Parallax by Ankur Kalra

In this episode of Parallax, host Dr Ankur Kalra is joined by Dr Adam DeVore (Duke University School of Medicine, US) to discuss the management of patients with newly diagnosed heart failure with reduced ejection fraction (HFrEF) and the persistent risk of sudden cardiac death during the early phase after diagnosis.

The discussion explores strategies for initiating and optimising guideline-directed medical therapy, approaches to risk stratification using imaging and clinical assessment, and the evolving role of wearable cardioverter defibrillators while patients await recovery or evaluation for ICD therapy. The faculty also review key findings from the SCD-PROTECT study and their implications for real-world clinical practice.

This series is supported by ZOLL and is intended for Health Care Professionals.

In this episode of Parallax, Dr Ankur Kalra welcomes Dr Anjali Tiku Owens, Associate Professor of Medicine and Director of the Hypertrophic Cardiomyopathy Center at the University of Pennsylvania, for an in-depth discussion on one of the greatest unmet needs in hypertrophic cardiomyopathy (HCM): the treatment of symptomatic non-obstructive HCM. Together, they explore the complex pathophysiology driving symptoms in these patients, the limitations of traditional therapies, and the evolving understanding of chronotropy, inotropy and lusitropy in clinical decision-making.

Dr Owens also shares insights from recent clinical trial data presented at ESC Congress 2025, highlighting emerging sarcomere-targeted therapies, including aficamten and the investigational agent EDG-7500. The conversation examines how these novel approaches may reshape treatment paradigms, improve functional capacity and address longstanding therapeutic gaps for patients with non-obstructive HCM, while offering a preview of where the field may be headed next.

Questions and comments can be sent to "[email protected]" and may be answered by Ankur in the next episode.

Host: @AnkurKalraMD and produced by: @RadcliffeCardio

Parallax is Ranked in the Top 100 Health Science Podcasts by Million Podcasts.

In this insightful episode of Parallax, Dr Ankur Kalra welcomes Dr Robert Riley, Director of Interventional Cardiology at Overlake Medical Center in Bellevue, Washington, for a masterclass on the contemporary management of complex PCI. Drawing on more than a decade of experience, Dr Riley explores how the field has evolved beyond technical success alone, with greater emphasis on patient selection, shared decision-making and aligning procedural goals with individual patient outcomes.

The conversation takes a deep dive into the assessment and treatment of calcified coronary lesions, with a particular focus on the challenge of nodular calcium. Dr Riley shares his practical approach to intravascular imaging, lesion preparation and plaque modification, discussing when to utilise atherectomy, intravascular lithotripsy (IVL) and OPN balloons. He also highlights his growing use of drug-coated balloons in de novo lesions and provides insights into tailoring DAPT duration based on individual patient risk. For interventional cardiologists seeking actionable strategies to optimise outcomes in complex PCI, this episode offers invaluable clinical pearls from an experienced operator.

How should operators approach heavily calcified lesions? When is atherectomy necessary, and where does IVL fit into modern practice? What role will drug-coated balloons play in the future of complex PCI?

Questions and comments can be sent to "[email protected]" and may be answered by Ankur in the next episode.

Host: @AnkurKalraMD and produced by: @RadcliffeCardio

Parallax is Ranked in the Top 100 Health Science Podcasts by Million Podcasts.

In this insightful episode of Parallax, Dr Ankur Kalra welcomes Dr Kim Smolderen, Professor of Medicine and Psychiatry at Yale University and psychologist at Yale New Haven Hospital, for a conversation on the growing field of cardiovascular psychology. Together, they explore how psychological well-being, medical trauma and social determinants of health influence cardiovascular outcomes, and why integrating these factors into routine cardiovascular care is essential for delivering truly patient-centred medicine.

Dr Smolderen discusses the evidence linking anxiety, depression and PTSD to longer hospital stays, repeat procedures and increased healthcare utilisation. She shares her vision for creating "healing eco-systems" that bridge traditional clinical silos, bringing psychology and cardiology together through integrated care pathways, psychosocial risk assessment and trauma-informed care. The discussion also examines the business case for cardiovascular psychology, from reducing readmissions and emergency department visits to improving efficiency and enhancing the patient experience. As cardiovascular psychology continues to gain momentum globally, this episode highlights how whole-person care can benefit both patients and providers.

