Libin Life 2021

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LIBIN LIFE

2021

MOVE TO IMPROVE

Libin Institute focuses on inspiring people to get active

LIBIN LIFE | Message from the Director

The new wellness initiative was also a great success, with residents, physicians, nurse practitioners and front-line workers all benefitting. As a result of all of this work, engagement levels within the Libin Institute have never been higher.

Unfortunately, we suffered some losses as well. Long-time Libin supporter Ken King, best known for his work with the Calgary Flames, passed away in 2020.

Ken’s philanthropy, through the Libin Gala, accelerated important work in experimental arrhythmias, as well as other important projects at the Institute. We will miss his presence and are grateful for his many contributions.

Dr. Paul Fedak, director of the Libin Cardiovascular Institute of Alberta.

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t has been a challenging, yet extremely rewarding year for the Libin Cardiovascular Institute.

The COVID-19 pandemic challenged us in ways previously unconsidered. Research labs were shut down, many of our clinical specialists moved to virtual appointments and some surgeries and procedures were cancelled.

Despite these difficulties, members of the Libin Institute came together and were able to pivot quickly to offer the best possible care for our patients. I want to extend my heartfelt gratitude to the leadership within the Dept. of Cardiac Sciences and all front-line staff for their tireless efforts, dedication and flexibility throughout the year. Your dedication was truly inspiring.

Our researchers also quickly rose to the challenge, changing their protocols to enable them to work under the rapidly changing restrictions. Libin researchers were still able to finish projects, publish ground-breaking work, and even undertook several COVID-specific projects (see story page 4).

The Institute held numerous virtual events and initiated new projects, including an exciting new data initiative that holds great promise for the integration of data across several platforms.

We also said goodbye to Libin supporter Tony Vanden Brink. Tony’s steadfast support of our research program was integral to our success, and his impact will be felt for generations to come.

Additionally, we keenly feel the loss of Tine Haworth, a generous supporter of education within the Institute. Tine’s commitment to education is a legacy that will live on in the Tine Haworth Cardiovascular Research Day and in the generous scholarships she funded.

Libin Life is published by the Libin Cardiovascular Institute, an entity of the University of Calgary and Alberta Health Services (Calgary Zone).

Libin Life exists to share news and information about the Institute’s cardiovascular research, education and patient care.

Institute Director Dr. Paul Fedak Editor Dawn Smith, Communications Coordinator Contributors Dawn Smith, Kelly Johnston, Dr. Paul Fedak, Allison Chorney, Britton Ledingham, Krista Armstrong Design and Layout Dawn Smith & Stacey Brown Printer McAra Printing @mcaraprinting Libin Cardiovascular Institute of Alberta University of Calgary HSC G242, 3330 Hospital Drive NW Calgary, Alberta T2N 4N1

Once again, thanks to everyone for your efforts over the past year. Together, we have made it through a challenging year. I look forward to a bright future.

Phone 403.210.6271 libin@ucalgary.ca libininstitute.org Twitter @LibinInstitute Facebook @LibinInstituteCV

Dr. Paul Fedak

Send comments and enquiries to libin@ ucalgary.ca. Please request permission to reproduce any part of this publication. All rights reserved. © 2021 Libin Cardiovascular Institute.

Director Libin Cardiovascular Institute

About the Libin Cardiovascular Institute The Institute is an entity of Alberta Health Services and the University of Calgary. It is made up of 1,500 members, staff, students and clinical trainees that coordinate cardiovascular research and education, along with delivering world-class cardiac care to a population of more than two million people in Southern Alberta, Saskatchewan and Eastern British Columbia.

Its vision is, “A better model for better care.” Its mission is, “To leverage our unique capacities and establish patient-centered, value-based practices that will improve quality and decrease costs while enhancing patient reported outcomes and access to care.”

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Libin Moves

Libin Cardiovascular Institute kicks off campaign aimed at getting Calgarians more physically active

Food Insecurity — 10 Researcher studying impact of healthy food on patients with diabetes Clinical Trials — 12 Projects focusing on what matters most to cardiovascular patients Looking Ahead — 14 International study shows cardiac MRI useful for predicting future cardiac events

COVID-19 Research

Calgary to Gdansk — 16 Local surgical team spreads knowledge about innovative techniquest to colleagues in Poland.

Alzheimer's Breakthrough

Cardiac ERAS — 20 Initiative focusing on improving process and outcomes for patients after cardiac surgery

Libin scientists working to understand, lessen the impact of novel coronavirus

Research team makes breakthrough discovery with potential to reverse, treat Alzheimer's disease

Better Together .

Multi-discipline team forms collaboration to improve outcomes for complex aortic surgical patients

Mentorship Matters

Libin clinician-scientists recognized for their excellence in the area of mentorship, both formal and informal

Labour of Love

Philanthropist and volunteer Alison Taylor Lobe joins fight against women's cardiovascular disease

About the cover The Libin Cardiovascular Institute seeks to improve cardiovascular health for all Albertans through research, education and clinical care. To this end, the Institute launched Libin Moves, a five-month movement campaign aimed at getting people moving a minimum of 150 minutes per week to improve their heart health. Learn more about the campaign at libin.ucalgary.ca/community/LibinMoves

Students recognized — 24 Doctoral candidates win prestigious Vanier Scholarships for academic excellence Raising the Bar — 26 Dr. Norman Campbell receives national recognition for research career dedicated preventing and treating high blood pressure Dreaming Big — 28 Young girl has eyes set on being cardiac surgeon, gets birthday experience of a lifetime Awards and Accolades — 32 Libin Institute members recognized locally, nationally and internationally

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LIBIN LIFE

Physical activity and cardiovascular health Q&A with Libin Institute experts

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t’s well known that activity is critical to physical and mental health. Despite most people understanding the importance of being physically active, 82 per cent of Canadians struggle to meet the recommended targets for physical activity. Others may not understand how to get started or what types of exercise is best for them.

Why is physical activity important?

Singh – Physical activity can help prevent chronic illnesses and disease, but it doesn’t necessarily mean you have to go to a gym. Even if you have mobility issues, are at the office or quarantined at home, you can get active. For example, do some gardening or cleaning, watch an at-home aerobics video, walk or bike on the local trails or do a short yoga or tai chi session.

By Dawn Smith For these reasons, the Libin Cardiovascular Institute is kicking off Heart Awareness Month with Libin Moves, a five-month lifestyle and movement program starting in February 2021. Libin Moves is about optimizing cardiovascular health by breaking down the barriers and getting people moving at least 150 minutes per week.

Yang – The important thing is to just move more and sit less.

How much should I move?

Singh – According to new Canadian 24-hour movement guidelines, adults should engage in at least 150 minutes of moderate to vigorous* physical activity each week. These guidelines, which

Continue reading for advice from the University of Calgary’s Dr. Shaminder Singh, PhD, RN and postdoctoral researcher whose work focuses on health promotion, and Dr. Lin Yang, PhD, an epidemiologist, research scientist and adjunct assistant professor who works in the field of physical activity for chronic disease prevention and management.

include specific recommendations for sleep, sedentary behaviour and physical activity for all different age groups, are available here: https://csepguidelines.ca/. The guidelines are the first-ever comprehensive recommendations for all age groups that integrate physical activity, sedentary behaviour and sleep. *Moderate exercise means you will be able to hold a conversation while exercising. If you are exercising vigorously, you won’t be able to maintain a conversation.

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What is sedentary behaviour and why is it unhealthy?

Yang – Sedentary means being in a sitting or lying posture and expending little energy.

There is growing evidence that sedentary behaviour, particularly prolonged sitting such as while watching TV or sitting at a computer, is bad for your physical and mental health.

Researchers recommend breaking up sedentary periods (such sitting at your computer or watching television) with periods of activity like doing chores around the house.

How do I overcome the barriers to activity?

