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Heart Podcast

276 episodes - English - Latest episode: 1 day ago - ★★★★★ - 34 ratings

Heart is an international, peer-reviewed journal that keeps cardiologists up to date with advances in the diagnosis and treatment of cardiovascular disease. Each issue contains original research, accompanying editorials and reviews.

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Episodes

Carotid artery disease: stenting vs surgery

August 10, 2016 11:24 - 15 minutes - 24.5 MB

In this episode of the Heart podcast, Associate Editor Dr. James Rudd is joined by Professor Marco Roffi from the University Hospital, Geneva. He is the first author of an Education in Heart paper entitled "Carotid Artery Stenting". They discuss how best to identify patients with carotid artery disease, the role of imaging, when to choose stenting vs surgery and the current ESC guidelines in this area. Read the full article: http://heart.bmj.com/content/102/13/1059.

Gender differences in coronary heart disease

July 28, 2016 10:43 - 14 minutes - 20.2 MB

In this episode of the Heart podcast, Associate Editor Dr. James Rudd is joined by Dr. Ramzi Khamis, from the National Heart and Lung Institute, Hammersmith Hospital Campus, Imperial College, London, UK. He is the lead author on a recent Education in Heart paper entitled "Gender differences in coronary heart disease". James and Ramzi discuss the complex and under-researched areas that lead to poorer outcomes for females with some forms of heart disease. Read the full article here: http://he...

Big data: a big deal for cardiology?

July 13, 2016 11:55 - 14 minutes - 20.6 MB

In this episode of the Heart podcast, Associate Editor Dr. James Rudd is joined by Professor Viktor Mayer-Schönberger, Professor of Internet Governance and Regulation at Oxford University’s Internet Institute. He is an expert in 'Big Data' and recently delivered the opening keynote lecture at the British Cardiovascular Society's annual meeting in Manchester, entitled ‘Big data: a big deal for cardiology?' Viktor shares his knowledge about how 'Big Data' is rapidly changing the way we do scie...

Physical activity in the prevention of coronary heart disease: implications for the clinician

June 29, 2016 14:30 - 9 minutes - 12.7 MB

In this episode of the Heart Podcast, Heart associate editor Dr James Rudd is in conversation with Dr Tina Varghese from Emory University, Atlanta. She has written a review paper on "Physical activity in the prevention of coronary heart disease: implications for the clinician". http://heart.bmj.com/content/early/2016/03/03/heartjnl-2015-308773.full In this podcast, they discuss the benefits of regular exercise, how much is too much, how exercise protects your heart and why we aren't good at...

Interview with Dr Marc Dweck - his journey into research

June 17, 2016 14:40 - 13 minutes - 17.9 MB

In this episode of the Heart podcast, digital media editor Dr James Rudd is joined by Dr Marc Dweck from Edinburgh University. Marc is a BHF Intermediate Fellow and an Honorary Cardiology Consultant who has won many awards for his approach to vascular imaging for risk prediction. As part of the Cardiology in Focus series, Marc shares his pathway into cardiovascular research and discusses its highs and lows. Marc has plenty of tips for those entering or established in a scientific career!

Monitoring the biological activity of abdominal aortic aneurysms - beyond ultrasound

May 24, 2016 15:03 - 12 minutes - 17.8 MB

In this episode of the Heart podcast, associate editor Dr James Rudd is joined by Dr Rachel Forsythe, a vascular surgeon from the University of Edinburgh. They discuss her recent review paper, "Monitoring the biological activity of abdominal aortic aneurysms - beyond ultrasound". This common disease still causes considerable morbidity and mortality despite advances in surgical technique, largely because it is difficult to predict aneurysm expansion and rupture. They cover established clinic...

Interview with Professor Peter Weissberg of the British Heart Foundation

May 24, 2016 12:13 - 8 minutes - 11.8 MB

In this edition of the Heart podcast, associate editor Dr. James Rudd sits down with Professor Peter Weissberg, Medical Director of the British Heart Foundation (www.bhf.org.uk/about-us/who-we-are/our-directors). As the largest independent funder of cardiovascular research in the UK (around £100 million annually), Peter has sage advice for young researchers considering a career in cardiovascular science. He looks back at some highlights from his 12 years as Medical Director of the BHF. Final...

