This week’s Parallax episode is focusing on the latest science and questions surrounding one of the conundrums of cardiovascular science: Lipoprotein(a).
Dr. Ankur Kalra invites Dr Salim S Virani to help simplify the concept of Lp(a) with answering key questions about its measurement and its place in practice and prevention.

Dr Virani is a Professor at Baylor College of Medicine, Director of the Cardiovascular Disease Fellowship Program and Vice Provost of Research at Aga Khan University from early next year.

Lp(a) was first described in 1963. Since then, many epidemiologic studies have noted association of high Lp(a) levels with elevated risk of cardiovascular disease, however, the role of this particle remained a conundrum (Kamstrup, 2017). New data from the development of novel drugs are offering strong evidence on the causality between Lp(a) and ASCVD and AVS (Kronenber et al. 2022).
Dr Virani, one of the authors of the new European Atherosclerosis Society consensus statement on Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis, summarises the key concepts, shares his advice on clinical practice and talks about emerging therapies.

What is Lp(a) and what are the main associations? In what patient population should we lower LP(a)? What do you tell patients about Lp(a) testing and how easy it is to get it tested?

Questions and comments can be sent to “podcast@radcliffe-group.com” and may be answered by Ankur in the next episode.
Guest: @virani_md, host: @AnkurKalraMD and produced by: @RadcliffeCARDIO.

EP 78: Your Guide to Lipoprotein(a) with Dr. Salim S Virani

This week’s episode is dedicated to one of the biggest cardiovascular meetings, AHA’s Scientific Sessions. Dr Ankur Kalra’s guest is Dr Manesh Patel, chair of the AHA Committee on Scientific Sessions and Chief of the Division of Cardiology and Co-Director of the Heart Center at Duke University.

Year on year, the organisers of the Scientific Sessions aim to give platform to cardiovascular science at its best: innovative, impactful, and collaborative.
In this information-packed episode, Dr Patel takes us behind the scenes and talks about the work that goes into the curation of the programme and the considerations that shape the event. Dr Kalra asks Dr Patel about his highlights over the years and the movement and changes that he observed as vice chair and chair of the event. Dr Patel elaborates on the key late-breaking science trials in 2022. Dr Kalra and Dr Patel discuss the grading system of the award applications and share some useful information with our listeners.

What does Dr Patel think about the function of the Scientific Sessions? What happens after you submit your application to an award? How do the organisers concert a balance between the scientific and the social need of a global community?

Questions and comments can be sent to “podcast@radcliffe-group.com” and may be answered by Ankur in the next episode. 
Guest: @manesh_patelMD, host: @AnkurKalraMD and produced by: @RadcliffeCARDIO.

EP 80: AHA’s Scientific Sessions: Science, Innovation and Community With Dr Manesh Patel

Although rare, the occurrence of a pacemaker or a defibrillator infection is an important complication which can and must be treated fast and effectively. On a weekly basis the story unfolds: how to best manage CIED patients when their device becomes infected and gather insights from physicians with different specialties in an interactive setting.

This series is supported by Philips.

What is a CIED? - Archie Rao and Angelo Auricchio

Although rare, cardiac implantable electronic device (CIED) infections may occur at any timepoint in the lifecycle. It is important to remain alert and recognise signs early. Traditionally, antibiotics alone are used to treat infection. But for CIED infections, when treated with antibiotics only, the relapse rate varies between 50 and 100 percent. But why is that? Dan Atar, Editor-in-Chief of the scientific journal ‘Cardiology’, and infectiologist Stefan Hagel, not only challenge the traditional point of view but tear down the decades of belief which surround it. Why are antibiotics not doing the job? What are the consequences? What is the solution? Why are infections sometimes overlooked and what is the action to change that in your practice?

This series is supported by Philips.

Why Do Antibiotics Fail With CIED Infection? - Dan Atar and Stefan Hagel

Infection of a cardiac electronic implantable device (CIED) is a rare, but serious, complication. When this happens, the removal of the entire system, generator and leads, is the only correct way to treat the infection. What happens during a procedure with lead extraction? Brigitte Osswald, an expert in the field who has performed more than 3,500 lead extraction procedures, talks to Nicola Montano, a physician in internal medicine, about the fundamentals of the procedure and explains why and how this is lifesaving for her patients.

This series is supported by Philips.

Procedure of Lead Extraction - Brigitte Osswald and Nicola Montano

In the finale of our series "Conversations about Hypertrophic Cardiomyopathy", Dr Ankur Kalra welcomes, Dr Anjali Tiku Owens, for a dynamic and practical discussion.

Dr Owens is Medical Director of the Center for Inherited Cardiac Disease and Associate Professor of Medicine at the Hospital of the University of Pennsylvania.

This series is supported by an unrestricted educational grant from Bristol Myers Squibb. Please see www.camzyosrems.com for important safety information.

In this week’s episode, Dr Kalra and Dr Owens take us on a journey through the complexities of hypertrophic cardiomyopathy (HCM), with focus on the diagnostic challenges and breakthroughs in this field.
Emphasising with the critical importance of making accurate diagnoses, Dr Owens shares her insights into identifying the common mimickers of HCM through a structured approach starting with taking the patients history.
As the conversation delves deeper, Dr Owens discusses the various diagnostic tools and tests used to rule out other conditions and uncover the underlying aetiology. She navigates us through the algorithm for interpreting genetic test results, differentiating pathogenic variants, benign variants and variants of uncertain significance (VUS). Dr Owens talks about the wider implications for family members and the cases in which she recommends screening.
Dr Kalra asks Dr Owens about her approach to exercise in HCM patients. Additionally, they cover the debated topic of defibrillator therapy and the use of HCM Risk-SCD risk calculator.
Dr Owens provides an overview of the treatment paradigms for HCM, touching on haemodynamic classifications, symptomatology and the evaluation of sudden death risk.