Yang – It's not easy for many people, but there are lots of ways to get motivated.

Try setting notifications throughout the day to remind get moving or use a free app to track your steps and activities. Finding a community or friend to engage in physical activity with, or simply be accountable to, can be helpful. You could also try taking an online class or joining a team. Be sure to reward yourself for your successes.

Singh – Consistency is more important than intensity, especially at the beginning.

For example, if you work at a computer all day and sit for long periods, your initial goal could be to get up from the desk every hour to move or stretch for a few minutes.

Consistent small achievements can help you to aim for increasingly complex goals such as running, brisk walking or muscle exercise for 10 minutes on alternative days. Barriers such as lack of time can be discussed with family, colleagues, employers and health care providers like your physician, community health nurse, or health coaches.

balance. With social distancing, homebased comprehensive exercise programs are good choices. For mind-body options, consider activities like tai chi or yoga. It is important to find the exercise program or the type of physical activity that you enjoy doing, so you are more likely to stick to it.

Singh – A program should include a movement-based activity of your choice, ability and availability. It should also include ways to make the process automatic. For example, use an already established habit, such as finishing your morning routine, as a trigger to go for a walk or follow an exercise regime from your favourite YouTube channel.

How do I get started on an exercise program?

Yang – Start with small, sustainable changes that can lead to big gains. For example, those with relatively inactive lifestyles can commit to walking three times a week. Once established, adding strength training, like squats, lifting weights (or even cans from your pantry) and stretching can improve your fitness level. Active individuals are encouraged to main their activity level and invite an inactive friend or family member to take part.

Singh – Knowing you need to move more is the first step.

Making small changes that fit in your day is the easiest way to get started. Involving family and friends can make activities fun. Developing a habit loop for physical activity can reinforce behaviour. This involves a cue, like finishing your morning routine, that triggers a routine, such as a 20-minute brisk walk, and leads to some sort of reward, which can be as simple as feeling good.

New Canadian Guidelines state that adults need a minimum of 150 minutes of moderate to vigorous exercise each week for optimal health.

For more information and to read the guidelines, which also offer information on sedentary behaviour and sleep, visit

csepguidelines.ca Learn more about how the Institute is inspiring people to move to improve their heart health at libin.ucalgary.ca/ community/LibinMoves

What are the components of a good exercise program?

Yang – A thorough program includes activities in the following areas: cardio, strength, flexibility and

#LibinMoves

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LIBIN LIFE

LIBIN MOVES

Move to Improve Weekly 150 for heart health

Adults need a minimum of 150 minutes of moderate to strenuous activity each week.

It all adds up! Start doing a little bit each day for better heart health.

Show us your moves on social media using

#LibinMoves Find out about events and details at

libin.ucalgary.ca/ community/LibinMoves @LibinInstitute

@LibinInstituteAB

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LIBIN LIFE

Tackling COVID-19 Libin Cardiovascular Institute responds to global pandemic

By Allison Chorney

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ibin Cardiovascular Institute clinicians and researchers joined the fight against COVID-19, an important effort given that the virus can have a big impact on the heart.

"What the basic science research has been telling us is that in the severe form of a COVID-19 infection, the endothelium – the inner lining of the blood vessels in our body – become adversely affected," said Dr. Imtiaz Ali, MD, Chief of Cardiac Surgery for Alberta Health Services (AHS).

The result is a higher risk of clotting, says Ali, explaining COVID-19 patients can develop clots in large blood vessels, including the aorta. In severe cases, the virus significantly increases the risk of stroke, heart attack and acute coronary syndrome.

"You have young patients presenting with strokes; young patients with no history of

coronary artery disease or heart disease presenting with acute coronary syndrome and heart attacks; young patients presenting with renal failure – as a result, their kidney vessels are being damaged,” said Ali, noting the severe form of the virus only occurs in a minority of cases.

Ali said the virus can also cause a hyperinflammatory response in these blood vessels. Data indicates this response is related to pre-existing risks like high blood pressure, high cholesterol, history of coronary disease, kidney disease or stroke.

"But other factors, such the blood type that we have, have been implicated in whether or not patients get the severe form of the disease," Ali said, adding genetic factors are likely.

Cardiologist and researcher Dr. Carlos Morillo, MD, who is the Section Chief

of Cardiology for AHS, said many heart patients, fearing the virus, also delayed seeking treatment during the pandemic, which may have had a detrimental impact.

"When you show up later to the hospital with a heart attack, the usual things that we can do – go in, open the artery and restore flow – these things are delayed, so other complications can arise," he said, adding it is important for people to seek treatment if they suspect heart issues.

"We know the rate of people that are infected in the hospital – health-care workers, physicians – we get tested all the time and the rates of infection are very low, lower than in the community,” he said.

“The safest place to be is the hospital."

Story cont. on next page...

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Banding together

By Allison Chorney Researchers within the Libin Institute were amongst the many around the world using science to battle COVID-19. The following three projects are just a sample of the various COVID-19 research projects taken on by investigators within the Libin Cardiovascular Institute. To learn more about COVID-19 research at the University of Calgary, visit: https://research.ucalgary.ca/research/our-impact/ impact-covid-19-research-innovation

Hospital avoidance during the pandemic

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collecting data on patients tested for COVID-19. This research is intended to help emergency department health care providers accurately identify the patients likely to test positive for the virus and those likely to end up in the intensive care unit (ICU) or on a ventilator.

he Libin Institute’s Dr. Andrew McRae, MD, PhD, an emergency physician and researcher, along with medical student Dan Lane, PhD, studied hospital avoidance, including changes in use of emergency departments and EMS, during the first wave of the pandemic.

They found that although emergency room visits dropped by about 30 per cent, EMS calls increased, more patients required admission to hospital and fewer patients followed EMS advice to go to the hospital.

Dr. Andrew McRae, MD PhD

"What we also saw is that the rate of death outside of hospitals tripled during that period," McRae said, noting patients should seek help if they need it.

having a worse outcome because they waited too long to come to hospital.”

"We would much rather see somebody and reassure them that we haven't found anything serious than take the chance on somebody staying home and potentially

McRae is also involved in the Canadian COVID-19 Emergency Department Rapid Response Network – a group of 51 emergency departments systematically

This study will help inform critical operational decisions such as which patients should be sent to the ICU early and which should be kept in isolation to reduce transmission risk while optimizing limited isolation spaces and personal protective equipment.

The data, McRae said, can also be paired with that from other studies looking at diagnostic tests and treatments for COVID-19 to provide a richer and more personalized look at how to best treat and test patients.

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Mental wellness needs for immigrant workers

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the wellness issues?'" he said, noting this includes both physical and mental health.

hile others are looking at physical outcomes of COVID-19, Dr. Turin Tanvir Chowdhury, MBBS PhD, is focusing on finding culturally-sensitive and innovative ways of supporting the mental-health needs of immigrants who are working during the pandemic.

Phase one of the project involves summarizing studies on what happened during previous epidemics such as Ebola, H1N1, SARS and MERS. In phase two, the team will engage with these communities to learn newcomers’ thoughts about mental wellbeing during the pandemic and if or how they have accessed available mental-wellness services.

He said newcomers working at facilities like Walmart, Cargill or other essential services that remain open during lockdowns face a "chaotic scenario," that takes a toll on them. It’s a unique area of research.

"Normally mental wellness is not a very recognized thing in newcomer communities. There's a huge stigma and a non-acceptance to talk about this issue," Chowdhury said.

five years working to build relationships within these communities.

Chowdhury's approach would have been limited had his team not spent the last

"This relationship-building made it easier to convince them, 'Why don't we look at

Dr. Turin Chowdhury, PhD

"We will be going into the community and talking, engaging, and then measuring the mental-health issues or resilience issues," Chowdhury said.