Questions and comments can be sent to [email protected] and may be answered by Ankur in the next episode.

Host: @AnkurKalraMD and produced by: @RadcliffeCardio

Parallax is Ranked in the Top 100 Health Science Podcasts by Million Podcasts.

In this insightful episode of Parallax, Dr Ankur Kalra is joined by Dr Barry Borlaug, Professor of Cardiology at Mayo Clinic and one of the world's leading experts in cardiac haemodynamics, for a comprehensive discussion on the evolving landscape of heart failure with preserved ejection fraction (HFpEF).

Together, they explore the complexities of diagnosing and managing a syndrome that continues to challenge clinicians. Dr Borlaug explains why exercise right-heart catheterisation remains the gold standard for uncovering "hidden" HFpEF, particularly in patients with normal resting filling pressures, and provides a detailed overview of the Mayo Clinic's invasive exercise testing protocol. The conversation also traces the evolution of HFpEF phenotyping, from the traditional hypertensive patient to the increasingly recognised obesity-driven phenotype, highlighting the role of systemic inflammation, visceral adiposity and disease progression across the HFpEF spectrum.

Dr Borlaug outlines what he describes as the modern therapeutic backbone for HFpEF in 2026, reviewing the evidence supporting SGLT2 inhibitors, mineralocorticoid receptor antagonists including finerenone, and incretin-based therapies such as semaglutide and tirzepatide. Looking ahead, he discusses emerging investigational approaches including sotatercept, the challenges facing device-based therapies, and the importance of identifying HFpEF mimics such as cardiac amyloidosis and hypertrophic cardiomyopathy to ensure patients receive the most appropriate treatment.

Questions and comments can be sent to "[email protected]" and may be answered by Ankur in the next episode.

Host: @AnkurKalraMD and produced by: @RadcliffeCardio

Parallax is Ranked in the Top 100 Health Science Podcasts (#48) by Million Podcasts.

In this episode of Parallax, Dr Ankur Kalra is joined by Ms Claudia Garbrecht, psychologist specialising in psycho-cardiology and organisational health. Together, they explore the critical “heart–brain connection,” examining the high prevalence of anxiety and depression among patients with cardiovascular disease and the bi-directional relationship between mental health and cardiac outcomes. The discussion reframes traditional risk by highlighting the clinical importance of psychological distress, social isolation and behavioural factors in shaping cardiovascular risk and recovery.

The conversation also turns to clinician wellbeing, with Ms Garbrecht outlining the impact of burnout, workplace stress and organisational culture on both physician health and patient outcomes. From the physiological effects of stress to the influence of communication and framing in consultations, this episode offers practical, time-efficient strategies to enhance patient interactions and reinforce positive behaviour. Dr Kalra reflects on applying these insights in practice, while Ms Garbrecht emphasises a fundamental principle: clinicians must prioritise their own wellbeing to deliver optimal care.

Questions and comments can be sent to "[email protected]" and may be answered by Ankur in the next episode.

Host: @AnkurKalraMD and produced by: @RadcliffeCardio

Parallax is Ranked in the Top 100 Health Science Podcasts (#48) by Million Podcasts.

In this week’s episode of Parallax, Dr Ankur Kalra is joined by Dr Chris Maroules, National Director for Cardiac Imaging at SimonMed and co-director of Innovation Health. Together, they explore why coronary CTA, now a Class 1 recommendation in the 2021 ACC/AHA chest pain guidelines, has become the standard first-line non-invasive test, and why proficiency in cardiac CT is essential for cardiology trainees in 2026.

The conversation shifts from traditional risk scores to direct disease assessment, highlighting the power of coronary CTA to identify and quantify plaque burden. Dr Maroules discusses high-risk plaque features, the limitations of calcium scoring, and the evolving role of FFRCT, before outlining a future of AI-enabled screening and precision prevention. He concludes with practical advice for fellows, encouraging Level 2 certification to stay ahead in an increasingly imaging-driven field.

