Medical professionals from throughout the state travel to Bunker Hill to provide information and answer questions from the viewing audience. The doctors presenting each week have expertise in the topic chosen for that program. Questions can be called in during the show or emailed prior to the broadcast.

The program airs live on Smoky Hills PBS at 7 PM on Tuesdays. You can also stream each episode live on the Smoky Hills PBS YouTube channel at http://bit.ly/StreamSmokyHillsPBS.

A schedule of programs and past episodes are available at http://www.SmokyHillsPBS.org.

To submit questions electronically on a specific topic, viewers can send an email to doctors@shptv.org. Questions submitted through email must be received by Noon on the day of the show. During the program, viewers can call 1-800-337-4788.

(Information courtesy SHPBS.)

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March 19 Doctors on Call Will Focus on Cardiology - KRSL

Cardiology

Cardiologist shares his long journey from Libya to United States – Cardiovascular Business

Almanfi found himself starting from scratch upon arrival in the United States. The U.S. medical system is notoriously rigorous and closed, requiring foreign-trained physicians to undergo a comprehensive evaluation and certification process. This involved passing standardized exams such as the USMLE (United States Medical Licensing Examination) steps, followed by applying for residency through the National Resident Matching Program (NRMP).

For Almanfi, this journey encompassed nearly a decade of dedicated effort, including three years of internal medicine residency and additional training in cardiology and interventional cardiology. The process demanded resilience and persistence, as foreign-trained physicians often encounter bureaucratic roadblocks and lengthy timelines in obtaining licensure and certification to practice medicine in the U.S. The requirement to meet the U.S certifications can be a significant deterrent for individuals who have already established careers in their home countries or seek expedited pathways to practice medicine in the U.S.

"I think if someone has a goal in mind and has determination to do this, maybe they can go through the process. I know it's painful, it can be long, but it can get you to your dream and get you to have a job and have a living and even become a U.S. citizen. That's probably the longest way and probably the official way," Almanfi said.

Almanfi suggests exploring alternative avenues for skill development, such as attending conferences, participating in hands-on training programs and leveraging online resources and simulators to enhance clinical proficiency.

Almanfi's own experiences underscore the significance of networking and utilizing social media platforms as valuable tools for professional advancement. As a social media ambassador for prestigious medical conferences, he has leveraged digital platforms to connect with colleagues worldwide, share insights, and collaborate on educational initiatives. Social media serves as a gateway for international physicians to engage with the global medical community, facilitating knowledge exchange, networking opportunities, and professional development.

"I think social media has became a central part of almost everything in our life nowadays. Not only in politics but also in medicine. I have been doing this for 10 years, which I think has impacted my career. And so I became more involved with physicians not only within the United States, but also outside the United States. Social media, it became like a window for the people there to look at the outside world. And so if you're traveling to the United States, you could see everything through social media, especially if you are connected with people or organizations that have a presence on social media," Almanfi explained.

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Cardiologist shares his long journey from Libya to United States - Cardiovascular Business

Cardiology

Cardiologists share historic research that led to FDA’s long-awaited approval of coronary DCB – Cardiovascular Business

Overall, clinical procedural success rates (92.1% for DCB patients vs. 88.7% for uncoated balloon patients) and technical success rates (93.4% for DCB patients vs. 89.7% for uncoated balloon patients) were similar. Bailout stents, meanwhile, were required for three patients treated with a paclitaxel-coated balloon and one patient treated with an uncoated balloon.

Target lesion failure after 12 months was seen in 17.9% of DCB patients and 28.6% of uncoated balloon patients. This difference was primarily attributed to lower rates of ischemia-driven revascularization and target vessel myocardial infarction among patients in the DCB group.

Drug-coated balloons have emerged internationally as an alternative treatment option, but despite promising international data, they have not been previously evaluated or approved for use in the United States, lead investigator Robert W. Yeh, MD, MSc, MBA, director of the Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology and section chief of interventional cardiology at Beth Israel Deaconess Medical Center, said in a statement. Even with advances in stent technology, patients with coronary in-stent restenosis continue to comprise approximately 10% of individuals undergoing angioplasty interventions each year. In particular, patients with multiple prior stents have very poor long-term outcomes. There's growing sentiment that drug-coated balloons could address an unmet clinical need among patients with coronary artery disease in the United States.

Click here to read the full analysis in JAMA, a journal from the American Medical Association.

