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A Cardiology Fellow’s Experience Studying Artificial Intelligence

For this blog, I am excited to have my co-fellow and husband, Tony Prisco, discuss how he became interested in studying artificial intelligence in cardiovascular diseases and some tips for others who are potentially interested in this field!

My name is Tony Prisco and I am a PGY-5 at the University of Minnesota in the Physician-Scientist Training Program. I am pursuing my fellowship training in cardiovascular diseases. I finished my PhD in 2014 focusing on mechanisms of angiogenesis induced by adult stem cells. Since then my scientific interests have transformed to mathematical studies, including fluid mechanics and artificial intelligence. The majority of my work since my PhD has focused on blood flow mechanisms in patients with mechanical circulatory support (ventricular assist devices and VA-ECMO).  I had been hearing about various forms of artificial intelligence since at least 2014 but did not realize the potential clinical applications until I started my residency in 2016.

When I started my dedicated research time back in 2019, I initially had planned on continuing studies that used computational fluid dynamics to better understand the mechanisms of cardiovascular diseases and the device-human interface. A month into my research, due to the growth of the field of Artificial Intelligence (AI), I watched several YouTube videos describing the math behind “deep-learning,” which is a form of AI. Interestingly, most of these videos were targeted towards the tinkering hobbyist working to do interesting home projects. They focused on getting started with a very low budget (i.e. free) and minimal computing background. Tutorials were primarily using high-level programming languages such as Python or MATLAB. After a day of struggling, I was then able to successfully recreate an example to train a neural network (type of deep-learning technology) that could identify the numbers 0 – 9 within an image.

I discussed this with my clinic mentor at the time, and after a few weeks we came up with a useful clinical project that I have spent the last 18 months working on. In doing this, I have learned 3 important lessons regarding using artificial intelligence in clinical cardiology:

  1. Artificial intelligence is a great technology to answer a simple question, for example—is a study normal or abnormal? Complex questions, i.e.— “Should I list this patient for a heart transplant?” not so much.
  2. Artificial intelligence will most likely improve patient care by helping physicians to interpret clinical data faster—especially areas where a significant amount of data exists (i.e. imaging and ECGs). Most likely, deep learning algorithms will help to give a “preliminary” interpretation of a piece of clinical data that will ultimately be analyzed by a cardiologist.
  3. Artificial intelligence ultimately is an analysis tool. It does not make up for having a good experimental design and/or following the scientific method.

The underlying mathematical principles of artificial intelligence have been around for at least 50 years. It is only recently that we have had the computational power to apply those principles to clinical data sets. I do not have a background in computer science—but I believe with the resources available online including free courses, tutorials, and software—the barrier to entry is low enough that anyone with enough intellectual curiosity can be up and running within a few weeks. Resources I would recommend looking at for those interested in starting out in this field are:

Software—Python (https://www.python.org/) is free for all. The majority of code available online and tutorials are done in Python. MATLAB is another option and for those at most major universities, this will be free as well. I use MATLAB primarily because it works better with the supercomputer we have at the University of Minnesota, but in most circumstances, this will not be necessary.

Tutorials—there are many available online, including full courses. I went through the lectures of Stanford’s CS221 on YouTube (primarily taught in Python). MATLAB has a few dozen examples on their website as well.

 

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”

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Vlog: What is one piece of advice you wish you previously knew or you think other early career investigators should know?

I am delighted to share my latest vlog where I ask researchers at various different stages of career development (from undergraduates to faculty members) to share one piece of advice they would give other trainees.

Thanks so much to everyone who agreed to participate in the video!

Check out the advice from the following researchers at the University of Minnesota’s Lillehei Heart Institute:

  • Megan Eklund, Researcher, Lab of Dr. Kurt Prins
  • Thijs Larson, Undergraduate Researcher, Lab of Drs. Daniel and Mary Garry
  • Javier Sierra-Pagan, Medical Scientist Training Program (MSTP) student, Lab of Dr. Daniel Garry
  • Lynn Hartweck, Research Associate, Lab of Dr. Kurt Prins
  • Satyabrata Das, Assistant Professor
  • Kurt Prins, Assistant Professor

Special thanks to my husband, Tony Prisco, who helped put the video together!

Hope you enjoy this vlog and thanks for checking it out!

 

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”

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My Journey as a Physician-Scientist Trainee

In this blog, I discuss my journey as a physician-scientist trainee to provide some insights to aspiring physician-scientists and in the hopes of encouraging others to consider pursuing this very rewarding career.

