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Chowdhury D, Bansal N, Ansong A, Baker Smith C, Bauser-Heaton H, Choueiter N, Co-Vu J, Elliott P, Fuller S, Jain SS, Jone PN, Johnson JN, Karamlou T, Kipps AK, Laraja K, Lopez KN, Rasheed M, Ronai C, Sachdeva R, Saidi A, Snyder C, Sutton N, Stiver C, Taggart NW, Shaffer K, Williams R. Mind the Gap! Working Toward Gender Equity in Pediatric and Congenital Heart Disease: Present and Future. J Am Heart Assoc 2024; 13:e032837. [PMID: 38639355 DOI: 10.1161/jaha.123.032837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
Evidence from medicine and other fields has shown that gender diversity results in better decision making and outcomes. The incoming workforce of congenital heart specialists (especially in pediatric cardiology) appears to be more gender balanced, but past studies have shown many inequities. Gender-associated differences in leadership positions, opportunities presented for academic advancement, and recognition for academic contributions to the field persist. In addition, compensation packages remain disparate if evaluated based on gender with equivalent experience and expertise. This review explores these inequities and has suggested individual and institutional changes that could be made to recruit and retain women, monitor the climate of the institution, and identify and eliminate bias in areas like salary and promotions.
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Affiliation(s)
| | - Neha Bansal
- Division of Pediatric Cardiology Mount Sinai Kravis Children's Hospital New York NY USA
| | - Annette Ansong
- Division of Pediatric Cardiology Children's National Hospital Washington DC USA
| | | | - Holly Bauser-Heaton
- Division of Pediatric Cardiology Children's Healthcare of Atlanta Atlanta GA USA
| | - Nadine Choueiter
- Division of Pediatric Cardiology Mount Sinai Kravis Children's Hospital New York NY USA
| | - Jennifer Co-Vu
- University of Florida Congenital Heart Center Gainesville FL USA
| | | | - Stephanie Fuller
- Division of Cardiothoracic Surgery Children's Hospital of Philadelphia Philadelphia PA USA
| | - Supriya S Jain
- New York Medical College-Maria Fareri Children's Hospital at Westchester Medical Center Valhalla NY USA
| | - Pei-Ni Jone
- Department of Pediatrics (Cardiology) Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Jonathan N Johnson
- Department of Pediatrics, Division of Pediatric Cardiology Mayo Clinic Rochester MN USA
| | - Tara Karamlou
- Department of Thoracic and Cardiovascular Surgery Cleveland Clinic Children's Cleveland OH USA
| | - Alaina K Kipps
- Division of Pediatric Cardiology Stanford School of Medicine Stanford CA USA
| | - Kristin Laraja
- Division of Pediatric Cardiology, Department of Pediatrics University of Massachusetts Medical School Worcester MA USA
| | - Keila N Lopez
- Department of Pediatric Cardiology Baylor College of Medicine, Texas Children's Hospital Houston TX USA
| | - Muneera Rasheed
- Department of Global Public Health and Primary Care University of Bergen Bergen Norway
| | - Christina Ronai
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School Boston MA USA
| | - Ritu Sachdeva
- Division of Pediatric Cardiology Children's Healthcare of Atlanta Atlanta GA USA
| | - Arwa Saidi
- University of Florida Gainesville FL USA
| | - Chris Snyder
- Division of Pediatric Cardiology UH Cleveland Medical Center Cleveland OH USA
| | - Nicole Sutton
- Children's Hospital at Montefiore, Albert Einstein College of Medicine Bronx NY USA
| | - Corey Stiver
- The Heart Center, Nationwide Children's Hospital Columbus OH USA
| | - Nathaniel W Taggart
- Department of Pediatrics, Division of Pediatric Cardiology Mayo Clinic Rochester MN USA
| | - Kenneth Shaffer
- Dell Children's Medical Center University of Texas at Austin Dell Medical School Austin TX USA
| | - Roberta Williams
- Division of Pediatric Cardiology, Keck School of Medicine of USC Children's Hospital Los Angeles Los Angeles CA USA
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Kovacs B, Lehmann HI, Manninger M, Saguner AM, Futyma P, Duncker D, Chun J. Stereotactic arrhythmia radioablation and its implications for modern cardiac electrophysiology: results of an EHRA survey. Europace 2024; 26:euae110. [PMID: 38666444 PMCID: PMC11086561 DOI: 10.1093/europace/euae110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 04/23/2024] [Indexed: 05/12/2024] Open
Abstract
Stereotactic arrhythmia radioablation (STAR) is a treatment option for recurrent ventricular tachycardia/fibrillation (VT/VF) in patients with structural heart disease (SHD). The current and future role of STAR as viewed by cardiologists is unknown. The study aimed to assess the current role, barriers to application, and expected future role of STAR. An online survey consisting of 20 questions on baseline demographics, awareness/access, current use, and the future role of STAR was conducted. A total of 129 international participants completed the survey [mean age 43 ± 11 years, 25 (16.4%) female]. Ninety-one (59.9%) participants were electrophysiologists. Nine participants (7%) were unaware of STAR as a therapeutic option. Sixty-four (49.6%) had access to STAR, while 62 (48.1%) had treated/referred a patient for treatment. Common primary indications for STAR were recurrent VT/VF in SHD (45%), recurrent VT/VF without SHD (7.8%), or premature ventricular contraction (3.9%). Reported main advantages of STAR were efficacy in the treatment of arrhythmias not amenable to conventional treatment (49%) and non-invasive treatment approach with overall low expected acute and short-term procedural risk (23%). Most respondents have foreseen a future clinical role of STAR in the treatment of VT/VF with or without underlying SHD (72% and 75%, respectively), although only a minority expected a first-line indication for it (7% and 5%, respectively). Stereotactic arrhythmia radioablation as a novel treatment option of recurrent VT appears to gain acceptance within the cardiology community. Further trials are critical to further define efficacy, patient populations, as well as the appropriate clinical use for the treatment of VT.