When the initial positive results from AGENT IDE were presented at TCT 2023, cardiologists were thrilled that a coronary DCB could finally be on its way toward FDA approval.

Our European colleagues have had these devices for a decade, Ajay J. Kirtane, MD, an interventional cardiologist with the Columbia University Department of Medicine, said during a TCT press conference in October 2023. In the United States, we basically tell patients routinely that we can use a peripheral balloon that is too big for your coronary and try to put it in your coronary to prevent the restenosis from happening, or you can buy a ticket to London and go over there to get this treated. Its embarrassing.

American College of Cardiology President B. Hadley Wilson, MD, meanwhile, described the new analysis as a game changer.

For 25 years, weve been trying to peel back this restenosis problem, he said during the same press conference. Now we can see light at the end of the tunnel.

Boston Scientific said the Agent DCB should be available on the U.S. market in the coming months.

In addition, AGENT IDEs researchers will be tracking patient data for up to five years, so expect updates on their findings as time goes on.

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Cardiologists share historic research that led to FDA's long-awaited approval of coronary DCB - Cardiovascular Business

Cardiology

Most physicians think private equity is bad for healthcare – Cardiovascular Business

Overall, 60.8% of physicians said they view the involvement of PE in healthcare in a negative light. Just 10.5% of physicians said they have a positive opinion about PE, and the remaining 28.8% said they were neutral. In addition, 52% of respondents said they think PE ownership is worse than being owned by a not-for-profit hospital or health system.

What is it about PE involvement that worries physicians the most? Its potential impact on physician well-being, healthcare prices/spending and health equity were the three most common concerns.

The authors also noted that the small subset of physicians who are owned by a PE-backed group were less likely to report high professional satisfaction and autonomy than physicians not owned by a PE-backed group. They were also less likely to say they would likely remain with their employer.

While this survey had a limited sample size and is not generalizable to non-ACP members, our findings add to the dearth of evidence on PEs perceived effects on physicians, the authors wrote. Our estimates of PE-involved physicians mirror those in the literature and suggest new areas for inquiry around clinical practice and workplace experience.

Read the full research letter in JAMA Internal Medicine here.

The rise of PE continues to be one of the biggest trends in all of healthcare, and its presence in cardiologyseems to be growing by the day. Cardiovascular Associates of America, Cardiovascular Logistics and other PE-backed cardiology management groups are acquiring more and more practices, and the trend has shown no signs of slowing down.

Click here and here for additional insights into PE's impact on cardiovascular care in the United States.

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Most physicians think private equity is bad for healthcare - Cardiovascular Business

Cardiology

Meth-Related Cardiomyopathy: Where the Biggest Clusters Are – Medpage Today

The American West has seen the biggest surge of cardiomyopathy-associated hospital admissions among methamphetamine users, based on 13 years of the latest available hospital admission data.

The National Inpatient Sample (NIS) showed that methamphetamine-related cardiomyopathy admissions spiked by 231% from 2008 to 2020 nationwide -- whereas overall admissions for heart failure increased just 12% during this period, according to Mohammad Bhuiyan, PhD, of Louisiana State University Health Sciences Center at Shreveport, and colleagues.

They reported various geographical and social disparities evident across methamphetamine-related cardiomyopathy admissions:

"Demographically, cardiomyopathy among methamphetamine users occurs predominantly in middle-aged patients and men and tends to be concentrated more in the western region of the United States," Bhuiyan's team reported in JACC: Advances.

Methamphetamine (popularly known as "meth") is a highly addictive psychostimulant drug. It is available as a prescription drug for obesity and attention deficit-hyperactivity disorder, while illegal versions are derived from over-the-counter drugs. An estimated 1.6 million U.S. adults reported past-year methamphetamine use in 2015-2018, the CDC estimates.

Methamphetamine has known links to cardiovascular disease (CVD), including cardiomyopathy, heart failure, pulmonary hypertension, and coronary artery disease.

"Given the rapidly increasing global burden of methamphetamine-associated cardiomyopathy, this work ... should be a call to action for researchers, healthcare providers, and policymakers to fight this growing epidemic. Importantly, the healthcare system must also acknowledge and address its bias towards patients with substance use disorders," urged cardiologist Nisha Parikh, MD, MPH, of University of California San Francisco Health, and two colleagues.