"That's the direct measurement part that will give us this idea about what can we do to improve things.”

Impact of positioning on critically ill patients

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espiratory specialist and researcher Dr. Jason Weatherald, MD, and his co-principal investigator Dr. Ken Parhar, section chief of Cardiac Critical Care, are investigating the impact of prone positioning (lying down facing downwards) in COVID-19 patients through the CORONA and COVI-PRONE studies, which are occurring in partnership with McMaster University.

The intervention places COVID patients suffering from acute respiratory distress syndrome (ARDS) on their stomach for 12 to 16 hours a day to improve oxygen consumption from the lungs.

This position also takes the weight of the heart off the left lung, improves oxygen transfer to the blood and helps secretion and mucus drainage in the lungs. Prone positioning is currently used in intensive care units on critically ill, intubated patients who are sedated in

The CORONA and COVI-PRONE studies are looking to answer this, whether the positioning has benefits other than increasing oxygen levels, if it makes a difference in patient outcomes and the amount of time required in prone for it to be beneficial.

The overall study includes two trials.

COVI-PRONE is investigating if prone positioning can prevent intubation and CORONA is investigating if the positioning helps patients who don’t want to be intubated survive.

Dr. Jason Weatherald, MD order to tolerate the extended period on their stomach. Clinical trials have found it benefits this specific group, but the question remains if non-intubated patients will experience similar results.

"They're looking at two very different groups of people who are at risk of different outcomes," Weatherald said.

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ALZHEIMER'S BREAKTHROUGH

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LIBIN LIFE

Libin lab identifies way to interrupt, prevent progression of devastating condition

By Dawn Smith

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research team at the University of Calgary’s Cumming School of Medicine (CSM) led by Dr. S.R. Wayne Chen, PhD, has made an exciting breakthrough with the potential to prevent and reverse the effects of Alzheimer’s disease.

The team discovered that limiting the open time of a channel called the ryanodine receptor, which acts like a gateway to cells located in the heart and brain, reverses and prevents progression of Alzheimer’s disease in animal models.

They also identified a drug that interrupts the disease process.

The effect of giving the drug to animal models was remarkable: After one month of treatment, the memory loss and cognitive impairments in these models disappeared.

“The significance of identifying a clinically used drug that acts on a defined target to provide anti-Alzheimer’s disease benefits can’t be overstated,” says Chen, a member of the Libin Cardiovascular Institute and the Hotchkiss Brain Institute at the CSM. Dr. Jinjing Yao, PhD, a student of Chen, is the first author of the study.

The results of this groundbreaking study were recently published in the peerreviewed journal, Cell Reports. This work is potentially highly impactful as more than half a million Canadians live with Alzheimer’s disease and other dementias, suffering memory loss and other cognitive impairments with a negative impact on quality of life.

The science behind the findings Previous research has shown that the progression of Alzheimer’s disease is driven by a vicious cycle of the protein amyloid β (Aβ) inducing hyperactivity at the neuron level.

Dr. S.R. Wayne Chen, PhD, in his lab at the Univerity of Calgary's Cumming School of Medicine.

However, the mechanism behind this wasn’t fully understood nor were there effective treatments to stop the cycle.

Chen’s team used a portion of an existing drug used for heart patients, carvedilol, to treat mice models with Alzheimer’s symptoms. After a month of treatment, researchers tested animal models with very promising results.

“We treated them for a month and the effect was quite amazing,” says Chen, explaining the drug was successful in reversing major symptoms of Alzheimer’s disease. “We couldn’t tell the drugtreated disease models and the healthy models apart.”

Chen, a Clarivate Highly Cited Researcher, is optimistic about the future of this research;

however, there are many steps to be taken before this finding would lead to a clinical trial.

If you are interested in finding out about clinical trials that are underway related to Alzheimer’s you can go to Participate in Research on the University of Calgary website (https://www.ucalgary.ca/ research/participate/). There you’ll find a number of studies looking for participants including control subjects, people not living with a specific condition.

Wayne Chen is a professor in the Department of Physiology and Pharmacology, Biochemistry and Molecular Biology at the CSM.

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Understanding the impacts of food insecurity

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Study to offer interventions that make healthy foods more accessible to Albertans with diabetes

“Food insecurity can be life-threatening for people with Type 2 diabetes because they need to eat healthy foods to control their blood sugars,” says Olstad. “If they can’t afford those foods, they will require more health-care interventions.”

These interventions can be costly. Type 2 diabetes costs the Alberta health care system $2.7 billion per year. Olstad says ensuring individuals with Type 2 diabetes can obtain healthy food will improve their health and may save the Alberta health care system up to $25 million per year.

his astute statement, made more than 2,000 years ago by the founder of modern medicine, has been proven through research. We now know that healthy eating can help prevent and treat chronic diseases, such as heart disease and diabetes.

She and fellow UCalgary researchers Dr. David Campbell, MD, PhD, a diabetes specialist and researcher, Dr. Eldon Spackman, PhD, a health economist, and Dr. Reed Beall, PhD, a population health researcher, are teaming up to make a difference for food insecure Albertans. The researchers recently received grants from Alberta Health Services, Alberta Innovates and Alberta Blue Cross for a study that will examine whether a subsidized healthy food prescription program can improve glycemic control and reduce health care costs for this patient group.

But for some Canadians, there can be financial barriers to accessing the recommended amount of healthy food, putting them at higher risk of these deadly diseases. UCalgary researcher and dietitian Dr. Dana Olstad, PhD, says food insecurity is one of the biggest barriers to good health.

The study will involve 400 participants with Type 2 diabetes from several rural and urban communities in Alberta who are also food insecure. Participants will receive information about healthy eating, (a healthy food prescription), and half will also receive a subsidy of $45 per month for

By Dawn Smith "Let food be thy medicine and medicine be thy food." — Hippocrates

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“Healthy foods, like fruit and vegetables, often cost more than less healthy choices.

So families who are food insecure often end up having really poor diets,” says Olstad, an assistant professor in the Department of Community Health Sciences at the Cumming School of Medicine (CSM) and a member of the Libin Cardiovascular Institute and the O’Brien Institute for Public Health.

According to Household Food Insecurity in Canada 2017-2018, a report published at the University of Toronto, almost 13 per cent of Canadian households experience food insecurity each year, making healthy diets out of reach for 4.4 million Canadians.

Some groups, such as patients with Type 2 diabetes, are at particular risk when they have a poor diet.

each household member for six months.

They will be able to choose and purchase healthy foods at supermarkets. Previous research has shown subsidies as small as $3.65 per month can significantly improve diet quality and improve blood sugar levels and other measures of health.

Researchers will monitor patients, measuring their blood sugar levels, blood pressure and other clinical results, to study the impact of the program on short and longer-term health and health-care costs.

“Normally we wait for people to get sick and treat them in the health care system, but we want to eliminate food insecurity in the first place,” says Olstad. “This is a small amount of money to invest to stop people from needing to access healthcare services.”

Olstad is excited about the study, noting it is the first of its kind in Canada. It requires numerous partnerships, including with local supermarkets and primary health clinics, who will help identify those eligible for participation in study.

“The subsidized healthy food prescription program will mobilize and unite multiple sectors to improve the health of the participants, bridging primary care, population health, social services and industry,” says Olstad.

“The benefits will extend to all household members, including children.”

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Practical science Clinical trials inform care while addressing what matters to patients

By Dawn Smith

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andomized clinical trials are widely considered the most robust form of evidence when it comes to medical research. The ultimate goal is designing trials that advance science and address issues important to patients. It requires clinicians and scientists to include patient advisers in the process.

Researchers within the Libin Cardiovascular Institute at the University of Calgary’s Cumming School of Medicine (CSM) received a $3 million grant from the Canadian Institutes for Health Research (CIHR) to conduct three innovative, patientoriented trials — science that can inform

health care and medical practices while addressing issues that matter to people living with chronic illness. These trials use clinical registries, existing surveys and electronic health record systems to recruit patients and collect data more efficiently than traditional randomized trials.

