NEWSLETTER OF THE FRIENDS of the Israel Heart …...President, Friends of the Israel Heart Society Announcing our Annual ACC Banquet!! Everyone is cordially invited to attend our Annual

NEWSLETTER OF THE FRIENDS

of the Israel Heart Society

FIHS is on the web at http://friendsihs.org/index.html. Winter 2018-19 ט׳עשת תבט

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Editor’s Note: Welcome tothe Winter 2018-19 FIHSNewsletter. We wish all ofour readers andmembers aHappy and Healthy NewYear!With our next issue wewill be finishing our 10thyear(yes,1decade!)sincethe new format andcurrent editorship. Tenyears does fly by in thewink of an eye! We willhave some lookbacks inour next issue at key

articles and memoriesfrom the past 10 years- ifanyone had a specialmoment,pleasecontactusand we’ll be happy toinclude it! Jeff Goldbergerwill also be finishing his10th year of leadership,which will be reflected inhisPresidentialmessage.

The current issue willinclude its usual features- amessagefromourPresident,Jeff Goldberger,announcements ofCardiology Meetings, HeartBeats section, and our newClassified Section. We willalso highlight several IsraeliResearch papers. Inaddition, we include otherIsraeli cardiology news ofinterest to our members.




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There is a special interviewwith Michael Glikson as hetakes over the DirectorshipofIntegratedHeartProgramatShaareZedekHospital,aninterview which took placethispastAugust.Finally, we will continue tohighlight our joint projectwiththeIsraelHeartSocietyto raise money to fundIsraeli cardiologyfellowships in theUSA/Canada. We will onceagain link to an excellentvideo created by the IsraelHeart Society to explaintheirneedsandhowwecanhelp.Please note- the descriptionof new technology in ourNewsletter does notconstitute an endorsement.We just want to give ourreadership a sense of thevast scope of Israeli

ingenuity in the fields ofCardiology.Remember, this Newsletterand Society belong to you,the membership. We lookforward to enhancing thisSociety and the connectionsthat we hope to fosterbetween Israeli and non-Israeli cardiologists andtheir institutions.Pleasefeelfree to email us withquestions, answers,comments,criticisms,orjustto tell us to keep workingharder!Ourimmediategoal istotryto grow our membershipand participation to includeanyandallcardiologistsandfellows from around theworld who would beinterestedinsupportingthisbridging relationship. If youknowofanycardiologistsorcardiology fellows who we




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cancontact,pleaseemailme(my email [email protected]) and feelfree to forward thisNewsletter.

MessagefromthePresident

ThankyoutoallourFriends

foryoursupportfortheFriendsoftheIsraelHeartSocietyin2018andyourupcoming

supportin2019.Yourhelp,support,andfriendshiparetrulyfeltandappreciatedbytheIsraelHeartSociety.

Asusual,thenewsletterispackedwithinterestinginformation.IhavehadthegreatprivilegeofworkingwithDr.JackStroh,ourtremendousnewslettereditor,forthelast10yearsonoursociety.Hisenthusiasmanddevotiontoputtingtogetherahighqualityandinformativenewsletteramazinglyconsistentlycontinuestooutperformeachofhispreviousefforts–IhopeyouwillallbeabletojoinusattheupcomingFIHSreceptionatthe2019AmericanCollegeofCardiologymeetingsinNewOrleanstothankhimpersonallyforhiseffortsandcontributions.

Inthisnewsletter,wehavestoriesfromtheAmericanfellowswhoattendedtheInternationalDeadSeaSymposium.Wehadaverydiversegroupandthemeetingandvisitmadequitean




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impression–SeePage14fortheirtestimonials.

FellowshiptraininghasbeenidentifiedasakeyneedfortheIsraelHeartSociety–theopportunityforIsraelicardiologytraineestocomeandreceiveadvancedtraininginNorthAmerica.KudostoCharlieAntzelevitchandhisgroupforsettingupthefundingtohelpthiseffort–seePage6.Weneedmorevolunteersandcenterstofurtherdevelopsuchprograms.PleasethinkabouthowYOUcanhelpfacilitatethis.Pleasecontactmeifyouareinterestedinpursuingthisinyourlocalarea.

Ischemicpreconditioning!WhowouldeverhavethoughtthattheJewishphylacteries–tefillin–wouldbewrittenupinanAmericanJournalofPhysiologystudyshowingtheirbenefit?SeePage25.Thereissomuchgoingonin

ourlives,inourmedicalcommunities,andinpolitics–weareabouttoseeanewround

ofIsraelielections.IhappenedtobeinIsraelwhentheywereannounced,followedbytheimmediatecreationofnewpoliticalparties,quiteanamazingprocess.Withallthesedistractions,howcaneachofyoufindthetimetohelptheFriendsoftheIsraelHeartSociety,eveninasmallway?Theanswerissimple–cometoIsraelforascientificmeeting,helprecruitmorememberstoourorganization,andhelpusraisefundstosupportIsraelicardiologyfellowsgetadvancedtraining.ConsidercombiningavisittoIsraelwithanyoneofthecardiologymeetingsthatofferaworldclassfacultyandcongeniallearningenvironment.ThefeedbackIcontinuallyreceivefromthoseattendingisoutstanding.Ifyouarenotyetasponsor,

pleasejointhemanysponsorsfortheFriendsoftheIsraelHeartSociety–seethelastpageofthisNewsletterforourlistofsponsors.WeareextremelygratefultoourSilver,Gold,and




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Platinumsponsorsfor2018fortheircontinueddedicationtotheFriendsoftheIsraelHeartSociety.Ifyoucanhelptowardanyof

thesegoals,pleasereachouttome.Iamconfidentthatourmembershiphasabroadnetworkthatcanhelpusmovetowardaccomplishingthesegoals.TheIsraelHeartSocietyhasputtogetheranoutstandingpromotionalvideothatcanbeusedtodevelopthis–linkonPage7.Westillneedyourhelp

reachingouttothelargenumberofcardiaccarespecialistswhoare(ormightbe)interestedintheactivitiesoftheFriendsoftheIsraelHeartSociety,butwhowehaveNOTYETreached.Pleaseforwardthisnewslettertotencolleagueswhoyoufeelmightbeinterested–newmemberscangetonourmailinglisteitherbysigningupviaourwebsitehttp://www.friendsihs.org/inde

[email protected]!Ifyou

havepersonaland/oracademicmilestonesyouwouldliketosharewiththeFIHSmembership,pleasesubmitthesetoJackStrohatjackstroh@usa.net.Thisisawonderfulopportunityforourmemberstosharenews.Withbestwishesforagreat2019! JeffGoldberger,M.D.President,FriendsoftheIsraelHeartSociety

AnnouncingourAnnual

ACCBanquet!!

Everyoneiscordiallyinvitedto attend our AnnualReception for theFriendsofthe Israel Heart Society.Come meet leaders of the

http://www.friendsihs.org/index.html

mailto:[email protected]




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American and IsraeliCardiologyworld.CambriaNewOrleans

632TchoupitoulasStreetNewOrleans

Sundayevening,March17,2019at6:30-8:30PM

Wehopetoseeyouthere!

NewProjecttoraisefundsforIsraeli

CardiologyFellowsoverseas(reprinted

fromthelastNewsletter)

The Friends of the IsraelHeart Society (FIHS) is anassociation of health careprofessionals from aroundthe world dedicated tosupport the delivery ofcardiovascular healthcare,

training, and research inIsrael.ThisisourMission.Recently, our President JeffGoldberger spoke with Drs.Glikson and Kornowski (theformer President andcurrent President of IHS)abouthowourSocietycouldbest help Israeli Cardiology.Bothagreed that they reallyneed help supporting moreIsraeli cardiology fellows todo their subspecialtytraining in the USA orCanada so they can bringback to Israel advancedexpertise and capabilities.The Israel Health Systemcurrently does not have theresources to provide thisadvanced training at home,and these opportunities arecostly to support. Weestimate each fellowposition would requireraising$60,000.




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We learned of a currentlysuccessful program atLankenau Institute forMedicalResearch fundedbythe Lankenau-IsraelStrategic Alliance (LISA)under the leadership of ourBoard Member Dr. CharlesAntzelevitch, ExecutiveDirector of CardiovascularResearch at LankenauInstitute for MedicalResearch. This group raisedenough for more than 2fellowships with localfundraisingdinnersatdonorhomes, physicians andcivilians.Our hope is to expand onthis excellent start inPhiladelphia to the rest ofNorth America. This videowas produced by the HISexplaining the need for theprogram. If any of ourreaders have any ideas onhow to raise funding or

would like to spearhead thecontinental effort, pleasecontact me [email protected].

https://www.youtube.com/watch?v=l00vxjoRAaQ&feature=youtu.be

https://www.youtube.com/watch?v=l00vxjoRAaQ&feature=youtu.be




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ClassifiedSectionIn this issue we debut ournew Classified Section. Thisis open to any ProgramDirectors, either in theUSA,Canada, or Israel who haveany position available for acardiologist.Weofferthisasa service to our membersand affiliated physiciansworldwide, with thisfurthering our goal to be abridge to connectingcardiologists. Send allrequests to the editor [email protected].

