Transforming Cardiovascular Medicine with Digital Technologies

On this episode of Inside the Texas Heart Studio, Dr. Nikolaos A. Diakos, interventional cardiologist and heart failure specialist at The Texas Heart Institute Center for Cardiovascular Care, sits down with Grand Rounds guest Dr. Yiannis S. Chatzizisis to discuss the future of cardiovascular medicine.

In this insightful conversation, Dr. Chatzizisis delves into the transformative power of digital technologies, including AI, machine learning, and virtual reality, in revolutionizing the field.

Discover how these cutting-edge tools are being used to:

• Enhance patient care: Improve diagnosis, treatment planning, and patient outcomes.
• Advance medical research: Accelerate drug and device development through advanced simulations and virtual trials.
• Revolutionize medical education: Immersive learning experiences to train the next generation of healthcare professionals.

Watch Dr. Chatzizisis' Grand Rounds: https://tv.texasheart.org/cardiology-grand-rounds-2024-25/videos/yiannis-s-chatzizisis-md-phd-a-new-digital-era-in-cardiovascular-interventions 

Watch On Demand Videos on Texas Heart TV

Visit Our Website: texasheart.org

Transcript

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Good afternoon.

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My name is Nico Diacos.

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I'm a cardiologist at the Texas Heart Institute,

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and I'm very happy today to be joined at the studio by Dr.

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Yani Had diseases. Um, Dr.

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Had diseases is an interventional cardiologist.

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He's a a professor of medicine and cardiology,

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and the chief of cardiology at the University of Miami.

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And today he gave a great talk in our grand rounds about the

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role of digital technologies in cardiovascular

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medicine. Dr. Harris, this is welcome.

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Hi. Hello, Dr. Kos,

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and I'm very thrilled to be here in this

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prestigious, uh, institution.

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Thank you very much. Um, so Dr.

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Had diseases, um, uh, there are a lot

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of people watching our channel

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and, uh, they're not familiar with, uh,

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the digital technologies that we have available.

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So if you can give us a few words about

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what do we currently have available in medicine

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and they're gonna shape the future of

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how we practice medicine.

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Yes. Uh, we literally live, uh, at the cusp

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of the fifth Industrial Revolution.

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And, uh, this is defined by

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what we call digital health,

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digital technologies, which are those technologies.

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It's ai, um, it is, uh, computation simulations

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and it's extended reality.

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AI is, uh, has some, some divisions, uh,

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under this big umbrella, uh, like machine learning, uh,

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deep learning, um, important technologies

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that help us essentially, uh,

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process the big data in a very seamless way,

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in a very efficient way.

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It's like a mega brain, essentially.

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And this is, uh, something that, um, uh,

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is gonna change the game in the years to come.

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Same with simulations.

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We essentially, it's like taking organs

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or functions from the body into the computer.

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Those are, uh, physiologically

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and anatomically digital faithful replicas

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of the different organs of the body.

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And we can use them to test different ideas,

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to acquire important new knowledge,

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and of course, extend the reality, which is the big umbrella

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of virtual reality or augment reality.

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It's like immersing yourself in an environment.

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Let's say you are a red blood cell with a camera

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and see everything from the inside.

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This is important for, uh, a better understanding

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of the organ structure, organ function,

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and of course, for education and training purposes.

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That's great. And you know, before,

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before your talk today, I always had in my mind, oh,

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we're developing artificial intelligence, uh,

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and machine learning to be able to diagnose diseases.

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Uh, after your talk now, uh, it seems that we are going

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to be using them to more safely

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and efficiently treat patients.

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And I'm a patient today, so I was told that, you know,

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I have a blockage, for example, in one

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of my arteries of the heart.

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So, um, my cardiologist told me that, you know, you need

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to have a stent tomorrow so that I can, I can treat that,

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uh, blockage that you have,

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how in a few years down the road, the implementation

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of digital technologies will change, uh, the way

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that this patient is gonna be treated, uh,

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for his blockage in the arteries.

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Yes. Um, as you very correctly said, um, the,

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the field is, is changing and it's changing rapidly.

