Cardiovascular Logistics CEO, David Konur pinpointing where we are in cardiology’s private equity expansion timeline.

We’re seeing more signs of private equity’s growing role in cardiology. But how does a private equity-owned cardiology platform work from the inside, and how do they go about expanding “the right way?” Get an insider’s perspective on this emerging trend in this Cardiac Wire Show interview with Cardiovascular Logistics CEO, David Konur.

Preventive Cardiology

Questioning Intermittent Fasting’s Cardiovascular Impact

A new AHA study shocked the world this week, suggesting that intermittent fasting might significantly increase people’s risk of cardiovascular death, sparking a wave of media coverage, and a frenzy of criticisms from the cardiologist and scientific communities.

• Time-restricted eating, which is a type of intermittent fasting, involves limiting eating to a specific number of hours per day (e.g. 4 or 8 hours) and fasting for the rest of the day.
• Intermittent fasting has risen in popularity due to a range of reported benefits to weight, cardiometabolic health, energy, and cognition.

This study set out to evaluate whether these perceived short-term benefits might lead to some serious long-term problems. 

A team of researchers from Wuhan University in China analyzed data from around 20k US adults from the 2003-2018 NHANES database (avg. age 49yrs), who had completed two 24-hour dietary recall questionnaires within the first year of enrollment.  

The poor folks who ate all their meals within shorter time frames on the days before those two particular surveys had far worse outcomes over the 8-year median follow-up period.

• People who ate within an eight hour window had a 91% higher risk of death due to cardiovascular disease.
• Participants with CVD who ate all their meals within an 8 to 10 hour window had a 66% higher risk of death from heart disease or stroke.

The media quickly jumped all over this story, with a long list of mainstream news outlets detailing how this “healthy” practice might actually be killing people, and even a few cardiology pubs sharing the same conclusion.

However, it didn’t take long for criticisms to start emerging about the study and its media coverage, noting that…

• These results conflict with far more reliable RCTs that showed intermittent fasting reduces LDL-C, blood pressure, and weight.
• The study was observational, relied on dietary responses (often unreliable), and didn’t capture the respondents’ baseline cardiometabolic status.
• The NHANES survey didn’t ask if these people were following time-restricted diets, they just asked what times they ate during two days. 
• If you’re not participating in intermittent fasting, not wanting to eat for 16 hours could be a disease symptom or a sign of an unhealthy lifestyle.

The Takeaway

Although we still don’t know whether participating in intermittent fasting diets actually almost doubles cardiovascular mortality risks, a big portion of the population now thinks it does.

Measuring True Cardiac Risk

How can AI help physicians “see” beyond conventional lipid profiles? Tune in to this on-demand webinar showcasing how Cleerly’s AI-QCT solution complements conventional approaches to evaluating heart disease risk factors, and improves coronary artery disease diagnosis and heart attack risk assessments.

The Evolution and Adoption of FFRCT

FFRCT has quickly become one of the most-used AI applications across healthcare, making a major impact on stenosis diagnosis and angiography caseloads. Still, many cardiologists are just now mapping out their own FFRCT adoption. See how one cardiologist made the move to FFRCT and how it impacted his practice in this Cardiac Wire show interview with Corazon Imaging’s John A Rumberger, PhD, MD, FACC, MSCCT.

The Wire

• TRYVIO’s FDA Approval: Patients with high blood pressure that isn’t adequately controlled by multiple antihypertensives now have a new add-on treatment option, following the FDA approval of Idorsia’s once-daily TRYVIO (aprocitentan, 12.5 mg). TRYVIO is the first endothelin receptor antagonist approved for these patients, and it might have a notable impact. Its Phase 3 trial achieved solid reductions in office systolic and ambulatory systolic blood pressure (-4-mm Hg & -5.0-mm Hg) after four weeks of treatment.

• Contrast-Free LAAC with LAMBRE: The LAMBRE device proved effective for left atrial appendage closure (LAAC) without the use of contrast dye, yielding a success rate of 97.5% with minimal complications like device embolization and pericardial effusion. The echo-guided LAAC approach was performed in an average of 47.2 minutes, with low radiation exposure compared to traditional LAAC, suggesting that it could be a safer option for both patients and operators.

• Queensland’s Cardiology Backlogs: The Australian state of Queensland is facing a massive cardiology care backlog, with 66% of category one heart patients not seeing a cardiologist within the recommended 30-day time frame. Reports out of Queensland include some scary situations, including a category one patient who has been on the waitlist for six months, and a hospital with three cardiologists trying to work through a 1,300-patient backlog.

• Forxiga Works, With or Without MI: A comprehensive analysis demonstrated the efficacy of dapagliflozin (Forxiga) in mitigating cardiovascular death and the progression of HF, regardless of patients’ history of MI. The analysis revealed that while individuals with a previous MI faced a 12% elevated risk of adverse cardiovascular events, including worsening HF, dapagliflozin reduced this risk by 17-24% across all levels of left ventricular ejection fraction.

