Dr Victoria Nankivell talks about her project as winner of the Ralph Reader Prize in Basic and Translational Science
Dr Aravinda Thiagalingam interviews Dr Victoria Nankivell, Post-doctoral Scientist at South Australian Health and Medical Research Institute. Victoria’s winning abstract presentation is on “Multifunctional porphyrin-lipid nanoparticles – novel nanoscale theranostics for atherosclerotic cardiovascular disease”.
Our goal is to engage a higher representation of women in Cardiology, given we have the lowest level of representation amongst all Medical specialties. Currently, only 15% of all cardiologists are women, with only 5% specialising as interventional cardiologists.
Chair: Dr Sonya Burgess, an interventional cardiologist based in Sydney.
Steering Committee: Dr Sarah Zaman, Dr Clara Chow, Dr Anastasia Mihailidou, Dr Rebecca Kozor, Dr Swati Mukherjee, Dr Belinda Gray, Dr Elizabeth Shaw, Dr Ruth Arnold, Dr Alicia Chan, Dr Cara Barnes, Dr Louise Segan, Dr Jain Manali, Dr Anastasia Vlachadis-Castles, Dr Lynne Pressley and Dr Rebecca Jedwab.
The focus of the Working Group is to have the CSANZ Board, and members, to support women and improve representation of women in cardiology at all levels – from conference invitations to committee membership, policies, equity and future leaders.
There are plans to coordinate preparing a WiC day focused on interview skills CV preparation for advanced trainee, fellowships, and early career positions, with a workshop and skills day led by Dr Rebecca Kozor and Dr Sonya Burgess.
We also wish to encourage having a network where the offline conversations, mentoring, and sponsorship can grow.
One of the most rewarding changes we have seen, as we try to achieve more equity and diversity in cardiology, is that it generates mentoring and support. We have had women in Cardiology at all levels reaching out to members of this group with questions, requests for data, support and further plans for research and networking.
In Australia and New Zealand, women are still under-represented at trainee level and published modelling, based on Australian data, suggests the rate of change is underwhelming. We currently are unlikely to reach gender parity for at least 50 years, and our rate of change is worse than that of Surgery.
Research shows women are under-represented at consultant, trainee level and professor promotion. Research also shows that in Cardiology we have ongoing cultural issues, including conscious and unconscious bias, that as a specialty we are yet to successfully address. These issues have an impact on outcomes for our colleagues, trainees, students and patients.
Importantly, changes are happening, in individual departments and hospitals throughout our countries, in our policies and systems, and in our conference committees as we all try to facilitate positive change.
One recent example of a WiC initiative supported by NSW cardiology heads of department, led by Dr Tom Ford, were changes to the under-representation of women at the Heads of Department “cull meeting” . This meeting considers, grades, and ranks all applicants for Advanced Training positions in Cardiology for advanced trainee positions in New South Wales. Of the large 12-15 person voting panel, there was only one-woman representative. As NSW health policy for recruitment and training aims to avoid poor representation of women on interview panels by stipulating on a 5-person panel, at least one voting panellist should be a man, and at least one person should be a woman. The CSANZ WiC group requested that for the panels, such as the cull meeting, that similar minimal ratios should be sought and the voting committee members should not be greater than 80% male (or greater than 80% female), based on the minimum 1:4 ratio within NSW policy. The CSANZ WiC group worked together with Dr Tom Ford (who chairs this meeting) and all of the Department Heads, which led to greater than 20% of the panel for were women this year for the first time.
As a group, we are working on increasing visibility on the both the national and international stage, to provide supportive role models for the next generation of not only Cardiology trainees but all women in cardiology, including nursing, allied health and research and more equity focused research and research funding.
In 2023, we have seen members of our steering committee actively working on these goals. Our proudest moments come when we see our trainees/mentees/students doing well and breaking their own glass ceilings.
For example, in 2024 Dr Roopa Krishnamoorthy will become the first female advanced trainee to take up an interventional cardiology fellowship at Nepean Hospital, and start her journey in interventional cardiology.
References
1. Manzo-Silberman S, Velázquez M, Burgess S, et al (2023). Radiation protection for healthcare professionals working in catheterisation laboratories during pregnancy: a statement of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) in collaboration with the European Heart Rhythm Association (EHRA), the European Association of Cardiovascular Imaging (EACVI), the ESC Regulatory Affairs Committee and Women as One. EuroIntervention; 19(1):53-62.
2. WHO (2023). Technical specifications for pre-market assessment of blood pressure measuring device with cuff, automated and semi-automated.