During the early part of my undergraduate training, I was not sure whether I wanted to go to graduate or medical school. I worked in a basic science lab throughout my undergraduate education. I enjoyed my time in the lab and the scientific process. As I was researching graduate and medical schools, I discovered MD/PhD and Medical Scientist Training Programs (MSTP) and thought that this would be a great option to merge my passions for medicine and basic science research.

I was fortunate to have the opportunity to be a part of the MSTP at the Medical College of Wisconsin (MCW). Prior to starting medical school, I did not know what medical specialty I wanted to go into or what specific project I wanted to work on. My MSTP training lasted 8 years. I rotated through labs the summer before the first year of medical school and the summer between the first and second years of medical school. After the second year of medical school, I joined the lab of Howard Jacob, Ph.D. and studied the genetic basis of hypertension and renal disease for four years. I loved my time in graduate school and the research environment in the Department of Physiology. I was so fortunate to be in the Department of Physiology at MCW where many of the faculty were generous mentors to trainees. I am especially grateful for all the mentorship that I received from Dr. Jacob, Dr. Joseph Lazar, Dr. Allen Cowley, Dr. Andrew Greene, Dr. Joseph Barbieri and the entire MSTP. Serendipitously, Dr. Ivor Benjamin (AHA president from 2018-2019) moved to MCW when I was training there and was willing to be a member of my dissertation committee. He is a phenomenal role model for aspiring physician-scientists. I am very appreciative that he took the time to mentor me clinically and scientifically. With his encouragement and guidance, I subsequently decided to pursue additional training in Cardiology with the goal of becoming a cardiovascular translational researcher.

After completing my Ph.D., I returned to clinical training to complete the third and fourth years of medical school. I subsequently joined a dedicated Physician-Scientist Training Program (PSTP) at the University of Minnesota that allowed me to simultaneously match into Internal Medicine residency and Cardiology fellowship and secure protected research time for postdoctoral research training. After completing medical school, I finished two years of Internal Medicine training and the first year of clinical Cardiology fellowship. I then joined a basic science laboratory and am now conducting research investigating the mechanisms of right ventricular dysfunction in pulmonary hypertension. I am fortunate to have three years of protected research time (I am currently in year 2 of research). During my postdoctoral research fellowship, I also see pulmonary hypertension patients in the clinic one-half day a week. After I complete my research time, I will then return to a clinical Cardiology fellowship to complete the last year of clinical training.

My journey to becoming a physician-scientist is still ongoing but there is never a day that I regret choosing this career. While the training can be long and arduous, it is rewarding. The transitions between research and clinical training can be challenging and you may constantly feel that you are trying to catch up with your peers. However, the job is never boring and there is always so much to learn! In clinical training, you gain a wide breadth of knowledge and when doing research, you study a narrow topic in depth. As a physician-scientist, you provide unique insights into what are the clinically relevant questions that need to be addressed. Whenever I am frustrated with troubleshooting experiments in the lab, feel that I am losing focus, or am dejected after paper/grant/award rejections, I become re-inspired and motivated to advance my research after seeing patients and being reminded of the many gaps in our medical knowledge.

The delineated path above was my path towards becoming a physician-scientist. There are multiple paths to becoming a translational researcher. Many medical trainees join labs or research groups during or after clinical training.

Here are some pearls that I picked up as an aspiring translational researcher:

  • When you are at the beginning of your medical training as a medical or MSTP student, you do not need to know exactly what you will do in the future. Be open-minded.
  • Selecting a mentor and lab environment that are a good fit for you is more important than the specific project you work on as a Ph.D. student. It is not expected and highly unlikely that you will study the exact same topic that you did your PhD work on for the rest of your career.
  • Throughout your training, find supportive environments and mentors. I am very thankful for the support of Dr. Kurt Prins, Dr. Thenappan Thenappan, Dr. Joseph Metzger, Dr. Samuel Dudley, Dr. Peter Crawford, Dr. Jane Chen, Dr. Cliff Steer and the entire PSTP, the CTSI program, and the entire Cardiology fellowship program at the University of Minnesota.
  • Be persistent and resilient.
  • Mentor and encourage others to become physician-scientists, especially those who are underrepresented in the biomedical community.
  • Enjoy the journey.

