On a morning in December 2021, Tiffani Craig woke up and had trouble breathing. At 27 weeks into her pregnancy, her first concern was her unborn baby so she rushed to the hospital, where she was immediately admitted to an intensive care unit (ICU).

“When I woke up, I did not know what was happening, I immediately started panicking,” Craig said. “I did not know if I was having a heart attack or if I had gotten pneumonia, or what it was.”

Her diagnosis was peripartum cardiomyopathy (PPCM), a condition with no known cause in which the muscles of the heart become weakened during the final month of pregnancy to as much as five months after delivery.

“She felt as if she was drowning and gasping for air because her lungs were filling up with fluid from her heart failure. However, thanks to the quick direction of our ICU team as well as our cardiology team, we were able to improve her condition rapidly within 24-72 hours,” said Alejandro Rodriguez, MD, assistant professor in the Department of Obstetrics and Gynecology in the USF Health Morsani College of Medicine.

Tiffani stayed in the hospital for 6 weeks due to her heart function being so low, and was monitored closely by Daniela Crousillat, MD, assistant professor in USF Health’s Division of Cardiology, who is a non-invasive cardiologist and advanced echocardiographer with a clinical interest in women’s cardiovascular health.

“We were nervous sending her home because we knew her heart function was so weakened, and we were worried about what that would mean for her and the rest of the pregnancy. She was given ultrasounds of her heart for us to see how it was functioning, which helped us tailor her care and determine the best time to deliver her baby,” Dr. Crousillat said.

During that period of time, Craig and her baby were monitored very closely, which helped Craig carry her baby to full term.

“This whole experience was worth it. It was just amazing to know that my baby is here, and he made it here safely,” Craig said.

Story and video by Ryan Rossy, USF Health Communications and Marketing

Robby Wu, DO, assistant professor of medicine in the Morsani College of Medicine and advanced heart failure and transplant cardiologist for USF Health and Tampa General Hospital, joined the team in August of this year to help strengthen the growing heart failure program. “I did my advanced heart failure and transplant fellowship at USF Health and loved my experiences at TGH, so stayed on as faculty with USF Health,” Dr. Wu said.

Robby Wu, DO, advanced heart failure and transplant cardiologist for USF Health and Tampa General Hospital.

One of the procedures that Dr. Wu performs as an advanced heart failure and transplant cardiologist is the implantation of Abbott’s CardioMEMS HF System. This device is a remote monitoring platform that is FDA approved for wirelessly measuring and monitoring pulmonary artery pressure and heart rate in the New York Heart Association (NYHA) Class III heart failure patients who have been hospitalized for heart failure in the previous year. The catheter-based procedure through the right groin takes about 30-45 minutes and once the paper clip-sized, pressure-sensing device is implanted, the patient will use an at-home electronics unit to take daily pressure readings. This measurement process takes less than a minute and the hemodynamic data and real-time notifications sent to your physician can be used for heart failure management with the goal of reducing heart failure hospitalizations. Patients can also stay engaged with their care by using the myCardioMEMS app where they can keep track of their uploaded readings, set medication reminders, and talk directly with their care team.

The sensor, app and at-home electronics unit used to take the daily measurements. CardioMEMS is a trademark of Abbott or its related companies. Reproduced with permission of Abbott, © 2020. All rights reserved.

Normally, to measure pulmonary artery (PA) pressure, the patient would have to visit a clinic and have a “balloon catheter” inserted by a venous approach. Frequent visits would be time consuming and costly but monitoring the pressure of blood through the PA is critical for heart failure patients. “These hemodynamic changes occur earlier than clinical symptoms such as shortness of breath or leg swelling, so we can catch these changes and act on them before the patient gets into trouble,” Dr. Wu said.

When relying on a manual measuring system at a clinic, the patient is then left in the dark about their health when they’re not hooked up and so, with little ability to take preventative action, rehospitalization is more likely. According to a randomized controlled trial for wireless pulmonary artery haemodynamic monitoring in chronic heart failure referenced by Abbott, “each time you are hospitalized for heart failure, your heart is damaged, which may contribute to your heart failure getting worse.”¹

CardioMEMS is a trademark of Abbott or its related companies. Reproduced with permission of Abbott, © 2020. All rights reserved.

The CardioMEMS HF System was FDA approved in 2014 but was not commercially available to Florida until July of last year. Previously, Tampa General Hospital had been implanting the device on a research-only basis. “The system has been used in many other parts of the country with tremendous success,” Dr. Wu said. “The COVID pandemic has placed a larger emphasis on the critical need for remote monitoring devices and so clearance in Florida was expedited for this use.”

According to Abbott, this remote monitoring platform is the only one on the market that is clinically proven to aid physicians in preventing worsening heart failure,⁴ lowering mortality rates³ and improving quality of life.²

• 33% overall reduction in heart failure hospitalizations over an average of 18 months²
• 50% reduction in heart failure hospitalization for HFpEF patients over an average of 18 months⁵
• Shorter length or stay when patients are hospitalized¹
• 6% freedom from device or system related complications¹
• No pressure sensor failures¹
• Better patient quality of life as shown by significant improvements in Minnesota Living with Heart Failure Questionnaire scores¹

Dr. Wu is passionate about patient-centered care, collaborative team management, and outcome driven protocols and USF Health is glad to have him on board and making life better for patients in the Tampa Bay community. “I am looking forward to the collaboration between USF and TGH and am excited to be a part of such a robust academic health system, Dr. Wu said. “I’m really proud to be working at the best cardiac hospital in Florida.”

Dr. Wu sees patients at USF Health Morsani Center for Advanced Healthcare and USF Health South Tampa Center for Advanced Healthcare (STC). To schedule an appointment, call 813-259-0600.

REFERENCES

1. Abraham, W. T., Adamson, P. B., Bourge, R. C., Aaron, M. F., Costanzo, M. R., Stevenson, L. W., … Yaday, J. S. (2011). Wireless pulmonary artery haemodynamic monitoring in chronic heart failure: A randomized controlled trial. The Lancet, 377(9766), 658-666. n=550. http://dx.doi.org/10.1016/S0140-6736(11)60101-3
2. Abraham, W. T., Stevenson, L., Bourge, R. C., Lindenfled, J., Bauman, J., & Adamson, P. B. (2016). Sustained efficacy of pulmonary artery pressure to guide to adjustment of chronic heart failure therapy: Complete follow-up results from the CHAMPION randomized trial. The Lancet, 387(10017), 453-461. http://dx.doi.org/10.1016/S0140-6736(15)007233-0

1. Abraham J, et al. Association of Ambulatory Hemodynamic Monitoring with Clinical Outcomes in a Concurrent Matched Cohort Analysis. JAMA Cardiology. 2019; 4(6):556-563.
2. Adamson PB. Pathophysiology of the transition from chronic compensated and acute decompensated heart failure: new insights from continuous monitoring devices. Current Heart Failure Reports. 2009; 6:287-292.