“We worked with patients to identify research projects that are practical and address the concerns they have about improving their quality of life and interactions with the health-care system,” says Dr. Matthew James, MD, PhD, a kidney doctor, associate professor at the CSM and one of the lead researchers.

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“Our findings will be relevant to patients and the health-care community.”

Over the next four years, the team plans to test health innovations and interventions that aim to improve care, safety and outcomes for people with three common and closely related chronic diseases: heart disease, diabetes and kidney disease.

These studies will focus on: the way patients' symptoms and experiences are recorded, communicated and acted upon during doctors’ visits, and whether these changes improve patient outcomes and experiences; the impact of using electronic health record systems on patients’ experiences and outcomes in various settings across Alberta; and, strategies using pharmacists to improve safety in using common medications during times of illness.

Winnie Pearson has been a cardiac patient for 30 years and is a trained patientresearcher and patient-adviser within the province’s Strategic Clinical Networks and the Libin Institute.

She believes patients like herself can help researchers and physicians improve Alberta’s health-care system.

“Involving patients in choosing what to research and how to research means we learn how to correct mistakes and do things better than we did before,” she says.

At age 73, Pearson registered at UCalgary to gain the education required to help design scientific studies. She says being involved in this work has been rewarding, especially in recent years, when patientoriented research has taken off.

Investigator Dr. Matthew James, MD, PhD, left, and patient-researcher Winnie Pearson.

“I am very, very pleased and honoured that I am able to be part of this research,” she says.

The researchers are part of the Interdisciplinary Chronic Disease Collaboration, a multi-discipline, multisite team made up of health-care leaders, researchers, patients and care providers who have united to address key challenges in chronic disease care.

Matthew James is an associate professor in the departments of Medicine and Community Health Sciences. He is also a member of the O’Brien Institute of Public Health.

“Our findings will be relevant to patients and the health-care community.”

— Dr. Matthew James, MD, PhD

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Dr. James White leads study showing magnetic resonance imaging useful for predicting major cardiac events

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Looking ahead

By Dawn Smith

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eart failure impacts between three to four per cent of the general population. While commonly related to heart attacks it can also be due to a condition called dilated cardiomyopathy (DCM), a disease characterized by an enlarged and weak heart muscle that can’t efficiently pump blood.

An international, multi-centre study led

by Dr. James White, MD, a clinician and researcher at the University of Calgary’s Cumming School of Medicine (CSM), has revealed magnetic resonance imaging (MRI) can be used to predict major cardiac events for people diagnosed with DCM. White’s study, published in Circulation Cardiovascular Imaging, confirms about 40 per cent of patients with DCM have scarring patterns on their heart muscle which can be seen with MRI. These patterns are associated with higher risk of future heart failure admissions, lifethreatening heart rhythms and death.

The study, which was the largest ever conducted using MRI in patients with DCM, also shows that cardiac MRI can play an important role in guiding the care of individual patients with heart failure, an approach called personalized medicine.

The results of this study could lead to trials looking at how patients at higher risk may benefit from more intensive treatments.

White says that treating patients with DCM is challenging because there is a lack of understanding into what causes the disease and why patients respond differently to the available treatments.

“We have tended to think of dilated cardiomyopathy as one type of heart disease and that all patients should respond the same way, but we are learning that it is a collection of disease states that affect each patient differently,” says White, explaining those that don’t respond well to treatments are more prone to cardiac arrest, which kills about 35,000 Canadians annually.

"The purpose of our study was to see if we could find individual patient features that can help us prescribe life-saving therapies, such as the ICD (implantable cardioverter defibrillator)."

White and his team assembled the MINICOR (Multimodal International Cardiovascular Outcomes Registry) group, which involves 12 centres from Canada, the United States, Spain and Italy, to provide researchers access to highly standardized data collected from patients around the world with the goal of promoting personalized care for patients with cardiovascular disease.

“We can have a much greater impact on patient care and on clinical practice in

general when we work together,” says White. “The true benefit of initiatives like this is our ability to test innovative ideas quickly and show they can work in different health-care systems and patient populations. This is the unique power of multi-national collaborations.”

White and his team of data scientists and students are currently tracking the health of more than 10,000 Albertans who have undergone cardiac MRI. With this data they are developing new approaches to deliver personalized risk prediction models for patients with cardiovascular disease.

Libin Institute director Dr. Paul Fedak, MD, PhD, is excited about the potential of this project and its alignment with the institute’s aim to lead in the area of “precision” cardiovascular medicine.

“These are important steps towards personalizing care decisions for individual patients,” says Fedak. “We are constantly being reminded that the more we know about each patient and their own disease, the better we can make decisions to improve their health.”

James White is a professor in the departments of Cardiac Sciences, Radiology and Medicine and a member of the Libin Cardiovascular Institute at the Cumming School of Medicine.

"The purpose of our study was to see if we could find individual patient features that can help us prescribe life-saving therapies."

— Dr. James White, MD, PhD

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By Dawn Smith

From Calgary to Gdańsk Team teaches innovative heart surgery techniques in Poland

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haring knowledge is often a key part of the medical profession, especially in an academic environment. But a surgical team from the Libin Cardiovascular Institute recently went above and beyond in their commitment to improving outcomes for patients.

Last November, cardiac surgeon Dr. William Kent, MD, and a team of Calgary-based physicians visited Gdańsk, Poland to teach advanced cardiac surgical techniques.

They focused on teaching a minimally invasive approach for aortic valve replacement. Kent has been performing these operations since 2016, and believes they are superior to conventional open heart surgery for many patients. Although experience to date is limited, studies

suggest that patients are released from the hospital sooner, have less pain and fewer complications with this surgical approach.

This includes a videoscope, which projects an image of the valve on a monitor in the operating room.

“It’s a real benefit for recovery,” says Kent, a clinical assistant professor in the Department of Cardiac Sciences at the Cumming School of Medicine, noting patients can be more active earlier, with no restrictions on their mobility when they are discharged from the hospital.

Calgary connection in Gdańsk

Minimally invasive valve operations are performed through a five-centimetre incision between the ribs that gives surgeons access to the patient’s heart.

Specialized instruments, designed to allow surgeons to perform their work in a confined space, are used to perform complex valve repair or replacement.

Kent performed several aortic valve replacement operations at the Medical University of Gdańsk, alongside Polish cardiac surgeon and transplant specialist, Dr. Wojtek Karolak, MD, PhD. Karolak trained at several institutions in the United States and Canada and spends a few weeks every year in Calgary working with the Libin Institute’s surgeons in the operating room.

His connections prompted Karolak to invite the Calgary team to teach the minimally invasive techniques in Gdańsk, where

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The Libin Institute cardiac surgery team, headed by William Kent, prepares to perform a surgery in a hospital in Gdansk, Poland. The team visited the city to teach new surgical techniques. Photo courtesy Dr. William Kent.

the surgical team performs about 1,200 operations each year, including lung and heart transplants.

“The visit was a huge help,” says Karolak.

“It impacted every aspect of our program here, brought many changes and everyone met and loved meeting each other. I am personally very thankful. I know each person who came sacrificed their personal and professional time, and this is something I will be thankful for always.”

Kent says he is pleased with the outcome of the surgeries and notes his Polish counterparts are well on their way to implementing the new procedures on their own.

Kent and Dr. Andrew Maitland, MD, created Calgary’s minimally invasive program.

Although most bypass operations and complex surgeries still require conventional open-heart surgery, Kent says half of the cases he performs are now completed using minimally invasive techniques.

Procedure a success The Calgary program has been a great success, so much so that Kent has been invited to teach the procedure at numerous other sites in Canada.