A 10-year prognostic model for patients with suspected angina attending a chest pain clinic

April 28, 2016 12:51 - 8 minutes - 11.8 MB

In this edition of the Heart Podcast, associate editor Dr James Rudd chats to Professor Adam Timmis from the Barts Heart Centre, London, UK about his recent publication "A 10-year prognostic model for patients with suspected angina attending a chest pain clinic" http://heart.bmj.com/content/early/2016/02/29/heartjnl-2015-308994.full?sid=bd5e1edf-49cd-4a7d-b2cc-17f0c311890d. They discuss the motivation for his study, debate diagnosis vs. prognosis in angina, and cover how the online prognosi...

Controlled release metoprolol for aortic regurgitation

March 29, 2016 14:54 - 9 minutes - 13.5 MB

In this episode of the Heart Podcast, Heart associate editor Dr James Rudd is joined by Dr Kaspar Broch of the Oslo University Hospital, Norway to discuss his recent paper in Heart entitled: "Controlled release metoprolol for aortic regurgitation: A randomised clinical trial" They discuss the rationale for beta-blockers in aortic regurgitation and the results of this first clinical trial of these agents. Full paper >> heart.bmj.com/content/102/3/191.…-a075-27b877e18613

Handheld echocardiographic screening for rheumatic heart disease by non-experts

March 04, 2016 16:47 - 10 minutes - 5.98 MB

Heart digital media editor Dr. James Rudd is joined by Dr Michelle Ploutz from the Department of Pediatric Cardiology, Children’s National Health System, Washington, DC, to discuss her recent paper in Heart, entitled "Handheld echocardiographic screening for rheumatic heart disease by non-experts". They cover using echocardiography, performed by trained local nurses, to diagnose rheumatic heart disease in Uganda. The need for this approach, and how it fared in this study of 1000 African scho...

Ischaemic cardiomyopathy: pathophysiology, assessment and the role of revascularisation

February 08, 2016 16:40 - 16 minutes - 22.8 MB

Dr Divaka Perera from King's College, London and Guy's and St Thomas' Hopsital joins Dr James Rudd, associate editor at Heart, to discuss his recent Education in Heart paper titled: "Ischaemic cardiomyopathy: pathophysiology, assessment and the role of revascularisation" They cover the aetiology of ischaemic cardiomyopathy, the definitions of stunning, hibernation and viability and what the trials and guidelines can tell us. Optimal imaging strategies are debated. There is also mention of ...

The optimal non-invasive imaging test selection for the diagnosis of ischaemic heart disease

February 03, 2016 14:45 - 9 minutes - 13 MB

In this episode of the Heart Podcast, Heart Digital Media Editor Dr James Rudd is in conversation with Dr Chris Fordyce from the Duke Clinical Research Institute. His team has just published an Education in Heart paper on "Optimal non-invasive imaging test selection for the diagnosis of ischemic heart disease." In this podcast, they discuss the similarities and differences between the international guidelines on the investigation of chest pain. They also highlight the results of the landmark...

Education in Heart - The Relaunch, with Dr Sarah Clarke

October 27, 2015 15:18 - 5 minutes - 8.17 MB

In this podcast Dr James Rudd talks to Dr Sarah Clarke, President of the British Cardiovascular Society and Editor of the Education in Heart section of the journal. They talk about the education stream of the journal, new multimedia developments, and aligning content with the ESC curriculum.

ESC conference London - Stephen Nicholls

October 20, 2015 14:19 - 11 minutes - 16.1 MB

In this podcast Dr James Rudd talks to Professor Stephen Nicholls, consultant cardiologist and Deputy Director of the South Australian Health and Medical Research Institute in Adelaide, at the 2015 European Cardiology meeting in London. They discuss the next generation of lipid therapies and imaging as a surrogate marker of disease.

Healthcare outcomes for treatment-naïve cancer patients using cardiovascular biomarkers

October 13, 2015 14:03 - 12 minutes - 16.7 MB

In this podcast Dr James Rudd speaks to Dr Alexander Lyon, consultant cardiologist at the Royal Brompton Hospital, about the effects of cancer treatments on the heart, the problems of an aging population, and the new field of cardio-oncology. Editorial >> http://heart.bmj.com/content/early/2015/09/09/heartjnl-2015-308208.full Full paper >> http://heart.bmj.com/content/early/2015/09/08/heartjnl-2015-307848.full

Is anger a trigger for cardiovascular disease?

