The Pulse

Welcome to The Pulse, the biannual UPMC Cardiovascular Fellowship Program e-newsletter. This publication is issued twice a year to keep graduates up to date on what’s happening with the program. It is our hope that this will help everyone to stay in close contact and promote ongoing interaction among graduates, new and old.

Fellowship News

Social Media – An Important Tool for Educators


By Mourad Senussi, MD
I distinctly remember as an intern years ago, I would religiously watch various podcasts which helped me over the years hone my skills with the ultrasound when caring for the critically ill. It was these podcasts that represented a treasure trove of innovative ideas and techniques that was shared amongst the medical community. We live in fascinating times with an ever-increasing amount of clinical research. However, as new evidence emerges, we are oftentimes slow to change our practice.

Social media now represents a fascinating means by which one can connect with colleagues across the globe. I have always been passionate about cardiac critical care, a burgeoning field that continues to evolve. The use of social media offered me the opportunity to connect with like-minded individuals and share a wealth of information. The educational value has been incredible and opens a facet of medical education that I believe represents an untapped potential for all physicians.

Vascular access is crucial in instituting lifesaving therapies in the critically ill. Subclavian central line placement over the years has fallen out of favor because of the fear of mechanical complications such as pneumothorax. As a fellow, I stumbled upon a simple yet effective modification of ultrasound guided subclavian/axillary central line placement that emphasizes safety. The trajectory of the needle is pointed in the direction of the underlying rib; therefore, any inadvertent advancement will lead to contact with the rib thus avoiding any lung injury. I have used this simple technique for years and call it the PART (Pleural Avoidance with Rib Trajectory) method.

Recently I had the distinct pleasure of being interviewed for the Ultrasound Podcast where I explain my technique in detail. There has been an outpouring of interest from physicians across different specialties all around the globe from various countries such as Germany, Brazil, the Netherlands, Ireland, and Japan. I was sent several videos of the very same technique being utilized by these physicians after watching the podcast. This has further fortified my belief that social media represents an avenue to disseminate and propagate knowledge like never before.

I’ve always believed that as physicians we have the ability to touch individual lives on a day to day basis. As educators, we help shape future generations in hopes of helping even more. Social media is a tool that can help us become even better physicians and reach even bigger audiences.

--Dr. Senussi is a second-year cardiology fellow who completed his critical care training at Cleveland Clinic prior to coming to UPMC. Listen to his interview on the Ultrasound Podcast.



Follow Us On Twitter

Josh Levenson, MD
By Josh Levenson, MD
We encourage friends and alumni of the fellowship to follow us on Twitter! Over the past few years, cardiologists from across the world have flocked to social media for its ability to innovate, educate, and inspire within health care. Our fellows and faculty are leading the way, acknowledging it as a novel medium to meet peers and to communicate directly with thought leaders. With the Twitter username @PittCardiology, the Division of Cardiology has focused on highlighting publications, awards, conference presentations, and clinical achievements by our fellows and faculty. Many fellows use Twitter to disseminate their own work and to share their viewpoints on other literature. Everyone is encouraged to join the growing social media health care community by creating a Twitter account and following @PittCardiology. And don’t forget to include @PittCardiology in your posts!

For those interested a more traditional way to stay up to date on the fellowship, we recommend that alumni and friends review our revamped online research highlights page. There will you find a summary of ongoing work by our fellows and faculty in a web based format – including, of course, posts from our Pitt Cardiology Twitter account!



Fellowship Match

We had another stellar recruitment year! After 700+ applications from across the nation, we are happy to report a fantastic match. We thank all current fellows, faculty, and staff for the dedication and spirit shown to help recruit our new trainees. We can’t wait to have the following join the HVI family in July 2018!

•   Stephen Broughton (Wake Forest University)
•   Abdallah Bukari (University of Chicago)
•   Becky Feldmeier (University of Maryland)
•   Vinaya Mulkareddy (Washington University)
•   Jonathan Pollock (Wright State University)
•   Anum Saeed (Brown University)
•   Daniel Shpilsky (UPMC)
•   Dan Wann (Beth Israel Deaconess Medical Center)
•   Adil Yunis (Boston University)


Fellows Research Night

The 2017 Fellows Research Night was an outstanding success. Every October, the second-year Heart & Vascular Institute cardiology fellows present a proposal of their intended research to be performed throughout the fellowship period. The night not only serves as formal training for the fellows to hone their scientific presentation skills, but more importantly intends to engage and inspire fellows as well as the entire HVI faculty and staff in cutting-edge science that will define the future of our specialty in the decades to come.

There was an exceptionally broad range of ideas that were presented this year, including basic and clinical research topics involving the exploration of heart failure, pulmonary hypertension, arrhythmias, women’s health, critical care medicine, palliative care, and beyond. Importantly, the quality and innovation of the projects were so impressive that, for the first time, all second-year fellows were awarded an HVI Fellow Research Prize, which provide crucial financial resources to ensure successful completion of each of the projects.