In an accompanying editorial, the trio said the present NIS study extends prior work showing that meth-associated heart failure (MethHF) hospitalizations increased at an exponential rate between 2002 and 2014, particularly on the West Coast and among men, younger patients, and lower socioeconomic groups. Also disproportionately affected were people of Hispanic, Native American, and Asian/Pacific Islander descent.

"This work should lead us to interrogate why certain geographic areas and populations suffer a disproportionate burden of MethHF and the ways in which local public policies, differential availability of psychostimulant drugs, and socioeconomic disparities have shaped the epidemic," Parikh and colleagues wrote.

They stressed the importance of targeted interventions -- development of a pharmacotherapy for methamphetamine use disorder (MAUD), for example -- and recognition of the "competing health and life priorities relevant for this vulnerable patient population."

"We should also consider employing innovative, multidisciplinary approaches to co-manage heart failure and MAUD. For example, the development of specialty heart failure clinics that also offer contingency management -- a highly effective, evidence-based behavioral treatment for MAUD -- deserves further study and potential scale up," the editorialists wrote.

The NIS study relied on hospital records from all 50 states and captured over 12.8 million cardiomyopathy-associated hospital admissions (59.3% men, over 57% were older than 65) during the study period.

Of these admissions, 222,727 were related to methamphetamine users based on medical records (58.5% men, over 55% were ages 41-64 years). Notably, people who used methamphetamine together with other drugs were excluded from the study.

Bhuiyan's group acknowledged that the study lacked individual-level data and any postdischarge information. The authors were also uncertain how people came to be diagnosed as methamphetamine users.

"Further research is warranted to identify high-risk populations and develop strategies to prevent and mitigate CVD among methamphetamine users," they urged.

Nicole Lou is a reporter for MedPage Today, where she covers cardiology news and other developments in medicine. Follow

Disclosures

The study was supported by grants or awards from the National Institutes of Health and Louisiana State University.

Bhuiyan and Parikh had no disclosures.

Co-editorialists reported support from the NIDA and Chan Zuckerberg BioHub San Francisco.

Primary Source

JACC: Advances

Source Reference: Al-Yafeai Z, et al "Cardiomyopathy-associated hospital admissions among methamphetamine users: geographical and social disparities" JACC Adv 2024; DOI: 10.1016/j.jacadv.2024.100840.

Secondary Source

JACC: Advances

Source Reference: Walker SL, et al "Facing a tsunami: methamphetamine heart failure demands novel approaches" JACC Adv 2024; DOI: 10.1016/j.jacadv.2024.100838.

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Meth-Related Cardiomyopathy: Where the Biggest Clusters Are - Medpage Today

Cardiology

Gilbert H. L. Tang Appointed Editor-in-Chief of JACC: Case Reports – Diagnostic and Interventional Cardiology

March 15, 2024 Renowned cardiovascular surgeon Gilbert H. L. Tang, MD, has been named Editor-in-Chief ofJACC: Case Reports, bringing a wealth of experience and expertise to the helm of one of the top cardiovascular journals published by the American College of Cardiology.

I am both honored and humbled to be a cardiac surgeon among the Editor-in-Chiefs in theJACCfamily of journals, Tang said. It is going to be an exciting time forJACC: Case Reportsto build on a team of multidisciplinary cardiovascular practitioners with diverse backgrounds and experiences, and at different stages of their professional careers, to enhance the journals academic and educational impact globally.

Tang is currently serving as a professor in the Department of Cardiovascular Surgery at the Icahn School of Medicine at Mount Sinai, the surgical director of the Structural Heart Program at the Mount Sinai Health System, and the director of Structural Heart Education at the Mount Sinai Fuster Heart Hospital in New York.

JACC: Case Reportsis one of 10 journalsin the ACCsJACCplatform of journals. It publishes high-quality, educationally valuable case reports, case series, images, and quality improvement projects covering all aspects of cardiology. It serves as a publication vehicle for early career cardiologists and members of the cardiovascular care team, providing a forum for mentorship on the review and publication process.

Widely recognized for pioneering innovative concepts and techniques in TAVR, Tang has set contemporary standards in the field. His impressive international academic collaborations include the establishment of multiple global registries and the training of heart teams in structural heart imaging and procedures worldwide. His research centers on the comprehensive management of patients post-TAVR, transcatheter mitral and tricuspid valve interventions, and advanced imaging techniques in structural heart disease.

