Dr. Jeff Hsu is currently an Advanced Heart Failure and Transplant Cardiology fellow at UCLA, where he also completed his general cardiology fellowship. He received his Ph.D. in Molecular Cellular & Integrative Physiology through the UCLA Specialty Training and Advanced Research (STAR) Program. He is a member of the ATVB and BCVS Councils, and his clinical interests are in heart failure and sports cardiology. @JeffHsuMD
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Why Attend #AHA19?

Jeffrey Hsu, MD, PHD

After returning home from the #AHA18 Scientific Sessions a few weeks ago, I was eager to tell my colleagues back in Los Angeles about my experience.

“What did you like about it?” they would ask. While my replies would consistently begin with, “Well, despite the freezing cold…” I found my answers that followed were widely varied. The innovative science, the networking with potential collaborators, the audible excitement over Late Breaking Clinical Trial results, the discussions about whether the trials would be practice-altering, the reunions with old friends from earlier in my training. There were countless things to choose from.

Curious to whether other trainees shared the enthusiasm I had for #AHA18, I asked some who attended to describe their favorite part of the meeting. Here were their responses:

David Paik, PhD (@dtpaikPhD), post-doctoral fellow at Stanford University:

“This year’s meeting in the new 3-day format was highly organized, with superb talks from all breadths of clinical & basic cardiovascular research. The focus on early career & mentorship was excellent, and I hope it continues in the next years’ meetings!”

Aly Sanchez, MD (@AlySanchezMD), Internal Medicine resident at the University of Miami:

“There were many new things introduced at AHA this year & a huge focus on prevention as well as women’s health. I loved seeing the force behind the women in cardiology movement. It’s great having inspirational females leading as well as the supportive men making this happen. The AHA could not have sent a better message & we should continue to remind ourselves to be a relentless force for a world of longer, healthier lives.”

Kevin Shah, MD (@KevinShahMD), Advanced HF & Transplant Cardiology fellow at Cedars-Sinai Medical Center:

“The networking! The Scientific Sessions and especially the AHA FIT and Early Career programming provided a tremendous opportunity to connect with old friends, meet new colleagues, and gain valuable career advice from faculty as we continue to grow professionally.”

Their sentiments and mine may have been palpable via Twitter feeds or news releases, and this year, the AHA offered a live-stream of Scientific Sessions for those unable to attend in person (see posts by Dr. Saurav Chatterjee and Dr. Dan Tyrell).

Yet nothing compares to attending Scientific Sessions in person. As elegantly summarized by Dr. Elizabeth Knight in her recent post, there are serendipitous collaborations that can arise from wandering around the meeting, as well as new research ideas that can emerge from a “cross-pollination among disciplines.”

In trying to encapsulate my own reaction to the meeting, however, I realized that the most important benefit of attending #AHA18 in person came down to one emotion: Leaving inspired. Inspired by meeting your heroes in cardiology, by meeting peers who are doing outstanding research, and by learning about new topics that can influence your own research ideas.

Moreover, it is one thing to read about the results of a late-breaking clinical trial from home. It is another experience entirely to be immersed in a crowd of colleagues who are hearing practice-altering results together for the first time. The first results slide of the REDUCE-IT trial presented at #AHA18 actually elicited applause:

 

Overall, I like to compare it with how you interact with your favorite band or musical artist. You can listen to their album from the comfort of your own headphones. Or you can go to their concert and see them perform your favorite songs live while surrounded by other passionate fans, augmenting the impact of the music. Some prefer the former, but I always choose the latter when I can.

Save the date for #AHA19 – November 16-18, 2019 in Philadelphia. Come and be inspired. See you next year!

 
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Sports Cardiology: Experts’ Advice for Trainees

Jeffrey Hsu, MD, PHD

As the AHA’s largest meeting of the year kicked off today in Chicago, the AHA Early Career / FIT Lounge, with its prime position at the main entrance to the exhibition hall, was the venue for the first ever Sports Cardiology session dedicated to early career trainees at Scientific Sessions. With the bustling crowd of Sessions attendees lining up alongside the FIT Lounge as they awaited registration check-in, many peered in to the first Early Career / FIT session of this year’s conference, in which an expert panel of Sports Cardiologists shared their insights on this emerging field within cardiology.