OpeningsatShaareZedekIntegratedHeartCenter,

Jerusalem.ThenewlyestablishedShaareZedekIntegratedHeartCenterinJerusalemislookingfora-cardiologistwithexperienceincardiacrehabilitationandpreventivecardiologytojoinitsCardiacRehabilitationInstitute.Preferencegiventocandidateswithacademicexperienceandinterest.Thispositionhasapotentialforpromotionopportunitiesinthenearfuture. -EchocardiographicspecialistwithexperienceinTEE,stressecho,and3-Decho.Experiencewithstructuralheartdiseaseinterventionsisanadvantage.Foreitherposition,thereisaclearprospectforpromotion.Ifyouareinterestedoryouknowsomeonewhois,please




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contactourfriendandpastPresidentoftheIsraelHeartSociety,ProfessorMichaelGlikson,MD:ProfMichaelGlikson,MD

DirectoroftheJesselsonIntegratedHeartCenter

ShaareZedekMedicalCenterJerusalem,Israel

Tel:+972-2-655-5974or5Fax:[email protected]

OpeningatSorokaUniversityMedicalCenter,

BeerSheva,Israel

TheSorokaUniversityMedicalCenterofBenGurionUniversity

oftheNegev,inBeerShevaislookingforan-ExpertinechocardiographyandTEEforthisverybusymajortertiarycarecenter.Structuralknowledgeisverywelcomebutnotamust. -DirectoroftheCoronarycareUnit.Applicantsshouldhaveexperienceinacutecardiaccareandholdanacademicposition.Ifyouareinterestedorknowsomeonewhois,pleasehavethemcontactourfriendandPresidentElectoftheIsraelHeartSociety,ProfessorDoronZahgerMD:DoronZahger,MD,FESC,FAHA

Director,DepartmentofCardiology

SorokaUniversityMedicalCenter

PresidentElect,IsraelHeartSociety

Kunin-LunenfeldProfessorofCardiology




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ViceDeanforAcademicPromotions,FacultyofHealth

Sciences,BenGurionUniversityoftheNegev

P.O.Box151BeerSheva84101

IsraelTel.:+972-8-640-3468Fax:[email protected]

OpeningsatLaniadoHospital,Netanya,IsraelTheHeartInstituteatLaniadoHospitalislookingtohiremultipleclinicalcardiologists.Withover2500cardiac

hospitalizations,4700echocardiograms,895cardiaccatheterizations,andanewelectrophysiologyprogram,wearethe4thlargestHeartInstituteinIsrael.Forfurtherinformationcontact:RonJosephLeor-Librach,MD,

PhDDirector,[email protected]

Mobile#-+972-52-847-4154https://www.ima.org.il/MainSite/Departments/ProfileDepartment.aspx?dco

de=0160410200103

https://www.ima.org.il/MainSite/Departments/ProfileDepartment.aspx?dcode=0160410200103




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Upcoming Meetings

The66thAnnualConferenceoftheIsrael

HeartSocietyinAssociationwiththeIsraelSocietyofCardiothoracic

Surgery,undertheAuspicesoftheIsraelCardiologyAssociation

DavidIntercontinentalHotel,TelAviv

April30-May1,2019

http://2019.en.israelheart.com/

Conference Topics: • Adult Congenital Heart Disease / Pediatric Cardiology • Basic Science • Cardiac Imaging • Echocardiography and Valvular Diseases • Heart Failure • Intensive Care / Myocardial/Pericardial Diseases

• Interventional Cardiology • Pacing and Electrophysiology • Rehabilitation/Epidemiology / Prevention and Risk Factors /Pharmacotherapy and Cardiac Pharmacology The upcoming meeting will focus on innovation in cardiovascular medicine, while combining original scientific contributions and invited lectures divided into plenary and parallel sessions in the various subspecialties. We are very proud to be hosting a large number of distinguished, world-renowned international guest speakers and leaders from the European Society of Cardiology (ESC), the American College of Cardiology (ACC), the American Heart Association (AHA), the Society of Cardiovascular CT (SCCT), AFICARDIO (French-Israeli




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Association in Cardiology) and many more. According to the attendees' request, we will supplement the 2019 meeting with additional educational sessions, some novel collaborative sessions and we will continue the tradition of conducting a unique session of women in cardiology and dedicated sessions for the trainees. While oral presentations may be presented in English or Hebrew, the plenary joint sessions of the Israel Heart Society with the international associations will be held in English and will include cutting-edge lectures on the latest advances in cardiology. Posters will be presented in English. An interesting exhibition of innovative devices and pharmaceutical companies will be presented in the

exhibit hall within the convention site. The meeting will take place in Tel-Aviv, a lively city combining modern facilities in a Mediterranean style. The meeting venue is located at the David Intercontinental Hotel, facing the wonderful promenade of the Tel Aviv beach. We therefore welcome you to submit your abstracts by December 31, 2018 and join us at this exciting conference combining high quality basic and clinical research, innovative technologies in a unique and friendly scientific atmosphere. We do hope that you will take the opportunity to participate in this esteemed scientific meeting and look forward to welcoming you on a wonderful visit to Israel in 2019.




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Ran Kornowski, MD, FACC, FESC President

Ronen Rubinshtein, MD, FACC, FESC Secretary General & Treasurer Israel Heart Society

Ehud Raanani, MD Chairman Erez Kachel, MD Secretary Amit Korach, MD Treasurer Israel Society of Cardiothoracic Surgery

FACULTY- Elad Anter USA

Jeroen Bax Netherlands Ivor J. Benjamin USA Dariusz Dudek Poland Richard Kovacs USA Martin B. Leon USA Amir Lerman USA James K. Min USA Athena Poppas USA Paul M. Ridker USA Gabriel Steg France




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15thInternationalDeadSeaSymposium

2019

(Tobeannounced)

ICIMeeting2019:ThePremierInternationalMeetingforInnovationinCardiovascular

Systems

December8-9,2019

DavidIntercontinentalHotel,TelAviv

http://icimeeting.com/

FellowsCaseCompetitionattheInternationalDeadSeaSymposium,October

2018




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The Friends of the Israel

Heart Society together withIndustry travel grantsrecently supported 6cardiology Fellows from theISAtopresenttheirwinningresearchattheIDSSmeetingthis past August. Fellowswereinvitedtosubmitcasesinvolving some aspect ofinnovation in cardiacarrhythmias or devicetherapy. Each winningcandidate was awarded a$2000 educational grant tobe used for conferencetravel and expenses. Thefollowingarethefellowsandtheirresearchtitles:

OholiToviaBrodie-UniversityofMiami-Right anterolateral accessory pathway ablation resolving dyssynchrony-induced cardiomyopathy and enabling lifesaving chemotherapy JoseSanchez-UniversityofCalifornia,SanFrancisco-PAC-induced Ventricular Fibrillation




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RajanLalitShah–StanfordUniversity-Intentional Pneumothorax Avoids Collateral Damage: Dynamic Phrenic Nerve Mobilization through Intrathoracic Insufflation of Carbon Dioxide Performed by Video-assisted Thoracoscopic Surgery JacksonLiang–UniversityofPennsylvania-Not Your Typical Atrial Fibrillation Ablation: Catheter Ablation of Atrial Fibrillation from Above in Patient with Congenitally Absent Inferior Vena Cava ZabeerBhatti–NYPresbyterian,Queens-Management of Paroxysmal Atrial Fibrillation and Transient Ischemic Attack in Woman with Hemophilia B

ShadiKalantarian-UniversityofCalifornia,SanFrancisco-Nodo-Ventricular Wide Complex Tachycardia

Dr. Sanchez was goodenoughtosendusaletterofthanksforthisopportunity:

Hi Dr. Stroh, I presented the following case: "PAC-induced Ventricular Fibrillation". This was highly unique case of a PAC leading to intra-fascicular re-entry utilizing a middle septal fascicle and inducing VF. Briefly, this was a 29-year-old healthy man who presented with an aborted cardiac arrest. In the hospital, he was noted to have a left posterofascicular tachycardia and was brought to the EP lab for ablation and ICD placement. During the EP study, numerous spontaneous episodes of VF were observed. All episodes were initiated by a PAC and were reliably reproducible when atrial extrastimuli were delivered. Intracardiac electrograms during this sequence was suggestive of left-sided fascicular re-entry, which was subsequently confirmed to be using a left septal fascicle when the left anterior and posterior fascicles were mapped. The left middle septal and left posterior fascicles were then ablated, and VF could no longer be induced despite frequent PACs and atrial extrastimulation testing.