In addition to serving on committees in the Heart Valve Collaboratory, and several clinical trials in structural heart, he has served as a member of the ACC Scientific Publications Committee. He is also a member of the ACC/STS TVT Research and Publications Committee, a four-time recipient of theJACCSimon Dack Award for Outstanding Scholarship and has served as an associate editor forCirculation: Cardiovascular Interventions.

Tang is a Diplomat and Fellow of the Royal College of Physicians and Surgeons of Canada (FRCSC), Fellow of the American College of Cardiology (FACC), and the first surgeon fellow of the Society for Cardiovascular Angiography and Interventions (SCAI). He has published over 250 peer-reviewed articles and lectures extensively worldwide.

Together with members of our editorial board and through closer collaborations with international communities and theJACCfamily of journals, we will strive to makeJACC: Case Reportsthe go-to digital resource to improve cardiovascular care and training worldwide, Tang said.

As the new Editor-in-Chief, Tang will officially assume the role of Editor in Chief on August 1, 2024,with his first issue slated for August 7, 2024.

For more information:www.jacc.org

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Gilbert H. L. Tang Appointed Editor-in-Chief of JACC: Case Reports - Diagnostic and Interventional Cardiology

Cardiology

SS Innovations’ SSi Mantra Surgical Robotic System used to perform Mitral Valve Replacement – Diagnostic and Interventional Cardiology

March 18, 2024 SS Innovations International, Inc., a developer of innovative surgical robotic technologies dedicated to making world class robotic surgery affordable and accessible to a global population, today announced that surgeons have successfully performed the worlds first mitral valve replacement using the Made in India, SSi Mantra Surgical Robotic System. This procedure was carried out at the Narayana Hrudayalaya Institute of Cardiac Sciences in Bengaluru, India, and represents a milestone in the treatment of heart disease using the SSi Mantra Surgical Robotic System.

The mitral valve surgery was performed by Dr. Nitin Kumar Rajput from the Narayana Institute of Cardiac Sciences in Bengaluru, Karnataka, and guided by SS Innovations Founder and Chairman, Dr. Sudhir Srivastava, one of the early pioneers of robotic cardiac bypass surgery.

Considering this accomplishment, Dr. Srivastava commented, We are very proud of our team for pushing the envelope to be able to add the field of full spectrum robotic cardiac surgery to all other surgical subspecialties. 90-95% of all cardiac surgeries are still done today using large sternum splitting incisions. Since the inception of the Company, it was always our goal to address the need of offering a highly minimally invasive solution for cardiac patients.

During my practice in the US, I found that patients benefited immensely from surgical approaches which spared splitting of the sternum. Many patients would be discharged the following day and in full functional recovery in just a week to ten days later. The results were inspiring. This led me to develop more complex robotic bypass procedures that were adopted by other surgeons and would ultimately benefit more and more patients who underwent heart surgery.

We are very proud that using our Made in India, SSi Mantra Surgical Robotic System, we have performed a variety of robotic heart surgeries including, Bilateral Internal Mammary Takedowns, Totally Endoscopic Coronary Artery Bypass on a beating heart, Atrial Septal Defect Repair and now a completely robotic Mitral Valve Replacement. I am very pleased that our original goal is now being met in conjunction with the highly talented surgeons at the Narayana Institute of Cardiac Sciences.

Dr. Nitin Kumar Rajput, Consultant Cardiac Surgeon from Narayana Health, the primary surgeon on the Mitral Valve Replacement, commented following the successful completion of the procedure, We have performed more than 60 CABGs (Heart Bypass Procedures) with the SSi Mantra Surgical Robotic System and we just did our first Robotic Mitral Valve Repair a few days back. The surgery went flawlessly, and it was wonderful operating with the Mantra System. Four ports were made for the robotic arm and a tiny 2.5 cm working port for the table side assistant. The surgery was completed quickly; the patient did well in the postoperative period and was discharged with good exercise tolerance three days post-surgery.

Dr. Srivastava said: SS Innovations is dedicated to improving patient access and optimizing surgical outcomes with our accessible and cost-effective surgical robotic system. We recognize the immense opportunity to address the significant unmet need for safe, timely, and affordable cardiac surgical care in India and around the world.

This milestone procedure is a testament to our commitment to advancing cardiac care. The successful operation opens new avenues for treating cardiac conditions, offering patients less invasive options, reduced recovery times, and better results.

The SSi Mantra embodies innovation and excellence and provides unmatched precision and control in robotic-assisted surgeries. Today's success is a proud moment for everyone at SS Innovations and our partners at Narayana Hrudayalaya, concluded Dr. Srivastava.