5. Adamson, P. B., Abraham, W. T., Bourge, R. C., Costanzo, M. R., Hasan, A. H., Yadav, C., … Stevenson, L. W. (2014). Wireless pulmonary artery pressure monitoring guides management to reduce decompensation in heart failure with preserved ejection fraction. Circulation: Heart Failure, 7(6), 935-944.  http://dx.doi.org/10.1161/circheartfailure.113.001229

The targeted growth will help extend the reach of the academic medical center into national spotlight.

In just over eight months, Guilherme Oliveira, MD, MBA, has reimagined USF Health’s cardiovascular program and established the foundations of a new cardiovascular institute – a collaboration of the USF Health Morsani College of Medicine (MCOM) and Tampa General Hospital (TGH).

“It’s been a busy year,” Dr. Oliveira said. “And there’s much more to come.”

Dr. Guilherme Oliveira

Dr. Oliveira joined USF Health in January 2020 as chief of the Division of Cardiovascular Sciences in MCOM and director of the USFH/TGH Heart and Vascular Institute (HVI), as well as associate director of the USF Health Heart Institute, dedicated to research.

Effectively, he serves as the executive responsible for the entirety of the heart services at USF Health and TGH, a position that provides the opportunity to redesign patient care, strengthen the scientific mission, and elevate the reputations of USF Health and TGH as national leaders in cardiovascular care.

“By redesigning our overall operations and expanding our areas of expertise through recruitment of talented physicians, we are developing greater depth and breadth in every aspect of our mission as an academic medical center: clinical care, research and education,” Dr. Oliveira said. “This all-encompassing approach will not only result in improved patient care and outcomes, but also stronger collaborative research and discovery, putting a national spotlight on our entire program.”

USF Health and TGH have coordinated cardiology efforts for many years and the collaboration has led to significant gains in national rankings – TGH just earned a #1 ranking in Florida by U.S. News & World Report for cardiology and heart surgery, programs led by USF Health faculty with full TGH support.

Designing a framework for comprehensive care and quality education

One of the first steps on the academic and clinical sides, Dr. Oliveira said, was to create dedicated specialty sections within the MCOM Division of Cardiovascular Sciences, which include electrophysiology, interventional, imaging, heart failure, education, and general cardiology/prevention. Careful growth in all sections is the plan, he said, but the general cardiology section will see the biggest push because of the ever-growing demand by patients for general and preventative heart care, especially among women.

“Our general cardiology program needs to meet patient demand and that includes adding a stronger focus on women’s health and prevention,” he said. “We are also taking advantage of our faculty expertise and establishing ultra-specialized programs, including cardiovascular genetics, cardiac amyloidosis, hypertrophic and inflammatory cardiomyopathies, pulmonary hypertension and a pericardial clinic.”

In addition, Dr. Oliveira said he is focused on expanding the aortic, mitral valve, and neurocardiology programs, bringing new and innovative technology to patients in Tampa Bay and beyond.

In partnership with Moffitt Cancer Center, Dr. Oliveira said he is also planning to expand cardio-oncology, transitioning from a small program to a full-fledged cardiology service line at Moffitt.

To support these and other areas, several talented faculty members have been successfully recruited, including two key hires he says will bring renowned expertise to the USF Health and TGH programs: the new chief of cardiothoracic surgery, Lucian Lozonschi, MD, whose expertise includes robotic and minimally invasive cardiac surgery, heart transplant and valve surgery, and Hiram Bezerra, MD, PhD, who, in addition to being an internationally recognized interventional cardiologist, brings with him a robust portfolio of clinical trials.

Dr. Lucian Lozonschi

In addition to leading cardiac surgery, Dr. Lozonschi serves as the associate director of HVI. He is also the surgical director of heart transplant and mechanical circulatory support, and associate director of the Transplant Institute.

Dr. Hiram Bezerra

And Dr. Bezerra is the section chief of interventional cardiology at USF Health and directs the Interventional Cardiology Center within the HVI. With more than 160 peer-reviewed research articles and memberships at numerous editorial boards and professional committees, Dr. Bezerra brings to USF Health and TGH his research experience in interventional cardiology and optical coherence tomography.

Building a new destination cardiovascular center

The new USF Health/TGH Heart and Vascular Institute is designed to be a destination cardiovascular institute built on the best clinical and scientific expertise available at both USF Health and TGH. It also benefits from collaboration and innovative opportunities provided by organizations outside of the academic medical center, including private practices and biomedical industry.

“Our main goal is to conduct high-impact, disruptive cardiovascular research,” Dr. Oliveira said. “And our collaborative reach will go beyond just TGH and USF Health and stretch well into the greater Tampa Bay area physicians in private practice. Together, we are building an institute that is unparalleled in Florida.”

The HVI comprises several centers of excellence focusing on core areas of cardiovascular care: cardiac surgery, vascular surgery, interventional, electrophysiology, heart failure, imaging, and prevention. In addition, Dr. Oliveira created centers for education and cardiovascular research, with a quality office that ties all the centers together and ensures world-class outcomes.

A central advantage of the HVI will be its ambulatory headquarters – within the new Morsani College of Medicine and Heart Institute tower, just opened in January 2020. On the ninth floor of the new building, HVI team members will offer direct patient care for the most complex cardiovascular conditions, which often require a multidisciplinary approach. There, patients can expect to have a wide range of cardiac testing followed by consultations with a multidisciplinary team of cardiologists, pulmonologists, geneticist and surgeons. Because clinical care at the HVI will take place adjacent to the world-class research facilities of USF Health Heart Institute, it will enable conduction of bench-to-bedside science that hopefully will impact cardiovascular disease for generations to come. Added to that is the proximity to TGH, where surgical intervention and transplant programs round out the entire spectrum of patient care.

“This will be a highly integrated, synergistic union of every facet of heart care,” Dr. Oliveira said. “Consider it the trifecta of clinical, translational and basic research within a clinical care setting. In other words, a one-stop shop for superior academic cardiovascular care.”

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USF Health has established a Neurocardiogenetics Clinic focused on improving the quality of life for patients with hereditary neuromuscular disorders who are at risk for or already experiencing cardiac complications. Innovative genetic research is a central component of the new clinic.