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Affiliation(s)
- Boldizsar Kovacs
- Department of Cardiology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, 48109 MI, USA
- Department of Cardiology, University Heart Center Zurich, Raemistrasse 100, Zurich 8091, Switzerland
| | - Helge Immo Lehmann
- Department of Cardiology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, 48109 MI, USA
- Corrigan Minehan Heart Center, Massachusetts General Hospital, 55 Fruit St, Boston, 02114 MA, USA
| | - Martin Manninger
- Division of Cardiology, Department of Medicine, Medical University of Graz, Graz, Austria
| | - Ardan Muammer Saguner
- Department of Cardiology, University Heart Center Zurich, Raemistrasse 100, Zurich 8091, Switzerland
| | - Piotr Futyma
- Medical College, University of Rzeszów and St. Joseph’s Heart Rhythm Center, Rzeszów, Poland
| | - David Duncker
- Hannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Julian Chun
- Cardioangiologisches Centrum Bethanien, Agaplesion Bethanien Krankenhaus, Frankfurt, Germany
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3
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De Luca G, Algowhary M, Uguz B, Oliveira DC, Ganyukov V, Zimbakov Z, Cercek M, Jensen LO, Loh PH, Calmac L, Roura-Ferrer G, Quadros A, Milewski M, Scotto di Uccio F, von Birgelen C, Versaci F, Ten Berg J, Casella G, Wong ASL, Kala P, Diez Gil JL, Carrillo X, Dirksen MT, Becerra-Muñoz VM, Kang-Yin Lee M, Juzar DA, de Moura Joaquim R, Paladino R, Milicic D, Davlouros P, Bakraceski N, Zilio F, Donazzan L, Kraaijeveld AO, Galasso G, Lux A, Marinucci L, Guiducci V, Menichelli M, Scoccia A, Yamac A, Ugur Mert K, Flores Rios X, Kovarnik T, Kidawa M, Moreu J, Flavien V, Fabris E, Lozano Martìnez-Luengas I, Boccalatte M, Bosa Ojeda F, Arellano-Serrano C, Caiazzo G, Cirrincione G, Kao HL, Sanchis Fores J, Vignali L, Pereira H, Manzo-Silberman S, Ordonez S, Özkan AA, Scheller B, Lehtola H, Teles R, Mantis C, Ylitalo A, Brum Silveira JA, Zoni R, Bessonov I, Savonitto S, Kochiadakis G, Alexopoulos D, Uribe C, Kanakakis J, Faurie B, Gabrielli G, Gutiérrez A, Bachini JP, Rocha A, Tam FC, Rodriguez A, Lukito A, Saint-Joy V, Pessah G, Tuccillo B, Cortese G, Parodi G, Bouraghda MA, Kedhi E, Lamelas P, Suryapranata H, Nardin M, Verdoia M. COVID-19 pandemic, mechanical reperfusion and 30-day mortality in ST elevation myocardial infarction. Heart 2022; 108:458-466. [PMID: 34711661 PMCID: PMC8561823 DOI: 10.1136/heartjnl-2021-319750] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 09/27/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The initial data of the International Study on Acute Coronary Syndromes - ST Elevation Myocardial Infarction COVID-19 showed in Europe a remarkable reduction in primary percutaneous coronary intervention procedures and higher in-hospital mortality during the initial phase of the pandemic as compared with the prepandemic period. The aim of the current study was to provide the final results of the registry, subsequently extended outside Europe with a larger inclusion period (up to June 2020) and longer follow-up (up to 30 days). METHODS This is a retrospective multicentre registry in 109 high-volume primary percutaneous coronary intervention (PPCI) centres from Europe, Latin America, South-East Asia and North Africa, enrolling 16 674 patients with ST segment elevation myocardial infarction (STEMI) undergoing PPPCI in March/June 2019 and 2020. The main study outcomes were the incidence of PPCI, delayed treatment (ischaemia time >12 hours and door-to-balloon >30 min), in-hospital and 30-day mortality. RESULTS In 2020, during the pandemic, there was a significant reduction in PPCI as compared with 2019 (incidence rate ratio 0.843, 95% CI 0.825 to 0.861, p<0.0001). This reduction was significantly associated with age, being higher in older adults (>75 years) (p=0.015), and was not related to the peak of cases or deaths due to COVID-19. The heterogeneity among centres was high (p<0.001). Furthermore, the pandemic was associated with a significant increase in door-to-balloon time (40 (25-70) min vs 40 (25-64) min, p=0.01) and total ischaemia time (225 (135-410) min vs 196 (120-355) min, p<0.001), which may have contributed to the higher in-hospital (6.5% vs 5.3%, p<0.001) and 30-day (8% vs 6.5%, p=0.001) mortality observed during the pandemic. CONCLUSION Percutaneous revascularisation for STEMI was significantly affected by the COVID-19 pandemic, with a 16% reduction in PPCI procedures, especially among older patients (about 20%), and longer delays to treatment, which may have contributed to the increased in-hospital and 30-day mortality during the pandemic. TRIAL REGISTRATION NUMBER NCT04412655.
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Affiliation(s)
- Giuseppe De Luca
- Department of Cardiology, AOU Maggiore della Carità, Eastern Piedmont University, Novara, Italy
- Department of Translational Medicine, Eastern Piedmont University, Novara, Italy
| | | | - Berat Uguz
- Division of Cardiology, Bursa City Hospital, Bursa, Turkey
| | - Dinaldo C Oliveira
- Pronto de Socorro Cardiologico, Centro PROCAPE Prof. Tavares, Recife, Brazil
| | - Vladimir Ganyukov
- Department of Heart and Vascular Surgery, Kemerovo Cardiology Center, Кемерово, Russia
| | - Zan Zimbakov
- University Clinic for Cardiology, Ss Cyril and Methodius University in Skopje, Skopje, Macedonia
| | - Miha Cercek
- Centre for Intensive Internal Medicine, University Medical Centre, Ljubljana, Slovenia
| | | | - Poay Huan Loh
- Department of Cardiology, Singapore Health Service, Singapore
| | - Lucian Calmac
- Clinic Emergency Hospital, University of Bucharest, Bucuresti, Romania
| | - Gerard Roura-Ferrer
- Interventional Cardiology Unit, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
| | - Alexandre Quadros
- Instituto de Cardiologia, Rio Grande do Sul State Department of Health, Porto Alegre, Brazil
| | - Marek Milewski
- Division of Cardiology, Medical University of Silesia in Katowice, Katowice, Poland
| | | | - Clemens von Birgelen
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Academisch Medisch Centrum, Twente, The Netherlands
| | | | - Jurriën Ten Berg
- Department of Cardiology, Sint Antonius Ziekenhuis, Nieuwegein, The Netherlands
| | | | | | - Petr Kala
- University Hospital Brno, Masaryk University, Brno, Czech Republic
| | - Jose Luis Diez Gil
- Department of Cardiology, Hospital Universitari i Politecnic La Fe, Valencia, Spain
| | - Xavier Carrillo
- Department of Cardiology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | | | | | - Michael Kang-Yin Lee
- Department of Cardiology, Queen ElizabethHospital University of Hong Kong, Hong Kong, Hong Kong
| | - Dafsah A Juzar
- Department of cardiology and Vascular Medicine, National Cardiovascular Center 'Harapan Kita', Jakarta, Indonesia