The mitral valve disease market size was valued at $2.5 billion in 2021 and is estimated to reach $5.7 billion by 2031, growing at a CAGR of 8.8% from 2022 to 2031.

The SSi Mantra Surgical Robotic System, the first surgical robotic system to be made in India, and one of the few cost-effective global options with a wide range of surgical applications, has received regulatory approval in India, Indonesia and Guatemala, and is clinically validated for over 50 different types of surgical procedures. To date, more than 800 surgical procedures have been conducted using the system. SS Innovations has initiated the regulatory approval process in the United States and the EU, with approvals anticipated in the latter half of 2024 or 2025.

For more information: http://www.ssinnovations.com

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SS Innovations' SSi Mantra Surgical Robotic System used to perform Mitral Valve Replacement - Diagnostic and Interventional Cardiology

Cardiology

Intravascular imaging during PCI in heart disease patients improves survival, reduces adverse outcomes – News-Medical.Net

Using intravascular imaging to guide stent implantation during percutaneous coronary intervention (PCI) in heart disease patients significantly improves survival and reduces adverse cardiovascular events compared to angiography-guided PCI alone, the most commonly used method.

These are the results from the largest and most comprehensive clinical study of its kind comparing two types of intravascular imaging methods (intravascular ultrasound, or IVUS, and optical coherence tomography, or OCT) with angiography-guided PCI. The study, published Wednesday, February 21, in The Lancet, is the first to show that these two methods of high-resolution imaging can reduce all-cause death, heart attacks, stent thrombosis, and the need for revascularization.

Our study, representing a synthesis of all early and recent clinical studies, has shown for the first time that the routine use of intravascular imaging guidance improves survival and enhances all aspects of the safety and effectiveness of coronary stenting, even with excellent contemporary drug-eluting stents."

Gregg W. Stone, MD.,first author

Dr. Stone is Director of Academic Affairs for the Mount Sinai Health System, and Professor of Medicine (Cardiology), and Population Health Science and Policy, at the Icahn School of Medicine at Mount Sinai.

"Prior studies had shown benefits of intravascular imaging, but never to this extent," Dr. Stone adds. "The addition of four recent trials in which 7,224 patients were enrolled now shows that intravascular imaging reduces all-cause death and all heart attacks across the wide range of patients who undergo stent treatment. As such, the routine use of intravascular imaging to guide stent implantation is one of the most effective therapies we have to improve the prognosis of patients with coronary artery disease."

Patients with coronary artery disease-;plaque buildup inside the arteries that leads to chest pain, shortness of breath, and heart attack-;often undergo PCI, a non-surgical procedure in which interventional cardiologists use a catheter to place stents in the blocked coronary arteries to restore blood flow. Interventional cardiologists most commonly use angiography to guide PCI, which involves a special dye (contrast material) and X-rays to see how blood flows through the heart arteries to highlight any blockages.

Angiography has limitations, however, making it difficult to determine the true artery size and the makeup of the plaque, and is suboptimal in identifying whether the stent is fully expanded post-PCI and in detecting other conditions that affect the early and late outcomes of the procedure. Intravascular ultrasound was introduced more than 30 years ago to provide a more accurate and specific picture of the coronary arteries. Even though studies have shown that IVUS-guided PCI is superior to angiography-guided PCI and reduces cardiovascular events, it is only used in roughly 15 to 20 percent of PCI cases in the United States, since the images may be difficult to interpret and the procedure is not fully reimbursed.

Optical coherence tomography uses light instead of sound to create images of the blockages. OCT images are much higher in resolution, more accurate, and more detailed compared to IVUS, and easier to interpret. However, as a newer technique, OCT is used in only 3 percent of PCI cases, partly because of a lack of study data-;a limitation this new study has addressed.

In their study, the researchers analyzed data from 15,964 patients undergoing PCI from 22 trials in hundreds of centers from the United States, Europe, Asia, and elsewhere between March 2010 and August 2023. Patients underwent either angiography-guided PCI or intravascular imaging-guided PCI using either IVUS or OCT. During follow-up ranging from 6-60 months with a mean of two years, patients who received intravascular imaging guidance experienced a 25 percent reduction in all-cause death, 45 percent reduction in cardiac death, 17 percent reduction in all myocardial infarctions, and 48 percent reduction in stent thrombosis compared with angiography guidance. The study also found that intravascular imaging reduced target vessel myocardial infarction by 18 percent and target lesion revascularization by 28 percent. The outcomes were similar for OCT-guided and IVUS-guided PCI.