The multidisciplinary clinic teams faculty and staff with clinical expertise in cardiology, genetics and neurology. The clinic is directed by Aarti Patel, MD, assistant professor of cardiology and director of the Cardiac Imaging Fellowship Program at USF Health in collaboration with Thomas McDonald, MD, professor of cardiology and molecular pharmacology and physiology, and a member of the USF Health Heart Institute, and Theresa Zesiewicz, MD, professor of neurology and director of the USF Health Ataxia Research Center. Patients receive a complete cardiac examination and testing along with a comprehensive family genetic evaluation from providers familiar with their neurological history.

“Combining all that information, we are able to come up with a personalized treatment plan,” Dr. Patel said.

Many patients initially seen at the Neurocardiogenetics Clinic have been diagnosed with Friedreich’s ataxia (FA), a rare, debilitating and life-shortening neuromuscular disorder that usually strikes in childhood. At some point in their lives 55 to 60-percent of FA patients develop some form of cardiac disease. The most devastating of these is cardiomyopathy, a heart muscle disease that limits blood pumped to the rest of the body and increases risk for heart failure and abnormal heart rhythms.

“FA is a multisystem disease that affects many different parts of the body, including the heart,” Dr. Zesiewicz said. “And one of its most sinister complications is cardiomyopathy, an enlarged heart.”

The Neurocardiogenetic clinic offers patients and their families the opportunity to participate in ongoing genetic studies exploring potential links between heart disease and neuromuscular diseases like FA and certain types of other ataxias and muscular dystrophies.

Dr. Aarti Patel (left), assistant professor of cardiology, collaborates with Dr. Thomas McDonald, professor of molecular pharmacology and physiology, at the new USF Health Neurocardiogenetics Clinic. Dr. Theresa Zesiewicz. professor of neurology (not pictured), is another collaborator.

While a deficiency in the frataxin protein can lead to fibrosis and scarring of heart muscle tissue in FA, competing theories exist about how a genetic mutation may actually result in heart problems in this particular ataxia and other neuromuscular disorders.

Dr. McDonald’s research team is searching for answers to many questions, including how different genetic variations may lead to cardiac abnormalities and affect the severity of heart disease.

Small blood samples are collected from patient volunteers with different inherited neuromuscular and/or cardiac disorders, as well as family members who are unaffected genetic carriers of neuromuscular diseases. In laboratory cell culture dishes, USF Health researchers genetically reprogram the blood cells into pluripotent stem cells that can grow into any cell type. Then they induce these stem cells — containing the same genetic make-up as the patient who provided blood — to become nerve cells and heart muscle cells.

The goal is to work out at a molecular level how FA or other inherited neuromuscular diseases damage the heart muscle. Once that is achieved, Dr. McDonald said, the “disease in a dish” can be used to identify potential drug targets and test treatment options on the patient’s own cells.

“With stem cell technology and disease-in-a-dish modeling, we’re looking for the earliest changes in either a heart or a nerve cell (that lead to disease),” he said. “A big unanswered question is whether the molecular or cellular process happening in the nerve is the same as that damaging the heart muscle. By using stem cell-based research we hope to be able to determine if there is a connection between the nerve and the heart – or whether it’s a separate, independent process but based upon the same genetic defect.”

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The collaborative research builds upon robust data collected by doctors in the clinic, including the wide range of symptoms seen in patients with hereditary neurological disorders involving cardiac complications.

Ultimately, that can help improve understanding of why genetic variations in certain neuromuscular diseases cause cardiac complications, Dr. McDonald said. “Having a clear clinical picture of each research participant will help us correlate the genetics and function of cells we see in the laboratory with how that translates to disease progression in the individual.”

“With careful clinical surveillance and novel biomarkers, our hope is that we will be able to predict which patients and their family members are at highest risk for cardiovascular disease so we can intervene early with effective treatment,” Dr. Patel said. “We’re hoping to identify patients even before they develop cardiac symptoms, so we can prevent heart disease.”

-Video and photos by Allison Long, USF Health Communications and Marketing

Cardiologists could and should take more action in guiding their patients to interventions aimed at delaying, and even preventing, diabetes, USF Health faculty proposed last month in a review published  in the American Journal of Cardiology.

“We propose cardiologists can play a key role in preventing diabetes and aligning practice patterns with guideline recommendations among endocrinology, cardiology, and primary care stakeholders,” wrote Nicholas W. Carris, PharmD, assistant professor in the USF Health College of Pharmacy.

The review article, which summarizes previously published studies on the topic, presents cohesively for the first time the specific factors contributing to an apparent lack of action by clinicians, and suggests an approach that might better encourage cardiologists to proactively engage their patients who have prediabetes.

“The prediabetes timeframe is an opportunity to act and significantly reduce the likelihood of someone progressing to diabetes,” Dr. Carris said. “It’s an opportune time to help patients at considerable cardiometabolic risk and to have a significant impact on the current diabetes epidemic.”

“Eighty-four million patients in the United States have prediabetes and at least 70 percent will develop diabetes unless they receive an intervention,” he said. “Most of these patients have or are at risk for cardiovascular disease, with recent reports describing significantly increased microvascular and macrovascular risks among patients with prediabetes.”

Central to what Dr. Carris and authors suggest is for cardiologists to actively engage their patients with prediabetes and implement evidence-based methods of diabetes prevention.

“For several key reasons, we believe cardiologists have a responsibility and opportunity to improve the health of their patients with prediabetes by making it a very high priority to prevent progression to diabetes,” Dr. Carris said. “First, we must recognize that multiple cardiovascular medications may increase risk for new-onset diabetes. Second, avoiding or delaying diabetes’ onset can improve quality of life and decrease health-system cost. And third, because heart disease and stroke are the most common causes of death in people with diabetes, we expect that preventing diabetes will improve long term health.”

The authors go on to note how strong an influence cardiologists could have on shifting the diabetes epidemic.

“Cardiologists are increasingly being asked to weigh in on diabetes management as select agents demonstrate cardiovascular benefit… as the mortality risk of patients with a history of myocardial infarction and diabetes is almost double that of patients with a history of myocardial infarction who are free of diabetes, there is even more potential benefit in delaying/avoiding diabetes in patients with cardiovascular disease.”

Current methods of intervention show an impact in reversing prediabetes or slowing progression to diabetes, Dr. Carris said.

“Cardiologists are centrally positioned to help patients adopt a healthier lifestyle and prescribe therapeutic and preventive medications when appropriate,” he said. “Studies have shown that intensive lifestyle intervention, metformin, and other medications reduce the progression to diabetes.

“The bottom line is, it cannot be ignored that avoiding diabetes is an important outcome – at the very least from a humanistic perspective – and cardiologists are pivotal to helping patients avoid diabetes.”

