Rush Cardiac News
The Rush Heart Institute Newsletter for Physicians
and Other Health Professionals Volume 7 · Number 1 · Winter-Spring 2001
Rush Heart Institute
1725 W. Harrison St.
Rush is first in the area
Chicago, IL 60612
to offer beta-radiation
Joseph E. Parrillo, MD,
for in-stent restenosis
Verdi J. DiSesa, MD, A 75-year-old woman presented at Rush in late 1998
with a nine-year history of persistent, intractable chest
Services: pain. A veteran of two CABG operations and 16
• General Cardiology
PTCAs, the patient could not remember a time when
Cardiology she did not experience the debilitating pain.
• Heart Failure and Her presentation and medical history indicated she
would be a good candidate for a trial under way at
• Cardiovascular- Rush using targeted low-dose beta-radiation to treat
in-stent restenosis. She received the new treatment, Beta-radiation sources
Pediatrics and now, more than two years post-treatment, she has at treatment site
• CV Stress Testing had no recurrence of symptoms.
Rehabilitation ment of in-stent restenosis. The FDA approval was in
No single subject in the past year has received more
• Preventive response to superior outcomes from the START (Stent
Cardiology attention or caused more excitement in cardiovascular
• Pulmonary Heart and Restenosis Therapy) trials, in which patients who
care than intracoronary radiation for the treatment of
Disease participated demonstrated a 66 percent reduction in the
• EBT Coronary in-stent restenosis.
Screening rate of in-stent restenosis when treated with targeted
This interest was validated last November when the low-dose beta-radiation.
FDA approved intracoronary radiation for the treat- (continued on page 7)
New Rush preventive medicine residency and cardiology fellowship at Rush-
Presbyterian-St. Luke’s Medical Center.
cardiology director Board-certified in internal medicine and cardiovas-
defines program goals cular medicine, he has more than 100 publications to
In light of growing evidence supporting the impor- his credit.
INSIDE tance of primary and secondary prevention in the care His article, “Effects of Continuous Estrogen and
of all patients, the Rush Heart Institute recently Estrogen-Progestin Replacement Regimens on
•Biventricular appointed one of the nation’s Cardiovascular Risk Markers in Postmenopausal
pacing for leading preventive cardiology Women,” appeared in the November 2000 issue of the
heart failure clinicians and researchers, Archives of Internal Medicine. It is one of his most
Michael Davidson, MD, as recent and important published works. He has also
•Pulmonary Medical Director of the Rush coordinated more than 500 clinical trials, and in
thromboen- Preventive Cardiology addition to his Rush responsibilities, will continue as
Program. President of the Chicago Center for Clinical Research
Dr. Davidson, a graduate of and Executive Director of Protocare Trials.
•New mitral Ohio State University The clinical research focus that has dominated much
valve repair School of Medicine, of Dr. Davidson’s work for the past decade underscores
completed both his internal
Dr. Davidson (continued on page 2)
Rush-Presbyterian-St. Luke’s Medical Center Page 1
Preventive Cardiology NIH study seeks recruits
(continued from page 1)
Partners for Life, a four-year $2.4 million NIH study
the goals he has set for the Rush Preventive Cardiology
conducted by Rush Heart Institute cardiac psychologist
Program. “The primary goals of an advanced preventive
Albert Bellg, PhD, and Tamara Sher, PhD, of the
cardiology program should be clinical practice, education
Illinois Institute of Technology, will examine whether a
and research,” says Dr. Davidson. “Within clinical practice,
behavioral change program that includes spouses or life
we are able to offer patient screening that is far beyond
partners can help patients maintain long-term change.
HDL, LDL and triglyceride levels.”
Patients appropriate for this study include those who:
The laboratory screening done through the program may
include determination of the following components: • are recovering from an MI, CABG or PTCA within
the past six months,
• particle size of HDL, LDL and VLDL,
• LDL particle concentration, • reside with a live-in spouse or partner,
• homocysteine levels, • require dietary changes or weight loss, cardiac reha-
• fibrinogen, bilitation and lipid-lowering medication.