September 25, 2015 12:35 - 7 minutes - 10 MB

Editor-in-Chief Dr Catherine Otto talks to Dr Elizabeth Mostofsky at the Cardiac Society of Australia & New Zealand meeting in Melbourne. They discuss the various environmental, physical and psychological triggers for heart disease.

Heart failure with preserved ejection fraction

September 25, 2015 12:32 - 9 minutes - 13.1 MB

Editor-in-Chief Dr Catherine Otto talks to Dr Carolyn Lam at the Cardiac Society of Australia & New Zealand meeting in Melbourne. They discuss her session on heart failure with preserved ejection fraction.

Ebstein's anomaly in adults

September 25, 2015 12:27 - 8 minutes

Editor-in-Chief Dr Catherine Otto talks to Dr David Calemajer at the Cardiac Society of Australia & New Zealand meeting in Melbourne. They discuss his session on managing the large spectrum of Ebstein's anomaly in adults in the absence of RCT data.

Ebstein’s anomaly in adults

September 25, 2015 12:27 - 8 minutes - 11.9 MB

Editor-in-Chief Dr Catherine Otto talks to Dr David Calemajer at the Cardiac Society of Australia & New Zealand meeting in Melbourne. They discuss his session on managing the large spectrum of Ebstein's anomaly in adults in the absence of RCT data.

Cardiovascular biomarkers in cancer patients and their association with all-cause mortality

September 22, 2015 16:39 - 16 minutes - 11.6 MB

Alistair Lindsey talks to Martin Hülsmann and Noemi Pavo, both from the Medical University of Vienna, about their paper examining cardiovascular biomarkers in cancer patients. Paper: http://heart.bmj.com/content/early/2015/09/08/heartjnl-2015-307848.abstract

Habitual chocolate consumption and risk of cardiovascular disease among healthy men and women

September 03, 2015 13:57 - 16 minutes - 22 MB

Chocolate is an important dietary source of flavonoid antioxidants, which are hypothesised to have a beneficial effect on endothelial function and protect against cardiovascular disease (CVD). In this podcast Dr Alistair Lindsay talks to Dr Phyo K Myint about his team's research into this topic. In order to evaluate any association between habitual chocolate consumption and the risk of cardiovascular events, they analysed data from the European Prospective Investigation into Cancer-Norfolk (...

Haemodynamic and anatomic progression of aortic stenosis

July 23, 2015 15:02 - 9 minutes - 13.5 MB

Aortic valve stenosis (AS) is a progressive disease, but the impact of baseline AS haemodynamic or anatomic severity on AS progression remains unclear. In this podcast Dr Alistair Lindsay talks to Dr Virginia Nguyen about her study to evaluate the impact of baseline AS severity assessed, either by using echocardiography (haemodynamic assessment) or MSCT (anatomic assessment) on AS progression.

PCI recommendations and guidelines 2015

June 08, 2015 13:56 - 11 minutes - 15.7 MB

Percutaneous Coronary Intervention (PCI) has a considerable evidence base and it is firmly established as the most common procedure used in the invasive treatment of patients with CHD in the UK. The evidence base relating to PCI has been reviewed and this has been published in Heart. The guidelines focus on issues pertinent to practice within the UK and set out a recommended template to ensure optimal delivery of patient care. Dr Alistair Lindsay speaks to Professor Adrian Banning from the J...

Type 2 myocardial infarction in clinical practice

April 21, 2015 14:35 - 9 minutes - 13 MB

Dr Alistair Lindsay speaks to Dr Tomasz Baron about his research which aimed to assess differences in incidence, clinical features, current treatment strategies and outcome in patients with type 2 vs. type 1 acute myocardial infarction (AMI). Full paper found here >> http://heart.bmj.com/content/101/2/101.full?sid=e9538ca9-604b-40af-95a7-c03f016f4c2e

Cardiovascular risk profile and frailty in a population-based study of older British men

April 17, 2015 11:05 - 13 minutes - 18.1 MB

Frailty in older age is known to be associated with cardiovascular disease (CVD) risk. However, the extent to which frailty is associated with the CVD risk profile has been little studied. Dr Alistair Lindsay talked to Dr Sheena Ramsay about her study and the clinical implications of the results. The original paper can be found here: http://heart.bmj.com/content/101/8/616.full?sid=767613b9-71bb-41af-80e8-361647c03828

Identifying low risk patients after a single high sensitivity troponin

March 25, 2015 16:32 - 11 minutes - 15.9 MB

Dr Alistair Lindsay speaks to Dr Edward Carlton about his published paper investigating whether a novel accelerated diagnostic protocol (ADP) for suspected acute coronary syndrome (ACS) could successfully identify low-risk patients suitable for discharge after a single high-sensitivity troponin T.