| | | | | | - Davor Milicic
- Department of Cardiology, University of Zagreb, Zagreb, Croatia
| | | | - Nikola Bakraceski
- Center for Cardiovascular Diseases, Ohrid University Hospital, Ohrid, Macedonia
| | - Filippo Zilio
- Division of Cardiology, Ospedale Santa Chiara di Trento, Trento, Italy
| | | | | | - Gennaro Galasso
- Division of Cardiology, University of Salerno, Salerno, Italy
| | - Arpad Lux
- Cardiology, Maastricht University Hospital, Maastricht, The Netherlands
| | - Lucia Marinucci
- Division of Cardiology, Azienda Ospedaliera "Ospedali Riuniti Marche Nord", Ancona, Italy
| | | | - Maurizio Menichelli
- Cardiology Division, Ospedale Fabrizio Spaziani, Roma, Italy
- Cardiology Division, Ospedale "F. Spaziani", Frosinone, Italy
| | | | - Aylin Yamac
- Department of Cardiology, Bezmialem Vakıf University İstanbul, Istanbul, Turkey
| | - Kadir Ugur Mert
- Division of Cardiology, Eskisehir Osmangazi Universitesi, Eskisehir, Turkey
| | | | - Tomas Kovarnik
- Department of Cardiovascular Medicine, University Hospital Prague, Prague, Czech Republic
| | - Michal Kidawa
- Central Hospital, Medical University of Lodz, Lodz, Poland
| | - Jose Moreu
- Division of Cardiology, Hospital Complex of Toledo, Toledo, Spain
| | - Vincent Flavien
- Division of Cardiology, Lille University Hospital Center, Lille, France
| | - Enrico Fabris
- Department of Cardiology, Universita degli Studi di Trieste Dipartimento di Scienze Mediche Chirurgiche e della Salute, Trieste, Italy
| | | | - Marco Boccalatte
- Division of Cardiology, Ospedale Santa Maria delle Grazie, Pozzuoli, Naples, Italy
| | - Francisco Bosa Ojeda
- Division of Cardiology, Consorcio Sanitario de Tenerife, Santa Cruz de Tenerife, Spain
| | | | - Gianluca Caiazzo
- Division of Cardiology, Ospedale "G Moscati", Aversa, Aversa, Italy
| | | | - Hsien-Li Kao
- Cardiology Division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Juan Sanchis Fores
- Department of Cardiology, Hospital Clinico Universitario, Universidad de Valencia, Valencia, Spain
| | - Luigi Vignali
- Interventional Cardiology Unit, Azienda Ospedaliera Sanitaria, Parma, Parma, Italy
| | - Helder Pereira
- Cardiology Department, Garcia de Orta Hospital, Almada, Portugal
| | | | - Santiago Ordonez
- Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
| | | | - Bruno Scheller
- Clinical and Experimental Interventional Cardiology, Saarland University, Saarbrucken, Germany
| | - Heidi Lehtola
- Division of Cardiology, Oulu University Hospital, Oulu, Finland
| | - Rui Teles
- Department of Cardiology, Hospital de Santa Cruz, CHLO - Nova Medical School,CEDOC, Carnaxide, Portugal
| | - Christos Mantis
- Division of Cardiology, Kontantopoulion Hospital, Athens, Athens, Greece
| | - Antti Ylitalo
- Division of Cardiology, Heart Centre Turku, Turku, Finland
| | | | - Rodrigo Zoni
- Instituto de Cardiología de Corrientes Juana Francisca Cabral, Corrientes, Argentina
| | | | | | | | | | - Carlos Uribe
- Division of Cardiology, Medellin Clinic Universidad UPB, Medellin, Colombia
| | - John Kanakakis
- Division of Cardiology, General Hospital of Athens Alexandra, Athens, Greece
| | - Benjamin Faurie
- Division of Cardiology, Groupe Hospitalier Mutualiste de Grenoble, Grenoble, France
| | - Gabriele Gabrielli
- SOD Cardiologia-Emodinamica-UTIC, Azienda Ospedali Riuniti - Presidio 'GM Lancisi', Ancona, Italy
| | | | | | - Alex Rocha
- Department of Cardiology and Cardiovascular Interventions, Instituto Nacional de Cirugía Cardíaca, Montevideo, Uruguay
| | - Franckie Cc Tam
- Department of Cardiology, Queen Mary Hospital, Hong Kong, Hong Kong
| | - Alfredo Rodriguez
- Department of Cardiology, Otamendi Hospital, Buenos Aires, Argentina
| | - Antonia Lukito
- Cardiovascular Department, Pelita Harapan University, Tangerang, Indonesia
| | | | - Gustavo Pessah
- Division of Cardiology, Cordoba Hospital, Cordoba, Argentina
| | | | - Giuliana Cortese
- Department of Statistical Sciences, University of Padova, Padova, Italy
| | - Guido Parodi
- Division of cardiology, Sassari University Hospital, Sassari, Italy
| | | | - Elvin Kedhi
- Cardiology, Hopital Erasmus, Universitè Libre de Bruxelles, Bruxelles, Belgium
| | - Pablo Lamelas
- Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
| | | | - Matteo Nardin
- Department of Translational Medicine, Eastern Piedmont University, Novara, Italy
- Ospedali Riuniti, Brescia, Italy
| | - Monica Verdoia
- Department of Translational Medicine, Eastern Piedmont University, Novara, Italy
- Cardiology, Nuovo Ospedale degli Infermi ASL Biella, Biella, italy
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Murugiah K, Chen L, Castro-Dominguez Y, Khera R, Krumholz HM. Scope of Practice of US Interventional Cardiologists from an Analysis of Medicare Billing Data. Am J Cardiol 2021; 160:40-45. [PMID: 34610872 DOI: 10.1016/j.amjcard.2021.08.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 08/10/2021] [Accepted: 08/16/2021] [Indexed: 11/27/2022]
Abstract
The contemporary scope of practice of interventional cardiologists (ICs) in the United States and recent trends are unknown. Using Medicare claims from 2013 to 2017, we categorized ICs into 4 practice categories (only percutaneous coronary intervention [PCI], PCI with noninvasive imaging, PCI with specialized interventions [peripheral/structural], and all 3 services) and evaluated associations with region, hospital bed size and teaching status, gender, and graduation year. Of 6,083 ICs in 2017, 10.9% performed only PCI, 68.3% PCI with noninvasive imaging, 5.7% PCI with specialized interventions, and 15.1% all 3 services. A higher proportion of Northeast ICs (vs South ICs) were performing only PCI (24.8% vs 7.3%) and PCI with specialized interventions (12% vs 3.4%), but lower PCI and noninvasive imaging (53.8% vs 71.7%) and all 3 services (9.3% and 17.6%). Regarding ICs at larger hospitals (bed size >575 vs <218), a higher proportion was performing only PCI (23.8% vs 5.2%) or PCI with specialized interventions (13.5% vs 1.7%) and lower proportion was performing PCI with noninvasive imaging (48.8% vs 78%), similar to teaching hospitals. Female ICs (vs male ICs) more frequently performed only PCI (18.9% vs 10.6%) and less frequently all 3 services (8.3% vs 15.4%). A lower proportion of recent graduates (2001 to 2016) performed only PCI (9.8% vs 13.8%) and PCI with noninvasive imaging (66.3% vs 72.6%) but a higher proportion performed all 3 services (18% vs 8.4%) than earlier graduates (1959 to 1984). From 2013 to 2017, only PCI and PCI with noninvasive imaging decreased, whereas PCI and specialized interventions and all 3 services increased (all p <0.001). In conclusion, there is marked heterogeneity in practice responsibilities among ICs, which has implications for training and competency assessments.