Michael Fradley, MD, had finished medical school. He’d completed training in internal medicine and cardiology.   He decided to pursue further training in electrophysiology, and began observing a substantial number of cancer patients were experiencing abnormal heart rhythms.   Then, in the midst of his fellowship, the unthinkable happened.  He received his own cancer diagnosis – melanoma.

“I had to undergo certain procedures and treatments but fortunately now I’m fine,” said Dr. Fradley, associate professor of medicine at the USF Health Morsani College of Medicine.  “As a result of this experience, I had this very new perspective on my life and my career. I had been personally affected by cancer … and I have this passion for cardiology. Wouldn’t it be an amazing opportunity to try to bring the two together?”

USF Health cardiologist Michael Fradley, MD, speaks to a patient at the Cardio-Oncology Clinic at Moffitt Cancer Center.

While Dr. Fradley was finishing his electrophysiology fellowship, Roohi Ismail-Khan, MD, a medical oncologist at Moffitt Cancer Center, was noticing a worrying trend — many of her breast cancer patients experienced cardiac issues during and after treatment. “We were getting much better at treating cancer,” she said, but “why put patients through something that’s going to help them survive the cancer and then have [cardiac] issues to deal with later on?” So, in late 2014, about a year after Dr. Fradley joined the cardiology team at USF Health, the pair began a Cardio-Oncology Program jointly developed by USF Health and Moffitt. “It was all just a perfect fit,” Dr. Fradley said.

Integrating research into cardio-oncology care

Cardio-oncology is an emerging field — one in which there are still many questions left to answer. Dr. Fradley and Dr. Ismail-Kahn didn’t just want to treat patients; they wanted to research how to do it better. They enlisted the help of biomedical engineer Hua Pan, PhD, MBA, an assistant professor of cardiovascular sciences and member of the USF Health Heart Institute. Dr. Pan conducts basic and translational research on the molecular mechanisms through which cancer treatments damage the heart. This includes investigating genetic signals that may help predict which patients receiving new drugs to boost the body’s immune system response against certain cancers are likely to develop cardiovascular complications.

Biomedical engineer Hua Pan, PhD, a member of the USF Health Heart Institute, works with Dr. Fradley and collaborators at Moffitt Cancer Center to incorporate basic science and translational research into the joint Cardio-Oncology Program.

The cardiologist, oncologist and basic scientist came together to form a powerful academic research and training program. “It’s one of the first [cardio-oncology programs] in this nation to incorporate basic science and the translational component into a cardio-oncology program,” Dr. Pan said. “It connected the dots. This is very unique.”

There was a time when a cancer diagnosis was almost equivalent to a death sentence. Nowadays, nearly 70% of people diagnosed with cancer will survive, thanks to the advent of treatments like chemotherapy, radiation therapy, and immunotherapy, according to the National Cancer Institute. But those life-saving therapies have come at a cost. Up to 30% of cancer patients develop cardiovascular complications. The issue is so common that it’s become the leading cause of death in cancer survivors. Those therapies, which so effectively attack cancer cells, can also damage the heart and increase the risk of heart disease in the future. And if a patient is already at risk of heart disease due to obesity, diabetes, or genetics, that risk is amplified by cancer treatment.

A collaboration that optimizes treatment

That’s something Dr. Ismail-Kahn had to consider when treating patients. For patients with clear risk factors for heart disease, she might choose a less aggressive — and potentially less effective — treatment plan to avoid cardiac complications.

Now, when a patient comes to see Dr. Ismail-Kahn for cancer treatment, she sets the patient up with an appointment with Dr. Fradley as well. Dr. Ismail-Kahn determines the ideal treatment for the patient’s cancer. She’ll send that information to Dr. Fradley, who after reviewing the patient’s cardiac history and conducting various tests on the patient’s heart and blood, will develop a plan to monitor and prevent cardiovascular complications throughout treatment. That plan may require guiding the patient through preventive measures like changes in diet and exercise or starting the patient on cardiac medications. It will also include regular cardiac checkups with Dr. Fradley so he can identify any cardiac effects before they become severe and offer an intervention or suggest a temporary break from cancer treatment if needed.

Moffitt Cancer Center oncologist Roohi Ismail-Khan, MD

“Let’s just say I have an 80-year-old patient with history of heart disease and she needs certain chemotherapy and certain targeted therapy to help with her cancer,” Dr. Ismail-Kahn said. Before working with a cardio-oncologist, she might have chosen a less effective treatment plan in order to prevent heart disease. Now, she says she’s “braver in treating patients.” Working with a cardio-oncologist who understands how cancer drugs interact with the heart, can watch the heart closely, and knows what interventions can help, gives her confidence that any cardiovascular risks will be managed appropriately so that she can give the right treatment for each patient.

One of the nation’s first cardio-oncology fellowships

But there aren’t enough cardio-oncologists for all programs to offer such care. As such, Dr. Fradley developed one of the first cardio-oncology fellowship programs in the United States, focusing on training a new generation of cardiologists to specialize in this field. ‘It’s important for trainees to get dedicated exposure to the complexities of this patient population,” Dr. Fradley explained. “This is an excellent opportunity to disseminate knowledge to other institutions and organizations. And these individuals will become the future leaders of the specialty.”

Moving the field forward will take more than training new specialists. That’s why the program is set up to conduct multidisciplinary research while it offers its multidisciplinary treatment. The physicians treating patients every day see first-hand which questions need to be answered to improve care. Not only do they design studies to test clinical interventions, but they pass their questions along to Dr. Pan through a special communication channel designed by Dr. Fradley to facilitate conversations between the extremely busy team members. Dr. Pan can use their observations to guide her studies looking at what patients are experiencing on a molecular level. This understanding can then be used to develop better, more precise treatments.

“A combination of both clinical investigation and translational research is necessary to advance the field,” Dr. Fradley said.

Cancer survivor Abby Jones with her husband Ross on a recent vacation in Colorado. Jones, one of the first patients in the Cardio-Oncology Program jointly developed by USF Health and Moffitt Cancer Center, credits the program with playing a “huge part” in helping restore her health.

Heart healthy and cancer free

The future of cardio-oncology is exciting, but the program is already making a huge difference for patients in Florida, like Abby Jones of Ocala.  Jones was one of the very first patients to participate in the program for cancers of her lung and kidney (removed completely by surgery) and breast cancer. She was young and otherwise healthy, so Dr. Ismail-Khan decided to treat Jones’ bilateral breast cancer with the most aggressive therapy available.  During chemotherapy and targeted therapy with the drug trastuzumab (a combination with a high likelihood of cure, but that can have toxic effects on the heart), Jones received routine echocardiograms to monitor her cardiac function.  When one of echocardiograms revealed that her heart wasn’t pumping effectively, Dr. Ismail-Khan immediately referred Jones to Dr. Fradley in the Cardio-Oncology Clinic.