Eager to show the impact of the technique, Kent is conducting a study to compare conventional open-heart valve surgery with minimally invasive techniques. The study will assess standard outcome measures, such as complications and valve function, as well as other previously unevaluated

qualitative outcomes, like patient-reported pain levels, mobility, respiratory function, quality of life and the length of time it takes patients to return to work.

He is hoping to have early results of this trial in the next year or so.

As for the Polish-Canadian connection, Karolak is hoping to facilitate a long-term relationship between the two centres, with the potential for more educational trips to other countries that need the support.

Other members of the team that travelled to Poland include intensivist Dr. Ken Parhar, MD; anaesthesiologist Dr. Duc Ha, MD; and perfusionist Dr. Steve Menzies, MD.

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Members of the Calgary Aortic Program, (back left to right) Dr. Scott McClure, MD, Dr. Eric Herget, MD, Dr. Kenton Rommens, MD, (front left to right) Dr. Randy Moore, MD, and Dr. Michelle Keir, MD, pose for a composite photo, created from single shots. The new program brings together multiple disciplines to improve outcomes for complex aortic surgery patients in Calgary and area. Photo composite created by Britton Ledingham.

LIBIN LIFE

Better together

By Dawn Smith

T

he Libin Cardiovascular Institute’s world-class cardiac surgery program is getting a boost thanks to a new multi-discipline collaboration created to improve patient outcomes.

Four groups—cardiac surgeons, cardiologists, interventional radiologists and vascular surgeons —have joined forces in the past eight months to form the Calgary Aortic Program, coming together both inside and outside of the operating room. Co-led by cardiac surgeon Dr. Scott McClure, MD, the program, which involves a new clinic, the Calgary Complex Aortic Clinic, based out of the South Health Campus, is an exciting first in Calgary.

“There are many patients that are far better treated if we all get together,” says McClure, estimating about 50 patients annually will benefit from the combined knowledge of the experts.

“Some treatment considerations are best approached in a collaborative manner.”

The aorta is the main artery in the body that carries blood away from the heart to the rest of the body. It is made of three parts: the ascending aorta, the aortic arch and the descending aorta, which can be divided into the thoracic and abdominal aorta, providing blood from the upper body down to the pelvis and eventually to the legs.

Surgeries on the ascending aorta, aortic arch and descending aorta within the chest are generally handled by cardiac surgeons whereas surgeries on the abdominal aorta are handled by vascular surgeons.

However, some problems, such as aortic dissections, thoracoabdominal aneurysms and complex aortic arch repairs, are in a grey zone, with discussion needed to determine which surgeon or surgeons—and which methods—would optimize outcomes for these patients.

Beyond surgery there are also options to consider where patients can be treated less invasively with insertion of a stent into their aorta through the groin. Interventional radiologists, vascular surgeons and cardiac surgeons all have the skills to do these less invasive (endovascular) procedures, but each discipline often has a slightly varied perspective to the problem based on their background training.

McClure explains bringing the teams together can ensure the best treatment strategy is pursued to benefit the patient, adding the group also hopes to launch research and training components in the future.

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Multi-disciplinary team collaborates to benefit aortic surgery patients

Optimizing medical therapies for patients with aortic disease is another major piece to the puzzle. These patients often require treatment for many years before any surgical or endovascular intervention and for their entire life following the intervention. Cardiologists have a major role to play in this aspect of the patients's care.

Led by McClure, vascular surgeon Dr. Randy Moore, MD, interventional radiologist Dr. Eric Herget, MD, and cardiologist Dr. Michelle Keir, MD, the program is off to a great start.

Herget, whose skills are in using radiology tools like imaging and ultrasound to perform minimally invasive endovascular procedures, has been supportive of a collaboration for years.

“Aortic disease includes abdominal and thoracic work, so there is a crossover in expertise,” he says. “Having all of the disciplines involved is very positive, because it ensures we have all of the anatomical areas covered.”

Vascular surgeon Dr. Kenton Rommens, whose expertise lies in complex aortic repair and advanced thoracic surgery, explains that the best centres in the world have collaborative programs, adding the group will also have access to cutting-edge techniques and devices.

“I think it is an important step for the treatment of these patients,” he says. “Our goal is to turn Calgary into a referral site known for being world leaders in our approach.”

Keir says long-term, multidisciplinary care has never been more important as Calgary cardiologists are meeting an increasing number of impacted families thanks to advancements in genetic testing and imaging. She says having the opportunity to ask questions and discuss cases in real time with her colleagues as part of the Calgary Aortic Program will help her treat patients more efficiently and effectively.

“This collaboration between specialties is really exciting,” says Keir.

“It’s a win for the patients. It’s also a win for clinicians as it will act as a springboard for research and quality improvement.”

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LIBIN LIFE

Enhancing recovery

Initiative seeks to improve experience for cardiac surgery patients

By Dawn Smith

T

he world-class cardiac surgical program within the Libin Cardiovascular doesn’t just happen.

It’s the result of a commitment to innovation and a willingness to question accepted practice by the entire care team.

Now that commitment is being formalized with a new Cardiac ERAS® (Enhanced Recovery After Surgery) program recently initiated within the Institute, which is amongst the first of its kind in Canada.

Led by a team of researcher-clinicians within the Institute, the project aims to improve the experience and shorten recovery time for cardiac surgery patients in Calgary by questioning all aspects of care and making small improvements that can add up to big gains.

Dr. Alex Gregory, MD, is a lead of the program and says the multi-phased project brings together everyone involved in the patient experience, from pre- to postsurgery care.

“It is a whole team approach and a great platform to get people who don’t always talk, talking,” he said. “Everyone has a say

in how we can improve things. It elevates every single person that participates in patient care to the same level.”

“To my knowledge, we are one of the first in Canada to undertake a formal cardiac ERAS program,” says Gregory.

ERAS isn’t a new concept. It began in Europe in the early 2000s when a group of general surgeons got together and asked the question, “why are we doing what we are doing?”

The Libin team completed Phase I of its ERAS program in the fall of 2020 and began gathering data to publish its findings.

What they realized is that some of their activities within the surgical room and in after-care were based on tradition, rather than evidence. They began making small changes, such as allowing patients to eat before surgeries and treating pain differently, that ultimately resulted in a better experience for patients, as well as reduced complications and costs.

Since then, ERAS initiatives—and guidelines— have become popular globally in many areas of surgical practice.

Cardiac surgical programs have recently begun to embrace the ERAS approach.

There have been several recent publications on the impact of implementing a cardiac ERAS program, although none from Canada – until now.

They looked at things like if patients were being extubated within a standard length of time, that they had good pain control following their surgery, and whether they were able to return home sooner.

The team created a web-based app that provided a checklist for providing patient care post-surgery. The app, used by staff in the Cardiovascular Intensive Care Unit (CVICU) at the Foothills Medical Centre, allowed researchers to keep track of what was happening in the unit.

Using this software, the team measured 200 data points in 185 patients—ranging from opioid use, to length of stay, to patient-reported pain levels—to allow them to assess whether their evidencebased protocols were occurring for each patient, and, if not, why. It was all done to improve overall patient experience.

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LIBIN LIFE

Barbara Jones, RN, Karen Wiens, RN, Dr. Alex Gregory, MD, and Chris Coltman, RN pose for a photo at Calgary's Foothills Medical Centre.

They are involved in the Cardiac ERAS® (Enhanced Recovery After Surgery) program recently initiated within the Libin Cardiovascular Institute, which seeks to improve the experience of cardiac surgery patients.

“We wanted to know if something wasn’t being done, was there a reason for it?” says Gregory, noting the software also acted as a prompt, helping the care team think through why they were doing what they were doing.

“It will be a way for us to adopt the latest and greatest innovations to improve care… that is exciting for me,” says Coltman, noting the potential benefits for patients include a decreased length of stay in hospital and fewer complications.