Coffee consumption and coronary artery calcium

March 25, 2015 11:44 - 7 minutes - 10.2 MB

Dr Alistair Lindsay spoke to Dr Eliseo Guallar about his study to nvestigate the association between regular coffee consumption and the prevalence of coronary artery calcium (CAC) in a large sample of young and middle-aged asymptomatic men and women. Read the article here http://heart.bmj.com/content/early/2015/02/06/heartjnl-2014-306663.full?sid=3959ea9e-52ba-4e69-97fa-1b55aa2b9738

Fitness and stress resilience in adolescence and coronary heart disease risk in middle age

January 22, 2015 12:13 - 8 minutes - 5.81 MB

Alistair Lindsay talks to Scott Montgomery, honorary professor of epidemiology and public health, Institute of Epidemiology & Health, UCL, about his paper investigating physical fitness and stress resilience in adolescence and risk of coronary heart disease in middle age. Read the paper: http://heart.bmj.com/content/early/2015/02/10/heartjnl-2014-306703

Adding ezetimibe to simvastatin: Results of the IMPROVE-IT trial

January 07, 2015 11:35 - 6 minutes - 4.48 MB

Alistair Lindsey talks to Christopher Cannon, Havard Clinical Research Institute, about the results of his IMPROVE-IT trial, which examined clinical outcomes of adding ezetimibe to simvastatin. This podcast was recorded at the American Heart Association scientific sessions in Chicago.

Endothelial function in contemporary patients with repaired coarctation of aorta

November 14, 2014 15:36 - 12 minutes - 8.53 MB

Some studies have suggested endothelial dysfunction in adult patients after repair of aortic coarctation (CoA), and it has been proposed to play a key role in the pathogenesis of arterial hypertension in the absence of re-coarctation. A study recently published in Heart aimed to assess the presence of endothelial dysfunction, the number of endothelial progenitor cells, and the levels of proinflammatory cytokines associated with endothelial injury in contemporary patients after CoA repair. ...

New ESC Guidelines for aortic disease

October 03, 2014 15:27 - 5 minutes - 3.93 MB

The ESC has published new guidelines for diagnosis and management of thoracic aortic disease. In this podcast, Catherine Otto asks Dr Iung, Professor of Cardiology, Bichat Hopital, Paris Diderot University, France, to summarise the key new points in these guidelines, specifically focusing on aortopathy in patients with bicuspid valve disease, and in those with Marfan syndrome and other inherited connective tissue disorders. This podcast was recorded at the European Society of Cardiology An...

Primary prevention of cardiovascular disease in children and young adults

September 26, 2014 16:22 - 12 minutes - 8.42 MB

In this episode of the Heart podcast, Dr James Rudd, associate editor, sits down to talk with Prof Valentin Fuster, director of Mount Sinai Heart and physician-in-chief at The Mount Sinai Medical Center in New York, at the ESC meeting in Barcelona. They discuss his ground-breaking work in the primary prevention of cardiovascular disease in children and young adults across the world and the role of imaging in identifying early heart disease. Prof. Fuster also explains the rationale behind the...

Risk models for pregnant women with congenital heart disease

September 05, 2014 15:48 - 10 minutes - 7.17 MB

In this podcast Catherine Otto speaks to Dr P G Pieper, Associate Professor of Cardiology, University Medical Center Groningen, the Netherlands, about the recent paper in Heart on assessing the risk of pregnancy for women with congenital heart disease. This study compared three different scoring systems and found that the WHO score provided the most accurate risk prediction. The importance of this issue is illustrated by the approximately 10% risk of maternal complications in this patient...

"Is climbing Everest good for my heart, doctor?"