Dr. Fradley recommended a 7-week break from the chemotherapy, during which Jones took low-dose blood pressure medications. Soon, she was able to safely continue her chemotherapy. Today, she is cancer-free. (In fall 2016, a different type of breast cancer was detected early; Jones underwent a lumpectomy, her heart was closely monitored during another potentially cardiotoxic chemotherapy regimen, and the treatment succeeded without cardiac complications.)

Jones continues annual appointments with Dr. Fradley to ensure her heart remains healthy, and follows up with Dr. Ismail-Khan to make sure she remains cancer-free.

“I’m two years clean from the most recent diagnosis and celebrating life. The Cardio-Oncology team played a huge part in helping me get back to myself,” she said. “We welcomed newborn twins into our home as foster children earlier this year with a goal of adoption on the horizon.  And last month, I got to drop my oldest off at his first day of kindergarten… it was so fun to watch!”

Jones with Dr. Fradley and Dr. Ismail-Khan at a luncheon in February 2016, marking the first year of the newly established Cardio-Oncology Program.

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Moffitt Cancer Center and USF Health (with Drs. Fradley and Ismail-Khan as co-chairs) will host the fourth Cardio-Oncology Summit, Sept. 27 and 28, at the Hilton Tampa Downtown, alongside the International Cardio-Oncology Society, the Canadian Cardiac Oncology Network and the British Cardio-Oncology Society.  This is the summit’s first time in Tampa; previous conferences have been held in London, Vancouver and Nashville. More than 320 participants from 23 countries are expected to attend the summit, which models a leading-edge interdisciplinary approach to preventive and targeted medicine in cardio-oncology. Read more.

-Story by Emma Yasinski

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After suffering his first heart attack 22 years ago, David Gilberg has endured more heart procedures than anyone could count on both hands. Fourteen in fact.  But today, the 72-year-old Minnesota native has a new lease on life, thanks to a procedure performed by cardiologist Bibhu Mohanty, MD, of the USF Health Department of Cardiovascular Sciences.

While the procedure to open a narrowed coronary artery in Gilberg’s heart was fairly routine as far as percutaneous coronary intervention (PCI) goes, the real magic occurred when he felt someone listened to his concerns at long last.

Gilberg spent his entire life farming dairy cattle in northern Minnesota.  A humble and spiritual man, Gilberg worked an area of the country that he termed as having “real, real cold weather.” After visiting Florida for years to escape the frigidity, he moved permanently to Sun City in 2013.  Solidifying the lifestyle change, Gilberg sold his farm last year.  “I had a hard time letting it go. When you’ve been a farmer all of your life, that soil is in your hands. It’s just something that is a part of you.”

Patient David Gilberg of Sun City Center with USF Health cardiologist Bibhu Mohanty, MD.

For more than a year, Gilberg dealt with a severe dysfunction, including shortness of breath.  At times Gilberg could hardly get from bed to bathroom. A quick trip to the grocery store was dreaded.

“I had to know exactly what I wanted and where it was,” he said.  I hurried through the aisles, sometimes having to sit down. After just a few minutes, I returned to the car out of breath and exhausted.”

Gilberg’s ongoing heart issues stemmed from heart disease on both sides of his family. Before seeing Dr. Mohanty, Gilberg took as many as 15 nitroglycerine pills daily. The pain in his arms and chest grew stronger every day.  When he complained to his cardiologist of five years, the doctor said he was fine.

In December, he’d finally had enough.  On a recommendation, he made an appointment with Dr. Mohanty for a second opinion.

When Gilberg met Dr. Mohanty in Sun City, he was concerned that the doctor would diagnose his problem and it would be the last time he saw him.

At the initial visit, the USF cardiologist wondered if one of the stents was possibly clogging up.

“From the beginning, Dr. Mohanty assured me he would be with me throughout my hospital stay.  He said he’d be right there and he was,” Gilberg said with a big smile.  “He came to my hospital room, checked in several times, and always had a very positive attitude.  His bedside manner is second to none. He is the nicest, most concerning fella.”

Not only is Dr. Mohanty’s bedside manner on point, “He saved my life!” said Gilberg, after Dr. Mohanty placed a 10th stent in his heart in January.  Just one month later, Gilberg is walking up to a mile and a half each day.

Dr. Mohanty speaks with Gilberg during an office follow-up visit.

“Being strictly adherent to an optimal medication regimen for coronary artery disease is critical,” Dr. Mohanty said. “When we met, his regimen was not optimal for his history, and we made some significant adjustments.”

With a new vigor, Gilberg is now making plans to visit Minnesota, and might even travel to Sweden to visit relatives in his homeland.  With a daughter, Jenny, in Sarasota and another, Molly, still in Minnesota, he has a lot of love and support.  Molly’s family will welcome their eighth child in July.  Gilberg now plans to visit them twice a year to celebrate his grandchildren’s birthdays.

Gilberg smiles big when he talks about visiting family in Minnesota, an adventure he never dreamed possible a couple of months ago.  “No matter where you go in this world, there is a place that’s home.  ‘Home’ sometimes is the things you have – what you bring with you that kind of makes it feel like home.  But home is always where you were born and raised. And home for me is Minnesota.”

Gilberg’s grandkids are a bright spot as well.   Prior to Hurricane Irma, they wanted to Facetime every day, and nervously asked him about impending Hurricane Irma.   “You know Papa,” 10-year old grandson George said at the time, “I want to see you a few more times — not just in heaven, so you have to take care of yourself and go to a shelter if the storm comes, ok?”

Thanks to Dr. Mohanty, Gilberg will be much more than a just a face on a phone screen. His grandkids will now be able to play with “Papa” in person for a long time.

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Dr. Mohanty attended Duke University Medical School and also did his residency at Duke.  He completed three fellowships: Cardiovascular Disease at Mouth Sinai School of Medicine, Interventional Cardiology at Johns Hopkins Medical Center, and Structural Intervention at Dartmouth Medical School.

To learn more about life-changing cardiovascular research and patient care at USF, visit the USF Health Heart Institute website.

-Story and photos by Michelle Young, USF Health Communications and Marketing

//www.youtube.com/watch?v=wbGCYIyMlEE

TAMPA, Fla.  (August 30, 2017) — Pacemakers help people live longer, active lives. They’re also often worn for decades at a time. But a pacemaker’s wiring could get infected, and the signs are too similar to typical ailments. It’s something 68-year-old Richard Agger of Brandon, Fla. experienced first-hand while trying to treat what he thought was a bacterial infection.

