Parallax by Ankur Kalra

In a 1-minute video, wearing scrubs, Dr Siyab, Md voices his concerns over the decision to end mask mandate on certain US airlines. “The people that are so intensely against these mask mandates, they are not the ones who are taking buses or trains to get to work and get back home every day because they are part of the privileged class.” Dr Siyab’s mission is to be a voice of reason and appeal to those who are hesitant or against getting vaccines. His plight goes out to his 405.3K followers on TikTok every day.

This week’s guest on Parallax is Dr Muhammad Siyab, PGY-6 Cardiology Fellow at Tulane University Heart and Vascular Institute.

In this engaging episode Dr Siyab talks about what prompted him to take a public stand on social media and why did he choose the video-based platform. Ankur and Muhammad talk about inherent authenticity and connecting with others through media. Ankur asks Muhammad about the work that goes into creating videos and his thoughts about his role both as an influencer and a physician.

What is the TikTok phenomenon? How can we use criticism and turn it into valuable feedback from the public?

Questions and comments can be sent to “[email protected]” and may be answered by Ankur in the next episode. Guest, @drsiyabmd hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

“There is a significant disparity in the inclusion of women on all national guideline committees, in addition to serving as a chair of cardiology guidelines. Further advocacy is required to promote equity, diversity, and inclusion in our cardiology guidelines globally.”

Rai D, et al. JAHA. 22

Why are we talking about inclusion, diversity, and equity? Recent years have seen many studies on the inequalities in representation of women in cardiology and yet the needle has not been moved as much as we hoped for. What does the data on the authorship of the guidelines tell us and what can be done to balance the scale?

Dr Ankur Kalra’s guests this week are Dr Martha Gulati, internationally recognized cardiologist specializing in Women and Heart Disease, Heart Disease Prevention and Dr Devesh Rai, first year cardiology fellow at Rochester General Hospital.

In this insightful and action-oriented episode Dr Gulati, chair of the recent 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain, talks about the guideline development process and the factors that can dictate the questions of representations and the integration of the latest findings. Next, Dr Rai shares insights from a recent study that compared gender differences in the authorship of the US, Canadian, and European Cardiology Guidelines From 2006 to 2020. Dr Kalra invites Dr Gulati and Dr Rai to share their take on how progress can be achieved through advocacy and what are the facts we can build on.

Read the full paper here: https://www.ahajournals.org/doi/epub/10.1161/JAHA.121.024249

Questions and comments can be sent to “[email protected]” and may be answered by Ankur in the next episode. Guests, @DrMarthaGulati & @DeveshRaiMDhosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

How can you navigate challenges whilst keeping an eye on your goals and your mission?

This week’s guest on Parallax is Dr Nadia Sutton, Assistant Professor in the Department of Internal Medicine, Division of Cardiovascular Medicine, Section of Interventional Cardiology at University of Michigan.

In this engaging and constructive episode, Nadia recalls her journey to medicine and reflects on the life decisions she had to make along the way: What is the career path that will get us closer to our mission? When is the right time to start family planning? How can we develop resilience in face of rejection? Nadia recalls the conversations with her colleagues and mentors as she progressed in her career. She talks about the practical aspects of tenure track and grant application. Ankur and Nadia discuss the importance of goal setting and exercising a positive mindset.

Questions and comments can be sent to “[email protected]” and may be answered by Ankur in the next episode. Guest, @nadia_sutton hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

Chemical engineering seemed like a sensible choice for Shon who is coming from a family of engineers. At the age of 18 the trajectory of his path took a turn when he blindly sent out 30 resumes and received one offer from a cardiologist to work in his lab. Looking back, he realizes that this was the first time “who” luck shaped his career in medicine.

This week’s guest on Parallax is Dr Shon Chakrabarti, Vice President Medical Affairs at Inari Medical.

In this rich and candid episode, Dr Chakrabarti recalls the early stages of his career and the non-linear route that led to his transition from an interventional cardiologist to working on devices that focus on improving the treatment of deep vein thrombosis (DVT). This journey was paved by self-reflection, hunger for tangible results, and connections with mentors who dared to dream big and wished the same for their mentees.

