Game Over.. literally | Parallox OST

In this essential episode of Parallax, Dr Ankur Kalra welcomes Dr Shelley Zieroth, Professor of Medicine, clinician-scientist, and advanced heart failure and transplant cardiologist in Winnipeg, Canada. As we mark the 10-year anniversary of the landmark EMPA-REG OUTCOME trial, Dr Zieroth provides a comprehensive update on how SGLT2 inhibitors have revolutionized cardiovascular care.

Dr Zieroth takes us through the remarkable journey from the initial 2015 trial that transformed SGLT2 inhibitors from anti-diabetic agents into cardiovascular powerhouses, delivering highly significant reductions in cardiovascular death and heart failure hospitalization. She explores how these medications have become fundamental pillars of cardio-kidney-metabolic medicine, with evidence spanning the entire ejection fraction spectrum.

Dr Zieroth discusses prescribing these agents in heart failure - including the straightforward 10-mg daily dosing, monitoring strategies, and crucial patient selection criteria. She shares insights from the recent EMPULSE trial on safe in-hospital initiation, addresses important considerations for diabetic patients, and highlights key contraindications like indwelling catheters that clinicians must recognize.

Beyond the basics, Dr Kalra and Dr Zieroth examine the evolving role of SGLT2 inhibitors in valvular disease and diastolic dysfunction, tackle the ongoing reimbursement challenges across different healthcare systems, and discuss the critical importance of multidisciplinary collaboration in the cardio-kidney-metabolic space. They also look ahead to exciting combination therapies on the horizon that promise to further advance heart failure prevention and treatment.

Questions and comments can be sent to "podcast@radcliffe-group.com" 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.

EP 141: From EMPA-REG to Clinical Practice: Mastering SGLT2 Inhibitors in Modern Cardiology

In this fascinating episode of Parallax, Dr Ankur Kalra sits down with Dr Alexander Fanaroff, an interventional cardiologist, clinical trialist, and behavioral economist at the University of Pennsylvania. Dr Fanaroff brings a unique perspective to cardiovascular medicine, combining his expertise in interventional cardiology with cutting-edge insights from behavioral economics to transform how we approach patient care and clinical decision-making.

Dr Fanaroff demystifies behavioral economics for the medical community, explaining how this field studies real-world decision-making beyond traditional economic models. He introduces key concepts like status quo bias, prospect theory, and the power of defaults in shaping both physician and patient behaviors. Through compelling examples, including Penn's successful intervention that increased 90-day statin prescriptions from 70% to 90% simply by changing EHR defaults, Dr Fanaroff demonstrates how small design changes can yield significant clinical improvements.

Looking beyond individual interventions, Dr Fanaroff discusses how behavioral economics can address healthcare disparities by creating system-wide improvements that lift all patients while specifically targeting underserved communities. He envisions a future where AI identifies at-risk patients from routine imaging, and where interventional cardiologists focus not just on procedural excellence but on ensuring optimal long-term medical management through thoughtfully designed care systems.

Questions and comments can be sent to "podcast@radcliffe-group.com" 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.

EP 142: The Psychology of Patient Care: Nudges, Gamification, and the Future of Cardiology

 “Parallax Factor” – a retro-futuristic electronic pop journey inspired by the 1980s synthwave era.

Parallax Factor

In this episode of Parallax, Dr Ankur Kalra speaks with Dr Benjamin A D’Souza, Associate Professor of Medicine at the University of Pennsylvania and Section Chief of Cardiac Electrophysiology at Presbyterian Medical Center. Together, they explore the challenges of mitigating sudden cardiac death and the evolving role of guideline-directed medical therapy in optimising patient outcomes.

Dr D’Souza reflects on current strategies for risk assessment and prevention, highlighting the importance of medical therapy, careful monitoring and timely use of defibrillators. He stresses that management must be tailored to individual patients, with decisions guided by evidence, imaging and multidisciplinary collaboration.