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Affiliation(s)
- Karthik Murugiah
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut.
| | - Lian Chen
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut
| | - Yulanka Castro-Dominguez
- Harrington Heart and Vascular Institute, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Rohan Khera
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut
| | - Harlan M Krumholz
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut
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Kuehn BM. Increasing Burnout Could Have Dire Effects on the Cardiovascular Workforce After the Pandemic. Circulation 2021; 144:997-999. [PMID: 34543063 DOI: 10.1161/circulationaha.121.056977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Williams MC, Shaw L, Hirschfeld CB, Maurovich-Horvat P, Nørgaard BL, Pontone G, Jimenez-Heffernan A, Sinitsyn V, Sergienko V, Ansheles A, Bax JJ, Buechel R, Milan E, Slart RHJA, Nicol E, Bucciarelli-Ducci C, Pynda Y, Better N, Cerci R, Dorbala S, Raggi P, Villines TC, Vitola J, Malkovskiy E, Goebel B, Cohen Y, Randazzo M, Pascual TNB, Dondi M, Paez D, Einstein AJ. Impact of COVID-19 on the imaging diagnosis of cardiac disease in Europe. Open Heart 2021; 8:e001681. [PMID: 34353958 PMCID: PMC8349647 DOI: 10.1136/openhrt-2021-001681] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 07/12/2021] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES We aimed to explore the impact of the COVID-19 pandemic on cardiac diagnostic testing and practice and to assess its impact in different regions in Europe. METHODS The online survey organised by the International Atomic Energy Agency Division of Human Health collected information on changes in cardiac imaging procedural volumes between March 2019 and March/April 2020. Data were collected from 909 centres in 108 countries. RESULTS Centres in Northern and Southern Europe were more likely to cancel all outpatient activities compared with Western and Eastern Europe. There was a greater reduction in total procedure volumes in Europe compared with the rest of the world in March 2020 (45% vs 41%, p=0.003), with a more marked reduction in Southern Europe (58%), but by April 2020 this was similar in Europe and the rest of the world (69% vs 63%, p=0.261). Regional variations were apparent between imaging modalities, but the largest reductions were in Southern Europe for nearly all modalities. In March 2020, location in Southern Europe was the only independent predictor of the reduction in procedure volume. However, in April 2020, lower gross domestic product and higher COVID-19 deaths were the only independent predictors. CONCLUSION The first wave of the COVID-19 pandemic had a significant impact on care of patients with cardiac disease, with substantial regional variations in Europe. This has potential long-term implications for patients and plans are required to enable the diagnosis of non-COVID-19 conditions during the ongoing pandemic.
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Affiliation(s)
| | - Leslee Shaw
- Presbyterian Hospital/Weill Cornell Medical Center, New York, New York, USA
| | | | - Pal Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Semmelweis University, Heart and Vascular Center, Budapest, Hungary
| | | | - Gianluca Pontone
- Department of Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | | | | | - Vladimir Sergienko
- National Medical Research Center of Cardiology of Healthcare Ministry, Moscow, Russian Federation
| | - Alexey Ansheles
- National Medical Research Center of Cardiology of Healthcare Ministry, Moscow, Russian Federation
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ronny Buechel
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Elisa Milan
- UOC Nuclear Medicine- Ospedale Cà Foncello, Treviso, Italy
| | - Riemer H J A Slart
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, Groningen, The Netherlands
| | - Edward Nicol
- Department of Imaging, Royal Brompton Hospital, London, UK
| | - Chiara Bucciarelli-Ducci
- Royal Brompton and Harefield Hospitals, London, UK
- Guys and St Thomas NHS Trust and King's College London, London, UK
| | | | - Nathan Better
- Royal Melbourne Hospital and University of Melbourne, Melbourne, Victoria, Australia
| | | | | | - Paolo Raggi
- Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada
| | - Todd C Villines
- Medicine (Cardiology), Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | | | - Eli Malkovskiy
- Columbia University Irving Medical Center, New York, New York, USA
| | | | - Yosef Cohen
- Technion Israel Institute of Technology, Haifa, Israel
| | - Michael Randazzo
- Columbia University Irving Medical Center, New York, New York, USA
| | | | | | - Diana Paez
- International Atomic Energy Agency, Vienna, Austria
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Ma M, Yang ZG, He Y. How cardiologists respond to COVID-19: the experience of West China Hospital, China. Intern Emerg Med 2020; 15:1561-1565. [PMID: 32676838 PMCID: PMC7365305 DOI: 10.1007/s11739-020-02413-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 06/16/2020] [Indexed: 02/05/2023]
Affiliation(s)
- Min Ma
- Department of Radiology, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, No. 37 GuoxueStreet, Chengdu, 610041, China
- Department of Cardiology, The Sixth People's Hospital of Chengdu, Chengdu, China
| | - Zhi-Gang Yang
- Department of Radiology, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, No. 37 GuoxueStreet, Chengdu, 610041, China.
| | - Yong He
- Department of Cardiology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, China.