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As a result of being awarded the grant, I was able to visit Israel and present this exciting case. I felt very honored to be awarded the stipend, and it was a great privilege to be in Tel Aviv among world-renown faculty who travelled from different parts of Israel as well as the United States, Europe, and Australia. I enjoyed being able to interact with and discuss various aspects of clinical electrophysiology with different faculty members. These types of interactions have been pivotal as I enter my career as a cardiac electrophysiologist and have helped foster strong relationships within this small community. Thank you, Jose José M. Sanchez, MD Clinical Cardiac Electrophysiology University of California, San Francisco

A special interview withformer IHS PresidentMichael Glikson, who isnow Director of IntegratedHeart Center at ShaareZedekMedicalCenter




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JS- CongratulationsontakingoverasDirectoroftheIntegratedHeartCenteratShaareiZedek(SZ).Whatareyourplansandhowwilltheydifferfromthoseofyourpredecessors?HowdoesbeinganelectrophysiologistaffectCardiologyatSZ?

MG-ThereisgreattraditionalreadyatSZ,wherewehaveastrongDepartmentofCardiologyandCardiothoracicSurgery,withbothintegratedtogether.Ourgoalistoimproveinanumberofareas.Forexample,structuralheart,improvedimaging

modalities,congenitalheartdisease,andaLVADprogram.WealsoplantodramaticallyexpandourCardiacRehabilitationservices.WearebringingnewmethodologiesinelectrophysiologyandenhanceourprogrambeyondCRT,ablations,LAAocclusion,andmore.

JS-WhenIinterviewedyouafterbecomingPresidentoftheIsraelHeartSocietywespokeofaninterestinPreventiveCardiology.IknowDanTzivonialsohadsuchaninterest.HowdoyouplanonaddressingthesemattersintheJerusalemarea?MG-AtShaareZedek,wehavetheHeartDiseaseRehabilitationandPreventionInstitute,whichisthelargestofitskindinJerusalem.JacobKleinhelpedfoundthisandmadeitintoaleadingprogram.PatientsarelessawareofpreventionhereinJerusalemthanonthewesterncoastofIsrael,sowehavealotofworktodo.




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JS-WhatarethemajordifferencesbetweenyourworkatyourprevioushospitalandinShaareiZedek?InwhatwaydoyoufeelyounowcanmakeagreaterimpactinHealthcare?MG-Inmypreviousposition,wewereleadingthelargestEPprograminthecountry.NowatShaareZedek,IaminchargeofallaspectsofCardiologyandCardiothoracicSurgery.IactuallygotatasteofthisfrommytimeasPresidentoftheIsraelHeartSociety,whereIgottorepresentallaspectsofcardiologycare.JS-Asyoumayremember,ourSocietywasestablishedbyDougZipes,EugeneBraunwald,andmanyotherstoaidourbrothersandsistersinIsrael.OureffortshaveincludedprovidingsubspecialtyfellowshipsforCardiologyfellows,offeringfinancialaidandawardsthroughothersourcessuchastheMeltzerfamilyAward,andinaddition-ourmembershiphelpedtosuccessfullydefendthe

StateofIsraelintheLancetafewyearsagofromalibelwhichappearedinitspages.DoyouhaveanymessagefortheFriendsoftheIsraelHeartSociety,suchasareaswherewecanhelpIsraelicardiologistsgoingforward,whethercardiologistsintrainingaswellasthePracticeofCardiologyingeneral?Inwhatadditionalwayscanwebeofsupporttoyou?MG-Obtainingadvancedcardiologytrainingopportunitiesforourfellowshasbecomemoredifficult,especiallyintheUSAgivenissuesrelatedtoimmigrationpolicy.OurfellowsneedCentersofExcellenceinwhichtoobtaintheiradvancedtraining.EveryCardiologyProgramthathastakeninourfellowshasbeenhappywiththeirwork.Inaddition,wewouldalsoencourageAmericanandCanadianCardiologiststocometoIsraelduringtheirSabbaticalsandextendedtimeoff,toworkoncollaborativeresearchand/orclinicalwork.




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Finally,membersoftheFriendsoftheIsraelHeartSocietyandfriendsoffriendsshouldattendourfabulousmeetingshereinIsrael-suchastheupcomingConferenceoftheIsraelHeartSociety(whichthisyearwilltakeplaceimmediatelyafterPassover),theInternationalDeadSeaSymposium(aWorldClassElectrophysiologyConference),andtheInternationalMeetingforInnovationinCardiovascularSystems.

IsraeliInnovation

The Israeli watch which monitors your heart Cardisense is an Israeli based company that is developing a watch that professionally monitors your heart condition. http://www.israelnationalnews.com/News/News.aspx/255891

https://www.youtube.com/watch?time_continue=17&v=dORVCXW_jxc

http://www.israelnationalnews.com/News/News.aspx/255891

https://www.youtube.com/watch?time_continue=17&v=dORVCXW_jxc




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StoriesofCoexistence

We come across stories relatedto healthcare from time to timethat show us how good theworld could be if onlywe couldgetalongwitheachother.

AfghanManArrangesforFive-Year-OldGirltoGetLife-SavingHeartSurgeryinIsraelbyISRAEL21c|http://www.thetower.org/6646oc-afghan-man-arranges-for-five-year-old-girl-to-get-life-saving-heart-surgery-in-israel/

NoorinaisfiveyearsoldandlivesinAfghanistan.InJuly,herfatherbroughthertoIsraelforlifesavingheartsurgeryarrangedbySaveaChild’sHeart(SACH),anIsraelimedicalcharitybasedatWolfsonMedical

CenterinHolon.Whensheisolder,NoorinamaybesurprisedtolearnthatanAfghanstrangerwillinglyputhimselfandhisfamilyatrisktogiveherthegiftofhealth.NoorinawasthefifthchildfromAfghanistansenttoSACHthroughtheeffortsofthatsameyoungMuslimfather,whoaskedISRAEL21ctocallhimJangzapali,apseudonymtohidehistrueidentity.“Jangzapali,”heexplains,“means‘victimofwar.’”Jangzapaliisinvolvedinalltypesofcharityworkandhasbuiltupaninternationalsocial-medianetworkoverthepastfewyears.Childrenneedingurgentmedicalcarearehistoppriority.“Almost10,000[medicalneed]casesareregisteredwiththeAfghanRedCrescent.Theyareunabletodoallcases,sothroughourbroadnetworkonsocialmedia,wearrangesurgeryforpoorchildreninAfghanistanorIndia.Forcomplicatedcasestheycannothandle,weworkwithSaveaChild’sHeart,”hesays.“SACH’ssloganisthattheysavechildrensufferingfromheartdefectsregardlessoforientation,




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faith,tribe,nationality,etc.Transport,meals,accommodations,surgery,medicineandinsuranceareallprovidedfreeofcost.”Theactualcostofeachchild’scareis$15,000,coveredentirelybydonations.ThefirstIsraeliNGOevertowinaUNPopulationAward,SACHwasfoundedin1995andhastreatedmorethan4,800childrenfrom57countries,GazaandthePalestinianAuthorityterritories,andtrainscardiologyteamsfromthosecountries.JangzapalifirstheardaboutSACHfromhisFacebookfriendAnnaMussman,aretiredUnitedStatesStateDepartmentemployeewhoadministerededucationalandculturalprogramsinAfghanistan.Inthe1970sshelivedinHaifa,whereshereturnedafterherretirement,andtaughthighschoolEnglish.OneofherstudentswasSimonFisher,nowexecutivedirectorofSACH.Twoyearsago,whenMussmanlearnedthatJangzapaliwasseekingmedicalcareforhisrelative,adesperatelyillAfghan

toddlernicknamedYaya,shedecidedtointervene.“IrealizehelpingachildfromacountrywithwhichIsraelhasnodiplomaticrelationsisnoteasy,butperhapspossible,”shewrotetoFisher.InJuly2016,Yayahadhissuccessfulsurgeryandtheconnectionwasforged.ThoughYayawasthefirstchildfromAfghanistantreatedatSACH,theorganizationhadalreadyhandledcasesfromIraqandSyria.BringingoverchildrenfromcountrieslackingdiplomaticrelationswithIsraelisadifficultprocessinvolvingmanygoodsoulsandIsrael’sForeignMinistry,InteriorMinistryandDefenseMinistry“becauseofobvioussecurityissues,”FishertellsISRAEL21c.HeadmitstosomehesitationtotakeinachildfromasviolentacountryasAfghanistanbecauseofpossiblerepercussionsforpatientandfamily.Jangzapaliwashesitant,too.“ThefirsttimeIwasgoingtosendachildtoIsraelItoldaPalestinianladyIknowthatIwasafraid,”Jangzapaliconfides.“Shesaid,