For any early-career trainees who are interested in becoming physician-scientists, feel free to contact me if you have any questions! I really hope that some of you strongly consider joining this very gratifying and important

 

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”

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Facing the Fear of Writing

Writing is an essential skill in academics. Metrics of productivity are often quantified by number of publications and funded grants. Very few people are naturally talented scientific writers. One of the most daunting tasks for early career trainees is writing and then receiving the subsequent deluge of feedback and critiques from mentors, co-authors, and reviewers.

Like any other technique, refining one’s scientific writing skills takes time and practice. Scientific writing can be challenging, especially early in your training. Here are some tips that may help you develop this important scientific skill:

 

  • Try to write as much as possible. Writing scientific papers is different than preparing grant proposals. Try to gain experience in both by either submitting papers and grant applications and/or attending mock grant writing courses during your training.

 

  • Set aside time to write and minimize detractions. This can be challenging when we have smartphones, email inboxes, and social media accounts. Try to write in chunks. When preparing manuscripts, I like to start with putting together the figures and figure legends; then writing the results and methods, introduction, discussion and finally the abstract.

 

  • Do not worry about putting together a perfect draft. It is better to try to overcome the writing inertia by free writing and then later revising.

 

  • Keep multiple versions of your drafts. You may like how you previously described something or organized the document.

 

  • Do not be horrified about the amount of edits that you will receive. I remember how dejected I was when one of my drafts was littered with red tracking changes and comments. However, receiving drafts back with a plethora of feedback and revisions is a sign that your mentor/co-authors care about what you wrote and want to further your professional development. I am extremely fortunate that my mentors take the time to provide detailed and specific feedback on how to improve my writing. Also, do not take the critiques personally. If needed, look at the comments, put them aside, and come back to them another time when you are less emotional – this is especially relevant after you receive critical negative reviews on your manuscript and/or grant submissions.

 

  • Read the literature and other people’s grant applications. There is no correct way to write a good manuscript or successful grant application. However, you can learn many stylistic approaches by examining others’ writing.

 

I also recommend checking out some of the great blogs on scientific writing that my fellow AHA Early Career Bloggers wrote:

 

Good luck!

 

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”

 

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Advice on Looking for Academic Cardiology Positions: The First Ever AHA Early Career Voice Vlog

I am happy to present the first-ever AHA Early Career Voice Vlog! I am pleased to be able to have Drs. Rajat Kalra, Forum Kamdar, and Kurt Prins, all early faculty in academic cardiology, discuss their experience looking for and obtaining academic cardiology positions. Drs. Kalra, Kamdar, and Prins have been my mentors and role models throughout my residency and fellowship training and I am so glad they were willing to share their experiences and advice with us! They discussed various topics from how they looked for academic cardiology positions to how they negotiated their contracts.

Speakers:

Dr. Rajat Kalra is a clinician-scientist in the Imaging Section of the University of Minnesota’s Cardiovascular Division. His academic interests pertain to the use of clinical, laboratory, and imaging biomarkers to define the mechanisms underlying heart failure and cardiac arrest and refine prognostication in these conditions, Dr. Kalra’s clinical interests encompass the breadth of general cardiology and cardiac imaging.

Dr. Forum Kamdar is an advanced heart failure and transplant cardiologist and a Doris Duke-funded physician-scientist. She has a strong clinical and research interest in advanced heart failure associated with neuromuscular disorders. Her lab developed patient cell-based models of Duchenne muscular dystrophy to further elucidate mechanisms and she co-founded the Neuromuscular Cardiomyopathy Clinic.

Dr. Kurt Prins is an NIH-funded physician-scientist who performs translational research to understand mechanisms of right ventricular dysfunction in pulmonary hypertension. He also sees pulmonary hypertension patients.

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”

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Concomitantly Being the Mentee and Mentor

We all need mentors to help guide us through our careers. I am very fortunate to have had and currently have many generous and knowledgeable mentors. I rely greatly on them to provide feedback and advice on how to navigate the many challenges of being a physician-scientist.

As early-career trainees, we are often concomitantly seeking mentorship and are being a mentor to younger trainees. Throughout my clinical and research training, I have had the opportunity to mentor many enthusiastic and talented undergraduate/graduate/medical students and residents. Since I have been a mentee for much longer than a mentor, I feel comfortable finding advisors who can assist with my career development. However, I feel relatively inexperienced as a mentor. I find mentoring challenging in that it requires adapting to the needs and personality of the trainee. I am constantly refining my coaching style and trying to emulate many of the outstanding mentors that I have.