This session’s faculty panel consisted of:

  • Ben Levine – Professor of Cardiology and Exercise Sciences at UT Southwestern in Dallas, Texas
  • Rachel Lampert – Professor of Cardiology and Electrophysiologist at Yale University in New Haven, Connecticut
  • Eugene Chung – Associate Professor of Cardiovascular Medicine and Director of the Michigan Medicine Sports Cardiology Clinic in Ann Arbor, Michigan

Sports Cardiology Early Career / FIT Session at #AHA18 Scientific Sessions

Along with Dr. Beth Hill (@BethHillDO, Cardiology Fellow at Scripps Clinic), I was fortunate to moderate the discussion from this distinguished group. They shared their stories about their varied paths towards Sports Cardiology, which included influential encounters with athletic patients, personal experience as a high-performing athlete, and sheer passion for sports and exercise physiology.

As Sports Cardiology is a relatively nascent sub-specialty, there currently is no distinct path for interested trainees to follow. At this time, only one formal training program in Sports Cardiology exists – the well-established Cardiovascular Performance Program at Massachusetts General Hospital, directed by Dr. Aaron Baggish. However, with the recent publication of a Sports Cardiology Core Curriculum by the ACC Sports and Exercise Cardiology Council (Baggish et al., JACC 2017) and rising interest in the field among trainees (Afari, JACC 2017), the field appears primed for growth.

The panel offered many salient pieces of advice for trainees interested in pursuing a career in Sports Cardiology, which I have done my best to distill into the following points:

  • Choose What You Love: Fellows seeking to become Sports Cardiologists often ask which sub-specialty they should choose (i.e., EP, Imaging, Heart Failure) to best position themselves to enter this field. The panelists agreed that the answer is to choose the area that best suits one’s own interests. More importantly, they advised to not forget that Sports Cardiologists are, by definition, Cardiologists, and to not lose sight of the importance of a thorough grasp of General Cardiology when practicing as a Sports Cardiologist.
  • Seek Specialized Training in Exercise Physiology: “What distinguishes a Sports Cardiologist from a General Cardiologist?” Dr. Levine made the argument that Sports Cardiologists offer the extra expertise in exercise physiology and understand the physical demands imposed on the cardiovascular system by elite athletes. Assessment of athlete physiology must go “beyond the Bruce protocol.” Indeed, the 2015 AHA/ACC Guidelines specifically state that “the exercise testing protocol [of athletes] should be based on maximal performance rather than achieving 80% to 100% of the target heart rate to come as close as possible to the level of exertion achieved during competitive sport” (Zipes et al, Circulation 2015). Every effort should thus be made to recapitulate this degree and mode of exertion. Further, the elite athlete’s response to various maneuvers, such as tilt table testing, may be different, and a deep understanding of these nuances are incredibly important in this unique population.
  • Educate and Network: While there has been increasing awareness of the specialized cardiovascular care needs of the athletic population, it remains important for budding Sports Cardiologists to educate those providers in their network who tend to be the first contacts with athletes. This group includes primary care and sports medicine physicians, sports trainers, and student health centers, as these providers are often the first ones to hear about potentially concerning cardiac symptoms in athletes. Along these lines, athletes themselves can benefit from education on their own cardiovascular health, as they are not immune from disease regardless of their level of fitness. Trainees are encouraged to consider giving educational talks to athletes in the community (e.g., cycling and running clubs) and volunteer at athletic events to help disseminate these important issues.

While the session was filled with many more helpful tips for interested trainees, the panel’s ultimate recommendation was to make every effort to attend the ACC’s Care of the Athletic Heart meeting next year, which will take place in June 2019 in Washington, D.C. As a participant in last year’s Athletic Heart meeting, I strongly agree.

Overall, the panelists engaged the audience in an excellent discussion, and this topic served as an excellent segue for the eagerly awaited release of the AHA’s physical activity guidelines, which will be announced this Monday, November 12th at Scientific Sessions.

(Left to Right) Faculty Panelists: Eugene Chung, Rachel Lampert, and Ben Levine;
Session Moderators: Beth Hill, Jeff Hsu

 

For more information on the rest of my experience at #AHA18, please follow my Twitter feed (@JeffHsuMD) as well as the hashtag #AHAEarlyCareerBlogger.