Click here to view the presentation slides and transcript from this CME-certified series held at select American College of Cardiology state chapter meetings.
Over the years, heart failure (HF) has been described in the context of a number of different theoretic models that capture a variety of perspectives of the disease process. Representative examples include the hemodynamic model, which envisions HF as compromised heart-pump capacity; the cardio-renal model, which views HF as a consequence of volume overload and compromised renal function; the neurohumoral model, which describes HF as hyperactivity of the sympathetic nervous system and vasopressor mechanisms that overwhelm vasodilator/natriuretic mechanisms; and the abnormal calcium cycling model, which focuses on metabolic stressors or genetic anomalies that lead to abnormal stimulus-contraction coupling of the cardiomyocyte. All of these models have provided insights about new pharmacologic targets for the management of HF, many of which are entering late-stage clinical development.
THE COMPLEXITIES OF HEART FAILURE: Novel Approaches for Management of Resistant Heart Failure will provide participants with a better understanding of the difference in pathophysiologic mechanisms between HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF). Participants will be better able to incorporate evidence-based guidelines and results from large outcomes studies into clinical practice to decrease morbidity and mortality in patients with HF. They will also better understand newer therapeutic targets involved in the pathophysiology of HF, and emerging therapeutic agents that interact with these targets.
Mark E. Dunlap, MD
Director, Heart Failure Section
Heart and Vascular Center, The MetroHealth System
Professor of Medicine, Physiology, and Biophysics
Case Western Reserve University
Mark E. Dunlap, MD is Professor of Medicine, Physiology, and Biophysics at Case Western Reserve University in Cleveland, OH. He received his medical doctorate from the University of Tennessee College of Medicine in Memphis, TN, and completed his medicine, cardiology, and research training at the Medical College of Virginia. He currently serves as Director of the Heart Failure Section for the MetroHealth System in Cleveland, OH.
His research has focused on abnormalities of autonomic control in hypertension and heart failure, showing that cardiopulmonary baro-reflex control of sympathetic activity is blunted in both animals and humans with HF. He has also focused on mechanisms underlying abnormal cholinergic control in HF, including the role of nicotinic acytylcholine receptor subtypes in ganglionic transmission. More recently his work has focused on the role of sympathetic activation in causing redistribution of fluid from splanchnic venous vessels into the circulatory volume leading to decompensated HF.
Dr. Dunlap has been a part of numerous clinical trials designed to test therapies aimed at treating the neurohumoral excitatory state in HF, including DIG (digoxin), MERIT-HF (beta-blocker), CHARM (angiotensin receptor inhibitor), OVERTURE (neutral endopeptidase inhibitor), PROTECT (adenosine a1 inhibitor), BALANCE (vasopressin receptor inhibitor), TOPCAT (aldosterone receptor blocker), and ASCEND (nesiritide), and has served on the Steering Committees and Endpoint Committees for several clinical trials. He also served as PI for the Symplicity HTN-1 and HTN-3 trials of renal denervation for the treatment of resistant hypertension, and is currently an investigator in the NHLBI-sponsored National HF Research Network. He has served on numerous study sections for the NHLBI, the American Heart Association, and the Department of Veterans Affairs, and is past President of the Society for Heart Brain Medicine.
James E. Udelson, MD
Chief, Division of Cardiology
Tufts Medical Center
Professor of Medicine and Radiology
Tufts University School of Medicine
James E. Udelson, MD is Chief of the Division of Cardiology, as well as Director of Nuclear Cardiology, at Tufts Medical Center. He is a Professor of Medicine and Radiology at Tufts University School of Medicine in Boston, and received the Distinguished Faculty Award from the Medical School in 2012. Dr. Udelson’s research interests involve studying the effects of new therapeutic modalities in the setting of heart failure and chronic coronary artery disease, as well as studying the development of imaging modalities to assess those effects. He has been an Associate Editor of the journal Circulation since 2004, and, in 2008, was appointed as the initial Editor-in-Chief for the journal Circulation: Heart Failure. He is on the editorial board and has served as a Guest-Editor for the Journal of the American College of Cardiology and the Journal of Nuclear Cardiology.
Dr. Udelson has served on the AHA/ACC/ASNC Radionuclide Imaging Guidelines Writing Task Force, as well as numerous other national Guideline and Appropriate Use Criteria writing groups, including as a Co-chair of the ACC/ACR Writing Committee for Appropriate Use Criteria to Assess Imaging Modalities to Evaluate Chest Pain in the Emergency Department. He is a chapter author for Braunwald’s Heart Disease textbook for several editions.
Dr. Udelson is Past President of the American Society of Nuclear Cardiology, and has served a 5-year term on the Board of Trustees of the American College of Cardiology (ACC). He has chaired the ACC’s Cardiovascular Imaging Committee, served on the ACC Publications Committee, and completed a term as Chair of the ACC Governance Committee. He has recently commenced a term as a member of the Executive Council of the Heart Failure Society of America.
Richard Allen Williams, MD, FACC, FAHA
Clinical Professor of Medicine
UCLA School of Medicine
Minority Health Institute, Inc.
Los Angeles, CA
Richard Allen Williams, MD, FACC, FAHA founded the Association of Black Cardiologists (ABC) in 1974 and served as its President for 10 years. He also became the first Chairman of the Board of Directors and started the ABC Newsletter. The ABC established the endowed Dr. Richard Allen Williams Scholarship for Black Medical Students in his honor in 1980. Dr. Williams then founded the Minority Health Institute (MHI) in 1987; he is President and CEO of the latter organization. Recently, he served as President of the Charles R. Drew Medical Society in Los Angeles, and was previously a member of the Board of Directors of the Charles R. Drew University of Medicine and Science.
Dr. Williams was awarded a full scholarship to Harvard University and graduated with honors as the first African American student at Harvard from Delaware. He received his Medical Doctorate from the State University of New York Downstate Medical Center, then performed his internship at the University of California San Francisco Medical Center, an internal medicine residency at the Los Angeles County-USC Medical Center, and a cardiology fellowship at Harvard Medical School and Brigham and Women’s Hospital in Boston. He has numerous publications and awards to his credit and is the author of The Textbook of Black-related Diseases published by McGraw-Hill in 1975. This is a 900-page book detailing medical conditions peculiar to African Americans; no other book of its kind has been written before or since, and it is widely considered the classic seminal work on the medical status of African Americans.
An internationally-recognized authority on hypertension, heart failure, and sudden cardiac death, Dr. Williams has been an active and long-time member of the American Heart Association (AHA) and served for more than 25 years on the Board of Directors of the Greater Los Angeles Affiliate. He served as Chairman of the “Search Your Heart” Program sponsored by the AHA in Los Angeles in November 2000. Part of that program included the establishment of the Tommy LaSorda Heart Institute at Centinela Hospital. Dr. Williams also served for 5 years as a panelist for the FDA Devices Committee, during which time he contributed to decisions regarding the artificial heart and other instruments.
This program is intended for community cardiologists, interventional cardiologists, primary care physicians, and other professionals who treat patients with heart failure.
At the conclusion of this activity, participants should be able to demonstrate the ability to:
- Identify current therapies for patients with both reduced and preserved ejection fraction heart failure, as well as for patients of diverse ethnicities
- Analyze mechanisms of action and different clinical attributes of approved therapies and those in clinical development for the management of heart failure
- List therapies under development that have the potential to improve overall outcomes in those with heart failure
- Adopt quality-improvement strategies, such as education and engagement, to involve patients more in the management and monitoring of their disease
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