For this blog, I have compiled a list of some tips that I have learned or received from others on how to be mentor-able and how to be an effective mentor.

Tips on How to Be a Good Mentee:

  1. Find the “right” mentors for you. Various factors play a role in making a match. Finding advisors is one of the most important steps needed to advance your career. It is not necessary to always find the most senior faculty members to be your mentor. There are many benefits of having a junior faculty member as a mentor, which I have discussed previously.
  2. Be accountable.
  3. Be receptive to feedback.
  4. Be respectful and appreciative. Respect your mentor’s time.
  5. Be diligent. You have to do the work. Mentorship is a two-way street so think about the value that you bring to the relationship (especially relevant to trainees who are completing research projects with their mentors).
  6. Let your mentor know what your short and long-term goals are and what you seek to gain from the mentorship.
  7. Keep in touch with your mentors. Update them on your achievements even after you have completed your training and/or moved to another institution.

Tips on How to Be a Good Mentor:

  1. Do not do all the work for the mentee.
  2. Give a new potential mentee a task/assignment to complete as a trial run to determine whether the mentee is committed and dependable. This may prevent loss of effort trying to mentor a trainee who may not be motivated or interested in your field.
  3. Be knowledgeable.
  4. Be a good listener and communicator.
  5. Keep your promises.
  6. Provide constructive, honest feedback.
  7. Encourage diversity of perspectives.
  8. Be available or willing to make time to meet with the trainee.
  9. Be open to learning from your mentees.
  10. Know your role and what your mentees’ expectations are for the relationship.
  11. Help provide opportunities for trainees (e.g. encourage attending conferences, submitting abstracts/papers, applying for awards, etc.) and help your mentees network with others.
  12. Emulate the excellent mentors that you know.

These lists are not comprehensive. I would love to hear about your thoughts, experiences, and advice on mentorship. I am especially interested to learn about the experiences of early-career investigators who have started new labs.

Thanks for reading and hope you have a safe, healthy, and happy new year!

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”

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The Sweet Spot in Treatment of Heart Failure With Reduced Ejection Fraction: SGLT2 Inhibitors

I am pleased to have the opportunity to summarize an important recent paper on the use of sodium-glucose co-transporter 2 (SGLT2) inhibitors by Drs. Muthiah Vaduganathan, Gregg Fonarow, and colleagues in JAMA Cardiology,1 that was published simultaneously with AHA20.

Background:

SGLT2 inhibitors are a class of medications that were initially developed for management of diabetes but were serendipitously found to be effective in treating individuals with heart failure. In May 2020, dapagliflozin became the first SGLT2 inhibitor approved by the US Food and Drug Administration (FDA) for use in patients with heart failure with reduced ejection fraction (HFrEF) after the pivotal Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure (DAPA-HF) trial, which showed that dapagliflozin reduced heart failure events and mortality.2 In the EMPEROR-Reduced (EMPagliflozin outcomE tRial in Patients With chrOnic heaRt Failure With Reduced Ejection Fraction) trial, use of another SGLT2 inhibitor, empagliflozin, was also found to reduce risk of cardiovascular death and heart failure hospitalizations.3

Major Question Addressed in the Paper: What proportion of contemporary patients with HFrEF in the US are potentially eligible for initiation of dapagliflozin based on the FDA label?

Approach: The investigators studied patients with HFrEF (EF≤40%) who were in the AHA Get With The Guidelines-Heart Failure (GWTG-HF) registry. They assessed patients admitted between January 2014 to September 2019 at 529 sites (started with 586,580 patients). Patients were excluded if they had any of the following based on the FDA label for dapagliflozin: estimated glomerular filtration rate [eGFR]<30 mL/min/1.73 m2 at discharge, dialysis (either history of chronic dialysis or required dialysis during hospitalization), and/or type 1 diabetes. After excluding patients who met the aforementioned criteria and those who had missing discharge eGFR or vital signs, the primary study cohort consisted of 154,714 patients at 406 sites.

Major Results:

  • Of the 154,714 patients studied in the GWTG-HF registry, 125,497 (81.1%) were candidates for initiation of dapagliflozin based on the FDA label.
  • When only looking at sites with ≥10 hospitalizations (355 sites that enrolled 154,522 patients), the median proportion of dapagliflozin candidates was still 81.1% (25th-75th percentiles 77.8-84.6%).
  • A higher proportion of patients without type 2 diabetes than with type 2 diabetes were candidates for dapagliflozin (85.5% vs. 75.6%).
  • The most frequent reason for not meeting the FDA label was eGFR<30 mL/min/1.73 m2, which was met more frequently in patients with a history of or new diagnosis of diabetes than those without diabetes (23.9% vs. 14.3%).
  • There was lower use of evidence-based heart failure therapies in the GWTG-HF patients compared to patients in the DAPA-HF trial.