September 01, 2014 10:55 - 21 minutes

Recorded at the 2014 British Cardiovascular Society meeting in Manchester, Heart associate editor Dr James Rudd talks to Dr Rob Casserley, summiteer of Everest, and his wife and cardiologist Marie-Kristelle Ross. Rob initially worked as surgeon and is now a GP with a specialist interest in altitude and expedition medicine. He has climbed Everest eight times, including double summits in spring 2007 and spring 2010, and is the first-ever Western climber to have achieved this feat. He was been ...

”Is climbing Everest good for my heart, doctor?”

September 01, 2014 10:55 - 21 minutes - 15.1 MB

Recorded at the 2014 British Cardiovascular Society meeting in Manchester, Heart associate editor Dr James Rudd talks to Dr Rob Casserley, summiteer of Everest, and his wife and cardiologist Marie-Kristelle Ross. Rob initially worked as surgeon and is now a GP with a specialist interest in altitude and expedition medicine. He has climbed Everest eight times, including double summits in spring 2007 and spring 2010, and is the first-ever Western climber to have achieved this feat. He was been ...

Patient selection for transcatheter aortic valve implantation

August 26, 2014 16:38 - 6 minutes - 9.16 MB

Professor Vahanian, Bichat Hospital, Paris, France, is a world leader in management of patients with Valvular Heart Disease and is the lead author of the European Society of Cardiology Guidelines. In this interview, held during the Transcatheter Valve Therapeutics Meeting in Vancouver, Canada in June 2014, Professor Vahanian talks with Catherine Otto about the current approach to patient selection for transcatheter aortic valve implantation (TAVI). The availability of TAVI has transformed o...

Transcatheter mitral valve repair: which patients benefit?

August 22, 2014 15:11 - 11 minutes - 7.96 MB

In this interview held during the Transcatheter Valve Therapeutics Meeting in Vancouver, Canada in June 2014, Heart editor Catherine Otto talks to Ted Feldman, Evanston Hospital. Professor Feldman is one of the leaders in the field of transcatheter mitral valve repair, and discusses patient selection, procedural aspects and intermediate term outcomes with this exciting new therapy. Clinicians will find this brief summary useful as this new technique offers a therapeutic options for many o...

Cardiac Electrophysiology in 2014

August 15, 2014 15:54 - 15 minutes - 10.8 MB

Recorded at the 2014 British Cardiovascular Society meeting in Manchester, Heart associate editor Dr James Rudd talks to Dr Arthur Yue, consultant electrophysiologist at the University Hospital of Southampton. In this podcast, they discuss the expanding roles of electrophysiological specialists in managing arrhythmias, accessory pathways and the new upcoming NICE guidelines on atrial fibrillation.

Physical activity level and prognosis in patients with coronary heart disease

August 04, 2014 15:57 - 11 minutes - 8.03 MB

Extensive research has established that physical activity is inversely associated with the risk of developing cardiovascular disease in healthy adults. In patients with manifest cardiovascular disease, current clinical practice guidelines recommend encouraging patients to undertake daily moderate intensity physical exercise for secondary prevention. While such recommendations are based on numerous clinical trials clearly showing that exercise-based cardiac rehabilitation improves prognosis...

Short-term effects of air pollution on a range of cardiovascular events in England and Wales

July 25, 2014 17:15 - 9 minutes - 12.7 MB

Experimental and epidemiological studies have provided evidence of associations between air pollution and cardiovascular health. More pollution-related deaths occur from heart disease than from any other cause. A recent study in Heart aimed to further current understanding of pathophysiological mechanisms by examining the strength and specificity of acute relationships between ambient air pollution and a range of CVD events. The key mechanistic question addressed is whether events of clear ...

Patient prosthesis mismatch: Does it matter?

June 20, 2014 16:14 - 9 minutes - 6.24 MB

In this podcast Heart editor in chief Catherine Otto, discusses patient prothesis mismatch with Professor Philippe Pibarot, Directeur, Chaire de Recherche du Canada sur les Maladies Valvulaires Cardiaques, after he presented a commentary on the issue at the Transcatheter Valve Therapies meeting in Vancouver, Canada on June 5, 2014. Aortic valve stenosis is prevalent in the elderly and valve replacement for severe symptomatic obstruction improves symptoms and prolongs life. However, some p...

