Heart Matters

Host: Janet Wright, MD Guest: Dan Roden, MD Long QT syndrome can be a silent threat. Although not all patients with congenital long QT syndrome develop symptoms, there is potential for dangerous arrhythmia that can cause sudden cardiac death. Can and should genetic testing guide clinicians in diagnosing and treating this condition? Dr. Dan Roden, professor of medicine and pharmacology and assistan...

Host: Janet Wright, MD Guest: Joseph Cleveland, MD Cardiac surgery can improve quality of life, but it also poses risks for patients over the age of 65. Can a screening test as simple as walking speed predict the outcomes of cardiac surgery for our older patients? Dr. Janet Wright hosts this discussion.

Host: Janet Wright, MD Guest: Thad Waites, MD Obesity is a nationwide epidemic, but this is nowhere more apparent than in Mississippi, which was ranked as the state with the highest obesity rate in 2009 by the Centers for Disease Control. How does the obesity issue in Mississippi mirror that of the rest of the nation, and what efforts are underway to address this public health problem? Dr. Thad Wa...

Host: Janet Wright, MD Guest: Caldwell Esselstyn, Jr., MD Some evidence suggests it is possible to prevent and reverse heart disease by adhering to a plant-based diet, but lifestyle changes are often the most challenging for physicians to prescribe and for patients to adopt. What strategies can physicians use to encourage a plant-based diet for patients who have or are at risk for having heart dis...

Host: Janet Wright, MD Guest: David Kaplan, PhD Although most bypass grafts are sourced from other parts of a patient's body, bioengineers are examining new materials that might be used for bypass grafts to reduce the risk of second-site complications. Silk has been a standard material in sutures for decades, and is now showing promise as a biomaterial in bypass grafts. Might silkworms help repair...

Host: Janet Wright, MD Guest: Robert Harrington, MD Recent studies have raised doubts about the efficacy of some common treatments for cardiovascular disease, including: the use of PFO closures (based on the CLOSURE trial); some methods of cardiac resynchronization therapy (or CRT, based on the SMART-AV trial); telemonitoring for patients with congestive heart failure (based on the Tele-HF trial);...

Host: Jack Lewin, MD Guest: Rashi Fein, PhD What can we learn from the past century of healthcare policy that can better inform how we develop such policies today? How has the landscape of medicine and economics surrounding health policy changed, and how have these changes influenced health policy? Join host Dr. Jack Lewin as he welcomes guest Dr. Rashi Fein, professor of the economics of medicine...

Host: Jack Lewin, MD Guest: Harry Greenspun, MD Will healthcare reform do enough to alleviate the current problems in our system, or is the entire delivery model in need of a substantial re-design? Dr. Harry Greenspun, chief medical officer of Dell Services and co-author of the book Reengineering Health Care: A Manifesto for Radically Rethinking Health Care Delivery , says that while health care r...

Host: Janet Wright, MD Guest: Michael Steinman, MD One of the characteristics of our older patients with heart failure is that they often have other conditions and therefore take multiple medications. How can we reduce the risk of adverse drug events among patients with heart failure and other comorbidities? Dr. Michael Steinman, associate professor of medicine at the University of California-San...

Host: Janet Wright, MD Guest: Richard Lange, MD, MBA First generation drug-eluting stents offer many advantages over bare metal stents, the most significant of which is their efficacy in reducing the rate of restenosis. Now second generation drug-eluting stents are proving to be even more beneficial. How are these second generation drug-eluting stents further reducing the risk of late stent thromb...

Host: Janet Wright, MD Guest: Caldwell Esselstyn, Jr., MD Beta blockers, anticoagulants, stenting procedures and bypass surgeries: these are all crucial cornerstones of cardiology that have saved and improved the quality of lives for our patients, yet the underlying causes of coronary artery disease aren't addressed by interventions and medications. Can we prevent and maybe even reverse heart dise...

Host: Janet Wright, MD Guest: James Scheulen, PA-C Guest: Jeffrey Trost, MD Door-to-balloon time for a patient with ST-segment elevation myocardial infarction (or STEMI) should be less than 90 minutes. Wireless electrocardiography (or EKG) programs around the country are helping to reduce door-to-balloon time by transmitting EKG data to hospitals via broadband internet, where a specialist at the h...

Host: Janet Wright, MD Guest: Deepak Bhatt, MD One of the biggest risks of antiplatelet therapy is gastrointestinal bleeding. Because of this risk, patients on the antiplatelet clopidogrel are often prescribed proten pump inhibitors, or PPIs. However, there are also concerns about PPIs decreasing the efficacy of clopidogrel. What approach should physicians take for patients at moderate to high ris...