Histogram from Vaduganathan et al. evaluating the proportion of patients meeting the dapagliflozin FDA label criteria from hospitals with at least 10 eligible HFrEF hospitalizations.

Major Study Limitations: Since the GWTG-HF data are de-identified, only unique hospitalization episodes were presented so some patients may be represented more than once in this study. Glycated hemoglobin levels were not measured in a protocolized way, thus type 2 diabetes could be underdiagnosed in this study. Data regarding post-discharge labs and the use of therapies were not available.

Key Take Home Message: This study using a large AHA registry (GWTG-HF) strikingly found that 4 out of 5 adults with HFrEF (regardless of whether the patient has type 2 diabetes) may be eligible for initiation of dapagliflozin, supporting the broad applicability of this therapy in US clinical practice.

For further learning, there are several great OnDemand sessions from AHA20 on SGLT2 inhibitors.

AHA20 OnDemand Sessions on SGLT-2 inhibitors:

  • New Glucose-Lowering Agents with CV Benefits: Working… But How?
  • SGLT2i for Non-Diabetic Indications: Updates from Mega-Trials and Mechanistic Insights
  • Novel Anti-Diabetic Agents: A Tidal Wave of Change in the Cardiovascular Care of Patients with CKD
  • The Heart, the Kidney, and SGLT2 Inhibition: For Clinical Trials to Patient Care

Potential Future Research Directions:

  • Determine the mechanisms leading to the efficacy of SGLT2 inhibitors in HFrEF.
  • Investigate the renal effects of SGLT2 inhibitors and whether SGLT2 inhibitors can be safely used in patients with more severe chronic kidney disease.
    • DAPA-CKD4 (Dapagliflozin and Prevention of Adverse Outcomes in Chronic Kidney Disease), which included patients with eGFR as low as 25 mL/min/1.73 m2, showed that dapagliflozin reduced risk of sustained eGFR decline of at least 50%, end-stage kidney disease, or death from renal or cardiovascular causes regardless of the presence or absence of type 2 diabetes.
    • EMPEROR-Reduced included HFrEF patients with eGFR as low as 20 mL/min/1.73 m2.
  • Evaluate whether SGLT2 inhibitors are beneficial in patients with heart failure with preserved ejection fraction (HFpEF). Current ongoing/future clinical trials with HFpEF patients include DELIVER (NCT03619213), EMPEROR-Preserved (NCT03057951), EMPA-HEART 2 (NCT04461041), PRESERVED-HF (NCT03030235), and EMBRACE-HF (NCT03030222).
  • Assess the effects of simultaneous use of SGLT2 inhibitors and another class of diabetic medications that have shown beneficial cardiovascular disease (CVD) effects, glucagon-like peptide-1 receptor agonists (GLP-1RA) and determine which of these two classes of medications should be prioritized in drug-naïve patients with type 2 diabetes and atherosclerotic cardiovascular disease (ASCVD).

Potential mechanisms underlying the beneficial effects of SGLT2 inhibitors. Figure from Dr. Subodh Verma’s talk entitled “SGLT2 inhibitors: Why do they work” in the “New Glucose-Lowering Agents with CV Benefits: Working… But How?” session at AHA20.

 