How did the transition from bedside medicine to industry shape the identity of Dr Chakrabarti? What are the highlights of his job as the Vice President Medical Affairs? What is his advice for early career cardiologists?

Questions and comments can be sent to “[email protected]” and may be answered by Ankur in the next episode. Guest, @shonmd hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

Joe’s journey as a patient with congenital heart disease set him on a route of becoming a professional patient advocate. Since 2016, his non-profit organisation, Team Uncle Joe is helping patients and families to better understand and help navigate CHD.

Parallax host Dr Ankur Kalra invites Joe Valente, a Board-Certified Patient Advocate (BCPA) and Co-Founder of Team Uncle Joe, to talk about his mission and practical considerations involving CHD care both from a patient and a healthcare provider perspective. In this informative and practical episode, Joe shares details about the process of getting certified as a BCPA and about the work that goes into setting up a non-profit organization. We learn more about how he and his team can support patients with CHD and what he considers to be the pillar of good patient-doctor communication.

To learn more about Joe’s work please visit this website: https://teamunclejoe.org

What were the most educational and the empowering experiences as a patient for Joe? What does being a Board-Certified Patient Advocate (BCPA) mean? How can Team Uncle Joe support patients?

Questions and comments can be sent to “[email protected]” and may be answered by Ankur in the next episode. Guest @@JoeyV1in100, hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

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In 2005, the concept of hemorrhagic MI was a preformed idea. In 2022, after years of collaboration, technical advances and research, the findings on large MI size have the potential to fundamentally improve the care of patients suffering from heart attacks.

In this week’s Parallax podcast, Dr Ankur Kalra welcomes Dr Rohan Dharmakumar, Executive Director of the Krannert Cardiovascular Research Center at IU School of Medicine, to talk about his research on hemorrhagic myocardial infarction (MI).

In this in-depth and engaging episode, Dr Kalra and Dr Dharmakumar invite us to a journey from the inception of the idea through the application of experimental imagining with serial scans to collaborative, mechanistic studies that shed light on an unmet clinical need.

What is the concept of hemorrhagic MI? How can these findings be translated to clinical practice? How can we mitigate hemorrhagic MI?

Questions and comments can be sent to “[email protected]” and may be answered by Ankur in the next episode. Guest @rohandkumar1, hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

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"There is a high global prevalence of hostile work environment in cardiology, including discrimination, emotional harassment, and sexual harassment.” Sharma G. et al. JACC 2021.

Dr Naidu was at the beginning of his career when, having experienced micro-aggression, his chairman shared an insight that still shapes the way he thinks about addressing professional jealousy and bullying: “Don’t let people bring you down, you just keep working and lift them up.”

In this week's Parallax, Dr Ankur Kalra is joined by Dr Srihari S Naidu, Director of Cath Labs and Hypertrophic Cardiomyopathy Center at the Westchester Medical Center and President Elect of NY ACC, for an honest conversation on a challenging topic within the cardiology community.

Cardiology, a highly competitive field, still generates the sense that power is equal to strength. In this insightful and practical episode, Hari revisits his own experiences both as a leader and as a trainee, navigating complex situations. What can you do as a target when being bullied? How can hostile environment, cliques be best addressed? Ankur asks what skills are needed to help mitigate the emotional impact of intimidation. Hari elaborates on what it means to belong to a team, and how can leaders at a local level work for an inclusive community, a better cardiology for all.

Questions and comments can be sent to “[email protected]” and may be answered by Ankur in the next episode. Guest @SrihariNaiduMD, hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

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In the second part of Parallax’s review of 2021, Dr Sukh Nijjer, Interventional Cardiologist from Imperial College London, and Dr Ankur Kalra discuss key advances in the field of heart failure and cardiac surgery.