• blood viscosity,
“Patients recovering from cardiac events often have a
difficult time making and maintaining the behavioral
• high-sensitivity C-reactive protein. changes recommended by their physicians,” Dr. Bellg
However, Dr. Davidson cautions, the program’s goal should says. “In the Partners for Life study, patients and their
not only be to diagnose and treat complex lipid disorders; partners will learn how to work together to improve
rather, the goal is also to integrate the concepts of preven- their adherence to taking lipid-lowering medication
tion into the care of all patients through risk-factor analysis and maintaining risk-reducing lifestyle changes, such as
and risk modification. weight loss, diet and exercise.”
The Preventive Cardiology Program provides a team Long-term adherence in this group will be compared
approach that includes an exercise physiologist, a clinical with that of patients who receive heart-healthy educa-
nutritionist, a cardiac psychologist (Albert Bellg, PhD) tion without including their partners.
and a nurse practitioner (Lynne Braun, RN, PhD). Dr. For more information or to refer a patient, contact
Braun directs clinic activities with Dr. Davidson, addressing Jennifer Tennant, RN, at (312) 942-2375.
many risk-modification issues with patients. “Patients often
need education, planning and support to address modifiable addition to plans for establishing a national cholesterol
risks. We provide the tools needed,” she says. index, Dr. Davidson plans to implement at Rush a nation-
wide quality assurance program developed by the
Clinical research will be an important aspect of Dr. American Heart Association entitled “Get With the
Davidson’s work at Rush. One of his recent endeavors is an Guidelines.” The program includes patient-discharge
abstract that will be presented at the American College of guidelines, such as specific education requirements needed
Cardiology Spring 2001 Scientific Meeting entitled to address risk-factor modification. Dr. Davidson has also
“Rosuvastatin is Superior to Atorvastatin in Reducing LDL developed a Palm Pilot program that uses cardiac risk
Cholesterol Levels to NCEP Guideline.” factors to compare the patient’s chronological age with his
or her calculated heart age. The program will debut at the
He also recently began enrolling patients in a clinical trial
American College of Cardiology Scientific Meeting.
that will evaluate the combined cholesterol-lowering effect
of adding ezetimibe—an investigational drug that blocks “Dr. Davidson brings a wealth of clinical and research
the absorption of cholesterol in the intestinal track—to a expertise to his new position at Rush,” says Joseph
patient’s current statin regimen. In addition, a clinical trial Parrillo, MD, Medical Director of the Rush Heart
will begin in June involving cholesterol-lowering and the Institute. “The commitment Drs. Davidson and Braun
Rush Heart Scan. The study will evaluate the progression have to improving cardiovascular health is a tremendous
of atherosclerosis in patients who have electron-beam CT benefit, not only to patients but to other clinicians as
scores of 30 or higher and low lipid levels and who are well.”
given cholesterol-lowering therapies.
For more information about preventive cardiology clinical
Providing education for clinicians and patients will also be and research programs at Rush or to speak with Dr.
a priority for the Rush Preventive Cardiology Program. In Davidson, call (312) 563-2011.
Page 2 Rush-Presbyterian-St. Luke’s Medical Center
Promising results seen cations for placement
of an implantable A C
for biventricular pacing cardiac defibrillator as
in heart failure well.
A 65-year-old patient presented at Rush with New York “Patients with
Heart Association (NYHA) Class III heart failure, demon- advanced heart failure
strating dyspnea even with mild exertion. Having have a high incidence
exhausted medical management options in search of of sudden cardiac
symptom relief, the patient agreed to participate in a biven- death,” Dr. Pinski says.
tricular pacing study.