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Botto GL, Gasparini M, Brasca FMA, Casale MC, Occhetta E, Racheli M, Bertaglia M, Zanon F, Zardini M, Rapacciuolo A, Mascioli G, Curnis A, Metra M, Normand C, Dickstein K, Linde C. Second European Society of Cardiology Cardiac Resynchronization Therapy Survey: the Italian cohort. J Cardiovasc Med (Hagerstown) 2020; 21:634-640. [PMID: 32740496 DOI: 10.2459/jcm.0000000000001035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
AIM Adherence to guidelines was not homogeneous in Europe, according to the survey on cardiac resynchronization therapy conducted in 2008-2009. The aim of our study was to compare the results in the Italian and European cohorts of the Second European Cardiac Resynchronization Therapy Survey. METHODS Patients' characteristics, procedural data and follow-up were collected. Italian records were compared with European countries. RESULTS Italian hospitals enrolled 526 patients. The italian cohort was older (71.6 ± 9.5 vs. 68.4 ± 10.8; P < 0.00001), had less severe NYHA class (>II 47.2 vs. 59.6%; P < 0.00001), higher ejection fraction (30.3 ± 7.4 vs. 28.4 ± 8.2%; P < 0.00001), and less atrial fibrillation prevalence (34.4 vs. 41.2%; P = 0.00197) than the European cohort. Italian patients were more frequently hospitalized for heart failure in the previous year (51.9 vs. 46.2%; P = 0.01118) and had lower mean QRS duration (151 ± 26 vs. 157 ± 27 ms; P < 0.0001). CRT-D were more often implanted in Italian patients (79.3 vs. 69.3%; P < 0.00001). The complication rate was similar (4.6% vs. 5.6%; ns). The rate of use of ACEi/ARBs in Italy was lower than in Europe (77.2 vs. 86.9%; P < 0.00001). Patients were followed up in the implantation centre (92.1 vs. 86%; P = 0.00014), but rarely with remote monitoring (25.9 vs. 30%; P = 0.04792). CONCLUSION The survey demonstrates important similarities as well as substantial differences regarding most of the aspects evaluated. Efforts to implement adherence to guidelines will be endorsed in Italy.
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Affiliation(s)
- Giovanni L Botto
- Cardiology and Electrophysiology Division, ASST Rhodense, Garbagnate M
| | - Maurizio Gasparini
- Electrophysiology Division, Humanitas Research Hospital IRCCS, Rozzano, Milan
| | | | - Maria C Casale
- Cardiology and Electrophysiology Division, ASST Rhodense, Garbagnate M
- Electrophysiology Division, Humanitas Research Hospital IRCCS, Rozzano, Milan
| | - Eraldo Occhetta
- Electrophysiology Division, AOU Ospedale Maggiore della Carità, Novara
| | | | | | - Francesco Zanon
- Cardiology Division, Ospedale Santa Maria della Misericordia, Rovigo
| | - Marco Zardini
- Cardiology Division, AOU Ospedale Maggiore di Parma, Parma
| | | | - Giosuè Mascioli
- Electrophysiology Division, Cliniche Humanitas Gavazzeni, Bergamo
| | - Antonio Curnis
- Cardiology Division, University of Brescia, Spedali Civili, Brescia, Italy
| | - Marco Metra
- Cardiology Division, University of Brescia, Spedali Civili, Brescia, Italy
| | - Camilla Normand
- Institute of Internal Medicine, University of Bergen, Bergen
- Cardiology Division, Stavanger University Hospital, Stavanger, Norway
| | - Kenneth Dickstein
- Cardiology Division, Stavanger University Hospital, Stavanger, Norway
| | - Cecilia Linde
- Heart and Vascular Theme, Karolinska University Hospital, Stockholm, and Karolinska Institutet, Stockholm, Sweden
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Sharma G, Zakaria S, Michos ED, Bhatt AB, Lundberg GP, Florio KL, Vaught AJ, Ouyang P, Mehta L. Improving Cardiovascular Workforce Competencies in Cardio-Obstetrics: Current Challenges and Future Directions. J Am Heart Assoc 2020; 9:e015569. [PMID: 32482113 PMCID: PMC7429047 DOI: 10.1161/jaha.119.015569] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Maternal mortality in the United States is the highest among all developed nations, partly because of the increased prevalence of cardiovascular disease in pregnancy and beyond. There is growing recognition that specialists involved in caring for obstetric patients with cardiovascular disease need training in the new discipline of cardio-obstetrics. Training can include integrated formal cardio-obstetrics curricula in general cardiovascular disease training programs, and developing and disseminating joint cardiac and obstetric societal guidelines. Other efforts to help strengthen the cardio-obstetric field include increased collaborations and advocacy efforts between stakeholder organizations, development of US-based registries, and widespread establishment of multidisciplinary pregnancy heart teams. In this review, we present the current challenges in creating a cardio-obstetrics community, present the growing need for education and training of cardiovascular disease practitioners skilled in the care of obstetric patients, and identify potential solutions and future efforts to improve cardiovascular care of this high-risk patient population.
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Affiliation(s)
- Garima Sharma
- Division of CardiologyJohns Hopkins Ciccarone Center for Prevention of Cardiovascular DiseasesJohns Hopkins University School of MedicineBaltimoreMD
| | - Sammy Zakaria
- Division of CardiologyJohns Hopkins Ciccarone Center for Prevention of Cardiovascular DiseasesJohns Hopkins University School of MedicineBaltimoreMD
| | - Erin D. Michos
- Division of CardiologyJohns Hopkins Ciccarone Center for Prevention of Cardiovascular DiseasesJohns Hopkins University School of MedicineBaltimoreMD
| | - Ami B. Bhatt
- Division of CardiologyCorrigan Minehan Heart CenterMassachusetts General HospitalHarvard Medical SchoolBostonMA
| | - Gina P. Lundberg
- Division of CardiologyDepartment of MedicineEmory School of MedicineAtlantaGA
| | - Karen L. Florio
- Department of Obstetrics and GynecologySaint Luke's HospitalKansas CityMO
| | - Arthur Jason Vaught
- Division of Maternal‐Fetal MedicineDepartment of Gynecology and ObstetricsJohns Hopkins University School of MedicineBaltimoreMD
| | - Pamela Ouyang
- Division of CardiologyJohns Hopkins Ciccarone Center for Prevention of Cardiovascular DiseasesJohns Hopkins University School of MedicineBaltimoreMD
| | - Laxmi Mehta
- Division of CardiologyDepartment of MedicineThe Ohio State University Wexner Medical CenterColumbusOH
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10
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Narahari AK, Cook IO, Mehaffey JH, Chandrabhatla AS, Hawkins RB, Tyerman Z, Charles EJ, Tribble CG, Kron IL, Teman NR, Roeser ME, Ailawadi G. Comprehensive National Institutes of Health funding analysis of academic cardiac surgeons. J Thorac Cardiovasc Surg 2020; 159:2326-2335.e3. [PMID: 31604638 PMCID: PMC7546359 DOI: 10.1016/j.jtcvs.2019.08.032] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 08/12/2019] [Accepted: 08/15/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine trends in National Institutes of Health (NIH) funding for cardiac surgeons, hypothesizing they are at a disadvantage in obtaining funding owing to intensive clinical demands. METHODS Cardiac surgeons (adult/congenital) currently at the top 141 NIH-funded institutions were identified using institutional websites. The NIH funding history for each cardiac surgeon was queried using the NIH Research Portfolio Online Reporting Tools Expenditures and Results (RePORTER). Total grant funding, publications, and type was collected. Academic rank, secondary degrees, and fellowship information was collected from faculty pages. Grant productivity was calculated using a validated grant impact metric. RESULTS A total of 818 academic cardiac surgeons were identified, of whom 144 obtained 293 NIH grants totaling $458 million and resulting in 6694 publications. We identified strong associations between an institution's overall NIH funding rank and the number of cardiac surgeons, NIH grants to cardiac surgeons, and amount of NIH funding to cardiac surgeons (P < .0001 for all). The majority of NIH funding to cardiac surgeons is concentrated in the top quartile of institutions. Cardiac surgeons had a high conversion rates from K awards (mentored development awards) to R01s (6 of 14; 42.9%). Finally, we demonstrate that the rate of all NIH grants awarded to cardiac surgeons has increased, driven primarily by P and U (collaborative project) grants. CONCLUSIONS NIH-funded cardiac surgical research has had a significant impact over the last 3 decades. Aspiring cardiac surgeon-scientists may be more successful at top quartile institutions owing to better infrastructure and mentorship.
