- November 2012 -
Partnership to Reduce Time from Onset of Chest Pain to Treatment

The GW Heart & Vascular Institute, CTIA-The Wireless Foundation, D.C. Fire and Emergency Medical Services, and D.C.-area hospitals, partnered to improve cardiac care in the nation's capital by equipping DC ambulances with technology that enables rapid, wireless transmissions of EKGs to both the on-call physician's wireless device and tertiary care hospitals, including The George Washington University Hospital, Howard University Hospital and Washington Hospital Center. This technology helps to streamline patient care for those who have suspected acute myocardial infarction (heart attack) and reduce time from onset of chest pain to treatment.


On November 15, 2012, NewsChannel 8 interviewed Jonathan Reiner, MD, and shared Daniel Peterson's experience of having a heart attack and being rushed in a DC ambulance directly to GW Hospital's treatment room, benefiting from this wireless technology:  http://www.wjla.com/articles/2012/11/d-c-ambulances-get-life-saving-technology-82142.html.  


The Institute Awards Research Grants to GW Cardiology Fellows

The GW Heart & Vascular Institute promotes the development of cardiovascular research projects through a grant-making program open to cardiology fellows at GW. Our 2011-2012 award winners, Palak Shah, MD, and Monica Mukherjee, MD, presented their research results at the International Society for Heart and Lung Transplantation (Prague, CZ) and the American Society of Echocardiography (Washington, DC) respectively. The Institute is pleased to announce two award winners for the academic year 2012-2013.


David Cohen, MD, a GW cardiology fellow, supervised by associate professor of medicine, Marco Mercader, MD, has been awarded $25,000 to study the "Use of NADH fluorescence to predict lesion size after radiofrequency ablation." Dr. Cohen's study is the next phase of Dr. Mercader's groundbreaking work developing a new imaging catheter approach to refine the treatment of atrial fibrillation. Dr. Cohen aims to correlate NADH fluorescence visualized on the surface of cardiac muscle to histologic evidence of the exact size and depth of injury under increasing contact force at varied temperature and duration of radiofrequency ablation. Understanding these dynamics will help validate real-time visualization of endogenous NADH fluorescence for use in patients.


Miriam Fishman, MD, a GW cardiology fellow, supervised by professor of medicine, Jannet Lewis, MD, has been awarded $25,000 to study "Heart Failure with Preserved Ejection Fraction: Is Management of Hypertension Associated with Changes in Traditional and Novel Echocardiographic Parameters?" Dr. Fishman's study will extend Dr. Lewis's recent advances in the echo assessment of patients with hypertension. Dr. Fishman's project aimsto evaluate the different clinical and echocardiographic parameters of patients hospitalized with uncontrolled high blood pressure and normal LV ejection fraction who present with or without clinical evidence of heart failure. Because heart failure with preserved ejection fraction disproportionately affects women with systemic hypertension, a major focus of the project is to identify gender related changes that predispose to heart failure.

Richard Neville, MD Presented Research on Advances in Limb Preservation  


Richard Neville, MD, co-director of the GW Heart & Vascular Institute, presented research on critical limb ischemia and limb preservation at the American College of Surgeons in Chicago, IL in September and at the Vascular Interventional Advances (VIVA) conference in Las Vegas, NV in October. Dr. Neville also served as course director for the European Summit on Critical Limb Ischemia in Munich, Germany in September.


Critical limb ischemia (CLI) is a severe blockage in the arteries of the lower extremities, which markedly reduces blood-flow. It is a serious form of peripheral arterial disease (PAD), which is caused by atherosclerosis. CLI is a chronic condition and if left untreated, the complications of CLI will result in amputation of the affected limb.


GW Cardiology Fellows and Faculty Present Research Findings at National Medical Conferences   


GW cardiology fellows and faculty presented results from research studies funded by the Institute at national medical conferences this fall.


Brian Choi, MD, assistant professor of medicine, published "Assessment of appropriate use criteria for stress echocardiography in the emergency room evaluation of chest pain," in the American Heart Association's academic journal, Circulation, with co-authors DC Akinniyi, HA Young, JF Lewis. The abstract was presented at the American Heart Association's scientific conference in Los Angeles in November by Deborah Akinniyi, MD, mentored by Dr. Choi. Medical imaging is the number one driver of increased health care expenditures, and understanding the cause of overutilization is important to reduce health care spending growth. This study applied appropriateness criteria (statements on when testing is appropriate or inappropriate) developed by the American Heart Association and American College of Cardiology, to real-world emergency room evaluation of chest pain, and found that for a certain test, stress echocardiography, the inappropriateness rate was approximately 50%, and these inappropriately ordered tests were more likely to be ordered in younger or female patients.


Behnam Tehrani, MD, a third year cardiology fellow, presented "Tale of Two Ruptured Plaques: A Case of Multivessel Acute Coronary Thrombosis," and "Risks and Consequences: A Case of Very Late Stent Thrombosis," at the Transcatheter Cardiovascular Therapeutics (TCT) Conference in Miami in October.


Benjamin Yang, MD, an interventional cardiology fellow, presented his research project "Enhancing the Diagnosis of Coronary Artery Disease by Deep Sequencing of Blood" at the American Heart Association's scientific conference in Los Angeles in November. Determining which patients with chest pain or shortness of breath have underlying coronary artery disease (CAD) is a major clinical challenge that can result in excessive hospitalization and cardiac testing. Using the sequencing technique developed by Timothy McCaffrey, PhD in GW's gemonics laboratory, Dr. Yang, and Dr. McCaffrey's team identified genomic markers in blood that could predict the presence or absence of CAD. Co-authors included Drs. Katz, Reiner, Mazhari, and Shah.