FALL 2018
Meet some of the researchers tackling women’s cardiovascular health issues. Pages 14-15.
LIBIN LIFE | Message from the Director
microvascular angina and difficult decisions about hormone replacement and oral contraception. Women are also often the main caregivers for their families, so raising awareness about the importance of a healthy diet and lifestyle allows for real changes.
Dr. Todd Anderson, MD, director of the Libin Cardiovascular Institute.
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he Libin Cardiovascular Institute continues to be a leader in cardiovascular health care, education and research. We recently formed the Women’s Cardiovascular Health Research Initiative, which brings together great research and clinical minds focused on women’s cardiovascular health. Members of this group are engaged in a wide variety of programs that focus on the entire lifespan of women from youth to pregnancy to menopause and beyond. The bold vision of our institute is to reduce the burden of suffering and premature death due to cardiovascular disease through transformative research. Women’s cardiovascular health is a critical area of consideration towards meeting this goal because heart disease and stroke remain the leading cause of death for both women and men globally. Moreover, women face unique cardiovascular risks during their lifetimes such as hypertensive disorders of pregnancy,
The Libin Institute has the expertise needed to become leaders in the area of women’s cardiovascular research. Our researchers have diverse backgrounds and interests. This includes basic scientists trying to understand how the heart functions at the molecular level to clinicians conducting interviews with patients to better understand how gender and culture impact an individual’s health-care decisions. There is huge potential for collaboration within this diverse group of researchers tackling issues that impact women. Over the coming months, we will focus on catalyzing collaborative research amongst our investigators, training the next generation of female cardiovascular researchers, engaging and educating our community partners and augmenting our clinics that specialize in women’s cardiovascular issues. We are confident this group of men and women will have a huge impact on women’s cardiovascular health moving forward, and we can’t wait to share the results with you. This edition of Libin Life offers a glimpse into the work of some of the women involved in our new group. (See page 14). We hope you are as inspired by their projects as we are.
Dr. Todd Anderson Director
Libin Cardiovascular Institute
About the Libin Cardiovascular Institute The Libin Cardiovascular Institute is an entity of Alberta Health Services and the University of Calgary. It is the only Canadian health institute to offer a single cardiovascular program, which promotes a standard of quality across the city of Calgary and the region. 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. The institute is committed to reducing the burden of suffering and premature death due to cardiovascular disease through transformative research.
Libin Life
Libin Life is published semi-annually by the Libin Cardiovascular Institute, an entity of the University of Calgary and Alberta Health Services (Calgary Zone). Our mission is to share news and information about the Institute’s impact in research, education and patient care. Institute Director Dr. Todd Anderson @Libin Director Institute Deputy Director Dr. Anne Gillis Institute Research Training & Mentorship Director Dr. Sofia Ahmed Editor Dawn Smith Editorial Committee Barb Jones, Myrna Linder, Martin Mackasey, Judy Siu, Dawn Smith, Jeannine Turnbull, AlKarim Walli Contributors Dr. Todd Anderson, Regan Evans Photo, Jacquie Moore, Adrian Shellard Photo, Dawn Smith, Pauline Zulueta Design and Layout Dawn Smith Cover Design UCalgary’s Creative Studio Printer McAra Printing @mcaraprinting Libin Cardiovascular Institute University of Calgary HSC G242, 3330 Hospital Drive NW Calgary, Alberta T2N 4N1 Phone 403.210.6271 Email libin@ucalgary.ca Website libininstitute.org Twitter @LibinInstitute Facebook @LibinInstituteCV Editorial Inquiries Dawn Smith Communications Coordinator dawn.smith@ucalgary.ca Send comments, requests for magazine copies, digital magazine issue subscriptions or change of mailing address notifications to libin@ucalgary.ca. Please request permission to reproduce any part of this publication. All rights reserved. © 2018 Libin Cardiovascular Institute of Alberta.
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Contents Departments:
Education:
2 Awards & accolades
5 Focus on Trainees
5 Focus on trainees
6 Annual Research Day showcases trainee projects
11 Community engagement
8 Enabling Success - Trainee discusses his mentor
16 New recruits
9 Scholarship keeps memory of cardiac anesthetist alive
Features:
Research:
10 International input Instituted receives World Health Organization classification
17 Members contribute to new guidelines for pregnant women
12 Taking it to the extreme
18 Clinician-scientists researches effective ways to communicate
Researchers team up with ultramarathoner 14 Taking Action New group investigates women’s health
Care Delivery:
FALL 2018
19 Heart failure patients benefit from new tool
The Women’s Cardiovascular Health Research Initiative, the newest group at the Libin Institute, brings together researchers tackling women’s unique cardiovascular concerns. Our researchers and clinicianresearchers have expertise across wide spectrum and are covering issues ranging from pregnancy and childbirth through to menopause.
20 Beating the odds 22 Chest pain clinics ease health care burden 23 Working together 24 Surgical assistant logs thousands of surgeries Meet some of the researchers tackling women’s cardiovascular health issues. Pages 14-15.
Correction: In the spring edition of Libin Life magazine, we stated Tine Haworth had donated more than $3.2 million to the Libin Institute. She has, in fact, donated about $3.7 million. We apologize for any inconvenience this may have caused. 18-CSM-001-LibinLifeMag_d6.indd 1
About the cover
2018-09-10 3:06 PM
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LIBIN LIFE | Awards & Accolades
Unlocking the mysteries of the heart Trainee earns award for research into irregular heartbeats By Dawn Smith
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ost of us don’t have to think about our hearts. They simply go on beating steadily while we go about our daily lives. But sometimes after working properly for many years, the heart develops an irregular beat, called an arrhythmia, the most common of which is atrial fibrillation (AF). The condition impacts about 350,000 Canadians. The prevalence of AF is increasing each year and experts project more than 10 million people in North America will be affected over the next 30 years. Those suffering with AF are often more than aware of the problem as the symptoms, which include heart palpitations, weakness, fatigue, dizziness, confusion and shortness of breath, can be life altering. Left untreated, AF can lead to stoke and heart failure. Worse yet, AF treatments, such as ablation and drugs, are inexact and may not be effective, partly because the underlying causes behind the condition aren’t well understood. Scientists at the University of Calgary’s Cumming School of Medicine (CSM) are trying to change that, and are getting noticed for their efforts. Dr. Hailey Jansen, PhD, a postdoctoral fellow in the lab of Dr. Robert Rose, PhD, recently received the 2018 Young Investigator Award from the Heart Rhythm Society for her efforts in trying to unlock the mysteries of what causes AF in patients with chronic high blood pressure, also known as chronic hypertension (HT). Competition was fierce with about 230 researchers from Europe and North America applying for the prizes, which are awarded to one basic scientist and one clinician scientist. “Winning this award is an
Dr. Hailey Jansen, PhD, stands besides her mentor, Dr. Robert Rose, PhD, a researcher and associate professor in the Department of Cardiac Sciences at the Cumming School of Medicine. Jansen, a postdoctoral fellow, recently received the 2018 Young Investigator Award from the Heart Rhythm Society. Photo by Dawn Smith. honour and very humbling,” says Jansen, who completed her doctorate with Rose in December 2017. The scholar also recently won the prestigious Killam Scholarship. Valued at $100,000, the award goes to just one University of Calgary postdoctoral fellow each year to encourage advanced education and research. “These awards serve as recognition of the impact of the work and of the quality of the applicant,” says Rose, a researcher and associate professor in the departments of Cardiac Sciences and Physiology and Pharmacology, and member of The Libin Institute of Alberta at the CSM. “It’s wonderful for Hailey to receive this kind of validation.”