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Uh, we have the traditional way of, uh,

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doing our procedures, putting stents, uh, as you said,

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or other devices in the blocked arteries.

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And that's very beneficial for our patients.

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But we also see that these procedures come with, um, uh,

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sometimes, uh, complications

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or with other events as we call them.

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Some other patients come back for another stent.

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Some patients come back with, uh, chest pain.

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Uh, some of them, um, uh, have other events down the line.

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The question is what we can do

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to push the whole on envelope further, what we can do

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to build on this foundation.

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We have right now on this technological advancements

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and do better job for our patients, improve efficiency,

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improve the workflow in our cath labs, uh, do more precise

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job, and at the end of the day, uh, improve the outcomes,

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uh, eliminate as much as possible the need for our patients

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to come back to the hospitals

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for another stand, for another procedure.

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And here is, uh, the big role of, uh, ai

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of these digital technologies,

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which can help us deliver faster care, better care,

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and more precise care.

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That's, that's excellent. Now, let's go to the other side.

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I'm the operator. I'm an interventional cardiologist.

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And to tomorrow I'm gonna put a, a stent

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to one of my patients.

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She has a very tight lesion in proximal front artery

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as the patients like to call their, uh, LAD, um,

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as an operator, how the use

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of digital technology will make me, uh, better

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as an operator, how will make me perform better in the

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procedure so I can deliver the best I can for my patient.

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Um, it's all about planning.

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Um, uh, there's a quote by, uh, Benjamin Franklin, uh,

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by failing to prepare, you're preparing to fail.

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So I think it's asim as it gets.

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Once the doctor, the operator has better understanding

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of the individual anatomy and physiology

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and function of this particular blockchain,

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this particular artery, then you can have better plan, um,

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better idea of what you should do.

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And once you have a clear understanding of

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what you're dealing with, then the level of care,

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the precision, and the whole, uh,

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plan is gonna be more precise

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and more tailored to this individual,

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more personalized as we call it.

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And that's how you improve outcomes.

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That's how you eliminate as much as possible the chances

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for these patients to come back to the hospital. Yeah,

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As you said, it's very important to personalize

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because each patient is individual, has individual needs.

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Um, how about the cost?

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So we know that the healthcare cost is increasing.

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Um, who the implementation of those technologies will lead

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to further increase of the cost?

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Um, do I need more tests to be done as plan, uh, as part

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of my procedural planning?

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Can I use tests that already have been done

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to help me get there?

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Yes. So all these technologies, um,

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are important aids in our hands,

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and as long as we use them wisely, mindfully,

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they will end up being beneficial.

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Uh, of course, there's a cost there,

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and of course there's limitations as well.

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And as we have seen with every technology in life, uh,

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all these costs down the line, over time, getting better

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and better, because as long as we have tools, uh, equipment,

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technologies that can help us do better

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and more precise job,

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and, um, refer to bigger masses of people,

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our patients in in particular here, then you have, uh, all,

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um, justification for this, uh, technologies to get cheaper

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and more affordable and more widely, uh,

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available, uh, down the line.

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So I'm very hopeful. Uh,

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we start from where we are right now.

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Indeed, those technologies are not widely available,

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are very expensive, but I'm very hopeful

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and optimistic that down the line,

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and soon they will be more affordable

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and more, more, uh, more available.

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And, and I think a big part

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of the reimbursement nowadays is

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linked to the complications.

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And as you said, if we're able to limit the complications,

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then we're limiting the length

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of stay, probably of that patient.

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So that also gonna bring the cost even more down if we are

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really well prepared for the, for those procedures.

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Yeah. And, and we need to acquire this kind

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of financial aspect as well, which is very important

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because financials always drive, um, uh, the evolution

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among other reasons, of course.

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But it's very important to acquire this financial

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aspect, uh, as well.

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And, um, we truly believe that with these technologies,

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with these technological breakthroughs,

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not only we gonna deliver more precise and better care,

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but more affordable, uh, uh, care.

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Um, financials are very, very important.

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And, uh, as you said, by making the operations faster,

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more precise, less complex, reducing the complication rates,

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reducing the need to use, um, um, uh, devices

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that at the end of the day might not be needed at all.