"With these results, we now need to shift from performing more studies to determine whether intravascular imaging is beneficial, to increasing efforts to overcome the remaining impediments to the routine use of OCT and IVUS, including better training of physicians and staff and increasing reimbursement," Dr. Stone said. "In this regard, we now have better 'hard evidence' that intravascular imaging guidance of PCI procedures makes a greater impact to improving our patients' lives than other routine therapies which are more widely used and reimbursed."

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Intravascular imaging during PCI in heart disease patients improves survival, reduces adverse outcomes - News-Medical.Net

Cardiology

PA Martine Altieri Brings an Obesity Medicine Clinic to Her Cardiology Patients – AAPA

PAs treat people with obesity every dayit affects every specialty

March 5, 2024

By Jennifer Walker

About nine years ago, when she was practicing in family medicine, Martine Altieri, PA-C, FMG, MHS, now a cardiology PA, was struck by how her collaborating physician addressed obesity with patients. He would tell them the long-held advice about treating this disease: They needed to exercise more; they needed to eat healthier food and less of it; they needed to fill half of their plate with greens. The patients really felt apprehensive about having this conversation because of the way he approached it and mostly blamed them for gaining weight, Altieri said. I always felt bad for them. I thought, Theres got to be another way.

During the pandemic, Altieri began to take courses on obesity medicine, completing the Fundamentals of Obesity Treatment course with the Obesity Medicine Association (OMA) and the Obesity Management in Primary Care Training and Certificate Program with AAPA in collaboration with The Obesity Society. In these programs, she learned how to approach an obesity diagnosis and craft comprehensive, evidence-based plans for patients based on the four pillars of clinical obesity treatment: nutrition therapy, physical activity, behavior modifications, and medical interventions.

Then in 2022, Altieri found a way to formally bring obesity medicine into her work. She was applying for a position with MyCardiologist, a group of private practices in Florida, when interviewers asked what new ideas she could bring to their practice. Altieri expressed a desire to start an obesity medicine clinic tailored to cardiology patients. She was hired and has since been making that dream a reality.

Today, Altieri, who is based in Boca Raton, Florida, is focusing on building up the clinic to address obesity, which was classified as a chronic disease by the American Medical Association in 2013. She is also a leader, advocate, and educator in several special-interest groups and AAPA caucuses, including PAs in Obesity Medicine, for which she is director at large. Altieriwho is also the public relations chair for PAs for Women Empowerment and a co-host for the Journal of the American Academy of PAs (JAAPA) podcastvalues this role because she sees the importance of all PAs learning how to approach obesity with their patients.

Every PA should be interested in obesity medicine, she said. It affects every specialty.

Addressing Obesity in a Cardiology Practice Altieri graduated from medical school in Haiti before moving to the United States in 2008 to be with her husband. To become a physician in the U.S., she would have had to go through the lengthy process of taking the three-step United States Medical Licensing Exam and completing at least a three-year residency program. Then she learned about the PA profession through her sister-in-law, and realized that she could practice more quickly if she became a PA.

After graduating from the PA program at Miami Dade College in 2010, Altieri practiced in family medicine, urgent care, and hospital medicine before transitioning to cardiology. At MyCardiologist, about 80% of her patients are age 70 or older. Altieri has a full schedule in this specialty: She does rounds at the hospital, cares for patients in an outpatient setting, and spends a half-day a week doing implants of loop recorders, a device that looks for causes of cardiac symptoms, such as irregular heartbeats and palpitations.

Yet, Altieri still has undertaken additional responsibilities to support her patients who have obesity and other chronic conditions that can increase the risk of cardiovascular diseases. She recently finished developing a template and resources for the obesity medicine clinic, including prioritizing the medication list and working with a dietician to create food plans that are specific for cardiac patients. When creating these resources, she thinks about her patients backgrounds. If you tell a Haitian patient they need to follow a Mediterranean diet, they dont know what that is, she said. We have to be specific. I give patients specific food lists so they know what they can buy and eat.

[For more information on obesity, check out AAPAs Obesity Toolkit]

When treating obesity, Altieri has also stuck to one approach that she learned in the beginning of her courses: She asks permission before starting the conversation. Not everyone is available or willing to talk about obesity, she said. You cant just offer obesity management. They have to be ready. Altieri likes to ask, May I talk to you about obesity? If her patients say no, she knows it is not the right time to address this topic.