What are the most common mimickers of HCM? What is Dr Owens and her heart team approach to decision making? What is the role of genetic testing in patients with HCM?

This content is intended for US-based physicians.

EP 97: Conversations about HCM: Differential Diagnosis, Genetic Testing & Patient-centric Therapy

What's hot at ESC Congress 2024?

Join us for a comprehensive analysis of the most impactful hot line trials presented at the European Society of Cardiology (ESC) Congress 2024. In the latest episode of the View from the Thoraxcenter, Prof Nicolas van Mieghem and Dr Joost Daemen (Thoraxcenter at Erasmus MC, NL) provides an overview of the new findings and their implications for clinical practice.


What should we consider when interpreting hotline data from ESC 24? How will these trials impact future research? What questions should we ask before applying the new data to clinical practice?

Trials in detail covered:
00:37 RESHAPE-HF2
06:11 MATTERHORN 
11:01 Tri.fr 
14:43 SWEDEGRAFT  
17:46 OCCUPI
22:59 REC-CAGEFREE I
28:10 SENIOR-RITA
32:58 EARTH-STEMI 
35:23 POPular PAUSE TAVI 
38:31 NOTION-3 
44:32 RHEIA

Support: This is an independent interview produced by Radcliffe Cardiology.

View from the Thoraxcenter: ESC 24 Hot Line Wrap Up

In this exclusive episode of the "Innovations in Cardiology" podcast series, host Dr Dipti Itchhaporia, past president of the American College of Cardiology, delves into the latest advancements in cardiovascular health. She is joined by Dr Valentin Fuster, a pioneer in the field, who shares invaluable insights into the impact of biological ageing, the connection between the heart and brain, and the role of artificial intelligence in healthcare.

Dr Fuster challenges the traditional focus on chronological age, highlighting the significance of biological age as a more accurate predictor of cardiovascular risk. Together, he and Dr Itchhaporia explore innovative ways to measure biological age and discuss the factors that influence it.

The conversation then shifts to the importance of early intervention in cardiovascular disease, with Dr Fuster advocating for screening in younger individuals. They also discuss the transformative potential of polypills in preventing and treating heart disease, weighing the benefits against challenges such as adherence and cost-effectiveness.

As the episode wraps up, Dr Fuster offers his predictions for the future of cardiovascular care and shares valuable advice for those just beginning their careers in the field.

If you have any questions or suggestions for topics to cover on the Radcliffe Podcast, please email managingeditor@ecrjournal.com.

Biological Aging, AI & the Brain-Heart Connection: A Conversation with Dr Valentin Fuster

In this compelling episode of Parallax, Dr Ankur Kalra explores South Asian cardiovascular health with preventive cardiology experts, Dr Jaideep Patel from Johns Hopkins, and Dr Romit Bhattacharya from Massachusetts General Hospital.

The conversation begins with both specialists sharing personal motivations behind their focus on South Asian heart health, from family losses to scientific curiosity about potential genetic and metabolic distinctions. They examine whether South Asians truly face different cardiovascular risks - discussing observations of earlier disease onset, unique lipid patterns, and metabolic dysfunction at lower BMIs - while emphasizing that fundamental prevention strategies remain effective across populations.

The episode culminates with powerful closing insights on prevention as an investment—how small, consistent lifestyle modifications can prevent cardiovascular disease onset even in those with genetic predispositions, ultimately enabling fuller, more functional lives in later years.

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

EP 133: South Asian Heart Health: Unveiling Risk Patterns and Prevention Strategies

In this profound episode of Parallax, Dr Ankur Kalra welcomes Dr Pam Taub, Professor of Medicine and Director of Preventive Cardiology at UC San Diego, for an enlightening conversation about integrating spirituality, purpose, and scientific curiosity in cardiovascular practice.

Dr Taub shares her unique philosophical foundation, shaped by exposure to diverse religions in South India. This experience fostered her belief that all faiths fundamentally center on being a good person and serving others. She explores how this spiritual perspective transforms medicine from a profession into a sacred calling, where patient interactions become profound privileges that fuel her desire to make meaningful impact beyond individual achievements.

The episode highlights Dr Taub's groundbreaking work with POTS (Postural Orthostatic Tachycardia Syndrome), demonstrating how scientific curiosity serves as a spiritual path. Her research journey—from recognizing misdiagnosed conditions to conducting the first clinical trial for ivabradine in POTS—exemplifies how deeper questioning and evidence-based inquiry can transform patient lives on a broader scale. The episode also explores Dr Taub's research on time-restricted eating, connecting modern scientific evidence to fasting practices across many faiths.

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 136: The Sacred and the Scientific: Integrating Spirituality in Cardiovascular Care

The Radcliffe Cardiology Podcast brings you the latest advancements, research and best practices in the field of cardiology. Each episode features expert insights and engaging discussions with leading healthcare professionals, covering a breadth of topics in cardiovascular science. 

Our podcast aims to build on the best science, with key takeaways from the top cardiology conferences and recent publications from our journals.

‘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.

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