Jansen’s doctoral research focused on determining the effects of HT on ion channel function in the atria, the upper chambers of the heart. Her work demonstrates that HT alters the ion channel function and these changes can predispose individuals to developing AF. She also looked at the role of a specific hormone receptor, natriuretic peptide receptor-C (NPR-C). She discovered targeting NPR-C can reduce the susceptibility to AF and partially prevent atrial remodeling in individuals with HT. Jansen explains it’s an important research area as 60 to 80 per cent of those with HT develop AF.
LIBIN LIFE
Kidney doctor, researcher takes on new role Dr. Braden Manns, a kidney doctor who holds the Svare Chair in Health Economics at the CSM, was named the Associate Chief Medical Officer of Strategic Clinical Networks (SCNs), an entity of Alberta Health Services. In his new role, Manns, a professor in the Department of Medicine, Section of Nephrology, will work closely with Tracy Wasylak, the chief program officer of SCNs. Together, the duo will provide strategic leadership to the 15 SCNS, which work in different areas of health, ranging from seniors health to cancer, cardiac care and addiction and mental health. Made up of patients and family members as well as front-line clinicians, such as physicians, patients and allied health services members, the SCNs share the goal of improving the quality and efficiency of Alberta’s health system by addressing gaps in care.
Emergency physician receives national accolades Innovative, impactful research in Calgary emergency departments (ED) has netted a local emergency medicine specialist and scientist some national accolades. The Canadian Association of Emergency Physicians awarded Dr. Andrew McRae, MD, PhD, an assistant professor in the departments of emergency medicine and community health sciences at the CSM, with the Dr. Stiell Researcher of the Year Award at the organization’s Annual Awards in May 2018. When asked about the award, McRae was quick to recognize the hard work of his research team on an important project focused on how best to use cardiac troponins —sensitive proteins that can be used to rule out heart attacks through a simple blood test—in patients presenting with chest pain in EDs. McRae’s team published two highimpact papers on the topic last year and are expecting to publish more in 2018.
Cardiologist awarded for humanitarian work Like all physicians, Dr. Debra Isaac, MD, is passionate about bettering the lives of her patients, but her commitment far extends the borders of her Calgary cardiology practice. Isaac spends weeks each year providing care to heart patients and educating health-care workers in Guyana as part of the Guyana Program to Advance Cardiac Care (GPACC), which she co-founded five years ago—alongside Dr. Wayne Warnica— after volunteering in the country, one of the poorest in South America. She recently received two prestigious awards for this work. Isaac received the Guenter (International Health) Award by the CSM and the Clinical/Adjunct/Research Promotions Committee. She also received an Arch Award for International Career Achievement from the University of Calgary Alumni Association. Isaac is honoured to have been chosen for these awards, and is quick to point out that her successes are the result of a team effort.
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Researchers receive prestigious grants
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ibin Cardiovascular Institute researchers recently received more than $1.23 million in funding from the Canadian Institutes for Health Research (CIHR), which funds all areas of health research. Applicants from the Institute had a 20 per cent success rate for the prestigious grant program, bettering the national average of 14 per cent.
Dr. Aaron Phillips Dr. Aaron Phillips, PhD, earned a five-year, $565,000 CIHR grant to develop a new neurostimulation therapy for people with spinal cord injuries. The goal of the multicentred study is to restore cardiovascular health in those with autonomic dysfunction due to their injuries. Phillips is an assistant professor in the departments of Physiology & Pharmacology, Cardiac Sciences and Clinical Neurosciences at the CSM. He is also a member of the Hotchkiss Brain Institute.
Dr. Alexander Ah-Chi Leung Dr. Alexander Ah-Chi Leung, PhD, received $478,124 for his project that will look at
Primary Aldosteronism (PA)—a common cause of resistant hypertension, a type of high blood pressure that can’t be controlled by medication. Leung and his team will study how well tests for PA work in those suspected of the condition with the goal of better diagnosis and ultimately more effective treatments for those with high blood pressure. Leung is an assistant professor in the division of endocrinology and metabolism in the departments of Medicine and Community Health Sciences at the CSM. He is also a member of the O’Brien Institute for Public Health.
Drs. Tolu Saiobi & Hude Quan Drs. Tolu Sajobi, PhD, and Hude Quan, PhD, principle investigator and co-principle investigator, respectively, received $191,251
for a multi-site collaborative project. The goal of the projects is to develop personalized prognostic tools to estimate patient-specific risk of mortality and/or hospital readmissions following cardiac catherization. The team hopes to engage patients, physicians and policymakers in developing the tools. Sajobi is an associate professor and senior biostatistician in the departments of Community Health Sciences and Clinical Neurosciences at the Cumming School of Medicine. He is also a member of the O’Brien and Hotchkiss institutes. Quan is a professor in the department of Community Health Sciences. He holds the Chiu Family/AstraZeneca Chair in Health Promotion and Disease Prevention at The Libin Institute and is also a member of the O’Brien Institute for Public Health.
The CIHR is the Government of Canada’s health research investment agency. It provides about $1 billion annually to support health research through a variety of programs and scholarships.
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LIBIN LIFE | Focus on trainees
Focus on Trainees
A glimpse into the next generation of clinicians Dr. Nouf Abdulaziz Alaniz
Dr.
Nouf Abdulaziz Alanazi, MD, received her medical training at King Saud University in Riyadh, Saudi Arabia in 2007 and is now a clinical fellow in interventional cardiology in UCalgary’s Department of Cardiac Sciences. Alanazi’s focus is on adult interventional cardiology, and she is training in the catherization lab. Her research interests are focused on interventional cardiology and she is hoping to obtain a masters degree in clinical epidemiology, which looks at clinical practice and outcomes to improve health care. Besides her passion for health care, Alanazi loves to draw, walk and spend time with her daughter and husband.
Dr. Michael Chiu
Dr.
Michael Chiu, MD, completed the joint MD/masters program at UCalgary, earning his master’s degree in biophysical chemistry. He is now in his last year of cardiology training with the ultimate goal of becoming a cardiac intensive care physician. Chiu works in the lab of Dr. Ed O’Brien and has a basic science research focus on heat shock protein 27, which has a role in cardiovascular disease. He is also conducting clinical research projects studying cardio-renal syndrome and cariogenic shock, a heart condition in which the heart can’t pump enough blood. Chiu plans to continue his research career in the field of biomarkers and cardiac intensive care. In addition to his medical pursuits, Chiu enjoys skiing and sailing and was previously involved in automobile racing.
Dr. Aaron Spooner
Dr.
Aaron Spooner, MD, is going into his final year of cardiac surgery in the Department of Cardiac Surgery at the University of Calgary. He recently completed a master of education in the health professions from Johns Hopkins University. He was inspired to pursue cardiac surgery because of the challenges and the impact it has on patients. Spooner’s research focuses on evidencebased educational practices, quality improvement and clinical outcomes. He plans to pursue further training in minimally invasive surgical techniques before practicing cardiac surgery and helping train the next generation of surgeons. Spooner and his wife have also caught the travel bug so future trips are likely in the future.