Altieri also manages the Ambulatory Patient Monitoring Program to offer earlier interventions for patients who have high blood pressure, heart failure, and/or obesity. This initiative focuses on at-home monitoring of blood pressure, oxygen, pulse, and weight. Patients use a blood pressure device and a digital scale that transfer their readings to their charts via the cloud. Based on these metrics, which Altieri checks monthly, she will schedule virtual visits for patients if changes need to be made to their treatment plans for hypertension or heart failure. Altieri estimates there are more than 170 patients enrolled in the program.

We are looking for opportunities to add patients who have recurrent hospitalizations for heart failure or repeated ED visits with uncontrolled hypertension, and who we feel would benefit from more care at home, she said. Our goal is to prevent hospitalization and reduce ER visits. And patients like the idea of someone looking after them.

Educating Communities About Obesity and More Altieri is involved with several groups and activities that focus on various aspects of medicine. For PAs for Women Empowermentwhich focuses on advocating and promoting leadership roles for women in the PA profession and healthcare in generalAltieri manages the groups social media accounts. She educates the community about initiatives like The Pump Act, which states that mothers in the workplace have a right to break time and a secure spot to express milk for up to one year after their childs birth, and highlights women who hold or have held prominent positions within healthcare.

In 2023, Altieri also became a co-host for the JAAPA podcast. Previously, each episode of this show was focused on summarizing and reviewing JAAPA articles. But Altieri and her fellow co-host, PA Kim Ketchersid, introduced a new concept: They started to interview the authors who published the articles.

And since 2021, Altieriwho is currently working on a certification in cardiometabolic healthhas been a founding member of PAs in Obesity Medicine (PAOM). This group offers periodic information sessions that highlight obesity medicine education programs for PAs. PAOM also hosts webinars on obesity medicine topics throughout the year, such as a recent CME presentation on approaching and treating obesity from the endocrine perspective.

PAOM, whose membership has grown by 32% in three years, also plans to hold a meeting at AAPA 2024 in Houston, Texas, where several board members will present on obesity medicine. The groups goal is to reach as many PAs as possible with education and resources about the growing specialty.

PAs treat people with obesity every day, Altieri said. The more PAs know about obesity as a disease, the more we can help our patients.

Jennifer Walker is a freelance writer in Baltimore, MD. Contact Jennifer at[emailprotected].

You May Also Like Experts Address Pressing Questions Regarding Pharmacologic Obesity Treatment Bilingual PA Ledyenska Ballesteros Has Built an Obesity Medicine Program to Serve Her Primarily Hispanic Patient Population TV Host and Wellness Kitchenista PA Jessica DeLuise Promotes a Food-as-Medicine Philosophy

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PA Martine Altieri Brings an Obesity Medicine Clinic to Her Cardiology Patients - AAPA

Cardiology

WEGOVY APPROVED FOR HEART RISK: U-Mich cardiology, obesity medicine experts available for interview – Newswise

BYLINE: Noah Fromson

On March 8, the U.S. Food and Drug Administration approved a new indication for the use of semaglutide (brand Wegovy) to reduce the risk of cardiovascular death, heart attack and stroke in adults with cardiovascular disease and either obesity or overweight. The FDA notes it should be used in addition to reduced calorie diet and increased physical activity. As you cover this, University of Michigan has experts in both prevention of cardiovascular disease and weight management/obesity medicine available for interview related to this development: Eric J. Brandt, M.D., M.H.S., is the director of preventive cardiology at the University of Michigan Health Frankel Cardiovascular Center. Brandt is a cardiologist/lipidologist and a clinical lecturer of internal medicine-cardiology at U-M Medical School.

Andrew Kraftson, M.D., is the director of the Weight Navigation Program and the Post-bariatric endocrinology clinic at the University of Michigan. Kraftson is an endocrinologist/obesity medicine specialist and a clinical associate professor of internal medicine-endocrinology at U-M Medical School. I am happy to facilitate an interview if you are interested. Noah Fromson (He/Him/His)Senior Public Relations Specialist & Medical Content ProducerFrankel Cardiovascular Center, Neurosciences, Kahn Pavilion, Broadcast ClipsC: (216) 509-8604

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WEGOVY APPROVED FOR HEART RISK: U-Mich cardiology, obesity medicine experts available for interview - Newswise