“The pacemaker had an infection on it, the wires had an infection on it. I had these other wires in for 12 years, they were eaten away,” Agger said.

USF Health electrophysiologists Dr. David Wilson (left) and Dr. Ray Cutro (right) performed the unique procedure to remove infections from a patient’s pacemaker wires.

“The attachment of the hardwire or attachment leads makes it difficult because as we remove the leads, the large foreign body attaches to it, the fungal ball. It can dislodge and cause cardiac pulmonary arrest,” said University of South Florida electrophysiologist Dr. Ray Cutro.

Dr. Cutro and Dr. David Wilson are assistant professors of cardiology and co-directors of the lead management program at the USF Health Morsani College of Medicine. Out of the hundreds of complex operations performed, they say this one required extensive teamwork and creativity.

“I had five infections. The infections broke off and were at the top of my heart and the top of my lungs and they had to use this new procedure to vacuum out those pieces which were as big as ice cubes,” Agger said.

Richard Agger, 68, eager to return to his hobby of paramotor sailing, said the USF team “diagnosed me, fixed me, saved my life.”

“The AngioVac is almost like a Shop-Vac or Wet-Vac you can use within blood vessels and it’s something that could suck anything out immediately in front of it in liters per minute,” Dr. Wilson said.

The device is typically used to remove foreign objects or a blood clot, not such a fragile infection like Richard’s.  “It’s definitely unique,” Dr. Cutro said.

“The USF people gave me the team approach, diagnosed me, fixed me, saved my life. I made it to the hospital just in time. I was septic, you know what happens when you’re septic? You die! They saved my life, I just made it. End of story,” Agger said.

“It puts in perspective everything that we are doing. Like every other profession there are days where the hours or stress may get to you. But having these positive success stories and really impacting someone’s life, makes it all worth it,” Dr. Cutro said.

Dr. David Wilson pulls up a video of the AngioVac procedure on his smartphone.

Drs. Cutro and Wilson encourage patients with a pacemaker who have a nagging illness to get checked for infected wires. It is very rare, but those with diabetes, kidney disease and other conditions are at greatest risk.

-Story by Tina Meketa, and video and photos by Ryan Noone

The founding director of the USF Health Heart Institute has a passion for innovation, translational medicine and entrepreneurship.

Samuel A. Wickline, MD, has parlayed his expertise in harnessing nanotechnology for molecular imaging and targeted treatments into an impressive $1-million portfolio of National Institutes of Health awards, multiple patents and four start-up biotechnology companies.

“We’ve developed nanostructures that can carry drugs or exist as therapeutic agents themselves against various types of inflammatory diseases, including, cancer, cardiovascular disease, arthritis and even infectious diseases like HIV,” said Dr. Wickline, who arrived at USF Health last month from the Washington University School of Medicine in St. Louis.

Dr. Wickline: “Innovation is not just about having a new idea, it’s about having a useful idea.”

 Dr. Wickline comments on how being a physician adds perspective to the science he conducts.

At Washington University, Dr. Wickline, a cardiologist, most recently was J. Russell Hornsby Professor in Biomedical Sciences and a professor of medicine with additional appointments in biomedical engineering, physics, and cell biology and physiology.

“I like the challenge of building things,” he said.

In St. Louis, he built a 29-year career as an accomplished physician-scientist keenly interested in translating basic science discoveries into practical applications to benefit patients. He served as chief of cardiology at Jewish Hospital, developed one of the first cardiac MRI training and research programs in the country, helped establish Washington University’s first graduate program in biomedical engineering, and led a university consortium that works with academic and industry partners to develop medical applications for nanotechnology.

At USF, there will be no shortage of challenging opportunities to build.

Building the USF Health Heart Institute

A major part of Dr. Wickline’s new job is helping to design, build and equip the Heart Institute. Most importantly, he will staff the state-of-the-art facility with a critical interdisciplinary mix of top biomedical scientists (including immunologists, molecular biologists, cell physiologists and genomics experts), who investigate the root causes of heart and vascular disease with the aim of finding new ways to detect, treat and prevent them. The Heart Institute will be co-located with new Morsani College of Medicine in downtown Tampa; construction on the combined facility is expected to begin later this year.

“I have been impressed by the energy and commitment here at the University of South Florida to invest substantial resources in a heart institute,” Dr. Wickline said. “I believe we have a lot to offer in terms of bench-to-bedside research that could solve some of the major cardiovascular problems” like atherosclerosis or heart failure.

“We want to put together a program that supplies the appropriate core facilities to attract the best and brightest researchers to this cardiovascular institute.”

Cardiovascular disease is the leading cause of death in the United States and worldwide, so exploring potential new treatment options is critical. One of the Heart Institute’s driving themes will be advancing concepts and findings that prove promising in the laboratory into projects commercialized for clinical use, Dr. Wickline said.

“Our goal is to make a difference in the lives of patients,” he said. “Innovation is not just about having a new idea, it’s about having a useful idea.”

Dr. Wickline also serves as associate dean for cardiovascular research and a professor of cardiovascular sciences at the Morsani College of Medicine. He holds the Tampa General Endowed Chair for Cardiovascular Research created last year with a gift from USF’s primary teaching hospital.

With Washington University colleague Hua Pan, PhD, a biomedical engineer and expert in molecular biology, Dr. Wickline is re-building his group at USF. Dr. Pan was recently recruited to USF as an assistant professor of medicine to continue her collaborations with Dr. Wickline.

 An example of Dr. Wickline’s group using nanotechnology to help combat atherosclerosis.

Dr. Wickline’s lab focuses on building nanoparticles to deliver drugs or other therapeutic agents to specific cell types, or targets.

Designing nanoparticles to “kill the messenger”

Dr. Wickline’s lab focuses on building nanoparticles – shaped like spheres or plates, but 10 to 50 times smaller than a red blood cell – to deliver drugs or other therapeutic agents through the bloodstream to specific cell types, or targets. These tiny carrier systems can effectively deliver a sizeable dosage directly to a targeted tissue, yet only require small amounts of the treatment in the circulation to reduce the risk of harmful side effects.

Some types of nanoparticles can carry image-enhancing agents that allow researchers to quantify where the illuminated particles travel, serving as beacons to specific molecules of interest, and enabling one to determine whether a therapeutic agent has penetrated its targeted site, Dr. Wickline said.