The conversation also turns to women’s cardiac health and representation in electrophysiology. Dr D’Souza highlights the persistent under-enrolment of women in clinical trials and their lower access to ablation and device therapy. He stresses the need for inclusive trial design, mentorship and acknowledgement of systemic bias to improve equity in cardiovascular care.

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

EP 143: GDMT Optimisation: Mitigating SCD Risk and Addressing Women’s Cardiac Health

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PARALLAX - Wedding Mix Vol 1

In this evidence-packed episode of Parallax, Dr Ankur Kalra welcomes back Dr Purvi Parwani, Associate Professor of Medicine at Loma Linda University Health, for a comprehensive review of groundbreaking trials presented at the European Society of Cardiology Congress.

Dr Parwani guides listeners through what she describes as a "tectonic shift" in post-MI care with the REBOOT and BETAMI-DANBLOCK trials. These studies challenge the routine use of beta blockers after heart attack, revealing that patients with preserved ejection fraction above 50% may not benefit, while those with EF between 40-49% show significant risk reduction from continued therapy.

The discussion moves to heart failure management, exploring the POTCAST trial's approach to optimising potassium levels in high-risk patients and the DIGIT-HF trial's examination of digitoxin as a potential option for patients who cannot tolerate modern four-pillar therapy. Dr Kalra and Dr Parwani conclude with the evolving role of aspirin in cardiovascular care. They discuss findings from NEO-MINDSET, TARGET-FIRST, and the AQUATIC trial, which together are reshaping antiplatelet strategies from the immediate post-PCI period through long-term management of stable coronary disease in patients requiring anticoagulation.

Questions and comments can be sent to "podcast@radcliffe-group.com" 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.

EP 144: ESC 25 in Review with Dr Purvi Parwani

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PARALLAX - Free Beat #1 (Trapsoul)

In the latest episode of Parallax, Dr Ankur Kalra welcomes Dr Martha Gulati and Dr Anu Lala for a groundbreaking conversation about reimagining heart failure prevention across the entire disease spectrum. Their discussion centres on an innovative scientific statement developed collaboratively between the American Society of Preventive Cardiology and the Heart Failure Society of America - a document that challenges conventional approaches to cardiovascular disease prevention.

Dr Gulati and Dr Lala make a compelling case for expanding prevention beyond atherosclerotic cardiovascular disease (ASCVD) to encompass heart failure, a condition affecting one in four individuals over their lifetime. They introduce the American Heart Association's Cardio Kidney Metabolic (CKM) health framework as a superior model for identifying at-risk patients, explaining how this approach shifts focus from disease management to health optimization. The conversation explores practical implementation strategies, including the new PREVENT risk score, which integrates critical heart failure risk factors like obesity and chronic kidney disease that traditional assessment tools overlook.

Questions and comments can be sent to "podcast@radcliffe-group.com" 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.

EP 146: The Heart Function Revolution: Why Prevention Matters at Every Stage of Disease

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‘Parallax’ (/ˈparəlaks/)-noun: the effect whereby the position or direction of an object appears to differ when viewed from different positions. Join Ankur Kalra, MD as he shows you a different side to cardiovascular care, management and science. Listen to Ankur’s conversations with legendary cardiologists, critical reviews of key congresses and late-breaking trials, and concise summaries. Published every second Monday of the month, this is your fix of reliable updates on all things cardiology by someone from a non-traditional background, who is always trying to look at it from new angles! Dear cardiologists, we want to make this podcast about you, and for you! Please email us critical thoughts, comments and questions for Ankur at podcast@radcliffe-group.com.

Lyricist, vocalist, keyboard player for Modern Chant 1980s. 
Co-composer, vocalist, lyricist, keyboard player, Impressionist Music improvising collective 1990s-2000s. 
Vocalist with Medusa singing Goddess acapella 2000s. 
Collaborated with Dale Chant, Marc Tracey, Chris Parthenides, Roland Seidel, Riley Jordan

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