Parallax by Ankur Kalra

In this special TIO Congress edition of Parallax, Dr Ankur Kalra is joined by two of interventional cardiology's most influential voices: Professor Roxana Mehran, incoming President of the American College of Cardiology and Co-Course Director of TIO, and Professor Nicholas Van Mieghem, TIO Course Director. The conversation spans the evolution of online medical education, sex-specific differences in cardiovascular disease, and the challenge of translating clinical evidence into everyday practice. The guests explore sex as a biological variable across valve disease, plaque formation, and left ventricular remodeling, address the underdiagnosis of microvascular dysfunction in women, and examine persistent access barriers for female and non-white patients despite advances in trials such as SMART and RHEA. Professor Van Mieghem adds insights on modern TAVI planning and lifetime valve management, while Professor Mehran shares promising data on Factor XI inhibitors and the case for simplifying antithrombotic regimen

In this episode of Parallax, Dr Ankur Kalra speaks with Dr Sameed Khatana, Assistant Professor of Medicine at the University of Pennsylvania and clinical cardiologist at the Philadelphia VA Medical Center. Their conversation examines the growing connection between environmental factors and cardiovascular health. Dr Khatana explains why conditions like air quality and temperature represent important determinants of cardiovascular outcomes. He shares observations from his Philadelphia practice: patients unable to exercise outdoors during extreme heat, medication challenges for those on diuretics during heatwaves, and economic pressures that force difficult choices between cooling costs and other necessities. The discussion explores both clinical interventions and systemic solutions, including programs like LIHEAP (Low Income Home Energy Assistance Program) and municipal heat action plans. Dr Khatana presents research showing that vulnerable populations—particularly older patients with multiple cardiovascular

In this episode of Parallax, Dr Ankur Kalra welcomes Dr Rakesh Shah, a former interventional cardiologist, Oxford MBA graduate, and founder of DRS.LINQ. Dr Shah brings a unique perspective on addressing critical delays in heart attack diagnosis through the intersection of clinical medicine, engineering, and business strategy. The conversation explores a pressing challenge in cardiovascular care: the majority of cardiac damage occurs within the first hour of symptom onset, yet treatment activation often takes several hours. Dr Shah introduces mHeart, a mobile EKG platform designed to create a "virtual cardiology office." Unlike consumer wearables that lack critical chest leads, this technology enables patients to initiate comprehensive cardiac evaluation anywhere—at home, at work, or while traveling—transmitting diagnostic-quality data directly to cardiologists. The episode delves into Dr Shah's diverse career path and offers candid advice for physician-entrepreneurs, emphasizing the importance of collaborat

In this key episode of Parallax, Dr Ankur Kalra sits down with Prof Naveed Sattar to explore how recent therapeutic breakthroughs are fundamentally reshaping the cardiologist's approach to diabetes management. Through real-world case discussions, Dr Sattar demonstrates practical decision-making for patients across the spectrum - from pre-diabetes to established CAD with Type 2 diabetes. He addresses the tension between robust evidence and cost barriers that limit widespread implementation, while acknowledging unprecedented patient demand driven by genuine quality of life improvements. The conversation concludes with insights on obesogenic environments and the hope that increased competition will ultimately democratize access to these transformative therapies. Questions and comments can be sent to "podcast@radcliffe-group.com" and may be answered by Ankur in the next episode. Host: @AnkurKalraMD and produced by: @RadcliffeCardio Parallax is Ranked in the Top 100 Health Science Podcasts (#48) by Million Podc

In this highly anticipated annual year-end episode of Parallax, Dr Ankur Kalra welcomes back Dr Sukh Nijjer, an interventional cardiologist in London, for their seventh consecutive year reviewing cardiology's most significant developments. This annual review offers a comprehensive look at the trials and breakthroughs that shaped cardiovascular medicine in 2025. Dr Nijjer guides us through a broad selection of clinical trials spanning post-MI management, heart failure therapeutics, atrial fibrillation strategies, and interventional innovations. The discussion challenges established practice, from questioning routine beta blocker use after MI in patients with preserved ejection fraction, to examining the controversial findings from the CLOSURE AF and OCEAN studies. The episode highlights encouraging advancements including the POLY-HF study's success with fixed-dose polypills for heart failure, promising data on bioadaptor stents and drug-coated balloons in interventional cardiology, and the robust cardiovascul