Dr. Wickline also is known for designing nanoparticles derived from a component of bee venom called melittin. While bee venom itself is toxic, Dr. Wickline’s laboratory has detoxified the molecule and modified its structure to produce a formula that allows the nanoparticles to carry small interfering (siRNA), also known as “silencing RNA,” or other types of synthetic DNA or RNA strand.

Among other functions, siRNA can be used to inhibit the genes that lead to the production of toxic proteins. Many in the nanotechnology research and development community are working to make siRNA treatment feasible as what Dr. Wickline calls “a message killer,” but the challenges have been daunting.

“The big challenge in the field of siRNA, and many companies have failed at this, is how to get the nanostructure to the cells so that the siRNA can do what it’s supposed – hit its target and kill the messenger — without being destroyed along the way, or having harmful side effects,” Dr. Wickline said. “We figured out how to engineer into a simple peptide all of the complex functionality that allows that to happen.”

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 Dr. Wickline comments on the underlying similarities between cardiovascular disease and cancer.

Different targets, same delivery vehicle

In a recent series of experiments in mice, Dr. Wickline and colleagues have shown that silencing RNA messages delivered by nanoparticle to a specific type of immune cell known as a macrophage – a “big eater” of fat – actually shrinks plaques that accumulate inside the walls of the arteries during atherosclerosis, one of the main causes of cardiovascular disease. The build-up of atherosclerotic plaques with fat-laden macrophages narrows, weakens and hardens arteries, eventually reducing the amount of oxygen-rich blood delivered to vital organs.

This type of plaque-inhibiting nanotherapy could be useful in aggressive forms of atherosclerosis where patients have intractable chest pain or after an acute heart attack or stroke to prevent a secondary cardiac event, Dr. Wickline said.

In another study, Washington University School of Medicine researchers investigated the potential of the siRNA nanoparticle designed by co-investigators Dr. Pan and Dr. Wickline in treating the inflammation that may lead to osteoarthritis, a degenerative joint disease that is a major cause of disability in the aging population. The nanoparticles — injected directly into injured joints in mice to suppress the activity of the molecule NF-κB — reduced local inflammation immediately following injury and reduced the destruction of cartilage. The findings were reported September 2016 in the Proceedings of the National Academy of Sciences.

Previously, Dr. Wickline said, the Washington University group had shown that nanoparticles delivered through the bloodstream inhibited inflammation in a mouse model of rheumatoid arthritis. And, another laboratory at the University of Kentucky is studying whether locally injected siRNA nanoparticles can quell the bacterial inflammation that can lead to a serious gum disease known as periodontitis. Other collaborating labs are using these nanoparticles in pancreatic, colon, and ovarian cancers with good effects.

“The specific targets in these cases may be different, but the nice thing about this kind of delivery system for RNA interference is that the delivery agent itself, the nanostructures, are the same,” Dr. Wickline said. “All we have to do is change out a little bit of the genetic material that targets the messages and we’re set up to go after another disease. So it’s completely modular and nontoxic.”

The St. Louis-based biotechnology company Trasir Therapeutics is developing these peptide-based nanocarriers for silencing RNA to treat diseases with multiple mechanisms of inflammation. Dr. Wickline co-founded the company in 2014 and continues to serve as its chief scientific officer.

Dr. Wickline with colleague Hua Pan, PhD, a biomedical engineer with expertise in molecular biology.

 Inhibiting chronic inflammation without getting rid of beneficial immune responses.

Calming the destructive cycle of inflammation

Dr. Wickline’s work is supported by several NIH RO1 grants, including one from the National Heart, Lung and Blood Institute to develop and test nanotherapies seeking to interrupt inflammatory signaling molecules and reduce the likelihood of thrombosis in acute cardiovascular syndromes.

In essence, Dr. Wickline said, he is interested in suppressing chronic inflammation, without disrupting the beneficial functions of surveillance by which the immune system recognizes and destroys invading pathogens or potential cancer cells.

“If you can inhibit the ongoing inflammation associated with (inappropriate) immune system response, you inhibit the positive feedback cycle of more inflammation, more plaques, more damage and more danger,” he said. “If you can cool off inflammation by using a message killer that says (to macrophages) ‘don’t come here, don’t eat fat, don’t make a blood clot’ – that’s what we think could be a game changer.”

Another NIH grant has funded collaborative work to develop an image-based nanoparticle that detects where in a compromised blood vessel too much blood clotting (hypercoagulation) occurs, and delivers potent anti-clotting agent only to that site. Formation of abnormal blood clots can trigger a heart attack when a clot blocks an artery that leads to heart muscle, or a stroke when a clot obstructs an artery supplying blood to the brain.

Because this site-specific nanotherapy targets only areas of active clotting, it may provide a safer, more effective approach against cardiac conditions like atrial fibrillation and acute heart attack than existing anticoagulant drugs such as warfarin and newer blood thinners like Xarelto® (rivaroxoban) or Eliquis® (apixiban), all which work systemically and come with raised risk for serious bleeding, Dr. Wickline said.

In a study published last year in the journal Arteriosclerosis, Thrombosis, and Vascular Biology, Dr. Wickline and colleagues found that nanoparticles delivering a potent inhibitor of thrombin, a coagulant protein in blood that plays a role in inflammation, not only reduced clotting risk but also rapidly healed blood vessel endothelial barriers damaged during plaque growth.

The preclinical work showed the experimental treatment “is actually an anti-atherosclerotic drug as well as an anti-clotting drug, so there are many potential applications,” Dr. Wickline said.

Dr. Wickline received his MD degree from the University of Hawaii School of Medicine. He completed a residency in internal medicine, followed by clinical and research fellowships in cardiology at Barnes Hospital and Washington University, where he joined the medical school faculty in 1987.

He has authored more than 300 peer-reviewed papers and holds numerous U.S. patents. Dr. Wickline is a fellow of the American College of Cardiology and the American Heart Association, and a 2014 recipient of the Washington University Chancellor’s Award for Innovation and Entrepreneurship.

– Photos by Sandra C. Roa and Eric Younghans

Abby Jones was diagnosed with breast, kidney and lung cancers at Moffitt Cancer Center two years ago – all at age 29.

“Who knew I would have to deal with the threat of cardiovascular disease while I was being treated for cancer,” said Jones, a healthy non-smoker who through genetic testing discovered she had a rare disorder that greatly increased her risk of developing several types of cancer.

Jones shared her personal story about overcoming cancer and a chemotherapy-associated cardiac complication Feb. 17 during a luncheon marking the first year of the Cardio-Oncology Program jointly developed by USF Health and Moffitt Cancer Center. More than 130 community, USF and Moffitt leaders attended the educational event, along with several patients and their families.

