Future Pulse Cardiology

This episode is a deep dive into Lipoprotein a with Dr Steven Nissen from the Cleveland Clinic.  He and Dr Nero discuss the genetics of Lp(a), its pathophysiology, current treatment strategies and research into lowering Lp(a) levels.  This is a fascinating conversation that also discusses the role of coronary inflammation in the work of Dr. Paul Ridker as well as the role of CT angiography in future clinical trials.

Dr Steven Nissen from the Cleveland Clinic discuses with Dr. Thomas Nero the basic clinical approach to Lp(a) with need for routine testing and a few simple case studies.  In the second (longer podcast) they take a deep deep dive into Lp(a) genetic, pathophysiology and the current research trials.  

Dr Thomas Nero speaks with Dr Aaron Baggish about coronary artery disease in the endurance athlete (and non-athlete as well!)  They discuss cardiovascular testing in Masters athletes including ETT, coronary calcium scoring and CT angiography as well as risk factor identification, inflammation, physical & emotional stress and ongoing research. Dr Baggish is  a Professor of Sports Cardiology at Université de Lausanne and founder of the  Cardiovascular Performance Program, Massachusetts General Hospital, Harvard Medical School.  He has been team cardiologist for USA rowing, US Soccer, and the New England Patriots.  He was the medical director for the Boston Marathon and is a consultant to the IADA, IOC and FIFA.  

Dr Mandrola discusses recent trail data with Dr. Thomas Nero including the results from Artesia, NOAH Afnet 6, Frail AF, Azalea and Oceanic-AF.  They also discuss Left Atrial Appendage Occlusion and utility of wearable devices.  Finally, a shout out to Dr. Andre Foy and his work on multi-morbidity and its role in clinical trial interpretation.

Dr. Thomas Nero speaks with Dr. Mathew Budoff about Coronary Calcium Scoring, CT Coronary Angiography and cardiovascular outcomes.  The discussion goes beyond basic risk factor enhancement, highlighting its role to help evaluate disease progression, power future clinical trials and determine efficacy of therapy.  Along the way, they discuss coronary inflammation, perivascular adipose tissue imaging and fat attenuation index (FAI) as well as diving into the plaque stabilizing effects of EPA.   

Dr. Elizabeth Ofili discusses the African American Heart Study with Dr. Thomas Nero.  They also discuss her work at the NIH and the African American Heart Failure Trial and the role of community based pragmatic clinical trials.

Dr. Thomas Nero discusses current therapy with Factor X inhibitors, the new research with Factor XI inhibition and specifically the enrolling Milvexian clinical trials with Dr. C Micahel Gibson.  In addition they discuss, the addition of these medications along wiht anti-platelet therapy, Lp(a) and other interesting current and future research in cardiovascular disease.

Dr. Thomas Nero speaks with Dr Peter Toth about the dramatic change occuring in diabtetes management and its effect on cardiovascular disease.  Starting with the biochemestry of diabetes and its effects at the cellular level, the discussion goes on to speak about the role SGLT2 inhibitors and GLP1 receptor agonists play in DM management as well as the future of diabetes care.  (If you want to skip the excelllent, but quite deep dive into biochemistry, jump to 11:22 - but honestly Dr. Toth's description is breathtaking)

Dr. Thomas Nero speaks with Dr. Peter Toth about the complex biology of lipids and atherosclerosis.  In this episode Dr Toth dives into LDL goals, therapies for attenuating non-LDL risk, vascular biology and the where are research studies lead us in choosing therapies.

Dr Paul Ridker discusses his paper on residual inflammatory risk that was recently published in the Lancet with Dr. Thomas Nero.  He discusses the pathology of inflammation as part of atherosclerosis, utilization of hs-CRP in clinical trials and in daily practice as well as current therapeutic options and ongoing investigations.