According to Kari France, unit manager of the CVICU, many of the protocols—such as early mobilization of patients post surgery—were already in place.

Now that phase one is complete, the team is looking forward to phase two of the initiative, which will assess a broader range of interventions including changes in the intensive care unit and standardizing pre-habilitation for patients, which involves getting patients as healthy as possible through improving their nutrition, exercise regime and mental health.

“We are at the forefront of science-based care, and we were already doing a number of things on the cardiac ERAS protocol,” she says, noting the biggest change was using having nursing staff use the software to track care.

That said, both France and CVICU nurse educator Chris Coltman are in favour of the ERAS initiative.

Phase two will also look at the barriers to patient compliance.

It’s exciting for Gregory, who believes Calgary is a leader in this area.

“Calgary is an ideal centre to design and implement these types of quality improvement initiatives," he says. "We are nimble, patient-based and we don’t put up barriers when it comes to doing what is right for patients.”

"We are nimble, patient-based and we don’t put up barriers when it comes to doing what is right for patients.”

— Dr. Alex Gregory, MD

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LIBIN LIFE

Mentorship “Dr. Ahmed has the unique ability to push her students to go beyond their limits while remaining encouraging and supportive,” she says.

By Dawn Smith

T

Besides supervising her own trainees, Ahmed serves on the Nephrology Residency Training Committee at the University of Calgary, is the Education Chair for the international Organization for the Study of Sex Differences, is a member of several graduate student committees, and has served as a doctoral external examiner.

he Libin Cardiovascular Institute has a nationally recognized education program.

Libin members work with students of all levels from undergraduate to residents and postdoctoral fellows, training the next generation of cardiovascular researchers, specialist physicians and surgeons. This training runs the gamut from bench science to advanced clinical training.

Mentorship is a critical component of the Libin’s education offering, says the Libin Education Director Dr. Jennifer Thompson, PhD. This mentorship is largely informal, occurring between supervisors and their trainees or between students of different levels.

“Effective mentorship is a critical component of the organizational culture of a successful research institute,” says Thompson. “A supportive mentor-mentee relationship has a positive impact on academic and career outcomes and helps to buffer the stress that comes with all the rigours of graduate or postdoctoral studies.”

But the need for mentorship doesn’t stop at graduation. Thompson say it continues to be important at the faculty level. Read on for a sneak peek into the lives of two Libin members who were recognized for their mentorship at the national and international level in 2020.

DR. SOFIA AHMED, MD

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hmed, a kidney specialist and researcher, received a Distinguished Mentor Award from the American Society of Nephrology (ASN) in the fall of 2020. Receiving the international award is an honour for the mid-career researcher, but not a surprise for those who work with the inspiring and passionate leader.

Ahmed’s acumen for mentorship is evident through the many successes of her students.

She has trained numerous award-winning students, including her current PhD student, Cindy Kalenga, who received a UCalgary-wide 2020 Women’s Resource Centre Distinguished Graduate Student Award for her work examining the associations between estrogen use and blood pressure.

Kalenga attributes much of her success to Ahmed’s ability to bring out the best in her trainees.

She is also the former education director of the Libin Cardiovascular Institute, and is currently the lead of the Institute’s Women’s Cardiovascular Research initiative, CV&Me. Her hard work and dedication to her students has been noticed. Ahmed has received numerous accolades for her supervision, including the CSM Faculty of Medicine Award for Mentorship (2018). She explains that she learned the importance of mentorship during her own studies and is grateful for all her supervisors.

For Ahmed, mentorship doesn’t end—or begin—when one receives their degree.

Instead, it’s a way of life.

“I have learned so much from my wonderful colleagues at all stages of their careers,” she says.

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LIBIN LIFE

Matters As a mentor, Sheldon has connected individuals with resources, helped them solve problems in both their studies and personal life and provided advice on career direction and work-life balance.

Formally, Sheldon has been a mentor for two decades.

But his mentorship has also been informal – taking the form of encouraging relationships between colleagues. He has also been on the receiving end of informal mentoring.

DR. ROBERT SHELDON, MD, PHD

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heldon is a cardiologist and researcher with numerous accolades, including a Canadian Cardiovascular Society Annual Achievement Award (2016) and an Arrhythmia Alliance Lifetime Achievement Award (2018).

Most recently, Sheldon received the 2020 Region 1 Mentor of the Year Award from the Royal College.

It is no surprise that the nomination came from several colleagues and trainees, individuals who have been mentored, both informally and formally, by the Cumming School of Medicine professor.

Sheldon is humbled by the recognition and quick to point out mentorship is a privilege.

“Mentoring is really fulfilling,” he says.

“You get to see people thrive and grow.”

“It’s all about relationships,” he said, noting that having a small network of peer mentors has been critical in his success.

“Mentors must be invested in their mentees’ lives and be comfortable talking about anything. You have to be able to get into their soul a bit, to help them sort out their issues.”

Sheldon says he learned a great deal from his own mentor, Dr. Henry Duff, MD, who helped Sheldon establish his molecular pharmacology research program in 1982 when Sheldon was still a medical resident.

faculty before returning to Calgary. It was in Calgary that he established a world-class research program.

Raj values the mentorship relationship and friendship he has with Sheldon, explaining he still goes to his mentor for advice on his career, work-life balance and research.

“We often think of the role of mentor as needed by someone when they are first starting out, but the truth is, even to this day, I view Bob [Sheldon] as a mentor, a collaborator and a friend, and I still go back to him and ask advice,” says Raj. For Raj, the key to a great mentor is someone who feels genuinely happy when their mentee is successful – a characteristic he sees in Sheldon.

“I think Bob [Sheldon] is motivated by the success of others,” he says. “He is invested in my research and I trust his advice.”

“We are still close,” says Sheldon of Duff.

“He is always there, and that is all you can ask for in a mentor.”

Libin Institute cardiologist and researcher Dr. Satish Raj, MD, met Sheldon when Raj came to Calgary as a cardiac electrophysiology fellow in 1999. The two have had a mentor-mentee relationship ever since.

Raj credits Sheldon for being instrumental in his decision to continue his research training at Vanderbilt University in Nashville, Tennessee, where Raj was on

"It's all about relationships."

— Dr. Robert Sheldon, MD, PhD

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LIBIN LIFE

Libin trainees receive

National recognition

By Dawn Smith

Perseverance key to Vanier scholar’s success

K

program before starting medical school. Her research focuses on the multi-dimensional impact of Postural Tachycardia Syndrome (POTS), an underrecognized autonomic nervous system disorder that predominantly affects young girls and women.

ate Bourne, a PhD candidate at UCalgary’s Cumming School of Medicine (CSM) under the mentorship of Dr. Satish Raj, MD, a clinician-researcher within the Libin Cardiovascular Institute, knows perseverance is an important key to success.

And as a recipient of a prestigious 2020 Vanier Scholarship, there is no doubt that Bourne, 30, is a highly successful scholar.

In fact, winning the scholarship places her amongst Canada’s elite graduate scholars.

“POTS can really affect the trajectory of a young woman’s life,” says Bourne, explaining the most common age of onset for POTS is 14. “That is why it is critical that we learn more about what causes the disorder and learn to better diagnose and treat it.”

But Bourne’s academic future wasn’t always so certain.

When she was just 12 years old, Bourne began feeling tired and unwell. Her symptoms worsened over the next few years to the point that, in Grade 10, she had to drop out of school. She was able to catch up the following year, doing both grades 10 and 11 in a single year, but again had to take a year off before completing Grade 12.

Bourne didn’t give up. She began her undergraduate degree in microbiology at the University of Victoria, in her hometown. But her illness made studying difficult, and it took her eight years to complete her degree.

During this time, 12 years after the start of her symptoms, Bourne was diagnosed with an autonomic nervous system disorder.