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Affiliation(s)
- Adishesh K Narahari
- Division of Cardiac Surgery, Department of Surgery, University of Virginia Health System, Charlottesville, Va
| | - Ian O Cook
- Division of Cardiac Surgery, Department of Surgery, University of Virginia Health System, Charlottesville, Va
| | - J Hunter Mehaffey
- Division of Cardiac Surgery, Department of Surgery, University of Virginia Health System, Charlottesville, Va
| | - Anirudha S Chandrabhatla
- Division of Cardiac Surgery, Department of Surgery, University of Virginia Health System, Charlottesville, Va
| | - Robert B Hawkins
- Division of Cardiac Surgery, Department of Surgery, University of Virginia Health System, Charlottesville, Va
| | - Zachary Tyerman
- Division of Cardiac Surgery, Department of Surgery, University of Virginia Health System, Charlottesville, Va
| | - Eric J Charles
- Division of Cardiac Surgery, Department of Surgery, University of Virginia Health System, Charlottesville, Va
| | - Curtis G Tribble
- Division of Cardiac Surgery, Department of Surgery, University of Virginia Health System, Charlottesville, Va
| | - Irving L Kron
- Division of Cardiothoracic Surgery, Department of Surgery, University of Arizona College of Medicine, Tucson, Ariz
| | - Nicholas R Teman
- Division of Cardiac Surgery, Department of Surgery, University of Virginia Health System, Charlottesville, Va
| | - Mark E Roeser
- Division of Cardiac Surgery, Department of Surgery, University of Virginia Health System, Charlottesville, Va
| | - Gorav Ailawadi
- Division of Cardiac Surgery, Department of Surgery, University of Virginia Health System, Charlottesville, Va.
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11
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Berg DD, Barnett CF, Kenigsberg BB, Papolos A, Alviar CL, Baird-Zars VM, Barsness GW, Bohula EA, Brennan J, Burke JA, Carnicelli AP, Chaudhry SP, Cremer PC, Daniels LB, DeFilippis AP, Gerber DA, Granger CB, Hollenberg S, Horowitz JM, Gladden JD, Katz JN, Keeley EC, Keller N, Kontos MC, Lawler PR, Menon V, Metkus TS, Miller PE, Nativi-Nicolau J, Newby LK, Park JG, Phreaner N, Roswell RO, Schulman SP, Sinha SS, Snell RJ, Solomon MA, Teuteberg JJ, Tymchak W, van Diepen S, Morrow DA. Clinical Practice Patterns in Temporary Mechanical Circulatory Support for Shock in the Critical Care Cardiology Trials Network (CCCTN) Registry. Circ Heart Fail 2019; 12:e006635. [PMID: 31707801 DOI: 10.1161/circheartfailure.119.006635] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Temporary mechanical circulatory support (MCS) devices provide hemodynamic assistance for shock refractory to pharmacological treatment. Most registries have focused on single devices or specific etiologies of shock, limiting data regarding overall practice patterns with temporary MCS in cardiac intensive care units. METHODS The CCCTN (Critical Care Cardiology Trials Network) is a multicenter network of tertiary CICUs in North America. Between September 2017 and September 2018, each center (n=16) contributed a 2-month snapshot of consecutive medical CICU admissions. RESULTS Of the 270 admissions using temporary MCS, 33% had acute myocardial infarction-related cardiogenic shock (CS), 31% had CS not related to acute myocardial infarction, 11% had mixed shock, and 22% had an indication other than shock. Among all 585 admissions with CS or mixed shock, 34% used temporary MCS during the CICU stay with substantial variation between centers (range: 17%-50%). The most common temporary MCS devices were intraaortic balloon pumps (72%), Impella (17%), and veno-arterial extracorporeal membrane oxygenation (11%), although intraaortic balloon pump use also varied between centers (range: 40%-100%). Patients managed with intraaortic balloon pump versus other forms of MCS (advanced MCS) had lower Sequential Organ Failure Assessment scores and less severe metabolic derangements. Illness severity was similar at high- versus low-MCS utilizing centers and at centers with more advanced MCS use. CONCLUSIONS There is wide variation in the use of temporary MCS among patients with shock in tertiary CICUs. While hospital-level variation in temporary MCS device selection is not explained by differences in illness severity, patient-level variation appears to be related, at least in part, to illness severity.
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Affiliation(s)
- David D Berg
- Levine Cardiac Intensive Care Unit, TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (D.D.B., V.M.B.-Z., E.A.B., J.-G.P., D.A.M.)
| | - Christopher F Barnett
- Medstar Heart and Vascular Institute, Medstar Washington Hospital Center, Washington DC (C.F.B., B.B.K., A.P.)
| | - Benjamin B Kenigsberg
- Medstar Heart and Vascular Institute, Medstar Washington Hospital Center, Washington DC (C.F.B., B.B.K., A.P.)
| | - Alexander Papolos
- Medstar Heart and Vascular Institute, Medstar Washington Hospital Center, Washington DC (C.F.B., B.B.K., A.P.)
| | - Carlos L Alviar
- Leon H. Charney Division of Cardiology, New York University School of Medicine (C.L.A., J.M.H., N.K.)
| | - Vivian M Baird-Zars
- Levine Cardiac Intensive Care Unit, TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (D.D.B., V.M.B.-Z., E.A.B., J.-G.P., D.A.M.)
| | - Gregory W Barsness
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (G.W.B., J.D.G.)
| | - Erin A Bohula
- Levine Cardiac Intensive Care Unit, TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (D.D.B., V.M.B.-Z., E.A.B., J.-G.P., D.A.M.)
| | - Joseph Brennan
- Department of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT (J.B., P.E.M.)
| | - James A Burke
- Lehigh Valley Health Network, Allentown, PA (J.A.B.)
| | - Anthony P Carnicelli
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (A.P.C., C.B.G., L.K.N.)
| | | | - Paul C Cremer
- Department of Cardiovascular Medicine, Cleveland Clinic Foundation, OH (P.C.C.)
