Heart health 101: Know your numbers

February is American Heart Month and the perfect time to check on your ticker. When it comes to a heart health, a few numbers can tell you a whole lot. Get to know your numbers for blood sugar, blood pressure, cholesterol and body weight. If these are too high, you are more likely to have heart disease and other health problems. Getting your numbers checked regularly and knowing what they mean is a great first step toward better health.

Here are the basics:

Blood sugar – aim for less than 100

  • What it is: Your blood sugar measures exactly that  how much sugar is in your blood. Elevated blood sugar can lead to diabetes, and an increased risk for heart attack and stroke.
  • What should your number be? Before eating, your blood sugar should be less than 100, and two hours after eating it should be less than 140.
  • Take action: Avoid foods high in carbohydrates (such as bread, pasta and desserts), which can elevate your blood sugar, and work to incorporate more raw, cooked or roasted veggies into your daily diet.

Blood pressure – aim for 120/80 or lower

  • What it is: Blood pressure measures the force of blood against the arteries when your beats (top number) and rests (bottom number). High blood pressure, or hypertension, can damage your heart, arteries and kidneys if left untreated.
  • What should your number be?
    • 120/80 is considered normal.
    • 140/90 or higher is considered high.
  • Take action: Incorporate regular exercise, which can help maintain a healthy blood pressure, into your daily routine. Limiting sodium intake to about 1 teaspoon of salt (2,300 milligrams) each day and reducing your alcohol intake can also help.

Blood cholesterol – aim for less than 200

  • What it is: Cholesterol is a waxy substance produced by the liver. If you have too much in your arteries, it can make it hard for your blood to circulate. Sustained high cholesterol can increase your risk for heart disease and heart attacks.
  • What should your number be?
    • A total cholesterol reading of 200 milligrams per deciliter (mg/dL) is good.
    • 200-239 mg/dL is borderline high, indicating some risk for heart disease.
    • A reading of 240 mg/dL or above is considered high.
  • Take action: Cholesterol is impacted in part by your diet, so reducing your intake of unhealthy foods like fried dishes and rich desserts can help improve your number.

Body mass index – aim for 18.6-24.9

  • What it is: Your ideal body weight takes into account your gender, age, height and frame. Your body mass index, or BMI, uses your height as well as your weight to give you a better idea of how much of your body is composed of fat.
  • What should your number be? The higher your BMI, the greater your risk of heart disease, hypertension and diabetes.
    • A healthy BMI is between 18.6 and 24.9.
    • A BMI between 25-29.9 is considered overweight.
    • Anything above 30 is considered obese.
  • Take action: Eat a healthy diet with lots of vegetables and increase your weekly activity and exercise. Burning 500 extra calories a day can help you lose up to one pound a week.

Next step:

Gardner and Jon Wes Adams

Twin brothers’ rare heart condition sparks unique research opportunity

In 2015, identical twins Gardner and Jon Wes Adams, then in their mid-20s, both nearly died when their hearts suddenly stopped beating. The incidents happened months apart, but the cause was the same: Brugada syndrome, a rare congenital heart rhythm disorder.

Jon Wes’ heart stopped first while he was running at The Arboretum at UK. Bystander CPR kept him alive until emergency medical personnel arrived. At the UK Gill Heart Institute, doctors ran a battery of tests to determine why this healthy, physically fit young man went into sudden cardiac arrest.

As soon as the results indicated Brugada syndrome, the care team knew they needed to test Gardner, since he has the exact same genes as his twin brother. They weren’t surprised to find that he had the syndrome, too.

Understanding the role of genetics

By that time, Jon Wes had received an implantable cardioverter defibrillator (ICD) that could detect abnormal heart rhythms and provide an electrical shock to restore a normal heartbeat and prevent cardiac arrest. Gardner and the doctors decided that he should receive an ICD, too. While sudden cardiac arrest in Brugada syndrome is uncommon, the chances seem greater if it’s happened to a family member, especially one with identical genetic material.

Only months later, Gardner’s heart stopped while he was running, and the ICD saved his life.