“This trial will
evaluate the benefits of
After being randomized to the pacing arm of the trial, the This illustration shows the
combined therapy of
patient experienced dramatic improvement, moving from the position of the catheters
biventricular pacing of a biventricular pacing
NYHA Class III to Class I, in less than six months. The
with an ICD for this system in the heart. One
patient can now ambulate several blocks without dyspnea.
complex patient popu- catheter is placed in the right
In a recent poll of cardiovascular experts, biventricular lation.” atrium (A), one in the right
pacing for the treatment of heart failure was listed as one of ventricle (B) and one in a
For more information coronary vein (C) to pace the
the top-ten advances in cardiology in 2000, an opinion
or to refer a patient to left ventricle.
shared by the heart failure and arrhythmia experts of the
the COMPANION or
Rush Heart Institute.
MIRACLE-ICD trials, contact Dr. Costanzo at (312)
Two clinical trials based on the scientific theory that 563-2121 or Dr. Pinski at (312) 942-6858.
ventricular resynchronization improves cardiac function in
severe heart failure are now being conducted at the Rush
Heart Institute to assess the benefits of biventricular pacing. Department News
Rush Principal Investigators Maria Rosa Costanzo, MD, Salpy Pamboukian, MD, recently joined the Rush
Medical Director of the Rush Heart Failure and Cardiac Heart Failure and Cardiac Transplant Program. She
Transplant Program, and Sergio Pinski, MD, Director of was also appointed Medical Director of the new
the Rush Arrhythmia Device Program, are currently Heart Failure Program at Cook County Hospital and
recruiting patients to the COMPANION (Comparison of an Assistant Professor at
Medical Therapy, Pacing, and Defibrillation in Heart Rush Medial College.
Failure) trial and the MIRACLE–ICD (Multicenter Dr. Pamboukian
InSync Randomized Clinical Evaluation with an completed both medical
Implantable Cardiac Defibrillator) trial. Both trials require school and her internal
that candidates have a left-ventricular ejection fraction medicine residency at
(LVEF) of 35 percent and symptomatic heart failure for at the University of
least six months. Toronto. She then
The COMPANION trial randomizes patients to one of completed fellowships
three arms: biventricular pacing, biventricular pacing plus in cardiology at the
backup defibrillator or medical therapy alone. Dr. Costanzo University of British
feels the initial patient results have been very promising. Columbia and in heart failure and cardiac transplant
at Rush-Presbyterian-St. Luke’s Medical Center. She
“Most of our patients randomized to biventricular pacing is board-certified in internal medicine and cardiovas-
improved their functional class within six months,” she cular disease.
says. “The hope is that we can reproduce that level of
improvement in many of our patients coping with Heart failure is Dr. Pamboukian’s area of interest,
advanced heart failure. We believe this therapy has incred- with a special emphasis on outcomes management
ible therapeutic potential.” and racial and gender differences in heart failure. She
recently published an article on “Transplant
The MIRACLE-ICD trial is also designed to assess the Coronary Vasculopathy” in Current Treatment
benefits of biventricular pacing for the treatment of heart
(continued on page 4)
failure, with one key difference. Candidates must have indi-
Rush-Presbyterian-St. Luke’s Medical Center Page 3
Rush pediatric CV KEY STEPS TO SURGERY
surgeon successfully According to Dr. Amato, surgical correction of
treats rare defect ectopia cordis requires four key steps:
1. covering the naked heart with skin as soon
Ectopia cordis is such a
rare defect in newborns,
representing less than 2. palliating or completely repairing major
0.1 percent of all intracardiac defects,
congenital heart 3. placing the heart into the thoracic cavity,
defects, that cardiac 4. reconstructing the sternum or chest wall to
surgeons may only see cover the heart.
one case in their entire
professional lifetime. outside the chest externally, cervically or abdomi-
nally, Dr. Amato explains. The resulting entity is
Yet, Joseph J. Amato,
called ectopia cordis.