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‘WehaveaproblemwithIsraelaboutthelandbutwegotoIsraelfortreatmentsowhyshouldn’tyou?’Iwashappytohearthat.IfeelthatJewsareAhliKetab(peopleoftheHolyBook)andweareallthesamehumanbeings.”Noteveryonefeelssimilarly,ofcourse.“SomepeopleheremaythinkIampro-WesternorapuppetofIsrael.Wedon’tknowwhattherisksareandwecan’ttellanyoneopenlythatthesechildrenwenttoIsraelforsurgery,”Jangzapaliadmits.Thepatients’parentsareatrisktoo,buttheirchild’swellbeingistheoverridingconcern,hesays.AftermedicalrecordshavebeenreceivedbySACHandthecaseaccepted,Jangzapaliandhisfriendsscrambletomaketravelarrangements.“Heisagreatnetworker,referringpatientsallovertheplace,”saysFisher.“AcoupleoftheAfghanikidshavearrivedhereviaDelhi.TheyandtheiraccompanyingparentwerehostedbyRotaryClubmembersontheirwaytoIsrael.”“WeprefertosendkidsviaIstanbul

onaTurkishtransitvisabecausethewayissonearandtheticketischeap,”saysJangzapali.ForYaya,theTurkishConsulateinKabulgrantedavisawithin30minutes.Thenexttwocasesalsowentsmoothly,butthefourthtimetherewasacomplicationsoJangzapaliappealedtotheIndianConsulate.TheIndianroutealsowastakenbyNoorinaandherfather.BecausethefamilycouldnotevenaffordtotraveltoKabultoreceivetheIndiantransitvisas,JangzapalicontactedhislongtimeFacebookfriend,KathleenThorrezofMichigan.Shewiredover$200tocovertheirexpenses.“Mydearfriend[Jangzapali]hasbeenextremelycourageousinhiseffortstomakealovingdifferenceinsomanypeople’slives.Hehasthistenderbutrelentlessdesiretoservefaithfullyandrespectfullythesechallengedfamilieswhofacetheworstfearoflosingapreciouschildwithoutthislifesavingsurgery,”ThorreztellsISRAEL21c.Buildingbridges“Thestoryofchildrencomingto




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IsraelfromAfghanistanisaclassicexampleofhowSACHbuildsbridgesbetweenpeopleandcultures,”Fishernotes,“becauseitbringstogetherpeoplefromdifferentwalksoflifeanddifferentreligions,motivatedonlybythedesiretosaveachild’slife.”InadditiontoJangzapaliinAfghanistan,MussmaninHaifaandThorrezinMichigan,Afghan-AmericanJewJackAbrahamandhischildrenhavesponsoredthetreatmentofthreeAfghanichildrenincludingNoorina.Iranian-bornRotarianandcardiacnurseFaryMoiniofCalifornia,whoisnotJewish,helpedsecuretheTurkishvisaforYayaandcametoHolontohelpcareforhim.YaakovGol,anIsraeliJewborninAfghanistan,volunteerstotranslatefortheMuslimAfghaniparentsandchildrenatSACH.“WhenwestartedtreatingchildrenfromAfghanistan,wediscoveredaspecialAfghan-JewishcommunityinIsraelstronglycommittedtopreservingtheirtraditionsandheritageand

keepingadialoguegoingbetweenpeopleinIsraelandAfghanistan,”saysFisher.Abraham,thedonorfromNewYork,contactedGolandJangzapaliafterreadingaboutYaya’ssurgery.JangzapalitellsISRAEL21cheisdeeplygratefulfortheAbrahamfamily’sgenerosity.“JewswereinAfghanistanfor2,000yearsandIwantedtogivesomethingback,”Abrahamexplains.“Inthisworld,therearetakersandgivers,andthosewhoaregiversarethehappyones.”HeisinconstantcontactwithJangzapali.“Thisguyisunique.He’sinvolvedineveryfacetofcharityinhiscountry—clothing,food,schoolsupplies.ForsomeonefromAfghanistantoarrangeforkidstocometoIsrael…well,itisnotnextdoor,”AbrahamtellsISRAEL21c.“ThechildrentheysendtoSACHaretheonesthatcannotbehelpedinthat‘neighborhood.’WhenIlookatNoorinaIknowthatifshehadn’tcomehereshewouldn’tbealive.”Thefactthatfivechildrensofar“havecomebackhealthy”




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motivatesJangzapalitocontinuethisabsurdlydangerousworkofsavinglives.“IdoallthesethingsforhumanityandforthesakeofGod,”hesays.

Research: Tefillin may offer heart benefits

Study suggests people who wear tefillin enjoy cardiovascular health benefits. (this one technically is Jewish, not Israeli, but we had numerous emails about it so we decided to include it in this Newsletter). http://www.israelnationalnews.com/News/News.aspx/253201 The study itself: https://www.physiology.org/doi/pdf/10.1152/ajpheart.00347.2018

Jack Rubinstein, MD, associate professor in the University of Cincinnati College of Medicine, is shown demonstrating a layman's version of Tefillin. Credit: University of Cincinnati College of Medicine

A pilot study led by researchers at the University of Cincinnati (UC) College of Medicine suggests Jewish men who observe the commandment to wear tefillin, which involves wrapping one arm with a leather strap as part of daily morning prayer, may enjoy cardiovascular health benefits.

The researchers suggest benefits may occur though "remote ischemic preconditioning" that would protect during heart attacks, reports Medical Xpress. The results are available online in the American Journal of


https://www.physiology.org/doi/pdf/10.1152/ajpheart.00347.2018




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Physiology-Heart and Circulatory Physiology.

Cardiovascular Health Division Associate Professor and UC Health cardiologist Jack Rubinstein, MD enrolled 20 Jewish men living in Greater Cincinnati in his study, nine who wear tefillin daily and 11 who do not wear tefillin. The men participating in the study were between the ages of 18 and 40 and all in good health. Researchers recorded early morning baseline information of all participants and then measured additional data after subjects wore tefillin for 30 minutes.

They measured vital signs, drew blood to analyze circulating cytokines and monocyte function and also measured blood flow in the arm not wrapped in tefillin.

"We found people who wear tefillin in either the short or long term, recorded a measurable positive effect on their blood flow. That has been associated

with better outcomes in heart disease," says Rubinstein.

"Blood flow was higher for men who wore tefillin daily and improved in all participants after wearing it just once as part of the study, explained Rubinstein. Men who wore tefillin daily also had fewer circulating cytokines—signaling molecules that can cause inflammation and negatively impact the heart—compared to non-users, suggesting that near daily use elicits an effect similar to that observed with other methods of eliciting remote ischemic preconditioning-like effect," said Medical Xpress.

Wearing tefillin, also called phylacteries, dates back to scriptural commandments in the books of Deuteronomy and Exodus urging Jews to follow Torah laws and to "bind them as a sign upon your arm".

"Tefillin are used for morning prayers by Jewish men over the age of 13 on an almost daily basis," says Rubinstein. "It is




27

placed on the non-dominant arm around the bicep and the forearm in a pretty tight manner. It is never worn in a fashion as to preclude the blood flow. This is worn for about 30 minutes continuously. Prayers are sitting and standing so often you have to retighten the strap around your arm."

Rubinstein says binding the arm and the discomfort users sometimes report may serve as a form preconditioning and offer a substantial degree of protection against acute ischemic reperfusion injury (a section of the heart is deprived of oxygen and then damaged when re-oxygenated) that occurs as a result of a heart attack.

"One of the ways that protection occurs is through pain," says Rubinstein, also a member of the UC Heart, Lung, and Vascular Institute. "Feeling pain is actually a preconditioning stimulus."

Researchers have studied preconditioning by inducing small heart attacks in animal models for years. They found the small, induced incidents protected the animal from larger, more serious heart attacks in the future. This same preconditioning could be used by partially occluding blood flow in one part of the body and thus serving as a protective element in another part of the body to lessen the injury, says Rubinstein.

"The problem with translating this to people is we don't know when someone will have the heart attack," says Rubinstein. "It's almost impossible to precondition someone unless they're willing to do something daily to themselves. Tefillin use may in fact offer protection as it's worn on an almost daily basis."

Rubinstein cites Israeli studies that found Orthodox men to have a lower risk of dying of heart disease compared to non-Orthodox men. The protection




28

is also not found in Orthodox women, who usually don't wear tefillin.

Several Torah commandments observed by Jews until this day have been found to enhance health, sanitation, social cohesion, economic prosperity, and other areas of life. However, Judaism stresses that while material benefit may indeed result from a Torah lifestyle, such benefit is not the reason for the commandment, which remains inscrutable.

THIS IS ISRAEL: Israeli Doctors Perform

Transplant To Save

Palestinian Baby Using Israeli Child's Heart

https://www.dailywire.com/news/37168/israel-israeli-doctors-perform-transplant-save-hank-berrien Despite the repellent claims of Palestinians in the past that Israel has targeted Palestinian children, the truth of Israeli compassion relentlessly finds its way to the world. A Palestinian baby in a Tel Aviv hospital is fighting for his life, but the only reason the baby is still alive is that an Israeli family that lost their one-year-old child the week before agreed to donate the child’s heart only hours before the Palestinian child became the recipient of a heart transplant, performed by Israeli doctors.

As The Times of Israel reports, Dr. David Mishaly, chief surgeon at

https://www.dailywire.com/news/37168/israel-israeli-doctors-perform-transplant-save-hank-berrien




29

Sheba’s Pediatric and Congenital Heart Surgery Unit, stated that this was the first time a Palestinian baby received a heart transplant from a Jewish child. Around three weeks ago, Musa’s health took a turn for the worse; his heart reached “end stage” failure.

