Mayo Clinic Cardiovascular CME

LVAD - Who Needs it?

LVAD – Who Needs It?

Guest: Andrew (Drew) N. Rosenbaum, M.D. (@werDrD)

Host: Malcolm R. Bell, M.D.

About 6.5 million people over the age of 20 years in the U.S. have heart failure. That number is estimated to grow to about 8 million by 2030. Of those patients, about 300,000 would potentially benefit from left ventricular assist device (LVAD) therapy. Among patients with advanced heart failure, 66% to 75% would have comorbidities that would preclude benefit from LVAD therapy, so approximately 75,000 to 100,000 patients in the U.S. would be potentially eligible for LVAD therapy.

Joining us today to discuss LVADs is Andrew (Drew) N. Rosenbaum, M.D., a cardiologist at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

• Types of left ventricular assist devices: durable, destination therapy, bridge to transplantation
• Who benefits from LVAD and why
• LVAD durability
• Age limitations for LVAD therapy
• Inappropriate candidates for LVAD
• End-stage renal disease, LVAD and dialysis
• When to consider referral for LVAD therapy

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV.

No CME credit offered for this episode.

Podcast episode transcript found here.

Lipoprotein A - A Cardiovascular Risk Factor Commonly Ignored

Lipoprotein A - A Cardiovascular Risk Factor Commonly Ignored

Guest: Vlad C. Vasile, M.D., Ph.D. (@VladCVasile)

Host: Stephen L. Kopecky, M.D. (@DrSteveKopecky)

Lipoprotein (a) is a circulating protein that associates with a cholesterol complex. It comprises two particles — a low-density lipoprotein (LDL, or "bad") cholesterol particle and an LDL-like particle — and apolipoprotein A. Lipoprotein (a) is associated with increased atherosclerotic cardiovascular events independent of the traditional risk factors. It has also been associated with valvular heart disease. Currently, there are no specific drugs that both reduce lipoprotein (a) levels and influence treatment outcomes.

Joining us today to discuss lipoprotein (a) is Vlad C. Vasile, M.D., Ph.D., a preventive cardiologist and co-director of Cardiovascular Laboratory Medicine at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

• Lipoprotein (a) and its impact
• Plaque formation and pro-inflammatory and pro-clotting molecules
• Drugs and available treatment options
• Lifestyle impact
• Genetic basis and importance of familial awareness
• Screening for lipoprotein (a)

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV.

No CME credit offered for this episode.

Podcast episode transcript found here.

TTR Cardiac Amyloid - How Common and How to Diagnose

TTR Cardiac Amyloid - How Common and How to Diagnose

Guest: Omar F. Abou Ezzeddine, M.D., C.M., M.S. (@abouezzeddine)

Host: Paul A. Friedman, M.D. (@drpaulfriedman)

There are two main types of cardiac amyloidosis. One is a medical emergency involving light chain amyloid. The source of the amyloid is the bone marrow, which secretes excessive amounts of monoclonal protein that infiltrate the myocardium and cause an acute necrotic infiltrative and restrictive cardiomyopathy. In the second type, transthyretin (TTR) amyloidosis, the source of the protein is the liver. The course of TTR amyloidosis occurs over years.

Joining us today to discuss cardiac amyloidosis is Omar F. Abou Ezzeddine, M.D., C.M., M.S., a consultant in Cardiovascular Medicine and director of the Cardiac Sarcoid Clinic at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

• Cardiac amyloidosis
• Signs and symptoms indicative of cardiac amyloidosis
• Patients who receive atrial fibrillation ablation and patients who receive transcatheter aortic valve replacement (TAVR)
• Tools for diagnosis, including pyrophosphate (PYP) and MRI scans
• Therapeutic options for patients with TTR amyloidosis, including tafamidis

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV.

No CME credit offered for this episode.

Podcast episode transcript found here.

COVID and Exercise - Pearls from the Experts

COVID and Exercise:  Pearls from the Experts

Guest: Thomas G. Allison, Ph.D., M.P.H. (@DrTAllison)

Host: Stephen L. Kopecky, M.D. (@DrSteveKopecky)

Aerosol-generating procedures are medical procedures in which a patient has some significant and strong ventilation, such as coughing, that causes aerosols of a size that might release virus into the environment. Mayo Clinic has implemented procedures to protect both patients and staff from COVID-19 aerosols during stress testing.

Joining us today to discuss COVID-19 and its impact on exercise is Thomas G. Allison, Ph.D., M.P.H., director of the Pulmonary Exercise Laboratory and the Sports Cardiology Clinic at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

• Aerosols and aerosol-generating procedures
• Aerosol generation during exercise
• Masking and recirculators
• Reduction in exercise capacity due to masking
• Paper masks versus O₂ consumption masks
• Patient and staff protection

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV.

No CME credit offered for this episode.

Podcast episode transcript found here.

Bileaflet MVP Syndrome

Bileaflet MVP Syndrome

Guest: Michael J. Ackerman, M.D., Ph.D. (@MJAckermanMDPhD)

Host: Paul A. Friedman, M.D. (@drpaulfriedman)

Mayo Clinic researchers looked at a 10-year experience of 1,200 patients who came to the Windland Smith Rice Genetic Heart Rhythm Clinic. The researchers found that 24 of those patients were survivors of out-of-hospital cardiac arrest. Ten of those 24 survivors — 42% — had bileaflet prolapse. That finding helped the research team identify the features of arrhythmogenic bileaflet mitral valve prolapse syndrome.