Dr. Amato MD, Chief of the
Section of Pediatric “When the child is born with a heart deformed in
Cardiothoracic Surgery in the Department of this way, there may be a condition within the
Cardiothoracic Surgery at Rush, has seen four heart so major that it cannot be corrected, and the
infants born with ectopia cordis and has treated child will die,” he says. “Surgeons have made many
three of them, the last one within the past several attempts to repair this defect, but not too many
months. In fact, Dr. Amato is believed to be the have been successful. There have been only seven
only surgeon in the Chicago area currently survivors reported in the world literature since
performing the complicated procedure necessary to surgical correction of ectopia cordis was first
correct this condition. performed successfully 24 years ago.”
“Ectopia cordis is a congenital defect defined as the Dr. Amato credits the recent patient’s survival
placement of the heart outside the chest,” Dr. thus far to the team effort at Rush and to the
Amato says. “A more formal definition is an extremely dedicated nurses in the pediatric inten-
extrathoracic heart coming to lie upon the outer sive care unit who work along with the physicians
surface of the body or within the abdominal and resident staff. “This type of care can only be
cavity.” given in a tertiary hospital where there is coordi-
nated interaction among all of the disciplines
As early as the third week of intrauterine life,
involved,” he says.
when both the heart and the sternum are being
formed in the primary germ layers, the For more information, or to speak with Dr. Amato
mesenchymal tissue that comprises the sternum directly, call (312)-942-5448.
may fail to fuse, allowing the fetal heart to develop
Department News chairman for the 5th Annual American Society of
(continued from page 3) Nuclear Cardiology Symposium and Scientific Session.
Options in Cardiovascular Disease (2001;3:55-63). She will James Calvin, MD, Rush cardiologist and Chairman of the
divide her clinical and research responsibilities between Division of Cardiology at Cook County Hospital, and
Rush-Presbyterian-St. Luke’s Medical Center and Cook Lloyd Klein, MD, have published an article, “Validated
County Hospital. Risk Stratification Model Accurately Predicts Low Risk in
Patients with Unstable Angina,” in the Journal of the
Lloyd Klein, MD, Director of Rush Interventional
American College of Cardiology (2000;36:1803-8).
Cardiology, was recently appointed to the Editorial Board
of the Journal of the American College of Cardiology. Dr. Philip Liebson, MD, Rush cardiologist, has published
Klein also was the course director for the fall 2000 9th “Optimal Antihypertensive Therapy for Prevention and
Annual Cardiac Intervention in Chicagoland meeting. Treatment of Left Ventricular Hypertrophy” in Current
Hypertension Reports 2000.
Robert Hendel, MD, Rush Director of Nuclear
Cardiology in the Section of Cardiology, was the program (continued on page 8)
Page 4 Rush-Presbyterian-St. Luke’s Medical Center
New mitral valve repair 1A Anterior leaflet
offered at Rush for Annulus
ischemic cardiomyopathy 1B
The complex changes in ventricular geometry that occur
in patients with ischemic cardiomyopathy often make
surgical repair of mitral valve insufficiency extremely diffi-
cult. However, cardiovascular surgeons at Rush have Posterior leaflet
begun using a new approach to mitral repair that has
proven successful for these challenging patients.
2A Anterior leaflet
Approximately 25 percent of patients with ischemic
cardiomyopathy have mitral insufficiency. Many of these
patients continue with significant shortness of breath and
fatigue despite optimal medical treatment with after-
loading drugs. These significant symptoms lead some 2B
patients and physicians to consider surgical repair. Posterior leaflet
There are several challenges to performing mitral valve
surgery for patients with this disease. The changes that
occur in ventricular geometry interact with mitral valve
function in a complex way. As with most forms of
cardiomyopathy, the failing ventricle dilates. This
dilation causes expansion of the posterior mitral annulus. Figures 1A and 2A illustrate the left atrial and lateral
When the annulus dilates, there is progressive failure of views of the incompetent mitral valve. Figures 1B and
good coaptation (fitting together) between the anterior 2B illustrate the competent valve after annuloplasty
and leaflet approximation.
and posterior mitral leaflets.