The diagnosis was a turning point, as she received treatment and was better able to manage her condition.

Kate Bourne Bourne’s illness has a silver lining. In fact, it was her condition and the frustration of an extremely delayed diagnosis that solidified her lifelong ambition of becoming a physician.

“My personal experience played a defining role in my desire to become a physician,” says Bourne, explaining she hopes to specialize in cardiology and continue her research with a focus on the unique issues women face when it comes to their cardiovascular health.

Bourne was recently accepted into the Leaders in Medicine program at the CSM. This program allows her to complete her PhD studies in the Faculty of Medicine’s Cardiovascular and Respiratory Science

One of the things Bourne found exciting about receiving the Vanier Scholarship is that the reviewers saw the importance of her research. She believes studying POTS will have a huge impact.

Raj agrees and is proud of his student's work.

“Kate has been a wonderful student and scholar,” he says. “In the setting of the health challenges that she has had, her accomplishments – both within academia and outside of academia – have been outstanding. These are a reflection of her perseverance and strength of character.”

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LIBIN LIFE

Hard work earns student country's top scholarship

D

r. Ali Fatehi Hassanabad, MD, received a prestigious Canadian Institutes of Health Research Vanier Canada Graduate Scholarship in 2020, placing him amongst an elite group of doctoral students with leadership skills and a high standard of scholarly achievement.

While the academic success of Fatehi Hassanabad, a cardiac surgical resident and PhD student under the mentorship of Dr. Paul Fedak, MD, PhD, is inspiring, his humble nature and genuine kindness is perhaps more so.

He is quick to credit his mentors, and the entire surgical program within the Libin Institute, in his successful application for the Vanier.

“The cardiac surgery training program is a phenomenal program that offers everything a trainee can expect,” says Fatehi Hassanabad. “The staff mentor me, and I am very appreciative of that. Without that support system, I would not have received this scholarship.”

With several degrees under his belt, including a masters in cellular and molecular oncology and a medical degree, Fatehi Hassanabad is hugely committed to his education. He is in both the Libin Institute’s cardiac surgery program and pursuing his research-based PhD in cardiovascular medicine.

He cites the work ethic of his parents— both academics—as his inspiration, noting he was taught that if he works hard, everything will fall into place.

“No matter how far I go, I am never going to forget that it is the support around me and hard work that brings me success,” says Fatehi Hassanabad.

Dr. Ali Fathei-Hassanabad, MD, (left) with cardiac surgeon, Dr. William Kent, MD. Fatehi-Hassanabad’s parents worked in several different places around the world, exposing their children to different cultures. Fatehi Hassanabad was born in Iran, but also lived in Scotland and France before emmigrating to Prince Edward Island (PEI) while still a high school student.

He received his undergraduate degree in mathematics and physics in PEI and was awarded a Natural Sciences and Engineering Council (NSERC) scholarship.

He then decided to tackle a new field and began his masters degree in Toronto. His strong work ethic came into play during this transition.

The scholar’s love of research emerged at a young age.

“Going from math to basic science was a huge learning curve,” says Fatehi Hassanabad, explaining he had no real knowledge about how to work in a lab before he began his masters program.

“My mom is an MD, PhD whose research involved cardiac physiology in rodents,” explains Fatehi Hassanabad. “When I was 12, I would visit her lab after school, and I was totally inspired.”

But he met the challenge and went on to earn more scholarships for his high academic standing. Following the completion of his masters, Fatehi Hassanabad started medical school at the

University of Toronto. It was during this time he worked with cardiac surgeons within the thoracic surgery group at the Toronto General Hospital. Those experiences ignited his desire to pursue cardiac surgery.

Fatehi-Hassanabad was accepted into the University of Calgary cardiac surgery program in 2016. Two years in, he decided he wanted to be a surgeon-scientist and began pursuing his PhD. His long-term goal is to pursue subspecialty fellowship and the Vanier Scholarship will help him reach his goals.

“This award means a lot to me. I am incredibly humbled and honoured to be a Vanier Scholar,” he says. “There is an immense amount of value in that, and I’m very grateful for it.”

By Dawn Smith

Raising the bar

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LIBIN LIFE

Researcher receives national recognition for career focused on reducing high blood pressure

By Dawn Smith

D

r. Norm Campbell, MD, professor emeritus from the University of Calgary’s Cumming School of Medicine (CSM), has spent 35 years working to improve the cardiovascular health of local patients in his clinical practice.

But that isn’t the only impact Campbell has had. Thanks to his population-based research, advocacy and contribution to policy creation in hypertension, the Libin Cardiovascular Institute member’s impact has reached national and international levels.

Campbell’s lifetime of achievement and dedication has been noticed.

He recently received a Senior Investigator Award from Hypertension Canada. Given to just one individual each year, the award recognizes significant contributions to the advancement and extension of knowledge in research related to hypertension or high blood pressure.

It’s quite an achievement for Campbell, who has been a member of Hypertension Canada since his days as a medical resident in 1982.

“I am very honoured to receive this award,” says Campbell. “This is an organization I have been involved with throughout my research career, which was focused on preventing and treating hypertension.

Dr. Paul Fedak, MD, PhD, director of the Libin Cardiovascular Institute at the CSM, says Campbell is deserving of the honour, given his lifetime of achievement.

“Dr. Campbell has been a strong advocate for a healthier population throughout

his career,” says Fedak. “His impact is widely acknowledged, and this award is evidence of that. Speaking on behalf of the Libin Cardiovascular Institute, we couldn’t be more pleased that Dr. Campbell is being recognized.”

“A lot of that was working with primary care,” says Campbell, adding leaders in the field worked with primary care doctors and their patients to raise awareness about the need for blood pressure screening diagnosis and control.

When he began his career, hypertension was a huge issue in Canada. In fact, only 13 per cent of Canadians had their high blood pressure under control and the majority of people were unaware of their condition and/or not effectively treated.

In the last decade, Campbell has retired from his clinical practice, but remains involved in research and policy creation nationally and internationally. His work, mostly volunteer, with the World Health Organization, World Hypertension League—of which he is past president— Pan-American Health Organization and Resolve to Save Lives takes him around the globe consulting on policies.

Those low numbers motivated Campbell to look for ways to make a difference in controlling hypertension, a major risk factor for the development of cardiovascular disease, like heart attacks and strokes.

“The light went on that we could do much better, and we should do much better,” says Campbell. “I started to examine how we could better control hypertension and realized that it is created by lifestyle and that we could prevent and control much of it by lowering sodium and eating healthy.”

From there, Campbell began populationlevel research looking at the impact of high sodium on Canadians and how to better assess and control hypertension. Campbell formed and transformed several research coalitions and contributed to national and international guidelines and policies with the goal of preventing high blood pressure.

His contributions, and those of his colleagues, helped raise the national hypertension control rate from 13 to 66 per cent in less than a decade, making Canada a world leader in this area.

“I flew over 50,000 miles in the first three months of 2020,” says Campbell, noting the COVID-19 pandemic has since kept him closer to home.

When he looks back at his career, Campbell, a third-generation physician, is pleased.

“It is a great privilege to a be a doctor and a great opportunity to help individuals and the greater community,” he says.

Campbell is a member of both the Libin Cardiovascular Institute and O’Brien Institute of Public Health at the University of Calgary's Cumming School of Medicine.

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LIBIN LIFE

Dreaming

Big

Young girl sets sights on becoming cardiac surgeon

By Dawn Smith

M

ost Grade 5 students would likely choose a pizza party or game night with friends for their birthday, but Adlynn Wandler isn’t like most kids her age.