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Dr. Hailey Jensen, a postdoctoral fellow working in the lab of Dr. Rob Rose, PhD, explains her research project to Dr. Katherine Kavanagh, MD (forefront) and Dr. Jennifer Thompson, PhD, during the poster competition at the Tine Haworth Cardiovascular Research Day on April 16, 2018. The event took place at UCalgary’s Foothills Campus. Photos by Dawn Smith.
Students soar Research Day highlights work of trainees By Dawn Smith
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work, ranging from basic science to clinical and population health. Todd Anderson, the director of the Institute, was impressed with the variety of projects.
Dozens of trainees, from undergraduates to postdoctoral fellows, presented their
“This is the highlight of our year when it comes to featuring our students,” said Anderson, noting the annual event has been ongoing for more than a decade. “From what I have seen today, the future of cardiovascular research is bright.”
bout 175 people attended the Tine Haworth Cardiovascular Research Day on April 16, organized by the Libin Cardiovascular Institute to highlight the work of trainees through a poster competition, rapid fire talks and longer oral presentations, Transformative Original iDeas (TOD) talks.
Andrew Braun, PhD, a professor in the Cumming School of Medicine’s Department of Physiology and Pharmacology and coorganizer of Research Day, agreed, saying Libin trainees have some strong skills. “There is a strength in science, a strength in communication,” he said of the students. “Their work is accessible and emphasizes real-world problems and discovery-driven research.”
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(Left) Libin Institute Director Dr. Todd Anderson, MD, presents Dr. Igor Efimov, PhD, the bioengineer who delivered the 2018 Dr. E.R. Smith Prize Lecture, with a token of appreciation for his involvement in Research Day. (Right) Trainee Cindy Kalenga gives a talk on her research into the impact of contraceptives on the heart of women of childbearing years. Attendees also got a glimpse into the work of several Libin researchers, including Dr. Steve Wilton, MD, a clinician specializing in heart rhythm disorders and an associate professor in the Departments of Cardiac Sciences and Medicine. Wilton spoke on the importance of collaboration when it comes to arrhythmia research in coronary heart disease. The research of two new Libin investigators was also showcased. Dr. Jennifer Thompson, PhD, an assistant professor in the Department of Physiology and Pharmacology, presented research highlighting how adverse conditions in the womb affect the cardiovascular health of the offspring later in life. Dr. Dana Olstad, PhD, an assistant professor in the Department of Community Health Sciences and a member of both the Libin and the O’Brien Institute for Public Health, presented her research describing the important impact that social policy has on dietary behaviours and health.
The day culminated with the Dr. E.R. Smith Lectureship in Cardiovascular Research, delivered by Dr. Igor Efimov, PhD, a professor and Chair of the Biomedical Engineering Department at George Washington University. Efimov detailed his fascinating research investigating electrical activity in the heart and his cutting-edge work engineering implantable devices using electrical engineering, molecular biology and imaging techniques. Dr. Sofia Ahmed, MD, the Libin Institute’s Director of Research Training and Mentorship, said, “Research Day was an outstanding showcase of the excellence in training in cardiovascular research at the Libin Institute.” The Dr. E.R. Smith Lectureship was created to honour Dr. Eldon Smith, MD, OC, for his ongoing dedicated leadership and services over the past 38 years including his term as Dean of the CSM. It is awarded to a distinguished scientist to further scientific knowledge in cardiovascular disease.
Tine Haworth, the title sponsor of the day, smiles at the camera during the Tine Haworth Cardiovascular Research Day.
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Enabling success
Q&A with doctoral candidate Dr. Tony Liwa
Dr.
Tony Liwa, MD, is a doctoral candidate in the labs of Dr. Bill Cole, PhD, and Dr. Donna Slater, PhD, studying the role of prostaglandins and prostaglandin receptors in regulating the functions of smooth muscles. He graduated with his medical degree from Hubert Kairuki Memorial University, located in Tanzania. Liwa went on to complete a masters degree in pharmacology in Cape Town, South Africa and a masters program in clinical epidemiology from New York’s Weill Cornell Medical College. This Q&A focuses on Libin member, Dr. Bill Cole, PhD. What are your future career plans and has your mentor influenced this at all? I work with the Catholic University of Health and Allied Sciences (CUHAS) in Mwanza, Tanzania as a lecturer. I have responsibilities in both academia and research, and I want to learn how to do better science so I can return to Africa and study the problems that
have so long burdened society. Having Drs. Cole and Slater as my mentors is helping me learn how to improve my science. How long have you been working in Dr. Cole’s lab? I came to the University of Calgary in 2013. I travel back and forth to Tanzania, juggling work and my studies in Calgary. Tell us about some of the lessons you have learned from your mentors. My mentors have helped me in the area of self-development and have honed me into a refined, hardcore scientist. Dr. Cole has taught me there is always a way. When I am frustrated, his smile, simple advice to relax and his confidence that I will solve the problem have always resulted in success. How do your mentors inspire you? They have inspired me to realize fulfillment in science comes from loving and appreciating what you do and always pushing yourself to the next best idea.
How is Dr. Cole a good mentor? Dr. Cole has the ability and willingness to communicate science. He is approachable, always available and has the rare ability to listen and encourage one to express their desires and thoughts. Drs. Cole and Slater are true mentors: they invest emotionally in their trainees and want to see their knowledge manifested in others. I will always carry their acceptance and belief in me. Even when I make a mistake, they tell me, “It will all be OK. You are stronger than you know.”
“Dr. Cole has taught me there is always a way. His simple advice to relax and his confidence that I will solve the problem have always resulted in success.” Dr. Tony Liwa
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Scholarships keep spirit of cardiac anesthetist alive By Jacquie Moore, Development and Alumni Engagement
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e called him Charlie.” Those four words alone, uttered by a longtime colleague, speak volumes about the widespread feelings of loss and affection for the late cardiac anesthetist Dr. Charles MacAdams, who died in the spring of 2016.
Certainly, MacAdams, who was only 62, had more to give. As part of UCalgary’s first Giving Day in 2017, Maitland and two dozen colleagues found a way to reignite his bright spark by creating a student award in his name, joining a growing number of faculty and staff who support the Energize campaign, and leveraging the impact of Giving Day when UCalgary would match their gifts.
“I met Charlie 30 years ago when he drove this awful little car from Calgary to Saskatchewan to do a locum,” says Dr. Andrew Maitland, a cardiac surgeon who would soon join MacAdams at the Foothills Medical Centre cardiovascular unit. “He was intense, he was meticulous, he was a keen teacher and he always wanted to give back. When he died my colleagues and I wanted to do something that would best honour his memory.” There’s no singular path to marking the life of an individual whose passion and energy touched the lives of so many and in such varied ways. MacAdams made enormous contributions to the field of anesthesiology as a highly regarded clinician, researcher and prize-winning educator in UCalgary’s Department of Anesthesia at the Cumming School of Medicine. A member of the Libin Cardiovascular Institute, MacAdams also served as a medical missionary, donating time and money to support anesthesia training in under-serviced countries, including his beloved Nepal. It was there, while on one of his trips that combined medical education with mountaineering, that MacAdams
“Each one of us could give $1,000, and the university matched each of those gifts on Giving Day,” says Maitland. “That meant we were able to create scholarships for two University of Calgary medical students to do an elective in cardiology.
The memory of cardiac anesthetist Dr. Charles MacAdams, a Libin member who died in the spring of 2016, is being kept alive through a namesake UCalgary scholarship made possible by his colleagues. Submitted photo.