This failure causes mitral insufficiency, which exacerbates and retraction of the mitral leaflet. This distortion and
the volume load on the heart and leads to further dilation restriction in leaflet movement can cause mitral insuffi-
and more mitral insufficiency. The cycle progressively ciency. “When a surgeon repairs mitral insufficiency in this
destroys normal myocardial and valve function. This situation, the alteration in leaflet motion should be
familiar mitral insufficiency scenario can be treated effec- addressed, as well as the annular dilation that typically
tively with ring annuloplasty alone. In ischemic accompanies heart failure of many etiologies,” says Verdi
cardiomyopathy patients, however, the etiology and the DiSesa, MD, Rush Chairman of Cardiovascular Surgery.
therapy are not so straightforward.
The procedure involves suturing the mid-portion of the
Coronary artery disease can cause changes in regional anterior leaflet to the corresponding mid-scallop of the
wall motion and regional ventricular shape. Because posterior leaflet. This approach creates a double-orifice
normal function of the mitral valve depends on the mitral valve. The technique was originally proposed by O.
normal shape and function of the left ventricle, these Alfieri, MD, from Milan, and it is often used to correct
regional wall changes mitral insufficiency as part of ventricular volume reduction.
can affect mitral compe-
Remarkably, the procedure does not produce significant
mitral stenosis, although it does change the flow pattern
infarction, akinesis and
through the mitral valve as assessed by echocardiography.
enlargement of the
region of ventricular Cardiovascular surgeons at Rush are the only surgeons in
myocardium near the the Midwest currently using this approach for this chal-
base of a papillary lenging group of patients. Successful outcomes have been
muscle can alter mitral demonstrated thus far, but Dr. DiSesa cautions that careful
valve function. follow up will be necessary to demonstrate the durability
and long-term efficacy of the procedure.
changes may cause For more information, or to refer a patient to Dr. DiSesa,
Dr. DiSesa please call (312) 563-2762.
traction on the chordae
Rush-Presbyterian-St. Luke’s Medical Center Page 5
This giant thromboembolism consisting of
clot and fibrosis was removed from branches
of the right pulmonary artery. It measures 6
inches long on the right side.
immediate postoperative period has
passed, many of these patients can
look to this procedure as being
Medical advances in the treatment
of pulmonary heart disease are also
being pursued at Rush, says Vallerie
McLaughlin, MD, Associate
Director of the Rush Pulmonary
Heart Disease Program. “Endothelin-
receptor antagonists and prostacyclin
analogues are the two most promising areas of
clinical study for pulmonary hypertension,” she says.
endarterectomy added to
“In addition to continuous intravenous prostacyclin
medical therapies at Rush medication (Flolan), which is one of the most effec-
Few centers exist nationwide that can address the tive therapies for the treatment of primary pulmonary
advanced needs of patients with pulmonary heart hypertension, there is a new continuous prostacyclin
disease. Even fewer offer surgical relief in the form of subcutaneous analogue, Remodulin. Also, an oral
pulmonary thromboendarterectomy for patients with analogue, Beraprost, is being studied,” she added.
According to Dr. Rich, the message is clear.
Under the direction of Stuart Rich, MD, Medical “Pulmonary heart disease continues to be an
Director of the Pulmonary Heart Disease Center, and extremely complex foe,” he says. “However, there are
William Piccione, MD, a Rush cardiovascular surgeon, more new drugs and therapies available in 2001 for
the Pulmonary Heart Disease Program offers Rush the treatment of pulmonary heart disease than in the
patients surgical removal of chronic pulmonary previous 10 years. And, Rush remains one of only a
embolisms, a condition that affects 15 percent of handful of centers in the world that can offer proven
pulmonary heart disease patients. medical and surgical therapies, as well as access to
the latest clinical trials.”