SGLT2 inhibitors are proving to be the blockbuster drug of this decade: Sukh summarises and compares the learnings from DAPA-HF, Emperor-Reduced, and Emperor-Preserved. Next, Sukh highlights the data from SOLOIST-WHF that showed sotagliflozin to have beneficial effects on CV outcomes among patients with type 2 diabetes and HF. Additionally, they discuss how findings on finerenone (FIGARO-DKD) will shape the field. Sukh talks about the semaglutide and the STEP studies, an injectable medication that further expends cardiologist knowledge beyond their speciality. Ankur and Sukh reflect on how the advancement of this field shaped their own practices.

2021 was a busy year for cardiac surgery trials: Sukh and Ankur review the most pertinent data from the AVATAR randomised study presented at AHA 2021. Sukh interprets the outcomes and asks Ankur about his clinical experiences. Finally, they review the investigator led LAAOS III study that showed patients with atrial fibrillation undergoing cardiac surgery, left atrial appendage occlusion was superior to no occlusion.

What were the top practice informing heart failure trials of 2021? What does the latest data say on current cardiac surgery practices? How will these findings inform patient care?

Questions and comments can be sent to “[email protected]” and may be answered by Ankur in the next episode. Guest @SukhNijjer, hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

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In the last Parallax episode of the year, Dr Ankur Kalra welcomed back Dr Sukh Nijjer, Interventional Cardiologist from Imperial College London, to review the most impactful events and advances in cardiology from 2021.

This year we had a number of studies that helped clarify our understanding of the world of antiplatelets: First, Ankur and Sukh discuss the take-home messages from HOST-EXAM, a Korean study presented at ACC 2021. They discuss their clinical experiences within the UK and US setting. Next, Sukh talks about the STOPDAPT-2 ACS study, presented at ESC 2021. Sukh interprets the findings in the light of TWILIGHT and summarises his thoughts on the therapy.

2021 was not a great year for physiology: Sukh shares his take on FLOWER-MI, presented at ACC 2021. He offers a deep dive into the data and highlights both the importance of the findings and the limitations of the study.

Next, they discuss RIPCORD 2 from ESC 2021 and finally, Sukh highlights the findings from the FAME 3 trial.

What is the importance of genotype testing in the world of antiplatelets? What are the considerations for clinicians? Should we stop using FFR? How can we incorporate novel findings to patient care? What are the practical considerations that we should take into account when looking at the physiology trials of 2021?

Stay tuned for Part 2 - heart failure and surgical trials coming in 2022.

Questions and comments can be sent to “[email protected]” and may be answered by Ankur in the next episode. Guest @SukhNijjer, hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

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In this AHA 2021 episode of Parallax, Dr Ankur Kalra’s guest is Dr Amit Khera, Professor and Director of Preventive Cardiology at UT Southwestern Medical Center, Dallas and Vice Chair of the Scientific Sessions.

For this week’s show, Dr Khera selected three thought-provoking late-breaking trials that will inform or change clinical practice. Ankur and Amit discuss how the AVATAR trial will influence guidelines, and whether these findings could be translated to TAVR. Most importantly, they discuss how AVATAR’s results could inform patient decisions.

Next, Dr Khera highlights a randomized trial that was designed to address the needs of a larger population. The China Rural Hypertension Control Project offers exciting insights and an innovative framework for relying on social healthcare work.

Lastly, Dr Kalra and Dr Khera discuss a trial that investigated the LDL-cholesterol lowering efficacy of MK-0616. This oral PCSK9 Inhibitor may open the door for more patients in the future.

What were the key findings? What are the take-home messages? How will these 3 trials foster new opportunities for patients?

Trials covered in detail include:

• Aortic Valve Replacement versus Watchful Waiting in Asymptomatic Severe Aortic Stenosis: The Avatar Trial

• A Cluster Randomized Trial of a Village Doctor-Led Intervention on Blood Pressure Control: China Rural Hypertension Control Project

• The Clinical Safety, Pharmacokinetics, and LDL-Cholesterol Lowering Efficacy of MK-0616, an Oral PCSK9 Inhibitor

Questions and comments can be sent to “[email protected]” and may be answered by Ankur in the next episode. Guest @dramitkhera hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

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