References

  1. Vaduganathan M, Greene SJ, Zhang S, Grau-Sepulveda M, DeVore AD, Butler J, Heidenreich PA, Huang JC, Kittleson MM, Joynt Maddox KE, McDermott JJ, Owens AT, Peterson PN, Solomon SD, Vardeny O, Yancy CW, Fonarow GC. Applicability of us food and drug administration labeling for dapagliflozin to patients with heart failure with reduced ejection fraction in us clinical practice: The get with the guidelines-heart failure (gwtg-hf) registry. JAMA Cardiol. 2020
  2. McMurray JJV, Solomon SD, Inzucchi SE, Køber L, Kosiborod MN, Martinez FA, Ponikowski P, Sabatine MS, Anand IS, Bělohlávek J, Böhm M, Chiang CE, Chopra VK, de Boer RA, Desai AS, Diez M, Drozdz J, Dukát A, Ge J, Howlett JG, Katova T, Kitakaze M, Ljungman CEA, Merkely B, Nicolau JC, O’Meara E, Petrie MC, Vinh PN, Schou M, Tereshchenko S, Verma S, Held C, DeMets DL, Docherty KF, Jhund PS, Bengtsson O, Sjöstrand M, Langkilde AM, Investigators D-HTCa. Dapagliflozin in patients with heart failure and reduced ejection fraction. N Engl J Med. 2019;381:1995-2008
  3. Packer M, Anker SD, Butler J, Filippatos G, Pocock SJ, Carson P, Januzzi J, Verma S, Tsutsui H, Brueckmann M, Jamal W, Kimura K, Schnee J, Zeller C, Cotton D, Bocchi E, Böhm M, Choi DJ, Chopra V, Chuquiure E, Giannetti N, Janssens S, Zhang J, Gonzalez Juanatey JR, Kaul S, Brunner-La Rocca HP, Merkely B, Nicholls SJ, Perrone S, Pina I, Ponikowski P, Sattar N, Senni M, Seronde MF, Spinar J, Squire I, Taddei S, Wanner C, Zannad F, Investigators E-RT. Cardiovascular and renal outcomes with empagliflozin in heart failure. N Engl J Med. 2020;383:1413-1424
  4. Heerspink HJL, Stefánsson BV, Correa-Rotter R, Chertow GM, Greene T, Hou FF, Mann JFE, McMurray JJV, Lindberg M, Rossing P, Sjöström CD, Toto RD, Langkilde AM, Wheeler DC, Investigators D-CTCa. Dapagliflozin in patients with chronic kidney disease. N Engl J Med. 2020;383:1436-1446

 

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”

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AHA20 Scientific Sessions From the Perspective of a New Attendee

I was overwhelmed when I attended Scientific Sessions for the first time last year. There were thousands of participants and dozens of sessions occurring simultaneously in a very large convention center. It was challenging to try to attend all of the sessions that I was interested in. I was frequently disoriented in the large convention center. Coordinating central meeting spots with colleagues was difficult. Although AHA20 is virtual this year, seeing the vast number of sessions available covering many important topics can still be overwhelming, especially to a first-time attendee. As I mentioned in my last blog, trying to prioritize live events over OnDemand events may help keep you engaged during the conference.

For this blog, I wanted to feature the perspective of Javier E. Sierra-Pagan, a first-time attendee of Scientific Sessions. Javier is an F30-funded medical scientist (MD/PhD) trainee (who is in his 5th year in the program, 3rd year as a PhD student) at the University of Minnesota Medical School. He is currently studying mechanisms of cardiovascular development and regeneration. He is interested in Cardiology. I am fortunate to work at the same research institute as Javier and have his lab bench next to mine!

Question: What are you looking forward to at AHA Scientific Sessions this year? Any specific events that you are interested in?

Javier: I’m really looking forward to listening to good talks regarding cardiovascular development and disease. Given the current pandemic, I am particularly interested in any talks regarding SARS-CoV-2 and its implications on cardiovascular disease. As a young trainee, I’m interested in attending some of the networking events to get to know more individuals in my field of research. 

Question: How has your experience with AHA Scientific Sessions been so far?

Javier: It has been great so far. I felt a little overwhelmed at the beginning with how big this conference is, but after setting my agenda and identifying good talks to attend to, I felt more comfortable and very excited about Scientific Sessions.

Question: How are you preparing for AHA Scientific Sessions?

Javier: I’m approaching Scientific Sessions with an open mind. It is my first time attending it and I’m just trying to learn as much as I can from both basic science, as well as clinical medicine. The benefit of having such a big conference is that I can learn a little bit from so many different areas in the field of cardiology. 

Question: How has COVID-19 affected your research?

Javier: The pandemic has put a lot of stress on everybody for sure. At the beginning of the pandemic, I was fortunate to be primarily focused on writing and submitting a manuscript, which allowed me to work from home. Now we are in a different situation entering November. I am working more hours in the laboratory and trying to stay safe while also maintaining my productivity. I haven’t had any significant setbacks with regards to my thesis, but I did want to attend some conferences in the Spring that were ultimately canceled because of COVID-19.

Question: Anything else you want to add?

Javier: I look forward to attending more AHA meetings in the future (hopefully in person) and interacting with colleagues from the field. I definitely miss the scientific conversations that happen in the hallways or in the elevators when you are trying to get to a lecture room. 