Abby Jones of Ocala, Fla., center, was one of the first cancer patients to benefit from the Cardio-Oncology Program jointly established in late 2014 by USF Health and Moffitt Cancer Center. She poses here with here with her doctors, Moffitt oncologist Dr. Roohi Ismail-Khan, right, and USF Health cardiologist Dr. Michael Fradley.

The Ocala resident was one of the first patients to participate in the USF Health-Moffitt program, which aims to reduce the risk of cardiovascular complications and prevent cardiovascular disease in cancer patients and survivors.

Jones’ kidney and lung cancers were completely removed surgically. But, research has shown that Herceptin (trastuzumab), one of the chemotherapy drugs administered to help treat Jones’ breast cancer, can have significant toxic effects on the heart. So, Roohi Ismail-Khan, MD, Jones’ oncologist at Moffitt, made sure Jones’ heart was monitored routinely during chemotherapy. When an echocardiogram indicated reduced heart pumping function, Dr. Khan referred Jones to colleague Michael Fradley, MD, a USF Health cardiologist.

After a 7-week “vacation” from Herceptin until her heart function returned to normal and the addition of a low-dose blood pressure medication, Jones said, she was able to successfully complete the optimal chemotherapy regimen for her type of breast cancer last year without cardiotoxic side effects. She will continue to see Dr. Fradley and have her heart tested yearly.

Last weekend, Jones and her husband took their 3-year-old son on a trip to Disney World. “I definitely benefitted from this program,” she said.

From left, Dr. Fradley speaks with Dr. Arthur Labovitz, chair of cardiovascular sciences at USF Health, and Dr. Charles Lockwood, senior associate vice president for USF Health and dean of the Morsani College of Medicine.

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Since its creation in late 2014, 520 patients have used the USF Health-Moffitt program – Florida’s first comprehensive academic cardio-oncology program. It is overseen by Dr. Fradley, assistant professor of cardiology at the USF Health Morsani College of Medicine, and Dr. Khan, a medical oncologist with the Center for Women’s Oncology at Moffitt.

“Based on our first year, this comprehensive and collaborative program is definitely filling a need,” said Dr. Fradley, a pioneer in the emerging field of cardio-oncology and director of the joint program. “It’s a partnership that will continue to strengthen as our patient volume grows and we expand our research and clinical efforts to reduce cardiac risk and improve outcomes for patients battling cancer.”

Today’s targeted cancer treatments are saving and extending lives, but some chemotherapy and radiation therapies can significantly damage the heart by aggravating preexisting heart disease or creating new cardiovascular problems.

Community leaders and officials from USF Health and Moffitt, as well as patients and their families, attended the educational event to raise awareness about the academic partnership that aims to reduce the risk of cardiovascular complications during cancer treatment.

Up to 30 percent of patients receiving cancer treatment experience cardiovascular complications – some not apparent until 10 to 20 years later, Dr. Fradley said. These cardiotoxicities may include heart failure, abnormal heart rhythms, heart attacks, high blood pressure and valve disease.

Moffitt and USF Health have begun research to find more effective ways to eliminate cardiac disease as a barrier to effective cancer therapy.

“Ultimately, our goal is to prevent these cardiotoxicities from ever happening,” Dr. Fradley said. “The last thing we want is for someone to survive their cancer and be left with lifelong cardiovascular disease.”

***

The Cardio-Oncology program serves male and female patients equally, but Dr. Ismail-Khan adds that breast cancer patients are at extra risk for cardiotoxicity. A single breast cancer patient may receive several chemotherapeutic drugs (including such agents as anthracyclines, trastuzumab, pertuzumab and tyrosine-kinase inhibitors) as well as radiation therapy — all of which may cumulatively increase the individual’s risk of heart disease, she said. Age and pre-existing heart conditions add to the risk.

Dr. Lockwood called the academic partnership in the emerging field of cardio-oncology a “model” for other collaborations between USF Health and Moffitt.

Moffitt and USF Health have already conducted an exploratory study to determine whether patients with mutations of the BRCA1 and BRCA2 genes also have a higher risk for cardiotoxicity. The researchers found that breast cancer patients with these genetic mutations may be at higher risk than the general population for heart failure, and plan to delve deeper into the reasons why.

Another research question to be investigated, Dr. Ismai-Khan said, is whether risk stratification and cardiac rehabilitation can improve the outcomes of patients undergoing chemotherapy with cardiotoxic drugs.

Dr. Labovitz thanked the cancer survivors who shared their experiences and recognized the Moffitt partners who “have been instrumental in the success of the program.”

“The relationship between cardiology and oncology is an absolute must for the future of cancer survival,” she said. “Many novel Phase 1 drugs fail due to cardiotoxicity. If we can control the (damaging) side effects, we may have more treatment options for our patients.”

***

Joining Dr. Fradley and Dr. Ismail-Khan as speakers at the luncheon were Arthur Labovitz, MD, FACC, chair of cardiovascular sciences at USF Health, Charles Lockwood, MD, senior vice president of USF Health and dean of the Morsani College of Medicine, and G. Douglas Letson, MD, executive vice president at Moffitt.

Among the luncheon speakers was Dr. G. Douglas Letson, executive vice president at Moffitt.

Recognizing that cardiovascular disease and cancer are the two leading causes of death, they praised the academic multidisciplinary partnership that seamlessly combines the expertise of cardiologists and medical and radiation oncologists.

“Just a few years ago, the field of cardio-oncology didn’t even exist and yet in a very short time our two institutions have developed a partnership to offer our community this unique and important resource,” said Dr. Labovitz, co-director of the USF Health Heart Institute.

“I see this Cardio-Oncology Program as a model for other collaborations between USF Health and Moffitt to make sure our patients collectively get the very best care than can,” Dr. Lockwood said.

In addition to comprehensive care and research, the partnership includes an educational component to teach Moffitt staff how to recognize signs of cardiotoxicity and patients the importance of reporting symptoms as well as healthy lifestyle changes to help reduce cardiac risk. A cardio-oncology fellowship training program has also been established, Dr. Letson said.

For more information on the Cardio-Oncology Program, please visit https://moffitt.org/tests-treatments/treatments/cardio-oncology/

Abby Jones shared her personal story about overcoming cancer and a chemotherapy-associated cardiac complication.

The event included lifestyle information about how to reduce the risk of cardiovascular disease, including a display of fat and sugar content in some popular foods.

Bernadette Shields, Moffitt nurse coordinator for the Cardio-Oncology Program, provides support and education to patients.

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Photos by Eric Younghans, USF Health Communications and Marketing