| | - Lori B Daniels
- Sulpizio Cardiovascular Center, University of California San Diego, La Jolla (L.B.D., N.P.)
| | | | - Daniel A Gerber
- Department of Medicine, Stanford University School of Medicine, CA (D.A.G., J.J.T.)
| | - Christopher B Granger
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (A.P.C., C.B.G., L.K.N.)
| | - Steven Hollenberg
- Department of Cardiovascular Disease, Cooper University Hospital, Camden, NJ (S.H.)
| | - James M Horowitz
- Leon H. Charney Division of Cardiology, New York University School of Medicine (C.L.A., J.M.H., N.K.)
| | - James D Gladden
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (G.W.B., J.D.G.)
| | - Jason N Katz
- Divisions of Cardiology and Pulmonary and Critical Care Medicine, University of North Carolina, Center for Heart and Vascular Care, Chapel Hill (J.N.K.)
| | - Ellen C Keeley
- Division of Cardiology, University of Florida, Gainesville (E.C.K.)
| | - Norma Keller
- Leon H. Charney Division of Cardiology, New York University School of Medicine (C.L.A., J.M.H., N.K.)
| | - Michael C Kontos
- Division of Cardiology, Virginia Commonwealth University, Richmond (M.C.K.)
| | - Patrick R Lawler
- Division of Cardiology and Interdepartmental Division of Critical Care Medicine, Peter Munk Cardiac Centre, Toronto General Hospital, University of Toronto, ON (P.R.L.)
| | - Venu Menon
- Department of Cardiology, St Vincent Hospital, Indianapolis, IN (S.-P.C., V.M.)
| | - Thomas S Metkus
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (T.S.M., S.P.S.)
| | - P Elliott Miller
- Department of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT (J.B., P.E.M.)
| | - Jose Nativi-Nicolau
- Division of Cardiovascular Medicine, University of Utah School of Medicine, Salt Lake City (J.N.-N.)
| | - L Kristin Newby
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (A.P.C., C.B.G., L.K.N.)
| | - Jeong-Gun Park
- Levine Cardiac Intensive Care Unit, TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (D.D.B., V.M.B.-Z., E.A.B., J.-G.P., D.A.M.)
| | - Nicholas Phreaner
- Sulpizio Cardiovascular Center, University of California San Diego, La Jolla (L.B.D., N.P.)
| | | | - Steven P Schulman
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (T.S.M., S.P.S.)
| | - Shashank S Sinha
- Inova Heart and Vascular Institute, Inova Fairfax Medical Center, Falls Church, VA (S.S.S.)
| | | | - Michael A Solomon
- Critical Care Medicine Department, National Institutes of Health Clinical Center and Cardiovascular Branch, National Heart, Lung, and Blood Institute of the National Institutes of Health, Bethesda, MD (M.A.S.)
| | - Jeffrey J Teuteberg
- Department of Medicine, Stanford University School of Medicine, CA (D.A.G., J.J.T.)
| | - Wayne Tymchak
- Department of Critical Care and Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Canada (W.T., S.v.D.)
| | - Sean van Diepen
- Department of Critical Care and Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Canada (W.T., S.v.D.)
| | - David A Morrow
- Levine Cardiac Intensive Care Unit, TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (D.D.B., V.M.B.-Z., E.A.B., J.-G.P., D.A.M.)
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12
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Anguita Sánchez M, Alonso Martín JJ, Cequier Fillat Á, Gómez Doblas JJ, Pulpón Rivera L, Lekuona Goya I, Rodríguez Rodrigo F, Íñiguez Romo A, Macaya Miguel C, Evangelista Masip A, Silva Melchor L, Bueno H, Díaz Molina B, Ferreira-González I, Elola Somoza FJ. Cardiologists and the Cardiology of the Future. Vision and proposals of the Spanish Society of Cardiology for the Cardiology of the 21st Century. Rev Esp Cardiol (Engl Ed) 2019; 72:649-657. [PMID: 31311762 DOI: 10.1016/j.rec.2019.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 02/07/2019] [Indexed: 06/10/2023]
Abstract
The Cardiology of the Future is a project of the Spanish Society of Cardiology (SEC) whose objectives are as follows: to define the action policies of the SEC; to analyze the trends and changes in the environment that will influence the practice of cardiology in Spain; to define the profile of the cardiologists needed in the future; to propose policies to achieve the objectives resulting from the identified needs; and to identify the role of the SEC in the development and implementation of these policies. This article describes the methodology and the most relevant findings of the final report of this project and the strategic lines to be developed by the SEC in the immediate future, resulting from the analysis performed.
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Affiliation(s)
- Manuel Anguita Sánchez
- Servicio de Cardiología, Complejo Hospitalario Universitario Reina Sofía, Córdoba, España
| | | | - Ángel Cequier Fillat
- Servicio de Cardiología, Hospital Universitario de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, España
| | - Juan José Gómez Doblas
- Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
| | - Luis Pulpón Rivera
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España
| | - Iñaki Lekuona Goya
- Servicio de Cardiología, Hospital Galdakao Usansolo, Galdácano, Vizcaya, España
| | | | - Andrés Íñiguez Romo
- Servicio de Cardiología, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, España
| | - Carlos Macaya Miguel
- Servicio de Cardiología, Hospital Clínico Universitario San Carlos, Madrid, España
| | | | - Lorenzo Silva Melchor
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España
| | - Héctor Bueno
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, España; Centro Nacional de Investigaciones Cardiovasculares (CNIC), España
| | - Beatriz Díaz Molina
- Servicio de Cardiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España
| | - Ignacio Ferreira-González
- Servicio de Cardiología, Hospital Universitario Vall d'Hebron, Barcelona, España; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), España
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Abstract
Women remain largely under-represented in cardiology worldwide, despite gender parity among medical graduates. This is particularly notable in procedural subspecialties such as interventional cardiology and electrophysiology and is consistent at all levels of training. Cardiology continues to have the lowest proportion of females of all adult medicine specialties. This is a review of existing literature and statistics pertaining to women in cardiology and highlights the relative paucity of data or publications within Australia. Australian data from the Medical Training Review Panel reported that the proportion of females in cardiology advanced training (˜22%) has not changed over the last 9 years and that there is a significant attrition as trainees progress through the various stages of training. In 2018, females represent only 16% of first year cardiology advanced trainees in Victoria and Tasmania. This represents a decrease from 20-25% in previous years. The factors affecting gender parity in cardiology are complex and diverse, from personal reasons such as family planning, work-life balance and perceived gender bias, to recruitment inertia and an imbalance in opportunities for career progression, research, financial remuneration and leadership positions. Worldwide, a number of initiatives have been explored to address the gender divide in cardiology, including networking and mentorship programs and Women in Cardiology working groups, dedicated to addressing the issue of female under-representation in cardiology. Unfortunately, the progress we are seeing worldwide is not being realised in Australia. A collaborative approach is essential to achieve gender parity in cardiology. This involves introspection and accountability by College bodies and policy changes committed to promoting workplace diversity by welcoming and retaining female talent. We must recognise and address the current barriers and support women pursuing a career in cardiology.