Joining us today to discuss arrhythmogenic bileaflet mitral valve prolapse syndrome is Michael J. Ackerman, M.D., Ph.D., a pediatric cardiologist and principal investigator at the Windland Smith Rice Sudden Death Genomics Laboratory at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

• Mitral valve prolapse versus arrhythmogenic bileaflet mitral valve prolapse syndrome
• Signs and symptoms of arrhythmogenic bileaflet mitral valve prolapse syndrome
• Characteristic findings of complex ectopy
• Work-up and next steps
• A role for MRI
• Mitral annular disjunction
• Treatment options
• A role for ablation
• A genetic condition or not?

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV.

No CME credit offered for this episode.

Podcast episode transcript found here.

Reducing Cardiovascular Risk in Minorities

Reducing Cardiovascular Risk in Minorities

Guest: LaPrincess C. Brewer, M.D., M.P.H., (@DrLaPrincess)

Host: Stephen L. Kopecky, M.D. (@DrSteveKopecky)

Health disparities are differences in the incidence, prevalence, mortality, burden of disease and other adverse health conditions among specific population groups.

Health care disparities are differences in health care coverage, access to care and quality of care between those groups. Health care disparities limit people's ability to achieve health equity — the equally fair and just opportunity to be as healthy as possible.

Joining us today to discuss research in health care disparities is LaPrincess C. Brewer, M.D., M.P.H., a preventive cardiologist at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

• Health disparities versus health care disparities
• Health equity explained
• COVID-19 pandemic and the social determinants of health
• Socioeconomic, racial and ethnic issues
• FAITH! cardiovascular health and wellness program
• FAITH! data and outcomes
• Next steps for providers

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV.

No CME credit offered for this episode.

Podcast episode transcript found here.

COVID-19 In Cardio Oncology

COVID-19 in Cardio-Oncology

Guest: Joerg Herrmann, M.D. (@mayocvonc)

Host: Malcolm R. Bell, M.D.

Coronavirus disease 2019 (COVID-19), heart disease and cancerous tumors were the top three causes of death in the U.S. in 2020. Providers recognized early in the COVID-19 pandemic that patients with underlying cardiovascular disease or cardiovascular risk factors were at the highest risk of developing a severe course and even dying of COVID-19. Patients with cancer also had a higher risk of severe and fatal outcomes.

Joining us today to discuss COVID-19, heart disease and oncology treatment of tumors is Joerg Herrmann, M.D., director of the Cardio-Oncology Clinic at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

• Relationship between heart disease, cancerous tumors and COVID-19
• Research in the connection between cardiac disease and an underlying tumor or the result of treatment of a tumor
• Changes to patient care during the pandemic
• Remote monitoring of patients and innovative artificial intelligence applications
• Cardio-oncology lessons learned

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV.

No CME credit offered for this episode.

Podcast episode transcript found here.

The Role of High-Intensity Interval Training and Strength Training in Cardiovascular Health

The Role of High-Intensity Interval Training and Strength Training in Cardiovascular Health

Guest: Amanda R. Bonikowske, Ph.D.

Host: Stephen L. Kopecky, M.D. (@DrSteveKopecky)

The primary advantage of high-intensity interval training (HIIT) — periods of higher intensity exercise followed by periods of lower intensity exercise in repetition — for cardiorespiratory fitness is peak VO2. HIIT is a more potent stimulus for increasing peak VO2 in a much shorter period of time compared with moderate-intensity continuous training.

Joining us today to discuss HIIT is Amanda R. Bonikowske, Ph.D., program director for the Cardiac Rehabilitation Program at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

• HIIT explained
• Variability, guidelines and rest-to-work ratios
• Benefits over moderate-intensity training
• The One-Minute Workout
• Physiology of HIIT
• Impact on HDL and LDL cholesterol, triglycerides and blood pressure
• Safety

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV.

No CME credit offered for this episode.

Podcast episode transcript found here.

 

Cardiovascular Toxicity and Immune Checkpoint Inhibitors

Cardiovascular Toxicity and Immune Checkpoint Inhibitors

Guest: Joerg Herrmann, M.D. (@mayocvonc)

Host: Malcolm R. Bell, M.D. 

Immune checkpoints are integral to the immune system, ensuring that there is no overactivation once an immune response is triggered. Seven immune checkpoint inhibitors — which interfere with that natural brake in the immune system — are currently approved for use in cancer treatment. The immune checkpoint inhibitors unleash T cells to attack a tumor, with dramatic results.

Joining us today to discuss immune checkpoint inhibitors and cardiovascular toxicity is Joerg Herrmann, M.D., director of the Cardio-Oncology Clinic at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

• Explanation and applications of immune checkpoint inhibitors
• Types of malignancies treated with T cell-based therapies and their outcomes
• Related cardiac toxicities and how to diagnose them
• Evaluation in the outpatient setting

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV.

No CME credit offered for this episode.

Podcast episode transcript found here.

Biological Age and Other AI Tools in Preventive Cardiology

Biological Age and Other AI Tools in Preventive Cardiology

Guest: Francisco Lopez-Jimenez, M.D., M.B.A. (@CVDprevention)

Host: Stephen L. Kopecky, M.D. (@DrSteveKopecky)

Vascular age is impacted by factors that determine the aging of the vascular system — the heart, arteries and veins. These factors might predispose people to develop heart attacks, peripheral vascular disease or strokes.

Joining us today to discuss efforts to better describe and measure vascular age is Francisco Lopez-Jimenez, M.D., M.B.A., chair of Preventive Cardiology at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

• The concept of vascular age explained
• Use of electrocardiogram (ECG) to determine vascular age
• Recommendations to reduce or reverse patients' vascular age
• Use of ECG to identify conditions it was not originally intended to identify
• Future impact of artificial intelligence in medicine

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV.

No CME credit offered for this episode.

Podcast episode transcript found here.