Thank you, Javier, for discussing your experience with other trainees!

Remember that you can watch all of the OnDemand AHA20 content until January 4, 2021, which can help relieve the stress of cramming in as many sessions as possible into 5 days. If you are an early career investigator or trainee and would like to be featured in one of my upcoming monthly blogs, please let me know (you can message me on Twitter or email me at szprisco@umn.edu)!

 

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”

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How to Stay Engaged During Virtual AHA Scientific Sessions

Attending AHA Scientific Sessions is one of the highlights of my year. I was looking forward to visiting Dallas and seeing old and new friends, along with presenting the research projects that I am excited about. Of course, it is difficult to replicate the in-person networking and interactions with friends, colleagues, and collaborators with virtual conferences, but there are many ways to try to improve your experience during AHA20. Dr. Elizabeth Knight (@TheKnightNurse) wrote a great blog about tips for attending virtual meetings.

 

With a conference the size of AHA20, it is important to find a way to stay engaged in order to maximize the benefits that you can receive from attending the meeting. Below are some suggestions to help you try to stay engaged throughout AHA20:

  • Follow the #AHA20 hashtag, @AHAMeetings, @AHAScience, @AHAResearch, the AHA20 Virtual CoPilots, and the AHA Social Media Ambassadors (you can find this list at @AHAMeetings and with the hashtag #AHAEarlyCareerBlogger) on Twitter.
  • Engage and discuss your experience at AHA20 with others. Tweet about the sessions that you are attending and the highlights of the findings. Tag your colleagues, mentors, #AHA20, @AHAMeetings, and some of the Social Media Ambassadors. Also, find some other people (e.g., colleagues in your lab or department) to have more in-depth talks about some of the exciting research you saw.
  • There is a plethora of great research and science presented during many on-demand sessions. Make a list of all of the programs you want to watch. You can use the AHA Scientific Sessions Online Program Planner (https://professional.heart.org/en/meetings/scientific-sessions/programming) or AHA Conferences mobile app (that can be downloaded through the Apple App Store or Google Play) to mark the sessions that you are interested in. Try to watch some of these sessions over Scientific Sessions and set aside some time the rest of the year to watch the other sessions that you are interested in. You can access the on-demand content until January 4, 2021.
  • Try to attend all of the live sessions that you are interested in, especially sessions in the FIT/Early Career Lounge and the Interactive Zoom Events. Here are some (but not a comprehensive list of) potential events that may be valuable for early career trainees:

On Friday 11/13:

  • Women and Leadership: Going from Good to Great (WPD.03) – Fri 11/13 from 10:30-11:30am CST
  • Racism in Medicine: What Medical Centers & Training Programs Can Do To Be Antiracist (FIT.01) – Fri 11/13 from 12-1pm CST
  • Prioritizing Self and Wellness During Cardiovascular Training (FIT.05) – Fri 11/13 from 5-5:50pm CST
  • CVSN (Council on Cardiovascular and Stroke Nursing) Research Mentoring Committee Mingle with the Mentors (WPD.05) – Fri 11/13 from 5-6pm CST
  • Imposter Syndrome – Our Stories (WPD.06) – Fri 11/13 from 5-6pm CST
  • Young Hearts Early Career Mentoring Roundtable Discussions (ECE.02) – Fri 11/13 from 6-7pm CST
  • Matching into Cardiology Fellowship: The Inside Scoop From Program Directors & AHA FITs (FIT.06) – Fri 11/13 from 6-7pm CST
  • Women in Cardiology Meet Up (WPD.07) – Fri 11/13 from 6-7pm CST

On Saturday 11/14:

  • Cardiovascular Imaging Early Career Roundtable (IM.EC.678) – Sat 11/14 from 5-6pm CST
  • My First Grant Funding Breakthrough – Tips and Tricks for Early Career Researchers (ECE.03) – Sat 11/14 from 5-5:50pm CST
  • Fireside Chat: What You Need to Know for a Career in Sports Cardiology (FIT.07) – Sat 11/14 from 5-5:50pm CST
  • Happy Hour with Distinguished Scientists (HQ.07) – Sat 11/14 from 5-6pm CST
  • ReSS Young Investigator Networking Event (ReSS.07)– Sat 11/14 from 5-7pm CST
  • Who’s the perfect mentee? (ECE.04) – Sat 11/14, 6-7pm CST
  • Fireside Chat: What You Need to Know for a Career in Heart Failure (FIT.08) – Sat 11/14 from 6-7pm CST

