Breakfast and Yoga
On Saturday, Aug. 20, 2023, the third and final day of the Women’s Cardiometabolic Health and Wellness Masterclass began with yoga and a healthy, protein-packed breakfast, all enjoyed right outside the general session ballroom of the Laguna Cliffs Marriott Resort and Spa.
Heart (Failure) Function in Women
To kick off the edcation on Saturday, Aug. 20, the audience welcomed Anuradha Lala-Trindade, MD, to share her insights and perspectives on overcoming barriers for better heart failure outcomes in women. Dr. Lala (as she is affectionately called by her patients and colleagues) is an assistant professor of medicine at the Zena & Michael A Wiener Cardiovascular Institute and in the Department of Population Health Science and Statistics at Icahn School of Mount Sinai and Mount Sinai Hospital in New York.
"Words matter. The word 'failure' feels intrinsically awful. It's not an engaging term and I've been pretty vocal about preferring the term 'heart function' instead of 'heart failure.' I don't downplay the morbidity and mortality associated with the diagnosis, but I do like to emphasize the spectrum of the disease and focus on improving function, not just function of the heart but of how the patient functions in life each day."
Transcatheter Aortic Valve Replacement in Women with Aortic Stenosis
Angela Lowenstern, MD, MHS, an interventional cardiologist at Vanderbilt University Medical Center, presented a session on how to identify a surgical candidate for transcatheter aortic valve replacement. She explained some sex-specific considerations in assessing women for this treatment, one of which is that women’s smaller anatomy may make the procedure more challenging because it can be difficult to navigate their smaller vasculature.
"I propose that quality care delivery be measured not just by procedural outcomes, but also using process metrics looking at what proportion of patients who are eligible for valve replacement actually undergo timely intervention."
Women and Peripheral Artery Disease
Roxana Mehran, MD, proposed a call to action on behalf of the community of interventional cardiologists. She discussed how vital it is to identify and treat peripheral artery disease (PAD) which often results in amputations if untreated. “There are below-the-knee and above-the-knee amputations. Women have higher rates of above-the-knee amputations, which can be a devastating life change,” said Dr. Mehran.
"Peripheral artery disease is a common but potentially deadly disorder that is underrecognized and undertreated, especially in comparison to coronary artery disease. Most patients affected actually do have adverse critical arterial limb events as well as cardiovascular events if you look at the global prevalence."
Afternoon Wellness Break and V-Works Zumba
After a packed morning of clinical insights on heart function, aortic stenosis, valve replacement, and the lack of sex-specific trial data to inform treatment decisions, attendees participated in V-Works Zumba, led by Christie M. Ballantyne, MD, and all-star fitness instructor, Vanessa Aguirre Velarde.
Hypertrophic Cardiomyopathy in Women
Theodore Abraham, MD, kicked off the afternoon sessions by covering current challenges and advances in the diagnosis and management of hypertrophic cardiomyopathy (HCM) in women. During his talk, he highlighted the overall gaps specifically in women, saying “Compared to men, a diagnosis of HCM is delayed by an average of six years in women, and is often ignored, misinterpreted or attributed to other causes in women, leading to significant missed opportunities for diagnosis and treatment.” Dr. Abraham also reviewed key data with the only FDA-approved option for HCM, mavacamten, mentioning that it represents a major advancement to fill current treatment gaps and that several other promising agents are in development.
Women and Chronic Kidney Disease
Internationally recognized expert in chronic kidney disease (CKD) Katherine R. Tuttle, MD, covered the impact of CKD worldwide, highlighting the fact that most patients with CKD will die of cardiovascular mortality, including atherosclerotic cardiovascular disease and heart failure, and only 10% will die of end-stage kidney disease, emphasizing the need for a comprehensive cardiorenal approach to prevent adverse outcomes in these patients. Because women have a higher prevalence and symptom burden of CKD, Dr. Tuttle emphasized that clinicians must do better in implementing guideline-directed medical therapy in women, including introducing ACE inhibitors, ARBs, and SGLT2 inhibitors. She also mentioned the gaps in the screening and diagnosis of CKD in women.
"If you can't find it, you can't treat it."
Managing Type 2 Diabetes in the Era of Cardiometabolic Outcomes Trials
Vanita R. Aroda, MD, gave the audience a practical overview of the individualized therapy for patients with type 2 diabetes. She outlined the potential for holistic approaches to reduce morbidity and mortality, specifically focusing on glycemic control, weight loss or maintenance, controlling cardiovascular risk factors, and addressing concomitant heart failure, chronic kidney disease, or atherosclerotic cardiovascular disease.
Panel Discussion
The final educational session of the 2023 Women's Cardiometabolic Health and Wellness Masterclass was a wonderful panel discussion moderated by Barry H. Greenberg, MD, professor of medicine at the University of California San Diego, with Drs. Abraham, Aroda, Taub, and Tuttle covering the spectrum of cardiorenal risk reduction in type 2 diabetes, cardiovascular disease, and other cardiometabolic considerations.
Champions for Women's Health Dinner Reception
This dinner, sponsored by Esperion, honored male practitioners who support, encourage, and champion their female cardiovascular provider colleagues. This closing reception was also a chance for the co-chairs, Dr. Michos and Dr. Taub, to introduce the recipients of the Future Leaders in Cardiometabolic Health Fellowship Program recognizing future leaders in the field of cardiometabolic medicine.
"This year, we wanted to honor our male counterparts. These clinicians are champions not only for female patients but also champions for other clinicians in the field. All these individuals have provided mentorship and helped advance so many hwomens' careers in the cardiometabolic field."
Thank you, and farewell from the 2023 Women’s Cardiometabolic Health and Wellness Masterclass! We hope to see you all in 2024, when we’ll meet again at the stunning Laguna Cliffs Marriott Resort and Spa for another conference designed to improve women’s cardiometabolic health and wellness!