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This, um, this, this solutions might potentially, uh,

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reflect to, uh, also, uh, cheaper,

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more affordable care down the line.

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Moving now to the, to the research applications.

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Um, you are a, a physician, but also you're a scientist

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and, uh, uh, you are, um,

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you are actively working in developing those technologies,

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how these technologies you envision, they will help the, uh,

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device discovery, uh, or the, uh, discover new medications

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and discover of new stents, new balloons

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that we can use in our cath lab.

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Um, and,

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and let's say we had those technologies a few years ago,

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would, would have expedited the discovery of our new valve,

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of our new stents that we're having right now.

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Yeah. When it comes particularly to devices, we,

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we call it, um, total product lifecycle from the inception

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to the going through FDA essentially

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and regulatory approval.

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And then finally, uh, see how the device,

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uh, performs in the market.

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These are the stages for a given device.

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And more or less, the same applies to drugs as well,

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but when it comes to devices, we see that, uh,

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what the traditional way of developing the so-called r

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and d of devices using, uh, animals

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and prototypes and fandoms.

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But now, uh, this is pushed also from the FDA.

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There is this concept of using simulations,

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computation simulations to achieve faster

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and more, um, relevant more pain specific, uh, r

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and d uh, of devices.

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And also, not only this,

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but also in the later stage of reg regulatory approval,

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we have now the concept of in silico virtual trials,

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which can help us accelerate

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and guide actual clinical trials to achieve faster, uh, um,

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knowledge to more affordable knowledge.

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And of course, uh, more impactful knowledge.

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So we see here essentially a shift, a paradigm shift, uh,

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in the whole total development of the product, the inception

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to the post-market monitoring,

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which is heavily based on the engagement

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of digital technologies

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to help us do the whole operation

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more relevant and faster and cheaper.

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And the, the last thing I would like to discuss with you,

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um, uh, is, uh, our medical training,

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interventional cardiology fellow training.

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Uh, we're both involved in the training and,

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and, you know, we're committed in our academic institutions

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to advance, uh, the field

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and get really good operators

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that they will take good care of the patients.

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Um, how do you think those technologies

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can help us get our fellows, um, uh, get,

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uh, the knowledge and the skills in the cath lab

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to make them really good operators,

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Uh, seeing is believing

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and, uh, this is essentially what, uh,

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also this digital health brings on the table.

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It brings us the ability, uh, to understand better

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how the devices work, how they interact with each other,

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with, um, with the body, with the coronary arteries, with,

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uh, whatever organ they're implanted to.

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Uh, we have traditional ways of learning using textbooks,

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videos, and those are totally indispensable.

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But we have now the opportunity to help our trainees

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by engaging virtual reality, immersing themselves

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into like a, as I said, an red blood cell

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with a camera into the heart artery to see how the device,

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um, uh, uh, interacts with the body.

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We have the unique ability to help them learn greater,

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faster, and better.

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And that's very, very important

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and should be, should be an investment for the future

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for our trainees, and

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They would get prepared.

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Uh, so learning in a virtual reality environment, the steps

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of a complex procedure.

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Then, uh, then when they go to

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actually do the procedure in the cath lab,

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they already know the steps they already prepared.

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They know what to anticipate, uh,

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that they will see in the cath lab. And then that's,

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And, and this,

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and this essentially reduces significantly

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the complication rates.

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Mm-hmm. Because once you familiarize yourself

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with the environment where you're going to operate,

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then the risks

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and the complication rates goes significantly down.

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So it's important from every aspect,

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not only education training, but also preparation

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and familiarization of yourself

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with the environment you're gonna be operating

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to use these technologies to be essentially more efficient

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and more precise in what you do.

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Thank you, Dr. Ka. This is, that was, uh, great.

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Thank you for the great lecture.

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And, uh, for all of you that you would like

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to learn more about the role of, uh,

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digital technologies in, uh, modern cardiovascular medicine.

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I urge you to go to our, uh, channel

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and, uh, uh, uh, you know, follow his, uh,

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full talk. Thank you so much.

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Thank you so much again for having me here. Thank you.