Determinants of effective heart failure self-care

June 20, 2014 10:52 - 15 minutes - 10.6 MB

Heart failure (HF) self-care matters, but what matters most in HF self-care? To inform the design of future interventions and promote effective HF self-care, a systematic review of qualitative studies has recently been published in Heart. This examines patients’ and caregivers’ needs, experiences and preferences regarding the nature and determinants of HF self-care. Alistair Lindsay talks to co-author Alexander Clark, professor in the Faculty of Nursing, University of Alberta, about the fi...

Joint British Societies’ consensus recommendations for the prevention of cardiovascular disease

March 25, 2014 15:22 - 12 minutes - 8.36 MB

This podcast discusses the 3rd Joint British Societies’ (JBS) consensus recommendations, released on 26th March 2014. These eagerly anticipated guidelines incorporate much of the recent research in primary and secondary prevention of cardiovascular disease, and include a new risk calculator for physicians. Heart’s social media editor, Dr Alistair Lindsay, discusses the most important points of the recommendations with Dr Iain Simpson, President of the British Cardiovascular Society and...

Validity of Charlson Comorbidity Index in patients hospitalised with acute coronary syndrome

March 21, 2014 16:33 - 10 minutes - 7.16 MB

In this podcast, Philip Urban, Cardiovascular Department, Hôpital de La Tour, Geneva, discusses the Charlson Comorbidity Index (CCI). Read the related paper: Validity of Charlson Comorbidity Index in patients hospitalised with acute coronary syndrome. Insights from the nationwide AMIS Plus registry 2002–2012 http://goo.gl/Kjpj0l

Long chain n-3 polyunsaturated fatty acids and coronary artery calcification in Japanese men

March 21, 2014 16:29 - 12 minutes - 8.78 MB

Coronary heart disease (CHD) is a major public health problem not only in developed but also in developing countries.1 CHD rates in Japan are uniquely low compared to the USA and other developed countries. In a paper in April's Heart, Akira Sekikawa and colleagues from the University of Pittsburgh looked at whether serum concentrations of long chain n-3 polyunsaturated fatty acids (LCn3PUFAs) contribute to the difference in the incidence rate of coronary artery calcification (CAC) between J...

Statins after acute coronary syndrome: a missed opportunity

March 07, 2014 16:36 - 8 minutes - 12.1 MB

Catherine Otto, Heart editor, talks to Greg Roth from the Division of Cardiology at University of Washington about his editorial which appears on heart.bmj.com and discusses prescription of statins after an acute myocardial infarction.

Maintenance of statin use over 3 years following acute coronary syndromes

February 18, 2014 17:25 - 18 minutes - 12.8 MB

Dr Alistair Lindsay speaks to Dr Corina Grey, School of Population Health, University of Auckland, about her recent study looking at long-term adherence to statins in ACS patients. Read the full paper: http://goo.gl/KF3NAK

Aortic dilatation patterns and rates in adults with bicuspid aortic valves

February 18, 2014 11:02 - 24 minutes - 33 MB

Bicuspid aortic valve (BAV) is related to aortic dilatation, but patterns/rates are conflicting with no comparison among aneurysms of different aetiology. In this podcast Alistair Lindsey talks to Hector Michelena from the Division of Cardiovascular Diseases at the Mayo Clinic about his research published in heart.bmj.com Read the full research: http://heart.bmj.com/content/100/2/126.full

Drs Bob Bonow and Catherine Otto discuss current issues in aortic valve stenosis

December 16, 2013 14:11 - 14 minutes - 20.2 MB

At the 2013 Uruguayan Society of Cardiology meeting in Montevideo, Dr Robert Bonow, Professor of Cardiology at Northwestern University Feinberg School of Medicine, gave a talk on aortic valve stenosis. In this podcast he and Catherine Otto, discuss some of the new concepts in diagnosis and management of the condition.

MRI-measured regression of carotid atherosclerosis induced by statins with and without niacin

December 02, 2013 15:54 - 19 minutes - 26.1 MB

Read the full research onine: http://heart.bmj.com/content/99/22/1675 Dr Joao Lima, from the Division of Cardiology at Johns Hopkins Hospital in Balitmore, and colleagues set out to evaluate the benefit of niacin in addition to statin therapy on plaque regression among older individuals with established atherosclerosis. They used MRI to more measure the plaque volume, and in this podcast Dr Lima explains to Laura Templer why that's a more accurate measure than the surrogates used in previo...

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