“It’s expensive for students to do electives — these awards will allow students to see what cardiology is like at an early stage. I admit it’s a little selfish because it means we can get really good people to come into our residency program, and we then train the best new cardiac surgeons,” added Maitland.
died on May 11, 2016, a day after exuberantly ascending 7,000 metres to the top of Mt. Everest’s North Col.
MacAdams would no doubt approve. Still, his old friend thinks he’d find the scholarship’s name — the Dr. Charles MacAdams Medical Elective Awards — a little awkward.
“Charlie was a fit guy and extremely intense,” says Maitland. “He would cycle in to work in a blizzard, and he did a lot of climbing with others on our team.” That night in the Himalayas, MacAdams went to bed in his tent at base camp and peacefully passed away in his sleep.
“Charlie might guffaw at that,” says Maitland. “He wasn’t the sort of person to put himself in the limelight — he would rise to the top, not put himself at the top. In that respect, he might not like it.” But, he adds with a grin, “tough.”
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WHO designates institute international Collaborating Centre By Dawn Smith
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he University of Calgary’s potential to address chronic diseases on an international scale is getting a significant boost from the World Health Organization (WHO). The Libin Institute has been designated a Pan American Health Organization/WHO Collaborating Centre for the Prevention and Control of Chronic Kidney Disease. The designation runs for four years, commencing in the spring of 2018. Directed by Dr. Marcello Tonelli, MD, the primary goal of the centre is to prevent chronic kidney disease and improve outcomes for those with the disease around the world. A secondary goal is to help improve the management of other noncommunicable diseases, such as diabetes, cancer, and heart and lung disease, in humanitarian settings. “The University of Calgary is very proud of the impactful research conducted by our scholars in health science,” says Ed McCauley, Vice-President Research. “Chronic kidney disease affects so many people. This collaborative centre will produce breakthroughs that will benefit people throughout the world. We are fortunate to have leaders such as Professor Tonelli who work tirelessly to pull together these important international collaborations.”
“Being named an official WHO Collaborating Centre is a testament to the expertise of our researchers and caregivers,” says Todd Anderson, a cardiologist and the director of the Libin Cardiovascular Institute. “It is a proud moment for UCalgary as the centre will have a large impact locally, nationally and globally on preventing chronic kidney disease and caring for those suffering from the disease.” A nephrologist, Tonelli is a recognized expert in the prevention and control of chronic kidney disease. He also completed a volunteer role at the WHO in 2014 focusing on treatment of non-communicable diseases following natural disasters and civil conflict. The work included modifying emergency medical kits—containing medication and equipment to treat chronic diseases like heart disease and diabetes—deployed after a humanitarian disaster. Tonelli isn’t tackling these significant health challenges alone. He is joined by a worldclass team that includes fellow physicians Drs. Brenda Hemmelgarn and Braden Manns— who were co-recipients of the Kidney Foundation of Canada’s Medal of Research Excellence last year.
“It is exciting to be named a WHO Collaborating Centre,” says Tonelli. “It provides a clear path to address these important challenges. Working in partnership with the WHO and other major organizations like the International Society of Nephrology allows us to impact a wide range of people around the world.” It becomes the second WHO Collaborating Centre at CSM, and the first centre worldwide with a focus on kidney disease. There are more than 800 WHO centres in over 80 countries worldwide working in nursing, occupational health, communicable diseases, nutrition, mental health, chronic diseases, health technologies and other areas. Non-communicable diseases are a major public health issue, with the WHO now describing them as the leading cause of death worldwide. Marcello Tonelli is UCalgary’s associate vice-president (health research) and senior associate dean (clinical research) of the CSM. He is also a professor in the Department of Medicine, and a member of both the Libin Cardiovascular and O’Brien institutes.
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LIBIN LIFE | Community engagement
Sharing knowledge Institute engages with community
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ommunity engagement is a mandate of the Libin Cardiovascular Institute. We hope to create awareness about the risks of cardiovascular disease, share tips for prevention of illness and relay how researchers are working to solve the problems related to cardiovascular disease, which is still the No. 1 killer globally. Libin members and trainees regularly attend public engagement sessions to share their insights into clinical care and research. To register for a free event, visit libininstitute.org.
@LibinInstitute @LibinInstituteAB
An expert panel prepares for a Q&A session at a two-day forum on Canada’s new food guide and policy. Photo by Dawn Smith.
Harvard Medical School’s Dr. Christine Seidman, a world-class cardiovascular genetics researcher, speaks with the Institute’s namesake donor, Alvin Libin, OC, before delivering the Libin Institute/AHFMR Prize For Excellence in Cardiovascular Research on May 14 in the Libin Institute Lecture Theatre at UCalgary’s Foothills Campus. Photo by Dawn Smith.
Attendees of the two-day forum, Canada’s Food Guide: A Healthier Canada Through Effective Nutrition Policy, listen attentively. More than 400 people took in the event, co-hosted by The Libin Institute and the O’Brien Institute for Public Health at UCalgary’s Downtown Campus on June 18-19, 2018. Photo supplied by the O’Brien Institute.
Shahzadi Devje, a registered dietitian and chair of The Ismaili Nutrition Centre, gives practical advice for healthy eating at a community engagement event at the Ismaili Jamatkhana & Centre on June 17. About 100 people attended to learn about the importance of a healthy diet.
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Taking it to the
extreme
Researchers team up with ultramarathoner By Pauline Zulueta Cumming School of Medicine
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espite being able to eat a pound of bacon in one sitting or devouring a box of ice cream cones, elite runner Dave Proctor says he’s in the best shape of his life. Proctor took on the challenge of running 7,200 km across Canada to raise $1 million for rare disease research. While training, he consumed 10,000 calories per day and ran up to 250 km a week. Proctor had a personal reason for taking on the challenge. At the age of two, Proctor’s son, Sam, now 9, was diagnosed with relapsing encephalopathy with cerebellar ataxia, a rare disease that causes lack of balance, impaired co-ordination and slurred speech. The disease is known to affect only four other people in the world. “One in 12 Canadians are affected by rare diseases – that’s not all that rare,” says Proctor. “We need to conduct a lot more research, and researchers need these dollars to be there in order to apply for grants.” With guidance from his team of managers and advisors, Proctor had planned to run an average of 108 km a day from Victoria, B.C. to St. John’s, Newfoundland, however, he halted his cross-Canada run just east of Winnipeg due to a severe back injury. Despite the disappointment of not finishing the run, Proctor was able to work with a a team of researchers from the Cumming School of Medicine (CSM) and Alberta Health Services along the way. These researchers studied his body to better understand the health effects of ultra-endurance sports.