The synchronicity of the situation was this: the Jewish child died of a chronic disease at the medical center; the Palestinian baby, Musa, had been sent by doctors in Ramallah in the West Bank to Sheba’s Safra Children’s Hospital repeatedly so they could treat him. Musa was born with tumors surrounding his heart.

Mishaly explained:

There were several miracles

associated with this complicated

surgery. There is no such thing in the

Palestinian Authority as an ‘organ

donor or organ waiting list.’ While

organ donor and waiting lists exist in

Israel, there was no Israeli baby on

the waiting list when the Palestinian

baby, who is called Musa, was

brought to Sheba in very critical

condition. By a twist of fate, a

miracle, Musa, was able to receive

the new heart from the Jewish child,

whose parents had agreed a few

hours earlier to donate the heart.

Mishaly called the medical center, “an island, an oasis of peace, where healing is the priority and everyone, regardless of who they are is treated equally, with dignity and respect.” Musa’s grandmother stated her family “would like to meet the family of the Jewish child in




30

the near future and thank them for their generosity.”

IsraelResearch

Peripheralarterialdiseaseandlimb

salvage:anewarenaforthecardiologist

ThisisanEditorialintheEuropeanHeartJournal,byBasilS.LewisandDanAtar

EuropeanHeartJournal-CardiovascularPharmacotherapy(2018)4,136–137

https://doi.org/10.1093/ehjcvp/pvy014

RelationofAtrialPrematureComplexesDuringExerciseStressTestingtotheRiskfortheDevelopmentofAtrialFibrillationinPatientsUndergoingCardiacRehabilitation

Younis A, Nof E, Israel A, Goldenberg I, Sabbag A, Glikson M, Peled Y, Klempfner R, Beinart R. The Leviev Heart Center, Sheba Medical Center, Ramat Gan, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: mailto:[email protected] https://www.ncbi.nlm.nih.gov/pubmed/30049459

https://www.ncbi.nlm.nih.gov/pubmed/30049459




31

Atrialfibrillation(AF)isassociatedwithincreasedmorbidityandmortality.Wesoughttodeterminewhetheratrialprematurecomplexes(APCs)detectedduringastandardexercisestresstest(EST)inpatientsundergoingcardiacrehabilitation(CR)areassociatedwithanincreasedriskofAF.Thepresentstudypopulationcomprised6,523consecutivepatientswithoutpriorAFwhoparticipatedinaCRprograminatertiarymedicalcenterinyears2009to2016.MultivariateanalysiswasusedtoidentifytheassociationbetweenAPCsduringthebaselineESTatCRandtheriskforthedevelopmentofAFoverameanfollow-upperiodof2.5years.Atotalof213(3.7%)patientshadAPCsduringtheirEST.Despitebeingolder(meanage63§13yearsoldvs58§13;p<0.001,respectively),nootherstatisticallysignificantdifferencesweredocumented.KaplanMeiersurvivalanalysisshowedthattherateofAFdevelopmentduringfollow-upwassignificantlyhigherinpatientswithAPCsatbaselineEST(11%)ascomparedwiththosewithoutAPCs(5%;log-rankp<0.001fortheoveralldifferenceduringfollow-up).Consistently,multivariateanalysisshowedthatpatientswithAPCsshowed>twofoldincreaseriskforAFcomparedwiththosewithoutAPCs(hazardratio2.1;95%confidenceinterval1.36to3.25;p<0.001).

Inconclusion,ourfindingssuggestthatAPCsdetectedduringESTinpatientsparticipatingintheCRprogramindependentlypredictAFandcanbeusedtoimproveriskstratificationinthispopulation.(AmJCardiol2018;122:395399)




32

ClinicalImpactofABOandRhesusDBloodTypeGroupsinPatientsWithChronicHeartFailure

IsraelGotsman,MD*,AndreKeren,MD,DonnaR.Zwas,MD,ChaimLotan,MD,andDanAdmon,MD

HeartFailureCenter,HeartInstitute,HadassahUniversityHospital,Jerusalem,Israel.

Bloodgroupsystemsbasedonredbloodcellantigensaregeneticallydeterminedandcanidentifypatientsatrisk.Typenon-OoftheABObloodgroupsystemhasbeenassociatedwithcoronaryarterydisease,thrombosis,andaworseprognosis.Thepresentstudyevaluatedthedistributionofbloodgrouptypesinpatientswithheartfailure(HF)andtheimpactonclinicaloutcome.WeevaluatedtheABOandRhesusDantigen(RhD)bloodtypesinalarge

cohortofchronicHFpatients(n=3,815).ABObloodtypedistributionintheHFpopulationwasnotsignificantlydifferenttothatreportedinthegeneralnationalpopulation(A40%,B20%,AB8%,andO33%).ThepercentageofRh-negativeperbloodtypewasalsosimilar(A10%,B9%,AB10%,andO7%).PatientswithtypeOweremorelikelytobehypertensivecomparedwithnon-Otype.Meanfollow-upwas4.2years.Overallsurvivalduringfollow-upwas55%.CoxregressionanalysisafteradjustmentforsignificantpredictorsdemonstratedthatRhD-negativewasassociatedwithaworseprognosisinpatientswithischemiccardiomyopathy(n=2,881,76%):hazardratio1.26,95%confidenceinterval1.04to1.53,p=0.02.Typenon-OwasalsoindependentlyassociatedwithaworseprognosiscomparedwithtypeOinpatientswithnon-ischemiccardiomyopathy:hazardratio1.32,95%confidenceinterval1.04to1.67,p=0.02.

Inconclusion,bloodgrouptypedistributioninHFpatientsaresimilartothegeneralpopulation.RhD-negativeisassociatedwithaworseprognosisinpatientswithischemiccardio-myopathy.(AmJCardiol2018;122:413419)

https://www.ncbi.nlm.nih.gov/pubmed/?term=Clinical+Impact+of+ABO+and+Rhesus+D+Bl

https://www.ncbi.nlm.nih.gov/pubmed/?term=Clinical+Impact+of+ABO+and+Rhesus+D+Blood+Type+Groups+in+Patients+With+Chronic+Heart+Failure




33

ood+Type+Groups+in+Patients+With+Chronic+Heart+Failure

ImpactofSelf-Reported

FamilyHistoryofPremature

CardiovascularDiseaseontheOutcomesof

PatientsHospitalizedforAcuteCoronary

Syndrome(fromtheAcuteCoronary

SyndromeIsraelSurvey[ACSIS]2000to2013)

Levi, Amos ; Chezar-Azerrad, Chava ; Hasdai, David ; Beigel, Roy ; Gottlieb, Shmuel ; Eisen, Alon ; Shlomo, Nir ; Goldenberg, Ilan ; Landes, Uri ; Kornowski, Ran ; Iakobishvili, Zaza

DepartmentofCardiology,RabinMedicalCenter,PetahTikva,Israel;SacklerFacultyofMedicine,TelAvivUniversity,TelAviv,Israel;LevievHeartInstitute,ShebaMedicalCenter,RamatGan,Israel;DepartmentofCardiology,ShaareZedekMedicalCenter,theHebrewUniversitySchoolofMedicine,Jerusalem,Israel;andIsraeliCenterforCardiovascularResearch,ShebaMedicalCenter,RamatGan,Israel.

Familyhistoryofprematurecardiovasculardisease(FHpCVD)isawell-establishedriskfactorfordevelopmentofcoronaryarterydisease.However,littleisknownabouttheimpactofFHpCVDontheoutcomeofpatientspresentingwithacutecoronarysyndrome(ACS).WethereforeaimedtoevaluatetheoutcomesofACSpatientsgroupedbythepresenceand/orabsenceofFHpCVD.Allpatients65atadmissionwhohadanACSeventandwereenrolledinthenationalACSIsraelSurveyregistryfrom2000to2013wereincluded.Patientsweregrouped

https://www.ncbi.nlm.nih.gov/pubmed/?term=Clinical+Impact+of+ABO+and+Rhesus+D+Blood+Type+Groups+in+Patients+With+Chronic+Heart+Failure




34

bythepresenceorabsenceofself-reportedFHpCVD.Nearestneighborpropensityscorematchingwasappliedtocreateanevenlymatchedcohortofpatients.Outcomesincluded30-dayMACE(definedasthecompositeofdeath,unstableanginapectoris,myocardialinfarction,stroke,stentthrombosis,andurgentrevascularization)anditsindividualcomponents.Of7,173ACSpatients,33.9%reportedFHpCVD.Thesepatientswereyounger,withlowerprevalenceofdiabetes,previouscere-brovascularandkidneydiseases,buthadhigherprevalenceofsmokingandhyperlipidemia(p<0.001foreach).Thepropensityscore-matchingcohortincluded1,793pairsofevenlymatchedpatients.Therateof30-dayMACEdidnotdifferinthegroups,aswellas1-yearmortality(2.4%vs2.2%,withvswithoutFHpCVD,respectively).Duringlong-termfollow-up(median7.6years),mortalityratewaslowerintheFHpCVDgroup(hazardratio0.82,95%confidenceintervals0.69to0.99).