3. Segan L et al. (2023) New-onset atrial fibrillation prediction: the HARMS2-AF risk score. Eur Heart J; 44:3443-3452
4. Lampert R, Ackerman MJ, Marino BS, Burg M, Ainsworth B, Salberg L, Tome Esteban MT, Ho CY, Abraham R, Balaji S, Barth C, Berul CI, Bos M, Cannom D, Choudhury L, Concannon M, Cooper R, Czosek RJ, Dubin AM, Dziura J, Eidem B, Emery MS, Estes NAM, Etheridge SP, Geske JB, Gray B, Hall K, Harmon KG, James CA, Lal AK, Law IH, Li F, Link MS, McKenna WJ, Molossi S, Olshansky B, Ommen SR, Saarel EV, Saberi S, Simone L, Tomaselli G, Ware JS, Zipes DP, Day SM; LIVE Consortium. Vigorous Exercise in Patients With Hypertrophic Cardiomyopathy. JAMA Cardiol. 2023;8(6):595-605
ACOR is looking forward to a big year ahead!
The execution of the Australian Transcatheter Valves Therapy Registry (ATVT) Agreement with SAHMRI will see the TAVI Registry converge from a singular Registry into a four-valve Registry. This has been over a year in the making, and we are very excited to see the projects and opportunities that come from the creation of this new Registry, including new databases that incorporate the mitral, pulmonary and tricuspid heart valves.
Currently, there are 52 TAVI sites, with two more onboarding and 17,685 cases (as of 23/10/2023) entered into the Registry since commencement (April 2018).
ACOR continues to seek funding opportunities and looks forward to an exciting year ahead.
Read more about the Australasian Cardiac Outcomes Registry at acor.net.au
Alana Carpenter, Project Officer for ACOR (above left) is about to have her first baby and will be on maternity leave from Friday, 23 February 2024. We wish Alana and her husband Scott well and look forward to seeing baby photos soon!
We are delighted to welcome Jessica Casley (above right), as the interim ACOR Project Officer. Jessica comes from an administration background and has a Bachelor of Science (Physiology) from Monash University. Jessica previously worked at Cabrini Health and the University of Melbourne. She brings with her strong experience in project co-ordination and administrative support, as well as a passion for health and scientific research.
It is with deep regret that we note the passing of Dr David Hunt, MBBS, FRACP, FCSANZ, DDU, FACC, who died at his home in Melbourne on Thursday 11 January 2024. On behalf of the Cardiac Society Board and members, we would like to extend our sincere sympathies to his family and CSANZ colleagues.
Image courtesy: Planning retirement from practice – Dr David Hunt discusses his career and retirement from his life long work on Youtube (RACP Channel) Dr Hunt’s own photo found in the CSANZ’s historical record of Cardiology of Australia and New Zealand, section 5.4 on the Royal Melbourne Hospital (contributors Dr David Hunt and Dr Alan Goble).
Prof Robert Denniss (outgoing Editor in Chief) and A/Prof Salvatore Pepe (new Editor in Chief).
On behalf of the Society we offer our congratulations to A/Prof Salvatore Pepe as the incoming Editor in Chief of the Heart, Lung and Circulation Journal (HLC) for the Cardiac Society of Australia and New Zealand (CSANZ) and the Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS). Read more about A/Prof Pepe here.
We would like to acknowledge and thank Prof A.R. (Robert) Denniss for his extensive service as Editor in Chief of the HLC. Prof Denniss first joined the CSANZ in 1988, served on the CSANZ Board from 2012-2022 as the appointed Editor in Chief of the HLC.
During his tenure, he created insightful initiatives: including the appointment of editorial fellows, a commissioning editor, introduction of prizes for best review and high impact, and establishing a HLC session at the CSANZ ASM in conjunction with the European Heart Journal and other international publications. Also during his time as Editor in Chief, the journal published 132 issues, 17,330 pages, 2,620 manuscripts, 25 scientific meeting abstracts and presented 38 awards. Read more about Prof Dennis here.
We are grateful for Prof Denniss’ valuable contributions over the past 11+ years as Editor in Chief and CSANZ Board Member.
Commencing 1 July 2024, two new diagnostic imaging MBS abdominal MRI items will be available for patients with a defined rare inherited condition associated with an increased risk of renal tumours, as well as ongoing assessment of changes over time to an existing renal tumour. This implements a recommendation from the Medical Services Advisory Committee (MSAC):
The MBS listing for cardiac MRI for myocarditis associated with mRNA COVID-19 immunisation (Item 63399) has been extended until 31 December 2024. MSAC is currently considering cardiac MRI in the diagnosis of myocarditis more broadly, which is anticipated to be considered in April 2024:
Here’s a snapshot of some of the most recent Heart, Lung and Circulation Journal articles for December 2023.