Dave Proctor runs through the mountains during his attempted cross-country run to benefit rare diseases. Proctor teamed up with researchers at the University of Calgary during his extreme endurance race. Photo by Kurtis Kristianson. “Ultramarathon running and other extreme forms of prolonged strenuous exercise are rapidly gaining popularity,” says Dr. Aaron Phillips, a researcher and member of both the Libin Institute and Hotchkiss Brain Institute. “We, as a scientific and medical community, need to catch up and be able
to understand the effects of these sports. Knowing more about how the body adapts to ultra-endurance sports will allow for the development of better training programs as well as safety guidelines for participants.” Phillips and his team at the Clinical and Translational Exercise Physiology (CTEP)
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Laboratory, a state-of-the-art facility within the CSM dedicated to researching exercise physiology in health and disease, assessed Proctor’s aerobic health and fitness. Proctor took the VO2 max test, a grueling fitness assessment done on a treadmill where the speed and incline gradually intensifies until the individual hits his or her anaerobic threshold – the point in which the body is no longer able to convert oxygen into energy quickly enough and must start supplementing with energy from reserve sources. “We think Dave’s anaerobic threshold, either genetically or through training, is much higher than the average person,” says Phillips, an assistant professor in the departments of Clinical Neurosciences, Cardiac Sciences and Physiology & Pharmacology at the CSM. “He’s a very unique individual.” The CTEP Lab also monitored Proctor’s vascular structure—the network of arteries and veins that transports blood, oxygen and nutrients throughout the body—by taking ultrasound videos of blood vessels in Proctor’s arms and legs. The Foothills Medical Centre’s Stephenson Cardiac Imaging Centre, led by Dr. James White, MD, tracked changes in Proctor’s heart. Using cardiac MRI, the researchers monitored the size, shape and function of the heart and watched for signs of inflammation or damage.
Dr. James White, the director of the Stephenson Cardiac Imaging Centre, looks at images of ultramarathoner Dave Proctor taken in the MRI machine in the Stephenson Centre, located at the Foothills Medical Centre. The scan gave researchers a baseline to measure how Proctor’s heart would be impacted by his attempted cross-country run. Photo by Kelly Johnston, CSM. pumping too much or too little, it will leave a signature behind in the proteins,” says Dufour, a member of the McCaig Institute for Bone and Joint Health. “What’s left behind in the blood is one way of piecing together what’s happened throughout his body.”
“We can measure the amount of fibrosis (scarring) or collagen within the heart muscle,” says White, a Libin member. “By doing this, we’ll be able to understand if, after repetitive strain, the heart adapts transiently or by laying down collagen. That’s a more permanent change.”
Dufour, who is also an assistant professor in the Department of Physiology & Pharmacology at the CSM, collected blood samples from Proctor throughout his run and processed them through a mass spectrometer, an instrument capable of analyzing tens of thousands of proteins within only two to three hours.
The scientists also generated 4D cardiac models of heart function and blood flow to more accurately see how changes in the heart affect its ability to pump blood throughout the body.
“This is a very rare opportunity,” says White. “Not just because Dave is doing something extreme, but because of his willingness to participate and be evaluated throughout the course of this journey.”
The lab of Dr. Antoine Dufour, PhD, examined proteins in Proctor’s blood to look for clues about how various systems within the body adapt to the prolonged physical exercise. “If the heart or lungs are
Proctor won’t be the only study participant. The research team also plans to recruit 10 ultramarathon runners—those who partake in races longer than a traditional 42.2-kilometre marathon—as well as 50 healthy volunteers.
“There’s never been a study like this in this field,” says Phillips. “There have been several studies on ultra-marathons, and some have focused on cardiac, on cognition or on vascular, but there’s never been a comprehensive study on prolonged strenuous exercise, especially not one on repetitive prolonged strenuous exercise.” White, who is also an associate professor in the departments of Cardiac Sciences, Radiology and Medicine at the CSM, adds that the integrated approach of this study, which brings together scientists with different backgrounds and specialties, will allow the researchers to get a truly global understanding of Proctor’s health and function. “There are very few places that have this unique combination of skill sets,” he says. “The resources that we have here at the CSM and FMC are really outstanding. It’s wonderful that we get this opportunity to show that.”
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Dr. Doreen Rabi Dr. Doreen Rabi, MD, is a clinical endocrinologist whose research focuses on how diabetes impacts cardiovascular health. She wants to help women achieve the same outcomes their male counterparts receive when faced with cardiovascular disease.
Dr. Dana Olstad Dr. Dana Olstad, PhD, is a registered dietician who looks at how public policy impacts health. Her research focus is on how policy can help reduce socioeconomic inequities on dietary behaviours, obesity and health.
LIBIN LIFE
Female researchers tackle cardiovascular issues
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The Libin Institute is committed to improving cardiovascular health for all through transformative research. Although cardiovascular disease is the leading global cause of death in both women and men, research has lagged in women. However, this is changing. Our newest initiative, the Women’s Cardiovascular Health Research Initiative, includes a strong group of investigators and clinicians who are tackling women’s unique cardiovascular health concerns at every age and stage. Get acquainted with some of these cardiac wonder women who are dedicated to enabling women’s cardiovascular health.
Dr. Sofia Ahmed
Dr. Sonia Butalia Dr. Sonia Butalia, MD, studies tools and strategies to improve diabetes and cardiovascular risk factors in the community. The clinicianresearcher wants to reduce the burden of cardiovascular risks on all Albertans.
Dr. Sofia Ahmed, MD, a kidney doctor and researcher, is tackling sex and gender differences in her lab with the goal of precision treatment for patients. A current research focus is examining the potential role of hormonal contraceptives and postmenopausal hormone therapy in cardiovascular risk.
Dr. Angela Kealey
Dr. Michelle Keir
Dr. Angela Kealey, MD, is a clinicianresearcher studying pre-existing and new heart conditions in pregnancy. Her goal is to improve outcomes for expectant moms.
Dr. Michelle Keir, MD, wants to discover the reasons behind why women with heart conditions have generally poorer outcomes then men. Her research includes talking to patients to determine the societal and cultural factors that play a role in this disparity.
Dr. Kathryn King-Shier Dr. Kathryn King-Shier, RN, PhD, is studying the factors that impact heart-health decisions, with a focus on ethnicity and gender differences. Her goal is to improve health care outcomes, especially in vulnerable immigrant communities.
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LIBIN LIFE | New recruits
Growing team
Get to know the Libin Institute’s new recruits Dr. Julio Garcia
Dr. Joon Lee
Dr. Leslie Skeith
Garcia is the newest recruit at the Stephenson Cardiac Imaging Centre. An assistant professor in the departments of Radiology and Cardiac Sciences, he is an imaging expert with a research focus on cardiac imaging, experimental modelling and automated imaging. His goal is to establish a world-class lab in the area of 4D cardiac imaging modelling for flow and function. Armed with a doctorate in experimental medicine and postdoctoral training in cardiovascular magnetic resonance imaging, Garcia joined the Stephenson team about 18
months ago as a postdoctoral fellow. He developed an academic program in 4D Flow MRI, accumulating more than 500 cases performed across a variety of cardiac disease states and over a dozen presented abstracts.
Joon Lee, PhD, a health data science researcher, was recently recruited to the Libin Institute. The associate professor of big data science earned his doctorate in biomedical engineering from the University of Toronto before completing a three-year postdoctoral fellowship in medical data science at MIT. In his research, Lee applies data science methodologies, including machine learning, to electronic data obtained from a variety of sources—such as electronic health records, social media and electronic mobile/wearable devices—for health applications. Primarily, Lee focuses
his efforts on intensive care medicine, aging and population health surveillance.
The Libin Institute is pleased to welcome Dr. Leslie Skeith, a clinical assistant professor, hematologist and blood clot specialist to the team.
pregnancy and during the postpartum period. Her goal is to prevent blood clots during and after pregnancy. She is also keen on engaging patients in her research projects.