Inconclusion,weobservednodifferencesinshort-andintermediate-termoutcomesbasedonthepresenceand/orabsenceofFHpCVD.However,patientswithFHpCVDhadbetterlong-term

survival.(AmJCardiol2018;122:917-921)

https://www.ncbi.nlm.nih.gov/pubmed/?term=Impact+of+Self-Reported+Family+History+of+Premature+Cardiovascular+Disease+on+the+Outcomes+of+Patients+Hospitalized+for+Acute+Coronary+Syndrome

https://www.ncbi.nlm.nih.gov/pubmed/?term=Impact+of+Self-Reported+Family+History+of+Premature+Cardiovascular+Disease+on+the+Outcomes+of+Patients+Hospitalized+for+Acute+Coronary+Syndrome




35

UsefulnessofSerumProcalcitoninasa

MarkerforCoexistingInfectioninPatientsWithAcuteMyocardial

Infarction

Vitkon-Barkay I, Lazarovitch T, Marchaim D, Zaidenstein R, Temkin E, Martin ET, Segaloff HE, Litovchik I, Rum V, Richter C, Tzuman O, Vered Z, Minha S

DepartmentofCardiology,Assaf-HarofehMedicalCenter,Zerifin,Israel;SacklerSchoolofMedicine,Tel-AvivUniversity,Ramat-Aviv,Israel;DepartmentofMicrobiology,Assaf-HarofehMedicalCenter,Zerifin,Israel;InfectiousDiseasesUnit,Assaf-HarofehMedicalCenter,Zerifin,Israel;Departmentof

Epidemiology,TelAvivSouraskyMedicalCenter,Tel-Aviv,Israel;DepartmentofEpidemiology,UniversityofMichiganSchoolofPublicHealth,AnnArbor,Michigan;JohnsHopkinsHospital,Baltimore,Maryland;andCardiologyDivision,AssutaAshdodUniversityHospital,Israel.

Asignificantproportionofpatientswithacutemyocardialinfarction(AMI)alsopresentwithclinicalmanifestationsofinflammatoryresponse,whichmaybeconfusedwithaconcomitantinfection.Thisleadstoadilemmaregardingtheempiricuseofantibiotics.Weexploredifserumprocalcitonin(PCT),whichisknowntobeelevatedinbacterialinfections,maybeutilizedtorule-outbacterialinfectioninAMIpatients.Inthispro-spective,singlecenterstudy,PCTwascollectedwithin48hoursfromAMIpatients.Patients’demographic,clinical,andlaboratorydatawerecollectedprospectively.TwoexperiencedinfectiousdiseasesspecialistsblindedtothePCTresultsindependentlydeterminedthepresenceofinfectionineverypatient.Sensitivity,specificity,positivepre-dictivevalue,negativepredictivevalue,andtheareaunderthereceiveroperatingcharacteristiccurvewerecalculatedtodeterminetheaccuracyofPCT,fever,whitebloodcell(WBC)count,andC-reactiveprotein(CRP)levelsforthediagnosisoftheinfection.Theanalysisincluded230AMIpatients(age63.0§13.0years)of




36

whom36(15.6%)hadcoexistinginfections.ThebestcutoffforPCTasadifferentiatingmarkerbetweenpatientswithandwithoutcoexistinginfectionwas0.09ng/dl(sensitivity94.4%,specificity85.1%,areaunderthecurve0.94).PCToutperformedCRP,WBC,andfeverfordiagnosinginfection.

Inconclusion,comparedwithCRP,fever,andWBC,serumPCThadabetterperformanceindifferentiatinginfectedfromnoninfectedAMIpatientsandthusshouldbeconsideredasanadjuncttestwhenfacingthedilemmaofinitiatingempiricantibioticinAMIpatientdemonstratinginflammatorysigns.AmJCardiol2018;122:729-734)

https://www.ncbi.nlm.nih.gov/pubmed/?term=Usefulness+of+Serum+Procalcitonin+as+a+Marker+for+Coexisting+Infection+in+Patients+With+Acute+Myocardial+Infarction

PulmonaryCongestionComplicatingAtrial

FibrillationCardioversion

Davarashvili I, Acha MR, Glikson M, Farkash R, Mazouz B, Butnaru A, Hasin T

https://www.ncbi.nlm.nih.gov/pubmed/?term=Usefulness+of+Serum+Procalcitonin+as+a+Marker+for+Coexisting+Infection+in+Patients+With+Acute+Myocardial+Infarction




37

JesselsonIntegratedHeartCenter,ShaareZedekMedicalCenter,Jerusalem,Israel.

Acutepulmonarycongestion(APC)mayoccurwithinhoursafterelectricalcardioversionofatrialfibrillation(AF).Thereisscarcedataaboutitsincidence,riskfactors,andtheoutcome.Inthepresentstudy,dataofconsecutivepatientsadmittedforfirstelectricalcardioversionforAFbetween2007and2016wereretrospectivelyreviewed.APCwithinthe48hoursfollowingcardioversionwasdefinedasdyspneaandatleastoneofthefollowing:dropinsaturationto<90%,administrationofintravenousdiureticoranemergentchestX-raywithnewpulmonarycongestion.All-causemortalitywasdeterminedfromthenationalregistry.Totalof1,696patientshadfirstcardioversionforAF,ofwhom66(3.9%)hadAPC.InamultivariatelogisticregressionmodelindependentpredictorsofAPCincluded(OR[CI],p):olderage(oddsratio[OR]1.05,95%confidenceinterval[CI]1.02to1.08,p=0.001),rapidventricularresponse(OR1.98,95%CI1.17to3.34,0.010),previousheartfailure(OR3.53,95%CI2.09to5.97,p<0.001),Amiodaroneloading(OR2.38,95%CI1.18to4.79,p=0.016)anddiabetesmellitus(OR1.7795%CI1.05to3.00,p=0.033).Therewasnodifferenceincardioversionsuccessrate(overall94%).In-hospital

mortalitywas1.5%withintheAPCgroupand0.5%without(p=0.301).PatientswithAPChadhigherrateof6-monthreadmissions(28.8%vs18.1%p<0.028).Withinamedianfollow-upof2.9years,APCfollowingcardioversionwasanindependentpredictorofoverallmortality(hazardratio1.73,95%CI(1.17to2.56)p=0.006).

Inconclusion,APCoccursin3.9%ofhospitalizedpatientsfollowingelectricalAFcardioversion.Riskfactorsincludeincreasedage,diabetesmellitus,heartfailure,Amiodaroneloadingandrapidventricularresponse.APCfollowingcardioversionisassociatedwithincreasedratesofreadmissionsandmortality.(AmJCardiol2018;122:1701−1706)

https://www.ncbi.nlm.nih.gov/pubmed/?term=Pulmonary+Congestion+Complicating+Atrial+Fibrillation+Cardioversion

https://www.ncbi.nlm.nih.gov/pubmed/?term=Pulmonary+Congestion+Complicating+Atrial+Fibrillation+Cardioversion




38

UsefulnessofGlobalLongitudinalStrainforEarlyIdentificationof

SubclinicalLeftVentricularDysfunction

inPatientsWithActiveCancer

Laufer-Perl M, Derakhshesh M, Milwidsky A, Mor L, Ravid D, Amrami N, Sherez J, Keren G, Topilsky Y, Arbel Y.

DepartmentofCardiology,Tel-AvivSouraskyMedicalCenter,6WeizmanStreet,64239TelAviv,Israel.DepartmentofCardiology,Tel-AvivSouraskyMedicalCenterisaffiliatedtotheSacklerSchoolofMedicine,TelAvivUniversity,TelAviv,Israel.

Cardiotoxicityfromcancertherapyhasbecomealeadingcauseofmorbidityandmortalityincancersurvivors.Themostcommonlyuseddefinitioniscancertherapeuticrelatedcardiacdysfunctiondefinedasaleftventricularejectionfraction(LVEF)reductionof>10%,toavaluebelow50%.However,accordingtotherecentAmericanandEuropeanSocietyofEchocardiography,globallongitudinalstrain(GLS)istheoptimalparameterforearlydetectionofsubclinicalleftventriculardysfunction.TheobjectiveofthisstudywastoevaluatethefrequencyofGLSreductioninpatientswithactivecanceranditscorrelationtootherechocardiographicparameters.DatawerecollectedaspartoftheInter-nationalCardio-OncologyRegistry.Allpatientsperformedatleast2




39

echocardiogramsincludingGLS.WeevaluatedthefrequencyofGLSreduction(≥10%relativereduction),itscorrelationtoLVEFreductionandwhetherthereareotherpredictingechocardiographicparameters.In64consecutivepatients,12(19%)had≥10%GLSrelativereduction,ofwhich75%hadnoconcomitantejectionfractionreduction.Therewerenosignificantdifferencesinthebaselinecardiacriskfactors(hypertension,diabetes,hyperlipidemia,orsmoking).TreatmentwithDoxorubicin,Pertuzumab,orIfosfamidewassig-nificantlymorefrequentinpatientsGLSreduction.Nootherechocardiographicparameters,includingdiastolicfunctionorsystolicpulmonaryarterypressureweresig-nificantpredictorsforGLSreduction.Inconclusion,ourstudydemonstratesthatGLSreductionisfrequentinactivecancerpatients,precedesLVEFreductionandcannotbeanticipatedbyotherechocardiographicparameters.UsingGLSroutinelyduringtherapymayleadtoanearlydiagnosisofcardiotoxicity.(AmJCardiol2018;122:1784−1789)

https://www.ncbi.nlm.nih.gov/pubmed/30217373

Incidence and Prognosis of Pericarditis After ST-Elevation Myocardial

Infarction (from the Acute Coronary Syndrome




40

Israeli Survey 2000 to 2013 Registry Database)

Lador A, Hasdai D, Mager A, Porter A, Goldenberg I, Shlomo N, Vorobeichik D, Beigel R, Kornowski R, Iakobishvili Z.