The precocious 10-year-old’s interest lies in anatomy and cardio-thoracic surgery, which is why for her birthday, she requested a meeting with a heart surgeon. Her dream came true in April 2020 when she had virtual meetings with Libin Cardiovascular Institute surgeon, Dr. Holly Smith, MD, and scientist, Dr. John Tyberg, MD, PhD. “I got really interested in this when my cousin had heart surgery,” says Adlynn.

“I have done a lot of research into heart stuff, and I want to be able to fix people’s hearts.”

Adlynn has dedicated many hours to learning human anatomy, reading textbooks and conducting research on the subject.

She recently joined her older sister’s Grade 12 biology class, where she got hands-on experience dissecting a heart and lungs.

Adlynn also took part in her school’s science fair, taking first place in her grade and receiving an invitation to participate at the regional science fair for the project she and a friend completed on the effects of stress on heart rate.

Adlynn’s mom, Colleen Wandler, says it’s not unusual for her daughter to focus on a topic of interest and learn as much as she can about it, but she says her daughter’s desire to learn about the heart has proven to be a bit different.

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LIBIN LIFE

Grade 5 British Columbia student, Adlynn Wandler, wanted nothing more than to speak to a cardiac surgeon for her birthday. Libin members made her dream come true.

“I am always excited when Adlynn gets excited about something and encourage it, but this time it didn’t stop, it just kept going and going,” says Colleen, whose background is in business and law.

Wandler is grateful that Drs. Tyberg and Smith were willing to take time out of their busy schedules to talk to her daughter.

“I have a depth of understanding and an appreciation for the fact that they took time out to speak with Adlynn,” she says, noting requests to surgical centres closer to the family’s home in Fort St. John went unanswered. “It was an amazing experience.”

Tyberg was also pleased to speak with Adlynn and was particularly impressed

with Wandler’s willingness to support her daughter’s interests.

“Adlynn has the personality and temperament to maximally realize her innate potential,” he says.

the piano and violin. She is also quite active in school sports, with her favourites being badminton and volleyball.

“Very importantly, she also has an outstanding parent who will help her.”

Tyberg, who has mentored dozens of trainees over the years, was pleased to be part of granting Adlynn’s birthday wish.

“A little encouragement can go a very long way, as I know from my own experience with my mentors,” he says.

Besides cardiac surgery, Adlynn is also interested in art, has been doing Highland dance for six years, and has studied both

“I have done a lot of research into heart stuff, and I want to be able to fix people’s hearts.” ­— Adlynn Wandler

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LIBIN LIFE

A labour of

Love

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LIBIN LIFE

Philanthropist and volunteer Alison Taylor Love making a difference for women

By Krista Armstrong, University of Calgary

lison Taylor Love’s world turned upside down when her father, a doctor, died suddenly of a heart attack at age 50.

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At the Libin Cardiovascular Institute, researchers are working to change this through the CV & Me Women’s Cardiovascular Health Initiative.

her free time to her family – including her five grandchildren (pictured left along with Taylor Love and her husband, Andrew Love.)

“My mother was never the same, and mourned him all the rest of her life,” Taylor Love recalls. “Even more than 40 years later, I am still haunted by this loss.”

Joining the fight, Taylor Love made a five-year financial commitment in 2020 to women’s cardiovascular health at the University of Calgary.

For Taylor Love, family is paramount, and a driver for her work.

Following his tragic death, she learned that heart disease ran in her family. Her grandmother and many cousins had all died of heart disease before their 60th birthdays.

Alison would like to make a difference.

She also joined a group of like-minded women committed to making a difference: the CV & Me committee.

“While cardiac care has improved [since my father passed away], there is still much to be done to prevent premature deaths from cardiovascular disease,” she says.

Taylor Love – former vice chair of the University of Calgary’s Board of Governors – began volunteering with the Libin Institute Strategic Advisory Board in 2019.

It was through this work that she heard about, and decided to attend, a presentation on women’s cardiovascular (CV) health.

During the presentation Love learned that despite cardiovascular disease being the leading cause of premature death for men and women in Canada, women are historically understudied.

In fact, much of the research in this area has been done on men and doesn't account for the unique challenges women face throughout their life, such as pregnancy.

As a result, women are under-diagnosed and under-treated when it comes to their cardiovascular health.

The role of the committee is two-fold – to raise awareness of the research and treatment gap in women’s cardiovascular health and to raise money to support this important work.

While COVID-19 has slowed some of the group’s outreach activities, they remain committed to getting more people engaged in this cause.

Their goal is to raise $10 million for this initiative, which includes funding for research seed grants to help launch important projects, scholarships to encourage the next generation of scientists to diversify their research and a chair to elevate this work to the next level. Philanthropic support is a catalyst to change the trajectory of women’s cardiovascular health.

"We can all play a role," says Taylor Love.

“If 1,000 women in Calgary commit $1,000 each year for five years, we would raise $5 million and be halfway to our goal,” she says.

Now semi-retired from a successful law career, Taylor Love dedicates much of

“A premature death from cardiovascular disease means no opportunity to enjoy our friends and families or see our children grow—and with luck, experience the joy of grandchildren,” says Taylor Love. “That is what we all want.”

Alison Taylor Love is one of 14 members of the the CV & Me volunteer committee.

The Libin Institute gratefully acknowledges the contributions of Alison Taylor Love, Betty Schultz, Bonnie Leach, Carol Ryder, Catherine Chow, Christina Chow, Colleen Hop, Eda Libin, Ellen Dilawri (Chair), Kiki Buttignol, Linda Atkinson, Mary Rozsa de Coquet, Sarine Mustapha and Shelley Stokes in furthering this important work.

Join the fight against women's cardiovascular disease.

Learn more at: libin.ucalgary.ca/research/ emerging-priorities/cv-me

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LIBIN LIFE

Awards and accolades Dr. Robert Sheldon, MD, PhD, received the 2020 Region 1 Mentor of the Year Award from the Royal College.

Dr. Norman Campbell, MD, received a Hypertension Canada Senior Investigator Award for his work in the area of high blood pressure.

Dr. Sofia Ahmed, MD, received a Distinguished Mentor Award from the American Society of Nephrology (ASN) in the fall of 2020.

Students Kate Bourne and Dr. Ali Fatehi-Hassanabad, MD, received prestigious Vanier scholarships.

Drs. Aaron Phillips, PhD and Alexander Leung, MD, were recognized as Avenue Calgary Top 40 under 40 recipients.

The Libin's Women's Cardiovascular Health Initiative, CV&Me, was recognized nationally with a Hypertension Canada Certificate of Excellence.

A team led by Dr. Dana Olstad, PhD, received funding from Alberta Blue Cross and through PRIHS, Partnership for Research and Innovation in the Health System, to study the impact of food insecurity on patients with diabetes.

Dr. Sonia Butalia, MD, took on a new provincial role as the Scientific Director of Alberta Health Services’ Diabetes, Obesity and Nutrition SCN.

The lab of Dr. S.R. Wayne Chen, PhD, made an exciting scientific breakthrough with the potential to prevent and reverse the effects of Alzheimer’s disease. The project was published in Cell Reports.

Cardiac surgeon Dr. Daniel Holloway, MD, was recognized as a University of Calgary Peak Scholar for inventing and patenting a training device designed to help heart surgeons practice their suturing skills.

Internal awards Peter Russell Award: Dr. Jessica Patzer, MD Cardiology Preceptor of the Year Award: Dr. Andrew Grant, MD Cardiac Surgery Preceptor of the Year Award: Dr. William Kent, MD L.B. Mitchell Award: Dr. Ali Fatehi Hassanabad, MD Clinician of the Year Award: Dr. Andrew Grant, MD Department of Cardiac Sciences Achievement and Recognition Award: Barb Jones, RN Todd Anderson Cardiovascular Research Award: Dr. Kara Nerenberg, MD Libin Researcher of the Year Award: Dr. Wayne Chen, PhD

LIBIN LIFE

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LIBIN LIFE

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