Skeith received her medical degree and hematology residency training at UCalgary’s Cumming School of Medicine and completed a fellowship in thrombosis (blood clots) at the University of Ottawa, before returning to her hometown of Calgary this year to take on her new role. Dr. Skeith’s research focus is on women’s health and blood clots, particularly in
Garcia will be expanding this program, with the aim of collaborating with physicians to improve diagnostics, treatment and management of cardiovascular problems for patients. He is also a proud father and husband to his wife Julie.
Lee has always found it fascinating to extract useful information from messy datasets, with the hopes of uncovering valuable information to improve health outcomes. Lee’s inspiration for coming to the Libin Institute was to explore how current cardiovascular and related research can be revolutionized by data science. On a personal note, Lee grew up in both Seoul, South Korea and Vancouver, B.C. and is a proud father.
In addition to her research and busy clinical practice, Skeith is pursuing a master’s degree in health professions education through the University of Illinois in Chicago. She is also married and has a little girl to keep her busy during her free time.
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Decreasing the pressure Members help create hypertension guidelines for pregnant women
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By Dawn Smith ibin Institute clinician-scientists had a big part in developing and writing Hypertension Canada’s inaugural Recommendations for the Management of Hypertension in Pregnancy, a condition that impacts about seven per cent of Canadian pregnancies and can cause maternal, fetal and newborn complications. Dr. Kara Nerenberg, a clinician and researcher, led the team that developed the recommendations and was senior author of the guidelines, published in the February edition of the Canadian Journal of Cardiology. Nerenberg works with expecting and new moms who have complications related to blood pressure issues. She explained these conditions range from mild hypertension to preeclampsia, which can be fatal for both mom and baby. The conditions also more than double a mother’s risk of developing future cardiovascular problems, which can result in strokes, heart attacks, heart rhythm problems or heart failure. Despite the increased risk, Nerenberg, who also conducts research in this area, said many women, and their health care providers, aren’t aware of the risks. That’s why she has dedicated herself to raising awareness of the problem. “I have tried to push it on the national agenda,” said Nerenberg, an associate professor in the Departments of Medicine, Obstetrics & Gynecology and Community Health Sciences at UCalgary’s Cumming School of Medicine. “These guidelines are a good first step because they are readily available to family doctors.”
Dr. Sonia Butalia, a clinician and researcher, also had an important role as lead author of the guidelines. Butalia, whose research deals with tools and strategies to improve diabetes care and other cardiovascular risk factors in the community, said coming up with a strategy of how to treat hypertensive pregnant women was important. “These guidelines will importantly assist clinicians on the appropriate management of hypertension in pregnancy,” said Butalia, a practicing endocrinologist and assistant professor in the Departments of Medicine and Community Health Sciences at the CSM. Nerenberg and Butalia are both also members of the O’Brien Institute for Public Health. Nerenberg was involved in the evidence review of the Future Cardiovascular Health Risks After High Blood Pressure in Pregnancy for the Canadian Lipid Guidelines in 2016. Prior to these guidelines being published, women who had a high blood pressure disorder in pregnancy weren’t included in any Canadian literature for cardiovascular health promotion. In addition, she was recently awarded the Heart and Stroke’s Foundation’s (HSF) MidCareer Women’s Heart and Brain Health Chair. The national award is a collaboration between the HSF and the CIHR and comes with up to $750,000 in funding over five years to support research.
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Dr. Robert Sheldon, a clinician-scientist at The Libin Instituterecently completed a multi-year project that examined effective letter writing techniques for specialists who are referring patients to physicians. His goal is to improve patient outcomes.
Improving outcomes
Clinician-scientist publishes paper on writing effective letters for referring physicians
Dr.
Robert Sheldon, MD, PhD, is no stranger to penning letters to referring physicians.
A cardiologist with a specialty in electrophysiology, Sheldon has spent hours writing documents outlining patient histories, diagnoses and treatment plans that were up to four pages long. But over the years, the clinician-scientist realized his treatment plans were often not followed, prompting him to ask the question why. “I realized the common denominator was me, and I began to ask myself ‘is there a better way to communicate?’” he said, noting the epiphany came several years ago and caused him to embark on a multi-year research project. That project has resulted in a research paper, “Valued Components of a Consultant Letter from Referring Physicians’ Perspective: A Systematic Literature Synthesis,” which was published
in the June 2018 edition of the Journal of General Internal Medicine. The project began with a systematic review of the letters that included asking physicians, specialists, health-care staff and surgeons for suggestions that would improve their experience. “We got a pretty clear understanding that my letters were all wrong in the order of content and structure,” said Sheldon, noting the goal of the research was to improve patient outcomes. As a result of his early findings, Sheldon changed the format and length of his letters, motivating him to creating a scaled down template with headings, lists and practical information, like treatment plans and diagnoses, included at the start of the letters. This method was a complete change from Sheldon’s previous letters, which began with a complete patient history before moving into diagnosis and treatment.
He hopes the new method improves both patient outcomes and the experience of the busy doctors receiving the letters. Dr. Carlos Morillo, the section chief of cardiology and a professor in UCalgary’s department of cardiac sciences, is impressed by Sheldon’s commitment to bettering patient outcomes. “Dr. Sheldon should be commended for having the insight and foresight to question his own methods and improving the overall care of our patients,” he said.
“Dr. Sheldon should be commended for having the insight and foresight to question his own methods...” Dr. Carlos Morillo
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Advanced heart failure
patients benefit from new tools By Dawn Smith
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magine if everyday activities, like walking, left you exhausted and short of breath. That’s the reality for advanced heart failure (AHF) patients. AHF has a list of causes, such as heart attacks, high blood pressures, obesity, genetics and even viruses or infections. It is diagnosed when the heart can no longer pump the blood needed to sustain the body. But AHF doesn’t have to be a death sentence. When conventional treatments, such as medication, no longer work, doctors may consider other treatments. One of those treatments is implanting a life-saving left ventricular assist device (LVAD), which is a pump implanted into the heart. The device has a drive line that exits the body and connects to an exterior power source. It can be used as a bridge to cardiac transplant or as a more permanent solution to improve patients’ quality of life. Jill Roy is a registered nurse and the LVAD coordinator with the Mechanical Circulatory Support Program at the Foothills Medical Clinic (FMC), the only such clinic in Southern Alberta. She says deciding whether to undergo the risky surgery can be difficult for end stage heart failure patients. But the decision and preparation for the open-heart surgery may have just gotten easier, thanks to three educational videos. Project 7 Media Group created the videos with funds from Dear Heart, a foundation created by Danny Stachiw, who received an LVAD and heart transplant but who has since passed. Dear Heart’s goal is to fund projects aimed at improving the lives of patients with end stage heart failure. The first video is about 30 minutes and informs patients what to expect as they are
Candidates of left ventricular assist devices, which are worn outside the body, as above, have some new tools to help them before and after surgery, thanks to teaching videos created by Project 7 Media for the Mechanical Circulatory Support Program at the Foothills Medical Centre. assessed for potential LVAD therapy. It also tells the story of several patients who have undergone the surgery. Two other short videos teach patients about post-surgery care. Roy is excited about the new tools. “It can be overwhelming for patients when facing this surgery. This is another resource that can make it easier,” she said, adding the videos also raise awareness about the program at Foothills Medical Centre, which serves patients from Red Deer south to the American border and east to Cranbrook, B.C. Dr. Debra Isaac, MD, said while the videos won’t replace one-on-one patient consultations, they are critical tools that
will help patients understand why the life-saving LVAD surgery is necessary. “It is fantastic to have something that is not mass produced for a worldwide audience, but rather reflects our local program,” said Isaac, a cardiologist with a specialty in advanced heart failure. “Patients will see the faces of the people who will be providing their care as well as patients who have already had surgeries.” FMC’s Advanced Heart Failure team has been implanting LVADs since 2006. The team, which includes cardiac surgeon Dr. William Kent, implanted 13 patients, ages 18 and up, with the devices in 2017.