Department of Cardiology, Rabin Medical Center, Petah-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel; and The Israeli Association for Cardiovascular Trials, Tel Hashomer, Israel.

There are scarce contemporary data regarding the incidence and prognosis of early postmyocardial infarction pericarditis (PMIP). Thus, we retrospectively analyzed 6,282 patients with ST-segment elevation myocardial infarction (STEMI) enrolled with known PMIP status in the Acute Coronary Syndrome Israeli Survey 2000 to 2013 registry. The primary outcome was the composite of all-cause mortality, nonfatal myocardial infarction, cerebro- vascular event, stent thrombosis, or revascularization. The secondary outcomes were mortality and length of stay during the acute hospitalization. Overall, 76 patients with STEMI had PMIP (1.2%). PMIP incidence gradually decreased from 170 per 10,000 in 2000 to 110 per 10,000 in 2013, respectively (35% reduction, p for trend =0.035). Patients with PMIP were younger

(median 58.0 vs 61.0; p =0.045), had less hypertension, higher cardiac biomarkers, and more frequently reduced left ventricular ejection fraction (87.0% vs 67.0%; p =0.001). Patients with PMIP had longer time to reperfusion (225 minutes vs 183 minutes; p =0.016) and length of stay (7.0 vs 5.0 days; p <0.001). The composite end point occurred similarly in patients with and without PMIP (10.5% vs 13.2%, respectively). There was no significant difference in 30-day, 1-year, and 5-year survival.

In conclusion, PMIP is a relatively rare complication of STEMI in the coronary reperfusion era, portends worse short-term but not long-term outcomes, and is associated with bigger infarct size. (Am J Cardiol 2018;121:690–694)

https://www.ncbi.nlm.nih.gov/pubmed/?term=Incidence+and+Prognosis+of+Pericarditis+After+ST-Elevation+Myocardial+Infarction+(from+the+Acute+Coronary+Syndrome+Israeli+Survey+2000+to+2013+Registry+Database)

https://www.ncbi.nlm.nih.gov/pubmed/?term=Incidence+and+Prognosis+of+Pericarditis+After+ST-Elevation+Myocardial+Infarction+(from+the+Acute+Coronary+Syndrome+Israeli+Survey+2000+to+2013+Registry+Database)




41

Characteristics, Management, and

Outcome of Transient ST-elevation Versus Persistent ST-elevation and Non–ST-

elevation Myocardial Infarction

Blondheim DS, Kleiner-Shochat M, Asif A, Kazatsker M, Frimerman A, Abu-Fanne R, Neiman E, Barel M, Levy Y, Amsalem N, Shotan A, Meisel SR

Heart Institute, Hillel Yaffe Medical Center, Hadera, Israel; and Bruce Rappaport School of Medicine, Technion- Israel Institute of Technology, Haifa, Israel.

Patients with acute myocardial infarctions (AMIs) present as persistent ST-elevation myocardial infarction (STEMI) or as non–ST-segment elevation myocardial infarction (NSTEMI). In some patients with STEMI, ST elevations are transient and resolve before coronary in- tervention (transient ST-elevation myocardial infarction [TSTEMI]). We analyzed our registry comprising all consecutive patients with AMI admitted during 2009 to 2014, and compared the characteristics, management, and outcome of patients with TSTEMI with those of patients with STEMI and NSTEMI. Of 1,847 patients with AMI included in the registry, 1,073 patients sustained a STEMI (58%), 649 had a NSTEMI (35%), and 126 presented with TSTEMI (6.9%). Patients with TSTEMI were younger than patients with NSTEMI and STEMI (56.5 vs 62.8, p




42

<0.001, and 59.5 years, p <0.02, respectively), smoked more (77.8 vs 54.0, p <0.001, and 62.1%, p <0.0005), and fewer were hypertensive (52.4 vs 74.2% and 58.8%, both p <0.001) and diabetic (26.2% vs 47.7%, p <0.0001, and 36.9%, p <0.02). The extent of coronary artery disease in patients with TSTEMI was similar to that of patients with STEMI except for less involvement of the left anterior descending artery (p <0.001), but less extensive than in NSTEMI patients. TSTEMI involved less myocardial damage by troponin-T level (p <0.005) with better cardiac function (LVEF 61% vs 55% and 49%, both p <0.0001). Mortality was lower among TSTEMI both in-hospital (0 vs 2.3% [p =NS] and 4.2% [p <0.01]) and long-term (4.8% vs 14.7% and 14.2%, both p <0.003) at a median of 36 months.

In conclusion, TSTEMI is an acute coronary syndrome distinct from NSTEMI and STEMI, characterized by fewer risk factors, a similar extent of coronary artery disease to STEMI, but is associated with less myocardial damage and portends a better outcome. Am J Cardiol 2018;121:1449–1455)

https://www.ncbi.nlm.nih.gov/pubmed/?term=Characteristics%2C+Management%2C+and+Outcome+of+Transient+ST-elevation+Versus+Persistent+ST-elevation+and+Non%E2%80%93ST-elevation+Myocardial+Infarction

Cardiovascular Health and Cognitive Decline 2

Decades Later in Men with Preexisting Coronary

Artery Disease

Lutski M, Weinstein G, Goldbourt U, Tanne D.

Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel; The Israel Center for Disease Control, Ministry of Health, Ramat Gan, Israel; School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel; and The Joseph Sagol Neuroscience Center, Sheba Medical Center, Ramat Gan, Israel.

Cardiovascular health (CVH) factors are associated with lower risk of cardiovascular disease, stroke, and mortality. We investigated the association between a modified CVH metrics score and change in cognitive functions 2 decades later in patients with pre-existing coronary artery disease. A subset of 200 men (mean age at baseline 57.3 ±6.3 years) who previously partici- pated in a secondary prevention trial (1990 to 1997) underwent cognitive evaluation 14.6 ±1.9 years after baseline (mean age 72.3 ±6.2 years, T1

https://www.ncbi.nlm.nih.gov/pubmed/?term=Characteristics%2C+Management%2C+and+Outcome+of+Transient+ST-elevation+Versus+Persistent+ST-elevation+and+Non%E2%80%93ST-elevation+Myocardial+Infarction




43

evaluation), and were re-evaluated for cognitive performance 19.9 ±1.0 years after baseline (mean age 77.2 ±6.4 years, T2 evaluation). A CVH metrics score at baseline was calculated, including 3 health parameters and 4 health behaviors. We have scored each of these CVH metrics into best (2 points), intermediate (1 point), and poor (0 points) levels. Cognitive function was assessed using the NeuroTrax Computer- ized Battery. A linear mixed model was used to assess change in cognitive functions between T1 and T2 cognitive evaluations. Among the 200 patients, 68 (34.0 %) had ≤7 (bottom group), 85 (42.5%) had 8 to 9 (middle group), and 47 (23.5%) had ≥10 (top group) CVH metrics points. After adjustments, the top group of CVH score versus others was associated with slower decline in the overall cognitive performance composite z-score (0.23 ±0.09, p =0.009) and on tests of executive and visual spatial functions (0.23 ±0.11, p =0.047, and 0.49 ±0.17, p =0.004, respectively).

In conclusion, an inverse association was observed between the score of best CVH metrics and cognitive decline. Lifestyle factors are important predictors of late-life decline in cognitive function among high-risk patients. (Am J Cardiol 2018;121:410–415)

https://www.ncbi.nlm.nih.gov/pubmed/?term=Cardiovascular+Health+and+Cognitive+Decline+2

+Decades+Later+in+Men+with+Preexisting+Coronary+Artery+Disease

Temporal Trends in Gender-Related Differences and

Outcomes in Patients Who Underwent

Transcatheter Aortic Valve Implantation (from the Israeli Transcatheter Aortic Valve Implantation

Multicenter Registry) Itzhaki Ben Zadok O, Kornowski R, Finkelstein A, Barbash I, Danenberg H, Segev A, Guetta

https://www.ncbi.nlm.nih.gov/pubmed/?term=Cardiovascular+Health+and+Cognitive+Decline+2+Decades+Later+in+Men+with+Preexisting+Coronary+Artery+Disease




44

V, Halkin A, Vaknin H, Planer D5 Assali A, Barsheshet A, Orvin K

DepartmentofCardiology,RabinMedicalCenter,PetahTikva,Israel;SacklerFacultyofMedicine,TelAvivUniversity,TelAviv,Israel;DepartmentofCardiology,SouraskyMedicalCenter,TelAviv,Israel;LevievHeartCenter,ChaimShebaMedicalCenter,TelHaShomerHospital,RamatGan,Israel;DepartmentofCardiology,HadassahMedicalCenter,Jerusalem,Israel;andFacultyofMedicine,HebrewUniversityofJerusalem,Jerusalem,Israel.