• CDS Helps Docs Control Hypertension: In a randomized study involving 2,026 CKD patients with hypertension, primary care doctors using clinical decision support with notifications  saw better results in their patients’ systolic blood pressure than clinicians practicing as usual with CDS on silent mode (-14.6 mm Hg vs. -11.7 mm Hg) and were more likely to treat per CDS recommendations (49.9% vs. 34.6%). However, patients’ overall BP control rates were similar (50.4% and 47.1%). 

• SESAME Procedure Reduces LVOT: A new transcatheter procedure, the septal scoring along midline endocardium (aka SESAME), successfully reduced left ventricular outflow track (LVOT) gradients and improved symptoms in patients with hypertrophic cardiomyopathy or needing valve replacements. Complication rates were low, with 97.4% survival. While further research is needed, SESAME could revolutionize treatment for LVOT obstruction, providing a minimally invasive alternative to surgery.

• inHEART 3D AI Clearance: inHEART announced the FDA 510(k) clearance and US launch of its AI software module, which automates the segmentation of preprocedural CT and MR images to create 3D cardiac models used to guide ablation procedures. inHEART-guided ablations could have a major impact if they match early clinical evaluations, which showed that inHEART cut VT procedure times by 60% (from 5hrs to <2hrs) and reduced VT recurrence rates by 38%. The solution already had European CE Mark approval.

• Which HF Patients Need Intravenous Iron? An analysis of the IRONMAN trial, featuring 1.1k heart failure patients with iron deficiency, identified a subgroup of these patients who may get the most benefit from intravenous iron transfusions. Participants who had more severe anemia (TSAT <20%) with ferritin ≥100 µg/L, had higher event rates without iron treatment, but greater absolute event reductions with iron treatment. However, the benefit wasn’t statistically significant and more research is needed.

• AI ECG Predicts Long QT: An ECG-based AI model outperformed expert QTc measurements in detecting and differentiating genetic subtypes of congenital Long-QT Syndrome (LQTS), a heart signaling disorder that can cause arrhythmias. Researchers used the model to analyze 4,521 ECGs from 990 patients, achieving an AUC of 0.93 for LQTS detection and 0.91 for genotype differentiation.

• ConKay’s Valvular Seed Round: ConKay Medical Systems raised $1.8M in Seed funding to support the development of its unique one-size-fits-all annular repair catheter system. ConKay will initially focus on the tricuspid valve, suggesting that its device avoids the “major limitations” of other TR repair systems due to its adjustable catheter, range of annulus sizes, and ability to avoid pacemaker leads. ConKay will raise its next round in Q2 and then advance to in-human testing.

• Quantitative Angiography Matches IVUS: The South Korea-based GUIDE-DES study found that a quantitative coronary angiography (QCA) algorithm allowed angiography to match the performance of IVUS for guiding PCI. In 1,528 patients undergoing PCI, QCA and IVUS had similar target lesion failure rates (3.81% & 3.80%) post-PCI mean minimum lumen diameter (2.57 and 2.60 mm) after 12 months. Despite widespread availability, IVUS is used in less than 25% of PCI procedures worldwide.

Advance Your Cardiac MR Visualization

Ready to advance your CMRI assessments? See how you could leverage TeraRecon’s Intuition Cardiac MR package for a range of cardiac anatomy and physiology evaluations, and how your peers are already benefiting from it.

AI Echo Copilot – The Future of Echocardiography

New technology from Us2ai called Us2.connect allows you to add AI automation to any echo device. Any echo machine can now have 100% automated reporting with disease detection and editable measurements – all generated in realtime as you scan.

The Resource Wire

• HeartFlow FFRCT Catches Missed Blockages: Karen Moore had always been diligent about her heart health, which is why she was concerned when she began showing symptoms of heart disease but all of her tests came back negative. See how Karen and her physician used HeartFlow FFRCT to catch a 90% blockage and place a stent in the right location, before it was too late.

• Better Cardiovascular Care, With a Better Bottom Line: Twenty million chest CTs are acquired in the U.S. each year, but CAC is typically unreported. See how you can leverage Bunkerhill Health’s Incidental CAC algorithm to screen for incidental coronary calcium on routine chest CTs in real-time, improving care and your bottom line.

• Ready for More Precise ECG Monitoring: Monebo designs, develops, and licenses complex ECG algorithms for use in a wide variety of monitoring applications. If you’re a medical device developer, monitoring center, or system integrator see why Monebo might be right for you.

• Experience the future of learning: Medtronic Academy 2.0 is here! Unlock your ultimate destination for structural heart medical education with the newly redesigned Medtronic Academy 2.0. Gain access to expert-led courses, webinars, and a wealth of resources to stay ahead in cardiovascular care. Visit now!

• Streamlining Cath Lab Hemodynamic Workflows: Is your hemodynamic solution keeping your cath lab efficient? Merge Hemo is a cath lab hemodynamic monitoring solution, providing a Best in KLAS user experience, while enhancing clinical workflows, automating data collection, and streamlining inventory management.