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Dr. Graeme Strathdee, who has his doctorate in chemistry, stands with Dr. Jehangir Appoo, the cardiac surgeon who saved Strathdee’s life by performing emergency surgery on his aorta seven years ago. Submitted photo.
Beating the odds Patient celebrates seven years after surviving aortic tear By Dawn Smith
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even years ago, Graeme Strathdee had a very bad day. The then 69-yearold woke up feeling normal, but after climbing a few stairs, he collapsed and was unable to stand. Before he knew it, Strathdee was being escorted into the back of an ambulance then into the emergency room at Calgary’s Foothills Medical Centre (FMC), to await a diagnosis. It turns out he was exactly where he needed to be as late that evening he met Dr. Jehangir Appoo, a cardiovascular surgeon, and agreed to an experimental open-heart surgery to fix a tear in his aorta.
More than 10 hours later, Strathdee, who has a PhD in Chemistry from McGill, came out of the operating room with a synthetic aorta and a stent. “There was no warning,” said Strathdee. “There was nothing abnormal until I wasn’t able to stand up… there were no other symptoms, no pain.” In fact, Strathdee had shovelled tons of snow and played competitive hockey the day before his collapse likely severely stressing his aorta. Although recovery took many months, Strathdee, a retired inorganic chemist, corporate research director, and adjunct professor at the
University of Saskatchewan and the University of British Columbia, knows he is lucky to have survived the incident. “Without that procedure, we wouldn’t be having this conversation,” he said, noting the expert team at the FMC saved his life with cutting-edge techniques. According to Appoo, who helped establish the Calgary Thoracic Aortic Program (CTAP) at the FMC 12 years ago and is now its co-director alongside interventional radiologist Dr. Eric Herget, there is still a 20 per cent mortality rate for those undergoing emergency surgery after an aortic tear.
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A sub-specialty of heart surgery, surgeons within the program fix problems with the largest blood vessel in the body, the aorta, including aneurysms and tears, which can be fatal. One issue with this area of the body is that patients (who can be as young as in their 30s, but are more commonly 55 plus) often have no symptoms, meaning they may have a potentially fatal aortic rupture without even knowing there was a problem. And although there is some genetic basis and conditions that predispose individuals to aortic problems, the issues are generally random, according to Appoo. “Blood flow generates blood pressure and, if the aortic wall is weak, an aneurysm can form. It is like a balloon, it gets bigger and bigger and the muscle gets thinner. We don’t understand when the balloon will burst; it’s very unpredictable,” said Appoo, an associate clinical professor in UCalgary’s Department of Cardiac Sciences. Appoo says one of the issues is that because there are no symptoms, it is difficult to determine who may be at risk of rupture. That’s why members of CTAP are employing new surgical and imaging techniques and researching ways to improve patient outcomes and better predict who may have aortic problems. Because of those efforts, CTAP is recognized as a centre of innovation, especially in the realm of surgical fixing of aortic tears.
What’s New Recent innovations include performing surgery through a small incision using X-rays to guide the surgeon and using software to superimpose an image of the repaired aorta on the damaged one as a guide for surgeons. Other changes in the thoracic surgery room include replacing open-heart surgeries with minimally invasive procedures and performing hybrid operations, which involve both open heart and non-invasive procedures, to cut down on recovery time and enable complicated reconstructions. New materials are also used.
A visual representation of an aortic reconstruction, similar to that Graeme Strathdee received.
CTAP’s research focuses on understanding which patients need surgical intervention and which are best with ongoing monitoring. Researchers are working on several projects, including Titan: SVS. The project involves a multicenter trial of medical versus surgical treatment of aortic aneurysms being studied in conjunction the University of Ottawa.
Appoo said the key to these innovations is the multidisciplinary aspect of the team, along with each member’s commitment to improvement. For example his co-director, Herget, an interventional radiologist whose expertise in imaging is critical in patient outcomes, is also a researcher whose goal is to find innovative ways to treat aortic problems with minimally invasive techniques.
HEADSTART compares the long- and shortterm effects of limited versus extended aortic replacement through a randomized trial of patients who have undergone emergency surgery to fix aortic tears. Stride looks at blood flow between the aorta and the brain during aortic surgery with the goal of understanding how often strokes occur during aortic surgery and knowing the risk factors.
Herget, a clinical assistant professor in the department of Radiology at the CSM, agrees that teamwork is important. “Our team is making every effort to stay on the leading edge of treating aortic disease,” he said. “As these patients are often medically complex and the traditional surgical treatments are highly invasive, we are always looking for ways of managing the patients in the least invasive way possible.”
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Easing the burden Chest pain clinics decrease patient wait time It’s not uncommon for emergency room doctors to see patients complaining of chest pain. That pain can be caused by many things, including stress and gastrointestinal problems. According to Dr. Andrew McRae, MD, PhD, a clinician-scientist in the Department of Emergency Medicine, about 85 per cent of patients visiting emergency rooms complaining of chest pain are sent home with doctors determining their heart wasn’t the problem. “Of those patients, 99 per cent will be just fine, but there is a cohort at risk of having an adverse cardiac event,” says McRae, noting emergency room physicians use blood tests and electrocardiograms to ensure patients aren’t suffering from a cardiac event such as a heart attack. Where there isn’t absolute certainty about the short-term risk for patients presenting with chest pain, Calgary doctors have an alternative: chest pain clinics, such as TotalCardiology and C-Era. These outpatient clinics follow up on the higher risk profile patients who might benefit from additional testing, with some good results. “According to the research, patients who go to chest pain clinics do fairly well,” says McRae. Dr. Eddy Lang, who heads the Department of Emergency Medicine, said these chest pain clinics have been around for some time. “There is a long tradition in Calgary of creating a place where patients who are suspected of possible coronary disease can be seen in an expedited manner after they have been seen in the emergency room,” he said. “We make sure that people are safe, that they aren’t having a heart attack,
Chest pain clinics follow up on patients who are suspected of having coronary disease after visiting an emergency room complaining of chest pain. The clinics expedite diagnosis and treatment and may result in fewer patients being admitted to hospital.
but we may have patients who may have a narrowing that needs to be picked up.” Lang says between 30 and 50 patients from Calgary emergency rooms are sent to chest pain clinics each week. Their appointments usually follow within a few days of their emergency room visits. The clinics not only benefit patients and their families by alleviating possible lingering concerns following incidences of chest pain, but they also result in fewer patients being admitted to Calgary hospitals. Feedback from the clinics may also help emergency room doctors hone their skills in the area of heart care. “One good outcome is that we usually hear back from the clinics, and that helps us with our diagnostic judgment,” said Lang.
Total Cardiology has offered its Rapid Access Cardiology Clinic (RACC Clinic) in Calgary for more than 10 years. The clinic opened in 2008 as a way of improving access to cardiac care for patients with chest pain syndromes. RACC clinic provides patients with improved access to heart specialists and a standardized approach to patient evaluations. RACC clinic expanded its offerings about five years to include patients with other cardiac conditions and assesses patients who may be at elevated risk for future cardiac problems to try to avoid adverse future outcomes. It has become a cornerstone for the outpatient management of cardiac patients.