In this landmark 150th episode of Parallax marking the start of Season 8, Dr Ankur Kalra welcomes Professor Robert Bonow, Professor of Medicine and Cardiology at Northwestern University and Editor-in-Chief of JAMA Cardiology. This milestone conversation explores the career of one of cardiology's most influential academic leaders and examines how strategic vision, mentorship, and institutional leadership have shaped modern cardiovascular medicine. The discussion reveals the practical realities of building academic excellence through Dr Bonow's 33-year tenure at Northwestern University. He details the strategic approach to growing a cardiology division from 25 faculty members to over 70, emphasizing that success hinges on recruiting exceptional talent, providing institutional support, and granting faculty freedom to pursue their visions. Dr Bonow offers candid perspectives on academic leadership challenges and creating environments where innovation flourishes. Dr Bonow reflects on his influence through editor

In this week's episode of Parallax, Dr Ankur Kalra welcomes Prof Rasha Al-Lamee, interventional cardiology consultant and professor of medicine/cardiology at Imperial College London, and deputy editor of JACC. Prof Al-Lamee has transformed interventional cardiology through her pioneering work on the ORBITA trial series and coronary sinus reducer device studies, introducing the paradigm-shifting concept of sham-controlled device trials to the field. What makes a clinical assumption worth questioning? How do we design trials that reveal truth rather than confirm bias? When does revascularization truly benefit patients with stable angina? Questions and comments can be sent to "podcast@radcliffe-group.com" and may be answered by Ankur in the next episode. Guest: @RashaAlLameeMD Host: @AnkurKalraMD and produced by: @RadcliffeCardio Parallax is Ranked in the Top 100 Health Science Podcasts (#48) by Million Podcasts.

In this episode of Parallax, Dr Ankur Kalra welcomes Dr Sarah Matt, Associate Clinical Professor at Upstate Medical University, health tech strategist, and author of the newly released The Borderless Healthcare Revolution. Dr Matt brings a unique perspective shaped by her experience both in academic medicine and as a former Oracle employee, positioning her at the intersection of clinical care and healthcare technology innovation. https://www.drsarahmatt.com/ This conversation explores the inflection point facing today's generation of physicians—a cohort that has navigated the evolution from paper charts to sophisticated EMRs, and now stands at the threshold of AI-driven healthcare transformation. Dr Matt offers actionable guidance for both healthcare delivery leaders and "builders" creating new technologies, emphasizing that improving access must be integrated from inception rather than retrofitted. She shares her vision for removing financial barriers entirely and provides practical checklists from her book

In this week's episode of Parallax, Dr Ankur Kalra welcomes Dr Courtney Maxey-Jones, Director of the Coronary Care Unit at Upstate University Hospital and a cardiac anesthesiologist intensivist by training. Dr Maxey-Jones co-founded and serves as Chief Operations Officer of GOMED, a not-for-profit organization transforming how we think about medical device waste and global healthcare equity. Dr Maxey-Jones shares the origin story of GOMED - born from witnessing the staggering waste generated in cardiac operating rooms, where expensive single-use devices are discarded due to expiration dates or changing surgeon preferences. Together with her partners, cardiac surgeon Dr Farhan Nadeem and physician assistant Connor Wasilnak, they recognized an extraordinary opportunity to make use of these waste items. Dr Kalra and Dr Maxey-Jones examine the ethical complexities of equipment reuse, the critical unmet needs for EP devices and cath lab equipment internationally, and GOMED's innovative partnership with Syracuse

In the latest episode of Parallax, Dr Ankur Kalra welcomes Dr Martha Gulati and Dr Anu Lala for a groundbreaking conversation about reimagining heart failure prevention across the entire disease spectrum. Their discussion centres on an innovative scientific statement developed collaboratively between the American Society of Preventive Cardiology and the Heart Failure Society of America - a document that challenges conventional approaches to cardiovascular disease prevention. Dr Gulati and Dr Lala make a compelling case for expanding prevention beyond atherosclerotic cardiovascular disease (ASCVD) to encompass heart failure, a condition affecting one in four individuals over their lifetime. They introduce the American Heart Association's Cardio Kidney Metabolic (CKM) health framework as a superior model for identifying at-risk patients, explaining how this approach shifts focus from disease management to health optimization. The conversation explores practical implementation strategies, including the new PREV