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Affiliation(s)
- Louise Segan
- Department of Cardiology, Barwon Health, Geelong, Vic, Australia.
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14
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Tong CW, Madhur MS, Rzeszut AK, Abdalla M, Abudayyeh I, Alexanderson E, Buber J, Feldman DN, Gopinathannair R, Hira RS, Kates AM, Kessler T, Leung S, Raj SR, Spatz ES, Turner MB, Valente AM, West K, Sivaram CA, Hill JA, Mann DL, Freeman AM. Status of Early-Career Academic Cardiology: A Global Perspective. J Am Coll Cardiol 2017; 70:2290-2303. [PMID: 29073958 PMCID: PMC5665176 DOI: 10.1016/j.jacc.2017.09.030] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 08/28/2017] [Accepted: 09/14/2017] [Indexed: 01/09/2023]
Abstract
Early-career academic cardiologists, who many believe are an important component of the future of cardiovascular care, face myriad challenges. The Early Career Section Academic Working Group of the American College of Cardiology, with senior leadership support, assessed the progress of this cohort from 2013 to 2016 with a global perspective. Data consisted of accessing National Heart, Lung, and Blood Institute public information, data from the American Heart Association and international organizations, and a membership-wide survey. Although the National Heart, Lung, and Blood Institute increased funding of career development grants, only a small number of early-career American College of Cardiology members have benefited as funding of the entire cohort has decreased. Personal motivation, institutional support, and collaborators continued to be positive influential factors. Surprisingly, mentoring ceased to correlate positively with obtaining external grants. The totality of findings suggests that the status of early-career academic cardiologists remains challenging; therefore, the authors recommend a set of attainable solutions.
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Affiliation(s)
- Carl W Tong
- Department of Medical Physiology, Texas A&M University College of Medicine and Department of Medicine, Division of Cardiology-Temple Region, Baylor Scott & White Health, Temple, Texas.
| | - Meena S Madhur
- Department of Medicine, Division of Clinical Pharmacology and Division of Cardiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Anne K Rzeszut
- Market Intelligence, American College of Cardiology, Washington, District of Columbia
| | - Marwah Abdalla
- Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York
| | - Islam Abudayyeh
- Division of Cardiology, Loma Linda University Medical Center, Loma Linda, California
| | - Erick Alexanderson
- National Institute of Cardiology and Medical Physiology, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Jonathan Buber
- Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel
| | - Dmitriy N Feldman
- Weill Cornell Medical College/NewYork-Presbyterian Hospital, New York, New York
| | | | - Ravi S Hira
- Division of Cardiology, University of Washington, Seattle, Washington
| | - Andrew M Kates
- Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri
| | - Thorsten Kessler
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Steve Leung
- Division of Cardiovascular Medicine, University of Kentucky, Lexington, Kentucky
| | - Satish R Raj
- Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | | | - Anne Marie Valente
- Department of Cardiology, Boston Children's Hospital, Department of Medicine, Division of Cardiovascular Disease, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kristin West
- Member Strategy, American College of Cardiology, Washington, District of Columbia
| | - Chittur A Sivaram
- Department of Medicine, Cardiovascular Section, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
| | - Joseph A Hill
- Department of Internal Medicine, Cardiology Division, and Harry S. Moss Heart Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Douglas L Mann
- Center for Cardiovascular Research, Department of Medicine and Washington University School of Medicine, St. Louis, Missouri
| | - Andrew M Freeman
- Department of Medicine, Division of Cardiology, National Jewish Health, Denver, Colorado
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15
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Radzimanowski M, Gallowitz C, Müller-Nordhorn J, Rieckmann N, Tenckhoff B. Physician specialty and long-term survival after myocardial infarction - A study including all German statutory health insured patients. Int J Cardiol 2017; 251:1-7. [PMID: 29092757 DOI: 10.1016/j.ijcard.2017.10.048] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 09/25/2017] [Accepted: 10/13/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND With a mortality rate above European average, myocardial infarction (MI) is the second most common cause of death in Germany. Data about post-MI ambulatory care and mortality is scarce. We examined the association between ambulatory treating physicians' specialty and the mortality of post-MI patients. METHODS Medical claims data of all 17 German regional Associations of Statutory Health Insurance physicians were analyzed, which cover approximately 90% of the German population. Patients with a new diagnosis of a MI in 2011 were divided into treatment groups with and without ambulant cardiology care within the first year after MI diagnosis. Propensity-score matching based on socio-demographic and clinical variables was performed to achieve comparability between groups. The 18-month mortality rate was derived employing a validated method. RESULTS 158,494 patients with a new diagnosis of MI had received post-MI ambulatory care in 2011. Half of them (51%) had at least one ambulatory contact with a cardiologist within the first year. During a follow-up of 18months, the mortality rate before and after propensity-score matching was 19% and 14% in patients without cardiology care and 6%, respectively, in patients with cardiology care (χ2=666.7; P<0.000 after propensity adjustment). Patients who only saw a cardiologist and had no additional contact to an ambulant general practitioner (GP)/internist within the first year did not have increased survival rates. CONCLUSIONS Outpatient follow-up care by a cardiologist in combination with consultations of GP/internists within the first year may be of importance for the prognosis of MI patients.
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Affiliation(s)
- Maria Radzimanowski
- Kassenärztliche Bundesvereinigung (KBV), National Association of Statutory Health Insurance Physicians, Herbert-Lewin-Platz 2, 10623 Berlin, Germany; Charité Universitätsmedizin Berlin, Institute of Public Health, Seestr. 73, Haus 10, 13347 Berlin, Germany.
| | - Christian Gallowitz
- Kassenärztliche Bundesvereinigung (KBV), National Association of Statutory Health Insurance Physicians, Herbert-Lewin-Platz 2, 10623 Berlin, Germany
| | - Jacqueline Müller-Nordhorn
- Charité Universitätsmedizin Berlin, Institute of Public Health, Seestr. 73, Haus 10, 13347 Berlin, Germany
| | - Nina Rieckmann
- Charité Universitätsmedizin Berlin, Institute of Public Health, Seestr. 73, Haus 10, 13347 Berlin, Germany
| | - Bernhard Tenckhoff
- Kassenärztliche Bundesvereinigung (KBV), National Association of Statutory Health Insurance Physicians, Herbert-Lewin-Platz 2, 10623 Berlin, Germany
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