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Working together Group collaborates to improve health care
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Why is the SCN’s work important?
he Cardiovascular Health and Stroke Strategic Clinical Network (SCN) is one of 12 such groups established by Alberta Health Services in 2012 to enhance knowledge translation, drive innovation and standardize care. Comprised of patients, families, physicians, clinicians, researchers, administrators and policymakers, the SCNS work to improve the quality and delivery of care within a focused area of health care.
SCNs are responsible for generating innovation, ensuring knowledge translation, implementing best evidence into practice and utilizing change management techniques to ensure longterm sustainability and success. They also build capacity with and within operations at the front lines of health care, using local improvements to drive system innovation. The Cardiac SCN’s vision is, “Healthy hearts and brains for all Albertans.” Our mission is “Supporting the health of Albertans through prevention, collaborative partnerships, research and innovation in cardiovascular health and stroke.”
Read on to learn more about the SCN from the group’s new senior researcher and assistant scientific director Dr. Christiane Job McIntosh, PhD.
What can you tell us about yourself? There are several things that have helped shape me. I love sports and fitness and played varsity basketball at Mount Royal University and the University of British Columbia, earning a national championship. My graduate training was in kinesiology. I was introduced to medicine early through one of my best friends, whose parents were both cardiologists. I recall many discussions around the dinner table about health promotion, cardiology and health policy. I love research and knowledge and enjoy finding ways to ensure research and evidence is accessible to broad audiences.
When did you join the cardiac SCN and what is your role? I joined the SCN in March 2018. I am part of a strong interdisciplinary team of frontline providers and research-scientists that lead in cutting-edge methodologies to address gaps in the delivery of health care. In my role I support cardiovascular health and stroke research in the province. I have opportunities to work
Dr. Christiane Job McIntosh, PhD, is the new senior researcher and assistant scientific director of the Cardiovascular Health and Stroke Strategic Clinical Network. She explains how the SCN works to improve health care. collaboratively, share results, drive innovation and engage with clinical, patient and caregiver populations— all while maintaining an ample amount of quiet research and writing time.
How did you become interested in cardiovascular health? With my background, interests and training, cardiovascular health is a triangulated “sweet spot.” I am not new to cardiovascular health, my doctoral work was in health promotion, and I was a post-doctoral fellow in the Cumming School of Medicine working with Dr. Debra Isaac and the Guyana Program to Advance Cardiac Care (GPACC). I worked with several members of the team to design research protocols to conduct a critical program evaluation for the Global Health Partnership.
How is the SCN connected to the Libin Institute? The SCN is a provincial network that unifies everyone working in cardiovascular health and stroke in the province. Our scientific office connects research to clinical populations and supports researchers with the scale and spread of their results and findings. It also facilitates the adoption of best evidence into practice, community engagement and fundamentally knowledge translation and dissemination locally and beyond.
“The SCNs work to improve the quality and delivery of care within a focused area of health care.” Dr. Christiane Job McIntosh, PhD
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She’s got heart Doctor has assisted in thousands of cardiac surgeries By Dawn Smith
Dr.
Angela Waleski is no stranger to the cardiac operating room. She was the first cardiac surgical assistant at the Foothills Medical Centre and has spent the past 30 years honing her skills while being involved in thousands of surgeries, during which she works closely with surgeons, essentially acting as a third arm for them. Trained as a general practitioner physician, Waleski, a member of the Libin Institute, wouldn’t change a thing about her career. “I am so lucky to have this job,” says Waleski. “It has been the perfect career for me.” Waleski began her career in the late 1980s. As a newly married graduate, she moved to Ottawa with her husband. It was there that she landed a job as a surgical assistant. Three years later Waleski and her husband moved back to Alberta to be closer to family and made a connection with the new cardiac surgery unit at FMC, which opened in 1988 after recruiting surgeons Drs. Teresa Kieser and Andrew Maitland. At that time, Kieser and Maitland assisted one another during surgeries, working out of two operating rooms performing cardiac, vascular and thoracic surgeries. Waleski joined the duo in March 1989, assisting the team in performing about five cardiac surgeries per week, with only one OR operating at a time. She also covered emergency call as the cardiovascular and thoracic surgical assist every night. In 1990, Dr. Baikunth Bharadwaj joined the FMC team as Chief of the Division of Cardiovascular and Thoracic Surgery and things got busier. Waleski became the manager of recruitment, training and schedule for cardiac surgical assistants—it’s a role she held for almost three decades. Unsurprisingly, Waleski is amazed and proud of the growth of FMC’s world-class program, which now
Dr. Angela Waleski was hired to work in the surgical area at the Foothills Medical Centre 30 years ago and has assisted in thousands of cardiac surgeries. Photo by Mark Wagner. has includes a team of 10 cardiac surgeons, 10 cardiac surgery assistants and a full residency program who complete more than 30 cardiac surgeries out of three operating rooms each week. “I feel a tremendous sense of pride,” she said. “One of my greatest passions is to be part of such a great team of very caring and intelligent people who always put the patient first. They are like a second family.” In her role as a surgical assistant, Waleski helps facilitate surgical procedures. She works closely with the surgeon, doing such hands-on activities as harvesting arteries and veins from the patient during coronary artery bypass
surgeries. The mother of two adult children is great at her job. “I’ve seen so many surgeries that some of the young surgeons ask me for advice,” said Waleski. “It’s an honour.” Dr. Maitland says Waleski is an invaluable asset to the surgical team. “Many surgeons, when looking at a complicated case, will suggest another surgeon assist, but I would rather have Dr. Waleski on the other side of the table,” he said. “At this stage there is little she has not seen, she knows the flow of the operation and doesn’t ask silly questions about what am I doing now? I have been very lucky to know Angela… [she is] a true asset and friend.”
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Thanks to sponsors, donors and guests, The Beat Goes On Gala raised more than $900,000 Proceeds from this year’s gala will support the new Women’s Cardiovascular Health Research Initiative. The funds will help us achieve our goal of enabling cardiovascular health through transformative research. SILVER SPONSORS
GOLD SPONSORS
SIGNATURE SPONSOR
BRONZE SPONSORS
Balmon Investments Ltd.
VIP TABLE SPONSORS Karen & Todd Anderson
Kwasnicia Scalf McAllister
/ Shoemakers
/ Don Seaman
The Arthur J.E. Child Foundation BCW Architects Cindy and Tim Down /
The McCaig Family
Dr. Paul and Robyn Fedak
The Paperny Family Charitable Foundation/
Ken Stephenson Dr. Oksana Suchowersky and Dr. Chris Eagle
DONORS Jenny Belzberg B’nai Brith Lois and Richard Haskayne Hoffman Dorchik LLP Hop Estate Planning Partners Jayman BUILT
Ken King Marilyn Libin Verda and Duncan McNeill The Philip and Harriet Libin Family Foundation
EVENT PARTNERS:
Raymond James Canada Foundation Riddell Family Charitable Foundation Rockwood Custom Homes Rogers Insurance Ltd.
Royop Development Corporation Gregg Scott Superior Lodging Corporation Switzer’s Investments Ltd. W. Brett Wilson Wood Automotive Group
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