Khaas Baat : A Publication for Indian Americans in Florida


Dr. Ravindra Nathan with Alfred Bove, president of ACC 2009-2010.


The place to be during last spring, for cardiovascular education, was Atlanta, where the Annual Scientific Session of American College of Cardiology (ACC) was held earlier this year. ACC greeted participants with the tagline: “The Future of Cardiology awaits you.” For us cardiologists, this is an annual pilgrimage. The four-day international conference was a true intellectual feast; you got almost everything you needed to stay on top of your profession, at any stage of your career. In addition to cardiologists, other participants included nurses, technologists, researchers, industry representatives, residents, fellows and dignitaries from all over the world.

The futuristic approach in cardiology presented in the convention involved scientific research, innovation, intervention, education and networking. There was representation from almost every country in the world. Yes, the future of cardiology was on display here and I enjoyed the four days of the information infusion.

During the presidential address at the scientific showcase session, Dr. Alfred Bove called for a greater role in ambulatory care and prevention. “We should learn how to treat our patients in an outpatient setting, managing chronic heart disease and providing guidelines and therapies for cardiovascular disease prevention.” Later, I caught up with him and briefly talked on some issues. There are clear benefits for managing patients at home with home monitoring and quarterly office visits.

During the 41st annual Bishop Lecture, which included a highly visual presentation, Richard Satava, cardiac surgeon from University of Washington, suggested that technology is going to revolutionize the medical practice – meaningful electronic medical records, medical informatics, interventional techniques, new kind of pacemakers and defibrillators, telemedicine and robotics. Yes, a surgical robot with its remote-controlled arms is the new technological marvel. It enables the surgeons to operate through small incisions with greater precision and visibility. Often, the surgeon only has to sit behind a screen and operate a joystick-like control. Truly mind-boggling, right?

The session on late-breaking trials reported the results of many new trials such as ACCORD, INVEST, EVEREST II and NAVIGATOR. While the acronyms may not carry any significance for the layperson, they brought out some important findings. The take-home messages are as follows: 1. Good control of systolic blood pressure (SBP) is important to reduce worst outcomes such as strokes and heart attacks but tight control (SBP of less than115) was not associated with any more improvement. 2. In selected patients with significant leaks of mitral valve, a new procedure – percutaneous Endovascular Valve Edge to Edge repair with a special clip – is a safe and effective alternative to open heart surgery. 3. Combination of a new diabetic drug ‘nateglinide’ and an old drug ‘valsartan’ seems to improve the progression of diabetes mellitus but neither had an effect in preventing coronary heart disease (CHD).

‘Lipids in heart disease’ continued to be a hot topic with several presentations and satellite symposia. The role of low-density lipoprotein cholesterol (LDL-C) in cardiovascular disease and the risk reduction associated with lipid-modifying therapies that lower LDL-C have been well established. And statins have risen to the forefront of primary and secondary prevention of CHD. However, it has become apparent that LDL-C does not tell the whole story. The residual risk for CHD is still significant particularly among patients with low levels of high-density lipoprotein cholesterol (HDL-C). By recognizing the importance of HDL-C functionality, new drugs that can boost your HDL will soon become available.

One of the most fascinating sessions was the prestigious Simon Dack lecture given by Anthony Atala, chair of Urology at Wake Forest University School of Medicine. He said, “Regenerative Medicine is inching closer to its promise.” With our greater knowledge in cell biology, availability of biomaterials and ability to grow cells outside human body, we can literally grow many tissue structures like liver, heart, pancreas, kidneys and even nerve cells. Researchers are now able to make a suitable scaffold required to mold tissues and organs. Hollow organs like uterus and solid organs like kidneys and liver can be grown like this. This gives hope for millions with organ failure.

“Regenerative medicine is evolving quickly but growing an organ takes tremendous effort and scientists must be cautious,” he said. Now that there is long-term data on the safety of implanting a regenerated organ in a patient, “We can afford to accelerate the timeline but still need to be methodical,” he added. Transplant specialists will definitely be happy to hear this since there are not enough organs to harvest (either from living or dead persons) currently, to meet the burgeoning demand as the waiting list for organ transplantation is growing steadily.

To be concluded in the next issue.

Dr. M.P. Ravindra Nathan is a Brooksville cardiologist and director of the Hernando Heart Clinic.

homeeventsbiz directorysubscribecontentclasses/places of worshipnewseditorialhealthimmigrationfinance
techno cornermoviesfashionmusic/dancebookshome improvementastrologycuisinemotoringgetawayclassifiedsARCHIVES
Read the Editor's Blog. By Nitish Rele Classifieds Getaway Motoring Cuisine Astrology Home Improvement Books Music and Dance Fashion Movies Techno Corner Finance Immigration Health Editorial News Classes/Places of Worship Content