Questions and comments can be sent to "[email protected]" and may be answered by Ankur in the next episode.

Host: @AnkurKalraMD and produced by: @RadcliffeCardio

Parallax is Ranked in the Top 100 Health Science Podcasts (#48) by Million Podcasts.

In this episode of Parallax, Dr Ankur Kalra is joined by Dr Matthew Budoff, Professor of Medicine at the David Geffen School of Medicine at UCLA and a leading authority on preventive cardiology and cardiac imaging. Together they examine the role of cardiac CT in detecting silent atherosclerosis, and ask whether imaging should displace traditional risk scores in routine practice.

Dr Budoff makes the case for the coronary calcium score as the foundation of personalised cardiovascular care, arguing that population-based risk factors often fail at the individual level. He weighs the calcium score against CT angiography in primary prevention - covering cost, radiation, the uncertain significance of trivial plaque, and the risk of inappropriate stenting in asymptomatic patients - while noting that symptomatic patients warrant CCTA first-line. He also addresses elevated Lp(a) with a zero score and the case for CCTA in younger high-risk patients, before outlining his scalable, score-tiered approach to therapy, drawing on data from the VESALIUS trial.

Is the calcium score ready to replace traditional risk scores? When should imaging guide therapy, and when should it be deferred?

Questions and comments can be sent to "[email protected]" and may be answered by Ankur in the next episode.

Host: @AnkurKalraMD and produced by: @RadcliffeCardio

Parallax is Ranked in the Top 100 Health Science Podcasts (#48) by Million Podcasts.

In this episode of Parallax, Dr Ankur Kalra is joined by Professor Ron Blankstein, a leading authority in preventive cardiology and cardiac imaging at Harvard Medical School and Brigham and Women's Hospital, Boston. Together they trace the remarkable journey of cardiac computed tomography (CT) from a niche diagnostic test to an indispensable pillar of contemporary cardiovascular practice. Professor Blankstein shares the moving story behind his new textbook, a companion to the legendary Braunwald's Heart Disease, recounting his personal collaboration with the late Dr Eugene Braunwald, who initiated the project and remained meticulously involved in its development until his passing.

How has cardiac CT reshaped the diagnosis and management of coronary disease? What does the future of plaque analysis and photon-counting technology hold? And why should every cardiology fellow now consider CT essential to their training?

Questions and comments can be sent to "[email protected]" and may be answered by Ankur in the next episode.

Host: @AnkurKalraMD and produced by: @RadcliffeCardio

Parallax is Ranked in the Top 100 Health Science Podcasts (#48) by Million Podcasts.

In this episode of Parallax, Dr Ankur Kalra welcomes Dr Eunice Dugan, a graduating interventional and structural heart disease fellow at the Cleveland Clinic, as she prepares to transition into independent practice in Fort Wayne in the summer of 2026.

Dr Dugan reflects on how early mentorship shaped her decision to engage with the American College of Cardiology during fellowship, and what professional societies can offer beyond the clinical environment — from expanding skill sets and building lasting networks to driving meaningful change. She shares how her role as a local FIT representative led her to organise a widely attended webinar helping fellows navigate the new interventional cardiology match.

The conversation also tackles the attrition challenge that affects many early-career cardiologists in their first three to five years of practice: Dr Dugan, now transitioning into the ACC's Early Career Council, discusses the "fog" of establishing a new career and makes the case for cultivating a specific project during fellowship as a professional anchor through the pressures of a new post, relocation, and family life. She also speaks to her advocacy for women in cardiology, including championing open discussion around family planning and reproductive strategies — topics that remain underaddressed in the field.

Questions and comments can be sent to [email protected] and may be answered by Ankur in the next episode.

Host: @AnkurKalraMD and produced by: @RadcliffeCardio

Parallax is Ranked in the Top 100 Health Science Podcasts (#48) by Million Podcasts.