Host: Janet Wright, MD Guest: Ken Fujise, MD Targeted molecular therapy has been successful in cancer therapeutics. How might this approach be applied in cardiology to prevent the development of atherosclerosis? Dr. Ken Fujise, chief of cardiology at University of Texas Medical Branch, where he is also professor of medicine and biochemistry and molecular biology, talks about his preliminary resear...

Host: Janet Wright, MD Guest: Prediman Shah, MD It is apparent to most physicians that patients at high risk for having a cardiovascular event should be screened, but what about those patients who fall into the intermediate risk category (classified using the Framingham risk score)? Dr. Prediman Shah, director of the division of cardiology at Cedars-Sinai Heart Institute in Los Angeles, suggests t...

Host: Jack Lewin, MD Guest: Francois de Brantes, MS, MBA As we all strive to improve quality of care, two crucial questions remain at the heart of the issue: How do we define, and identify, quality in practices, hospitals and other health care settings? Then, how can new methods of identifying quality in practices help improve the standardization of processes and care that patients receive? Join h...

Host: Jack Lewin, MD Guest: James Wilentz, MD Before the January 2010 earthquake rattled Haiti, healthcare access for the country's citizens was unreliable, but after the disaster, everything changed. How has an influx of foreign physicians impacted Haiti's healthcare system, and what lessons can the US learn from the proposed public-private partnership solutions in Haiti? Dr. James Wilentz, assis...

Host: Janet Wright, MD Guest: Stuart Connolly, MD, FRCPC Because atrial fibrillation increases the risk for stroke, especially among those with other underlying conditions, what anticoagulation therapies should be considered for these patients? Dr. Stuart Connolly, professor of medicine and director of the division of cardiology and the Salim Yusuf Chair in Cardiology at McMaster University in Ont...

Host: Janet Wright, MD Guest: Christopher O'Donnell, MD, MPH We know that genes play a role in cardiovascular health, but new research has identified specific DNA regions that are associated with risk factors for coronary heart disease. It's estimated that 30-50% of cardiovascular health is influenced by family history or genetics, while the rest is influenced by other environmental factors,...

Host: Janet Wright, MD Guest: Mark Hlatky, MD Implantable cardioverter defibrillators, or ICDs, can be life saving for patients after myocardial infarction, but are also costly and may not be appropriate for all of the hundreds of thousands of patients who have had MI. Which subsets of patients might benefit most from ICDs, and might prophylactic use of ICDs early after MI reduce the risk of cardi...

Host: Janet Wright, MD Guest: Albert Starr, MD On the 50th anniversary of the first successful prosthetic mitral valve replacement, how far has cardiac surgery come, and where are we headed? Tune in to hear Dr. Albert Starr, co-founder of the first artificial mitral valve, medical director of the Providence Heart and Vascular Institute, and director of Academic Affairs & Bioscience Development...

Host: Janet Wright, MD Guest: Sanjay Kaul, MD, MPH Atrial-fibrillation, or a-fib, affects nearly 2.5 million patients in the US, and is one of the more common forms of arrhythmia. The antiarrhythmic armamentarium has been expanded to include dronedarone, which was recently approved by the FDA for the treatment of a-fib. What's the efficacy and safety of dronedarone, compared to other antiarrhythmi...

Host: Janet Wright, MD Guest: Paul Heidenreich Sudden cardiac death among high school or college athletes is rare but tragic, and is jarring to families, friends and communities. What additional measures can physicians take to prevent sudden cardiac death among these students? Current guidelines for screening of young athletes in the U.S. do not include electrocardiography but should they, especia...

Host: Janet Wright, MD Guest: Sidney Smith New evidence strengthens the link between air pollution and heart disease. How strong is the data suggesting a causal relationship between the two? Dr. Sidney Smith, professor of medicine and director of the Center for Cardiovascular Science and Medicine at the University of North Carolina in Chapel Hill says there are two areas of interest in determining...

Host: Janet Wright, MD Guest: Stephen Kopecky, MD Drastic lifestyle changes can seem daunting to patients and physicians alike. Fortunately, new research is demonstrating the importance of moderation in improving cardiovascular health. How can small tweaks to a patient's lifestyle have a substantial impact his or her heart health? Dr. Steve Kopecky, cardiologist at Mayo Clinic's Cardiovascular Hea...