In this essential episode of Parallax, Dr Ankur Kalra welcomes Dr Monica Tincopa, Assistant Professor of Medicine at the University of California San Diego, for a crucial conversation about Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and its profound implications for cardiovascular care. Dr Tincopa guides listeners through the recent transformation from NAFLD to MASLD, explaining why this nomenclature change represents more than just terminology, instead reflecting a deeper understanding of metabolic health that directly impacts cardiology practice. The conversation explores practical screening strategies that cardiologists can implement immediately, including the use of FIB-4 risk stratification and recognizing incidental findings on cardiac imaging. Dr Tincopa shares insights on when to refer patients to hepatology specialists and how the shared risk factors between MASLD and cardiovascular disease create opportunities for comprehensive patient care. This episode equips cardiologists

In this evidence-packed episode of Parallax, Dr Ankur Kalra welcomes back Dr Purvi Parwani, Associate Professor of Medicine at Loma Linda University Health, for a comprehensive review of groundbreaking trials presented at the European Society of Cardiology Congress. Dr Parwani guides listeners through what she describes as a "tectonic shift" in post-MI care with the REBOOT and BETAMI-DANBLOCK trials. These studies challenge the routine use of beta blockers after heart attack, revealing that patients with preserved ejection fraction above 50% may not benefit, while those with EF between 40-49% show significant risk reduction from continued therapy. The discussion moves to heart failure management, exploring the POTCAST trial's approach to optimising potassium levels in high-risk patients and the DIGIT-HF trial's examination of digitoxin as a potential option for patients who cannot tolerate modern four-pillar therapy. Dr Kalra and Dr Parwani conclude with the evolving role of aspirin in cardiovascular care.

In this episode of Parallax, Dr Ankur Kalra speaks with Dr Benjamin A D’Souza, Associate Professor of Medicine at the University of Pennsylvania and Section Chief of Cardiac Electrophysiology at Presbyterian Medical Center. Together, they explore the challenges of mitigating sudden cardiac death and the evolving role of guideline-directed medical therapy in optimising patient outcomes. Dr D’Souza reflects on current strategies for risk assessment and prevention, highlighting the importance of medical therapy, careful monitoring and timely use of defibrillators. He stresses that management must be tailored to individual patients, with decisions guided by evidence, imaging and multidisciplinary collaboration. The conversation also turns to women’s cardiac health and representation in electrophysiology. Dr D’Souza highlights the persistent under-enrolment of women in clinical trials and their lower access to ablation and device therapy. He stresses the need for inclusive trial design, mentorship and acknowledg

In this fascinating episode of Parallax, Dr Ankur Kalra sits down with Dr Alexander Fanaroff, an interventional cardiologist, clinical trialist, and behavioral economist at the University of Pennsylvania. Dr Fanaroff brings a unique perspective to cardiovascular medicine, combining his expertise in interventional cardiology with cutting-edge insights from behavioral economics to transform how we approach patient care and clinical decision-making. Dr Fanaroff demystifies behavioral economics for the medical community, explaining how this field studies real-world decision-making beyond traditional economic models. He introduces key concepts like status quo bias, prospect theory, and the power of defaults in shaping both physician and patient behaviors. Through compelling examples, including Penn's successful intervention that increased 90-day statin prescriptions from 70% to 90% simply by changing EHR defaults, Dr Fanaroff demonstrates how small design changes can yield significant clinical improvements. Look

In this essential episode of Parallax, Dr Ankur Kalra welcomes Dr Shelley Zieroth, Professor of Medicine, clinician-scientist, and advanced heart failure and transplant cardiologist in Winnipeg, Canada. As we mark the 10-year anniversary of the landmark EMPA-REG OUTCOME trial, Dr Zieroth provides a comprehensive update on how SGLT2 inhibitors have revolutionized cardiovascular care. Dr Zieroth takes us through the remarkable journey from the initial 2015 trial that transformed SGLT2 inhibitors from anti-diabetic agents into cardiovascular powerhouses, delivering highly significant reductions in cardiovascular death and heart failure hospitalization. She explores how these medications have become fundamental pillars of cardio-kidney-metabolic medicine, with evidence spanning the entire ejection fraction spectrum. Dr Zieroth discusses prescribing these agents in heart failure - including the straightforward 10-mg daily dosing, monitoring strategies, and crucial patient selection criteria. She shares insights

