Parallax by Ankur Kalra

In this insightful episode of Parallax, Dr Ankur Kalra welcomes Dr Robert Riley, Director of Interventional Cardiology at Overlake Medical Center in Bellevue, Washington, for a masterclass on the contemporary management of complex PCI. Drawing on more than a decade of experience, Dr Riley explores how the field has evolved beyond technical success alone, with greater emphasis on patient selection, shared decision-making and aligning procedural goals with individual patient outcomes. The conversation takes a deep dive into the assessment and treatment of calcified coronary lesions, with a particular focus on the challenge of nodular calcium. Dr Riley shares his practical approach to intravascular imaging, lesion preparation and plaque modification, discussing when to utilise atherectomy, intravascular lithotripsy (IVL) and OPN balloons. He also highlights his growing use of drug-coated balloons in de novo lesions and provides insights into tailoring DAPT duration based on individual patient risk. For interven

In this insightful episode of Parallax, Dr Ankur Kalra welcomes Dr Kim Smolderen, Professor of Medicine and Psychiatry at Yale University and psychologist at Yale New Haven Hospital, for a conversation on the growing field of cardiovascular psychology. Together, they explore how psychological well-being, medical trauma and social determinants of health influence cardiovascular outcomes, and why integrating these factors into routine cardiovascular care is essential for delivering truly patient-centred medicine. Dr Smolderen discusses the evidence linking anxiety, depression and PTSD to longer hospital stays, repeat procedures and increased healthcare utilisation. She shares her vision for creating "healing eco-systems" that bridge traditional clinical silos, bringing psychology and cardiology together through integrated care pathways, psychosocial risk assessment and trauma-informed care. The discussion also examines the business case for cardiovascular psychology, from reducing readmissions and emergency de

In this insightful episode of Parallax, Dr Ankur Kalra is joined by Dr Barry Borlaug, Professor of Cardiology at Mayo Clinic and one of the world's leading experts in cardiac haemodynamics, for a comprehensive discussion on the evolving landscape of heart failure with preserved ejection fraction (HFpEF). Together, they explore the complexities of diagnosing and managing a syndrome that continues to challenge clinicians. Dr Borlaug explains why exercise right-heart catheterisation remains the gold standard for uncovering "hidden" HFpEF, particularly in patients with normal resting filling pressures, and provides a detailed overview of the Mayo Clinic's invasive exercise testing protocol. The conversation also traces the evolution of HFpEF phenotyping, from the traditional hypertensive patient to the increasingly recognised obesity-driven phenotype, highlighting the role of systemic inflammation, visceral adiposity and disease progression across the HFpEF spectrum. Dr Borlaug outlines what he describes as the

In this episode of Parallax, Dr Ankur Kalra is joined by Ms Claudia Garbrecht, psychologist specialising in psycho-cardiology and organisational health. Together, they explore the critical “heart–brain connection,” examining the high prevalence of anxiety and depression among patients with cardiovascular disease and the bi-directional relationship between mental health and cardiac outcomes. The discussion reframes traditional risk by highlighting the clinical importance of psychological distress, social isolation and behavioural factors in shaping cardiovascular risk and recovery. The conversation also turns to clinician wellbeing, with Ms Garbrecht outlining the impact of burnout, workplace stress and organisational culture on both physician health and patient outcomes. From the physiological effects of stress to the influence of communication and framing in consultations, this episode offers practical, time-efficient strategies to enhance patient interactions and reinforce positive behaviour. Dr Kalra refl

In this week’s episode of Parallax, Dr Ankur Kalra is joined by Dr Chris Maroules, National Director for Cardiac Imaging at SimonMed and co-director of Innovation Health. Together, they explore why coronary CTA, now a Class 1 recommendation in the 2021 ACC/AHA chest pain guidelines, has become the standard first-line non-invasive test, and why proficiency in cardiac CT is essential for cardiology trainees in 2026. The conversation shifts from traditional risk scores to direct disease assessment, highlighting the power of coronary CTA to identify and quantify plaque burden. Dr Maroules discusses high-risk plaque features, the limitations of calcium scoring, and the evolving role of FFRCT, before outlining a future of AI-enabled screening and precision prevention. He concludes with practical advice for fellows, encouraging Level 2 certification to stay ahead in an increasingly imaging-driven field. Questions and comments can be sent to "podcast@radcliffe-group.com" and may be answered by Ankur in the next epi