We are certainly proud of all our fellows who presented their projects (listed below) and received these prestigious awards. We greatly look forward to the realization of their work and many of their promising careers as physician-scientists.

Fellow Mentor(s) Presentation
 
George Cater, MD Mark Gladwin, MD Quantitative Assessment of Myocardial Fibrosis in a Rat Model of Pulmonary Hypertension - Heart Failure with Preserved Ejection Fraction
 
Malamo Countouris, MD Janet Catov, MD
Flordeliza Villanueva, MD
Placental Malperfusion and Association with Later Life Microvascular Coronary Flow Reserve, Global Longitudinal Strain, and Diastolic Dysfunction
 
Dingxin Qin, MD, MSc João Cavalcante, MD
Samir Saba, MD
Erin Kershaw, MD
(endocrinology)
Clinical Management of Patients with Atrial Fibrillation and Class 3 Obesity
 
Zachary Rhinehart, MD Jared Magnani, MD EHR Identification of Atrial Fibrillation
     
Mourad Senussi, MD Mark Schmidhofer, MD
Michael Risbano, MD
Michael Pinsky, MD
Validation of Carotid and Femoral Doppler Derived Cardiac Output Measurements
     
Roy Sriwattanakomen, MD Samir Saba, MD
Dan Forman, MD
The Effect of Frailty on Defibrillator Placement and Outcomes Among Patients Receiving Cardiac Resynchronization Therapy
     
Wei Sun, MD, PhD Stephen Chan, MD, PhD SCUBE1, a Novel Player for Pulmonary Arterial Hypertension
     
Alicia Topoll, MD Dio Kavalieratos, MD
Stephen Chan, MD, PhD
Outcomes of Patients with Pulmonary Arterial Hypertension and Palliative Care Intervention


The Dawn of the Age of the Cardiac Intensivist
By Zach Rhinehart, MD, Meshe Chonde, MD, and Andrea Elliott, MD

Consider that only a few decades ago, the coronary care unit was established to provide rapid access to defibrillation for patients completing their myocardial infarction. No longer does the cardiac ICU (aptly renamed) care only for patients with acute coronary syndrome, but also for those with mixed shock with multisystem organ failure on mechanical ventilation, circulatory support, and renal replacement therapy. Despite the exponential rise in the complexity of disease, the training for most of those who run CICUs has changed little. Typical CICU physicians have completed general cardiology fellowships and perhaps a year of advanced heart failure or interventional fellowship, though this is not standardized.

We believe that times are changing. CICU thought leaders and some of our very own progressive trainees recognize that in order to provide optimal care, we must go beyond training that is similar to our peers in interventional, EP, and heart failure.

With this in mind, the UPMC Heart and Vascular Institute has partnered with our own Department of Critical Care Medicine to offer further training in critical care medicine following completion of a general cardiology fellowship. We are ecstatic to work with one of the foremost leaders in intensive care medicine. The goal of this training is to achieve competency in advanced airway, ventilator management and bronchoscopy, as well as to develop further expertise in the management of critically ill patients. The opportunity is considered unique and attractive to many general cardiology fellowship applicants. We are off to a successful start with the graduation of our second trainee in June (Dr. Chonde) and with more in the pipeline (Drs. Rhinehart and Elliot).

At times, we are asked why we would seek further training given the additional time and expense. The answer is the same as for many other rigorous tasks of training: because it is the right thing to do for our patients. We must provide the best subspecialty care that is unique to critically ill patients. There is robust literature demonstrating the value of intensivist care in medical and surgical ICUs. Recently this model has expanded to the cardiac ICU. In 2012, the AHA issued a scientific statement on critical care cardiology training and ICU design. And in the past year, two studies demonstrated reduced mortality with incorporation of a dedicated cardiac intensivist staffing model. With a number needed to treat as low as twenty-two for in-hospital 28-day mortality, a dedicated cardiac intensivist may provide more benefit than any other single current therapy.

There is an imminent need to train this new type of cardiologist as systems incorporate this new evidence and begin to model care to reflect these advances. Because of the foresight of our department and institution, we have one of the most robust clinical training pathways for critical care cardiology in the country. Under the leadership of HVI and critical care, UPMC is a vanguard in this revolutionary change. We are at the dawn of the age of the cardiac intensivist.



Share Your Publication News

Have you had an article published recently? Share this news with the UPMC Heart and Vascular Institute for inclusion in a new section of the Our Research page on the HVI website! Email the link to your article, along with a brief description, to HVIpublications@upmc.edu.


Request for Updates

We know how much you value the education you received here, and invite your input and support. One of our first priorities is to gather contact information for all of our former trainees.

Please email Denise Goppman at goppmanda@upmc.edu with your current email address and any updates that you might like to share.




 
UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.



© 2018 UPMC  |  UPMC Physician Resources
200 Lothrop St., Pittsburgh, PA 15213