Patients commonly present with progressive shortness of
breath. CT scans and pulmonary angiography are done For more information about medical management of
to confirm the presence of thromboembolism. Surgical primary pulmonary hypertension, contact Drs. Rich
removal is the treatment of choice for these patients, and McLaughlin at (312) 563-2169, and for surgical
Dr. Piccione reports. options in the treatment of pulmonary thromboem-
bolism, contact Dr. Piccione at (312) 563-2762.
“It is a complex procedure not performed at many
centers nationwide,” says Dr. Piccione, who has
performed more than 20 of the procedures. “Fortunately, Rush Cardiac News®
The Rush Heart Institute Newsletter for Physicians
advances in instrumentation now allow us to reach and Other Health Professionals
segmental arteries more efficiently, significantly Volume 7 · Number 1
decreasing the patient’s cardiopulmonary bypass time.” Rush Cardiac News® is published
by the Rush Heart Institute,
The need for exceptional surgical expertise is not the 1725 West Harrison Street, Chicago, IL 60612,
312-563-2230. All rights reserved.
only issue for these patients, says Dr. Rich. “Pulmonary
Joseph E. Parrillo, MD Verdi J. DiSesa, MD
thromboendarterectomy patients are extremely labile Medical Director Surgical Director
postoperatively. They require continuous, expert Valerie Larkin, RN, MA Robert Hughes
medical management by staff trained to assess and react Marketing Director Administrator
to patients whose hemodynamic status changes quickly Dennis Connaughton
and dramatically,” he says. “Fortunately, once the Editor
Page 6 Rush-Presbyterian-St. Luke’s Medical Center
(continued from page 1)
Cardiologists in the Rush Interventional Cardiology
Program were among the most active participants in
the START trials and subsequent compassionate use
of the device, having performed more than 200 cases
in the last three years. Rush cardiologists also
performed the first commercial beta-radiation proce-
dure in the Chicago area using the Beta-Cath System
from Novoste Corporation. Rush is one of only three
Chicago area sites to offer beta-radiation therapy for
patients with in-stent restenosis.
The Rush investigators, Gary Schaer, MD, Director of Gary Schaer, MD, (left) and R. Jeffrey Snell, MD,
the Rush Cardiac Catheterization Lab, and R. Jeffrey discuss beta-radiation protocols in the Rush Cardiac
Snell, MD, Assistant Director of Interventional Catheterization Lab.
Cardiology, agree that the patient results are unequiv- wall, automatically centering the radiation source.
ocally positive. “This is the first effective tool we have This unique combination of shape and centering
had to combat restenosis,” Dr. Snell says. maximizes both the amount and uniformity of the
dose given to the target tissue.
Beta vs. Gamma Radiation
In addition to the beta-radiation trials, concurrent “The initial trials conducted by Radiance with the
gamma-radiation trials were conducted at several U.S. catheter system yielded an unprecedented zero percent
sites, demonstrating a similar reduction in restenosis. restenosis rate at six month follow-up for 27 patients,
However, warns Dr. Schaer, there are several caveats the lowest rate reported for this therapy,” reports Dr.
to the use of gamma therapy. Schaer.
“Gamma is much more penetrating, with a significant The unique delivery system also allows a dose rate to be
increase in radiation exposure,” says Dr. Schaer. “This delivered effectively to larger vessels, such as saphenous
increase in radiation exposure necessitates medical vein grafts, overcoming a limitation of previous delivery
personnel leaving the patient unattended during the systems. Patients who are appropriate candidates for
15- to 30-minute dwell time. With the beta-radiation these trials must have a left-ventricular ejection fraction
used at Rush, these problems do not occur.” (LVEF) greater than 25 percent, must be suitable candi-
dates for percutaneous intervention and must be able to
Two new brachytherapy trials are now under way at tolerate an aspirin, ticlopidine or clopidogrel regimen.