In this compelling episode of Parallax, Dr Ankur Kalra sits down with Dr Anandita Kulkarni, preventive cardiologist at Baylor Scott and White Heart Hospital, for an eye-opening conversation about addressing cardiovascular disparities in South Asian populations through the innovative Dilwale registry. Dr Kulkarni tells the story of returning to her Texas community to serve South Asian patients and her determination to create meaningful change through data. What started as a local initiative grew into something much larger: a comprehensive registry of over 31,000 South Asian patients that's revealing critical insights about heart disease in this underserved population. Beyond the clinical data, this episode delves into the practical challenges of culturally informed preventive care. Dr Kulkarni shares insights on addressing barriers to physical activity within South Asian communities, helping patients navigate dietary changes while respecting cultural food traditions, and the delicate work of motivating lifes

In this essential episode of Parallax, Dr Ankur Kalra is joined by Dr Carolyn Ho, Professor of Medicine at Harvard Medical School and Medical Director of the Cardiovascular Genetics Program at Brigham and Women's Hospital, for a comprehensive discussion on how genetic testing is reshaping hypertrophic cardiomyopathy management. The conversation explores the VANISH HCM trial results, which showed that valsartan can slow disease progression in young, asymptomatic individuals with early sarcomeric HCM. Dr Ho discusses how this evidence influenced the 2024 HCM guidelines and created new opportunities for disease-modifying therapy before clinical symptoms appear. The episode also examines emerging gene-based therapeutics, from current adeno-associated virus approaches to future CRISPR technologies that could address the underlying genetic causes of HCM. Dr Ho addresses practical considerations for clinicians, including when to initiate genetic testing, how to manage family screening, and the promise of AI-assist

In this insightful episode of Parallax, Dr Ankur Kalra explores the emerging field of cardiac epigenetics with Dr Manuel Rosa-Garrido, assistant professor of medicine at the University of Alabama in Birmingham. Their conversation examines how the three-dimensional organization of DNA within the cell nucleus influences heart disease development beyond traditional genetic sequencing. Dr Rosa-Garrido shares his pioneering work using Hi-C technology to map genome structure, revealing that DNA arrangement plays a crucial role in cardiac pathology. The discussion covers key concepts including chromatin loops, topologically associating domains, and compartmentalization—explaining how these structures regulate gene expression and how their disruption contributes to cardiovascular disease. The episode explores practical implications for clinical practice, from early biomarker identification to potential CRISPR-based therapies that could target chromatin structure. Dr Rosa-Garrido outlines how this research could tra

In this essential episode of Parallax, Dr Ankur Kalra is joined by Dr Michelle O'Donoghue, cardiologist at Brigham and Women's Hospital and co-author of the recently updated AHA/ACC acute coronary syndrome guidelines. Together, they explore the revolutionary changes reshaping ACS management in 2025. Dr O'Donoghue shares insights from the landmark guideline development process that unified non-ST elevation ACS and ST elevation MI recommendations into a single comprehensive document. The conversation covers game-changing updates including new risk stratification approaches, the shift toward selective invasive strategies, and the introduction of bivalirudin as an alternative anticoagulation option. The discussion highlights the groundbreaking "lower is better" approach to LDL management with new targets below 55 mg/dL, evolving antiplatelet therapy strategies, and the emerging role of ticagrelor monotherapy. Dr O'Donoghue also addresses future directions in cardiovascular care, from GLP-1 agonists to mechanica

In this profound episode of Parallax, Dr Ankur Kalra welcomes Dr Pam Taub, Professor of Medicine and Director of Preventive Cardiology at UC San Diego, for an enlightening conversation about integrating spirituality, purpose, and scientific curiosity in cardiovascular practice. Dr Taub shares her unique philosophical foundation, shaped by exposure to diverse religions in South India. This experience fostered her belief that all faiths fundamentally center on being a good person and serving others. She explores how this spiritual perspective transforms medicine from a profession into a sacred calling, where patient interactions become profound privileges that fuel her desire to make meaningful impact beyond individual achievements. The episode highlights Dr Taub's groundbreaking work with POTS (Postural Orthostatic Tachycardia Syndrome), demonstrating how scientific curiosity serves as a spiritual path. Her research journey—from recognizing misdiagnosed conditions to conducting the first clinical trial for i