Abstract We evaluated temporal trends in gender-related differences in patients who underwent transcatheter aortic valve implantation (TAVI) for severe symptomatic aortic stenosis from a multicenter TAVI registry during the years 2008 to 2016. Our final cohort included 1,159 males and 1,370 females, with a median follow-up of 2.3 (IQR 1.2, 4.4) years. For temporal trends analysis, the entire population was divided according to period of procedure: 2008 to 2012 and 2013 to 2016. During the 2008 to 2012 period, the rates of in-hospital aortic paravalvular leak, myocardial infarction, pacemaker implantation, and stroke were higher among men than women, but became comparable between the gender during the 2013 to 2016 period. Multivariate analysis demonstrated that female patients who underwent TAVI between the years 2008 and 2012 had a 26% lower risk of death compared with male patients (p = 0.004), but there were no gender-related differences in mortality

risk between the years 2013 and 2016 (hazard ratio 1.07, p = 0.6; gender-by-year of procedure, p = 0.027 for interaction).

In conclusion, the favorable long-term prognosis described in female patients during the earlier TAVI period seemed to diminish with contemporary TAVI. This might be attributed to current technological advances and improved valve sizing, with a more significant benefit in favor of male patients. https://www.ajconline.org/article/S0002-9149(18)31839-3/fulltext

https://www.ajconline.org/article/S0002-9149(18)31839-3/fulltext




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We would also encourageIsraeli programs to let ourmembership know abouthappenings and offers fortraining in Israel: Pleaseemail these [email protected].

FIHSHeartBeats This IssuehasnewsaboutaHeart Center that made thepapers-Israel's most sophisticated

heart center opens in Hadassah

Hadassah Ein Kerem doubles

ability to treat heart patients

with new state of the art Irma

and Paul Milstein Heart Center

in Jerusalem. http://www.israelnationalnews.com/News/News.aspx/253268





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In the presence of Deputy Minister of Health Yaakov Litzman, National President of Hadassah, the Women's Zionist Organization of America Ellen Hershkin, Director General of Hadassah Hospital Prof Zeev Rotstein, Howard Milstein inaugurated the Irma and Paul Milstein Heart Center in Hadassah Ein Kerem, Jerusalem in honor of his parents.

The new center occupies the entire third floor, 4500 square meters, of the Sarah Wetsman Davidson Hospital Tower. It makes use of the world's most sophisticated medical technology and more than doubles the department’s previous capacity to treat heart patients. This includes 11 intensive care private rooms plus 11 post-catherization beds and another 32 beds in the cardiac ward.

Irma Milstein is a member of Hadassah, the Women's Zionist Organization of America. She and

her late husband Paul, from New York, earmarked their ten-million-dollar donation for the heart center.

Howard Milstein, an American entrepreneur and real estate developer and his wife Abby Milstein attended the dedication ceremony, with a large delegation of American Hadassah supporters and Israeli health leaders.

Prof. Chaim Lotan, Director of the Heart Institute at Hadassah Medical Organization, said: "The new center, located in the Sarah Wetsman Davidson Hospital Tower and spread over 4,500 square meters, catapults us fifty years ahead. Several decades ago we established the most advanced cardiac intensive care unit in Israel; this new Heart Center covers more than four times the space of our previous department. Now, we will be able to treat more patients. The Heart Center includes four of the most advanced catheterization labs in the world and another two more catheterization labs are planned. An additional catheterization lab will operate at Hadassah Mount Scopus to prevent the need to transfer patients to Ein Kerem.”

A direct pathway brings patients with heart attacks to the catheterization




47

labs without the need for processing through the emergency room.

Giant high-resolution screens connected to the imaging equipment display all of the patient's vital data at once.

The catheterization labs include one room that operates a bi-plane system providing three-dimensional imaging of the heart from two cameras at the same time.

Said Lotan, "Our experts use these imagines in real time for maximum accuracy. In a hybrid room, we can switch from catheterization to open heart surgery if necessary without moving the patient and losing valuable time. The 2019 dual-camera system is among the first installed in the world. There are inner-aortal cameras and numerous other technological advances that were considered science fiction not long ago. "

Complementing the technological advances are new and spacious conditions, comfortable for patients and their families. In addition to monitors, doctors and nurses will be able to see patients through a closed-circuit video system.

Irma and Paul Milstein, whose generous contribution enabled the

establishment of the center, have long contributed to health and medicine. In addition, the family supports education, the arts and scientific research in New York and in countries abroad, including the Milstein Building at Columbia Presbyterian Hospital in New York. The Milsteins value the combination of research and treatment that is the hallmark of Hadassah Medical Organization.

Ellen Hershkin, President of the Hadassah Women’s Zionist Organization of America, said: “We are proud and excited to open the Heart Center in Honor of Irma and Paul Milstein, the most advanced cardiac center in Israel. Irma Milstein, a dedicated member of Hadassah Women, personally chose to support and advance cardiology. Irma knows that by improving the medical methods and facilities, the excellent physicians at Hadassah will continue to improve research and treatment in the field. We are eternally grateful for their commitment and dedication to the field of heart treatment at Hadassah.”

Janice Weinman, CEO of Hadassah Women’s Zionist Organization of America, presided over the dedication and noted that, “The center brings sophisticated




48

technology, and for the first time, enough room to teach heart professionals from around the world who have asked to learn from Hadassah’s cadre of experts and innovators.”

Howard Milstein said at the event: “My father, Paul, Of Blessed Memory, and my mother, Irma, saw Hadassah’s mission statement as the highest expression of the founding ideals of the State of Israel: to forge ‘links between patients of all nationalities, races and religion who come to its doors for healing.’ Here at Hadassah, all patients – Jewish, Christian, Muslim, Druse, secular and religious – receive dignified care from a top flight team of equally diverse medical workers. As such, Hadassah is also a bridge to peace. If you need proof of that, look no further than the Syrian children who, in the midst of a horrific humanitarian crisis, have been brought to Hadassah for treatment of congenital heart defects. The Milstein family resonates with that. We, too, are engaged in supporting a multi-faith effort to alleviate the Syrian crisis.

“We couldn’t be more proud of what you’ve done here. On behalf of Abby, Michael, my parents, and the entire Milstein family, thank you for honoring us in this way. May you

continue to go from strength to strength.”

Another citation: https://www.jns.org/state-of-the-art-10-million-cardiac-center-dedicated-at-hadassah-hospital-ein-kerem/

Are you a member of FIHSand have major news youwouldliketosharewithourreaders?Haveyoupublisheda book or been honored byyour Society? Share it withus all! Please email these [email protected].

That’sit forthis issueofthenewsletter of the Friends ofIsrael Heart Society. Specialthanks as always to BatiaZivandKarenDavidsonforbeingour “eyesandearsontheground”inIsrael.Specialthanks in America to ourSociety Administrators-JaniceandLarryBrown!




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Haveanyideastomake thisabettertoolforourSociety?Sharethemwithus!

Tell your friends that wewant them to join ourmission to be a bridgebetween Israeli Cardiologyand the world. If you haveany questions, comment,criticisms (my favorites!)please email me [email protected].

AnnouncingourAnnual

ACCBanquet!!

Everyoneiscordiallyinvitedto attend our AnnualReception for theFriendsofthe Israel Heart Society.Come meet leaders of theAmerican and IsraeliCardiologyworld.CambriaNewOrleans

632TchoupitoulasStreetNewOrleans

Sundayevening,March17,2019at6:30-8:30PM

Wehopetoseeyouthere!

Thank You to our 2018 Sponsors

Dr. Paul FriedmanDr. Je�rey Goldberger

Dr. Howard GoldschmidtDr. Philip Greenland

Dr. Charles LoveDr. Bruce Wilko�

Dr. Je�rey BorerDr. James Goldstein

Dr. Edo Kaluski Dr. Michael Wolk Dr. Douglas Zipes

Dr. Joseph AlpertDr. Samuel Asirvatham

Dr. Benico BarzilaiDr. Peng-Sheng Chen

Dr. Neal EiglerDr. Gary Gershony

Dr. Allen GutovitzDr. Alan Kadish

Dr. Andrew KrumermanDr. Valentina KutyifaDr. Alexander Mazur

Dr. Richard Popp

Dr. Robert Sa�anDr. Melvin Scheinman

Dr. Daniel SchwartzDr. Gregory Schwartz

Dr. Bradley StraussDr. Jack Stroh

Documents

NEWSLETTER OF THE FRIENDS of the Israel Heart …...President, Friends of the Israel Heart Society Announcing our Annual ACC Banquet!! Everyone is cordially invited to attend our Annual