Rush: the BRITE II (Beta Radiation to Reduce In-
stent Restenosis) trial and the BRITE-SVG On the Horizon
(Saphenous Vein Bypass Grafts) clinical study. BRITE Several new applications of beta-radiation are being
II is a prospective, randomized (3:1 active vs. placebo) evaluated, reports Dr. Snell. “I believe radiation to
trial designed to determine the efficacy of the RDX prevent restenosis for peripheral vascular disease will
coronary radiation delivery system from Radiance soon be available,” he says. “And using brachytherapy as
Medical Systems Inc. an adjunct during an initial coronary angioplasty proce-
dure is on the horizon. At advanced centers like Rush,
BRITE-SVG is a non-randomized registry for patients
we will continue to explore treatment options that
with either restenosis or new lesions not previously
would expand the utilization of this therapy.”
treated. The trials, under the direction of Drs. Schaer
and Snell, will evaluate the RDX system for treating Drs. Schaer and Snell report that in addition to
in-stent restenosis in native coronary arteries and brachytherapy advances, new gene-therapy trials and
saphenous vein grafts. The Rush Heart Institute is the several other acute-intervention studies are soon to
only Chicago area site for these studies. begin at Rush.
The BRITE II and BRITE-SVG trials use a radiation For more information on brachytherapy or to speak
source housed within an angioplasty balloon. The directly with Drs. Schaer or Snell, call Dr. Schaer at
flexible catheter conforms to the shape of the vessel (312) 942-4655 or Dr. Snell at (312) 942-6569.
Rush-Presbyterian-St. Luke’s Medical Center Page 7
Department News Scientific Symposium recently. His presentation was
entitled “Managing Abnormal Vessels and Damaged
(continued from page 4)
Heart Muscle in Circulatory Shock.” Dr. Parrillo also
Kathleen Grady, PhD, RN, received the participated as a faculty member for the Society of
Arteriosclerosis/Heart Failure 2000 Research Prize from the Critical Care Medicine’s Fifth Critical Care Refresher
American Heart Association and the Council of Course, presenting “Arrhythmia Management”, “Acute
Cardiovascular Nursing for her manuscript entitled Coronary Syndromes”, “The Development of a Clinical
“Change of Life from Before to After Discharge Post Left Research Career” and “Cardiology—Year in Review.”
Ventricular Assist Device Implantation.”
Steven Feinstein, MD, Director of the Rush
Steven Hollenberg, MD, Walter Kao, MD, and Sergio Echocardiography Laboratory, was course director for the
Pinski, MD, Rush cardiologists, have recently been fall 2000 15th Annual Advances in Echocardiography:
promoted to associate professors of medicine at Rush The Latest Research and Clinical Information in
Medical College. Contrast Echocardiography and Perfusion Imaging
meeting. In addition, Dr. Feinstein’s article entitled “A
Two Rush Cardiology Fellows received clinical poster
Retrospective Experience of Right Atrial and Superior
awards at a recent meeting of the Illinois and Wisconsin
Vena Cava Thrombi Diagnoses by Transesophageal
Chapter of the American College of Cardiology. Francis
Echocardiography” was recently accepted for publication
Q. Alameda, MD, won 1st place for his case presentation,
in the Journal of the American Society of Echocardiography.
“A Unique and Unusual Case of Metastatic Tumor
Infiltration of the Pericardium Masquerading as Pericardial
Tamponade.” Barry S. Merrill, MD, took 2nd place for his Dr. Feinstein also reports that important new
clinical research, “Comparative Value of Troponin I versus Health Care Financing Administration legislation
Clinical Risk Assessment as Predictors for In-hospital has been approved that provides Medicare reim-
Events in Acute Coronary Syndrome.” bursement for diagnostic contrast agents and
contrast-enhanced echocardiographic diagnostic
Joseph Parrillo, MD, Medical Director of the Rush Heart procedures. The effective date for this provision is
Institute, was a plenary session speaker for the Society of July 2001.
Critical Care Medicine’s 30th International Educational &
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