Anticoagulation During PCI: Is It Time for RCTs?
Unfractionated heparin (UFH) has been the preferred anticoagulant in percutaneous coronary intervention (PCI) for over 40 years, say Al-Mukhtar and colleagues. Recently, they surveyed interventional cardiologists in Australia and New Zealand and found that, while this practice is indeed standard, there’s a lot of variation in not only how much (and when) UFH is used in PCI, but also whether (and when) activated clotting time is measured. Al-Mukhtar et al. say their survey results reflect variations in international guidelines and the findings of past studies and meta-analyses. They call for further randomised controlled trials to guide clinical practice and optimise the clinical outcomes of contemporary PCI. https://www.heartlungcirc.org/article/S1443-9506(23)04362-7/fulltext
Sudden Death in the Young: Autopsies for Underlying Causes?
One in four cases of young sudden death have more than one potential primary cause of their death identified, according to Paratz and colleagues. In an analysis of 3 years of data from the End Unexplained Cardiac Death (EndUCD) Registry, they determined, among other things, that comprehensive autopsy remains the gold standard investigation in this circumstance, complemented by other data such as, from post-mortem whole-body CT scanning, and biochemical and toxicological assessment. Paratz et al. say identifying all contributors to a sudden death is important, especially as diagnoses may carry important implications for surviving family members. https://www.heartlungcirc.org/article/S1443-9506(23)04398-6/fulltext
After SCAD: What Could Standard Care in Recovery Look Like?
Not only physical but also emotional recovery is important for patients after spontaneous coronary artery dissection. So say Turner and colleagues, who conducted a comprehensive literature review that identified, and then examined the findings of, five studies involving 447 patients after SCAD. They suggest that the ideal recovery program would reflect the patients’ preference for tailored cardiac rehabilitation and web-based resources, both specifically designed for SCAD. For example, with respect to emotional recovery, cognitive behavioural therapy-based groups and online peer support have been shown to benefit patients with spontaneous coronary artery dissection (SCAD) and could be integrated into standard care. https://www.heartlungcirc.org/article/S1443-9506(23)04367-6/fulltext
These highlights and more are available online now in the December 2023 edition of Heart, Lung and Circulation.
Compiled by Dr Ann Gregory, Commissioning Editor, Heart, Lung and Circulation. ([email protected])
Empagliflozin (Jardiance®) (10 mg tablet) is now listed on the PBS for the treatment of chronic heart failure.
Chronic heart failure
Empagliflozin (Jardiance®) (10 mg tablet) is now listed on the PBS for the treatment of chronic heart failure. Prescriptions for treatment are Authority Required (STREAMLINED).
For more information about the Online PBS Authorities system visit www.servicesaustralia.gov.au/hppbsauthorities
Over the last 10 years Prof Figtree has led an expanding international team addressing the mechanisms and unmet needs regarding clinical pathways for patients who develop coronary artery disease and myocardial infarction despite no standard modifiable risk factors (SMuRFs).
She is the National Scientific Lead of the large global clinical trial AEGIS II and was appointed to the adjudication panel, co-leading the heart failure analyses and publications for the highly cited CANVAS program demonstrating of benefits of SGLT2 inhibition in diabetics.
Using validated pre-clinical models, she has made seminal contributions that have provided unique insights into the mechanisms of cardiovascular disease susceptibility.
Captured at this year’s CSANZ ASM was an impressive line up of previous R T Hall Prize winners. Pictured together here, at the 2023 CSANZ ASM President’s Welcome on Thursday evening – an “RT Hall Prize Hall of Fame”.
View the full list R T Hall Prize winners below from 1965 to date.
(from left to right): Prof Paul Nestel (awarded in 1965, the first RT Hall Prize recipient), guest with Prof Gerald Watts (2022), Prof Phil Aylward (1984) and Prof Stephen Nicholls (2018).
ADS will host an exciting virtual event.
Join the experts, including Prof John Atherton, A/Prof Sarah Glastras, A/Prof Samantha Hocking, Prof Stephen Nicholls and Prof Sophia Zoungas for a Live Panel Discussion on Monday 13 November 2023 from 7.00pm – 8.00pm (AEDT).
Discussion will cover the outcomes of the 2023 AHA Scientific Sessions in relation to managing cardiovascular disease in people living with obesity, plus a review of the trial results presented at the AHA Meeting. Download the flyer for full details. Register here for the Live Discussion