On Sunday 11/15:

  • Speed Mentoring: Meet the Experts in Pulmonary Vascular Disease (PH.EC.694) – Sun 11/15 from 10:30-11:30am CST
  • How I Did This: Lessons Learned in Developing a Career in Cardiometabolic Health (CM.EC.668) – Sun 11/15 from 12-1pm CST
  • Tips to Residency Interview Webinar (ECE.05) – Sun 11/15 from 5-5:50pm CST
  • PVD Council Virtual Networking Session (ECE.06) – Sun 11/15 from 6-7pm CST
  • Fireside Chat: What You Need to Know for a Career in Interventional (FIT.10) – Sun 11/15 from 6-7pm CST

On Monday 11/16:

  • Surviving and Thriving in the Early Career Lessons Learned? – Live Zoom Discussion (ECE.07) – Mon 11/16 from 5-5:50pm CST
  • Fireside Chat: What You Need to Know for a Career in Imaging (FIT.11) – Mon 11/16 from 5-5:50pm CST
  • Happy Hour with Distinguished Scientists (HQ.09) – Mon 11/16 from 5-6pm CST
  • Navigating Academic Paths for Women and Minorities Roundtable – ATVB Women’s Leadership Committee (WPD.09) – Mon 11/16 from 5-6pm CST
  • BCVS Early Career Social Networking (ECE.08) – Mon 11/16 from 6-7pm CST
  • Fireside Chat: What You Need to Know for a Career in Critical Care (FIT.12) – Mon 11/16 from 6-7pm CST

On Tuesday 11/17:

  • Developing a Career in Cardiovascular Omics (ECE.09) – Tue 11/17 from 5-5:50pm CST
  • Fireside Chat: What You Need to Know for a Career in Pediatric Cardiology (FIT.13) – Tue 11/17 from 5-5:50pm CST
  • Professional & Personal Self-Care (WPD.11) – Tue 11/17 from 5:30-6:30pm CST
  • ATVB Council Networking Session (ECE.10) – Tue 11/17 from 6-7pm CST
  • Fireside Chat: What You Need to Know for a Career in Preventive Cardiology(FIT.14) – Tue 11/17 from 6-7pm CST

Looking forward to connecting with you during AHA20!

 

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”

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My Experience at BCVS20

Thank you to the organizers for putting together a vibrant and informative fully virtual AHA Basic Cardiovascular Sciences Scientific Sessions 2020 (BCVS20) conference this year!

While I have attended many meetings and classes virtually this year, BCVS20 was the first major scientific conference that I attended virtually and I did not know what to expect. I was pleasantly surprised by the many benefits of participating in the meeting virtually but there were many things that I missed about attending meetings in person.

I enjoyed the convenience of being able to work in specific sessions into my usual work week of attending clinic, doing lab experiments, and attending classes and into my personal life. Additionally, I liked being able to watch some sessions in the comfort of my home, sitting next to my dog. Similar to fellow AHA blogger, Dr. Mo Al-Khalaf, I also appreciated being able to easily jump between many live sessions without having to run across a large convention center. Moreover, I felt that it was sometimes easier to pay attention to certain talks without the distraction of being in a crowded area with many simultaneous presentations. I was impressed by the quality of the presenters’ talks and efforts by the participants to stimulate lively discussions.

I did not take time off to attend the meeting and I felt that the week of BCVS20 was extremely busy for me. Although I appreciate the convenience of having a fully virtual meeting, I miss being able to take a short reprieve from some of my usual responsibilities to give my undivided attention to specific sessions. Furthermore, due to my other obligations, I was unable to attend some of the very valuable, live early career sessions. However, the ability to rewatch the BCVS20 sessions (which are available for 90 days after the meeting) will allow me to catch up on many of the sessions that I missed!

While there are many benefits to attending in-person meetings, not least of which is being able to see your friends and colleagues in person, having a virtual meeting allows people throughout the world to conveniently participate in and attend a meeting. I hope that conferences in the future will continue to be a hybrid in-person and virtual format to accommodate everyone’s busy schedules.

For those of you who attended the BCVS20 meeting, don’t forget to provide your feedback on the meeting via the link emailed to you. If you missed registering for the meeting, it is not too late to get access to the recorded sessions. I hope to continue seeing many of you either virtually or in-person during future AHA meetings!

 

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”