In this episode of Parallax, Dr Ankur Kalra is joined by Dr Matthew Budoff, Professor of Medicine at the David Geffen School of Medicine at UCLA and a leading authority on preventive cardiology and cardiac imaging. Together they examine the role of cardiac CT in detecting silent atherosclerosis, and ask whether imaging should displace traditional risk scores in routine practice. Dr Budoff makes the case for the coronary calcium score as the foundation of personalised cardiovascular care, arguing that population-based risk factors often fail at the individual level. He weighs the calcium score against CT angiography in primary prevention - covering cost, radiation, the uncertain significance of trivial plaque, and the risk of inappropriate stenting in asymptomatic patients - while noting that symptomatic patients warrant CCTA first-line. He also addresses elevated Lp(a) with a zero score and the case for CCTA in younger high-risk patients, before outlining his scalable, score-tiered approach to therapy, drawi

In this episode of Parallax, Dr Ankur Kalra is joined by Professor Ron Blankstein, a leading authority in preventive cardiology and cardiac imaging at Harvard Medical School and Brigham and Women's Hospital, Boston. Together they trace the remarkable journey of cardiac computed tomography (CT) from a niche diagnostic test to an indispensable pillar of contemporary cardiovascular practice. Professor Blankstein shares the moving story behind his new textbook, a companion to the legendary Braunwald's Heart Disease, recounting his personal collaboration with the late Dr Eugene Braunwald, who initiated the project and remained meticulously involved in its development until his passing. How has cardiac CT reshaped the diagnosis and management of coronary disease? What does the future of plaque analysis and photon-counting technology hold? And why should every cardiology fellow now consider CT essential to their training? Questions and comments can be sent to "podcast@radcliffe-group.com" and may be answered by An

In this episode of Parallax, Dr Ankur Kalra welcomes Dr Eunice Dugan, a graduating interventional and structural heart disease fellow at the Cleveland Clinic, as she prepares to transition into independent practice in Fort Wayne in the summer of 2026. Dr Dugan reflects on how early mentorship shaped her decision to engage with the American College of Cardiology during fellowship, and what professional societies can offer beyond the clinical environment — from expanding skill sets and building lasting networks to driving meaningful change. She shares how her role as a local FIT representative led her to organise a widely attended webinar helping fellows navigate the new interventional cardiology match. The conversation also tackles the attrition challenge that affects many early-career cardiologists in their first three to five years of practice: Dr Dugan, now transitioning into the ACC's Early Career Council, discusses the "fog" of establishing a new career and makes the case for cultivating a specific proj

In this episode of Parallax, Dr Ankur Kalra is joined by Dr Kendra Grubb, Vice President and Chief Medical Officer for Structural Heart Interventions at Medtronic and former cardiac surgeon and professor at Emory University. Dr Grubb discusses her career journey from being an active clinician to a leader within the medical device industry, elaborating on the philosophy behind her choices and the concept of scaling impact beyond the operating theatre. This leads the discussion into an analytical dissection of the Evolut low-risk trial, with Dr Grubb explaining how the evolution of procedures such as cusp overlap and pre-dilation have made a world of difference in terms of improving results concerning paravalvular leaks and pacemaker implantations as well as comparing current long-term reintervention data to older methods. Other topics in this podcast include sex disparity in structural heart disease, specifically the issues around the diagnosis and treatment of female patients with fibrotic, low flow-low gra

In this episode of Parallax, Dr Ankur Kalra is joined by Dr Michelle Kittleson, Professor of Medicine and Advanced Heart Failure Cardiologist at Cedars-Sinai Medical Center, for a clinically rich breakdown of her standout trial picks from the 2026 ACC Annual Scientific Sessions. Dr Kittleson brings her characteristic precision to four landmark studies spanning heart failure and atrial fibrillation. She unpacks the SPIRIT HF trial — a negative study of spironolactone in HFpEF that, she argues, does not consign the drug to the shelf — and explains why its high discontinuation rate and pandemic-era disruptions complicate the headline result. For clinicians managing cost-conscious patients, her take on spironolactone as a practical alternative to finerenone is a perspective worth hearing. The conversation turns to the CADENCE trial, a Phase 2 study of sotatercept in Group 2 pulmonary hypertension secondary to HFpEF — a phenotype Dr Kittleson treats with particular caution given the risks of misdirected pulmonar

In this fascinating episode of Parallax, Dr Ankur Kalra is joined by Dr Benjamin Levine, Director of the Institute for Exercise and Environmental Medicine and a pioneering figure in the field of space cardiology. Together, they explore the remarkable cardiovascular adaptations that occur in microgravity, and what they are teaching clinicians about treating patients on Earth. Dr Levine unpacks the haemodynamic realities of spaceflight, from the counterintuitive finding that central venous pressure actually drops to zero in microgravity, to the physiologic cardiac atrophy that results when the heart no longer pumps against gravitational load. He shares how this research has transformed the understanding and treatment of POTS, reframing it not as a disorder of the autonomic nervous system, but as a consequence of reduced stroke volume - and how horizontal exercise training borrowed directly from astronaut countermeasure programmes is now changing clinical practice. The conversation also turns to the emerging c

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