This unusual clinical case – genetically identical twins with a rare heart condition – prompted one of their doctors, heart rhythm specialist Samy-Claude Elayi, to seek a greater understanding of Brugada. Genetic testing revealed a specific mutation behind the condition in Jon Wes and Gardner. The mutation causes the membrane of the heart cells to stop conducting the electrical current that powers the heart. It turned out that their non-twin brother and their father also had the mutation, but no symptoms. Elayi wanted to know why the condition was presenting so differently in family members with the same genetic mutation.

With support from a high-impact pilot award from the UK Center for Clinical and Translational Science, Elayi and a multidisciplinary group of researchers are trying to find answers. The team includes Brian Delisle, PhD, associate professor of physiology and a recognized expert in the field of the basic mechanisms of congenital cardiac arrhythmias; Mark Farman, PhD, associate director of UK HealthCare Genomics and professor of plant pathology; and Jonathan Satin, PhD, professor of physiology. The case inverts the oft-quoted paradigm of “bench to bedside,” a reference to the trajectory of science that starts in the lab and then progress to patient care.

“This is a really fantastic opportunity because we have different members from a single family from whom we can get cells,” Elayi said. “We are trying to do a specific analysis of how what is really going on with this family and this gene because this disease is still very poorly understood.”

Testing blood cells

The research team is looking at cells from Jon Wes and his non-twin brother, as well as the rest of the family, with the hypothesis that there will be differences in each of them. Blood samples were sent to collaborators at the Stanford Cardiovascular Institute, where the blood cells are being transformed into inducible pluripotent stem cells (iPSC) – cells that can become any type of cell in body. The iPSCs will then be sent back to UK, where Satin will make them into heart cells that the team can study.

The team hopes to make a certain type of cardiomyocyte, or heart muscle cell, that few labs have been able to create. If they can do it, it would be a major advancement of this science at UK. They also hope that better knowledge of the genetic factors of Brugada could advance precision medicine in the field.

“This case is at the intersection of developmental biology, functional biology and molecular biology,” Delisle said. “Hopefully we can use this approach of reprogramming patient cells into stem cells to better understand their heart condition. And it could be a platform for understanding other types of congenital arrhythmias.”

Jon Wes and Dr. Elayi have taken their story into the community to talk with students about CPR and heart health. Check out a video of a recent visit they made to Lexington’s School for the Creative and Performing Arts.

Next steps:

‘Gill Goes Red’ on Feb. 3 in support of heart health in Kentucky

In February, institutions around Lexington will celebrate Heart Month with activities that promote healthy habits such as exercise, smoking cessation, stress reduction and improved diet.

This year’s ‘Gill Goes Red’ will involve treats and prizes

UK’s Gill Heart Institute will focus on ways to make your diet more heart-healthy with a celebration and information about simple ingredient substitutes that can make your transition to a healthy diet easier.

“Gill Goes Red” will take place at noon on Friday, Feb. 3 in the hospital’s Pavilion A atrium. There will be giveaways and free treats with a “secret ingredient” that makes them a healthier option. People who correctly guess the secret ingredient will be eligible to win a prize.

Starting a healthy diet? Taking baby steps can help.

According to Gretchen Wells, MD, PhD, director of Women’s Heart Health at the Gill, excess dietary fat, sugar and salt all contribute to poor heart health and can cause diabetes, heart attack or stroke, among other diseases. However, she acknowledges that drastic changes in diet can be difficult to maintain long-term.

“For some people, making gradual changes in their diet reduces the likelihood of failure,” said Wells. “We encourage people to make significant changes to reduce the amount of fat, sugar and salt in their diet, but if taking baby steps over time increases their chances of success, I’m all for it.”

Finding ways to increase nutrients in food

Vanessa Oliver with LiveWell, UK’s Health and Wellness program, will be a featured speaker at Gill Goes Red. Oliver will share her tips on easy substitutions and add-ins to increase nutrient value in foods.

“I’m often looking for ways to add healthy ingredients into meals,” Oliver said. “As long as people pay attention to portion size, there are easy ways to make foods healthy and tasty at the same time.”

Next steps:

Read some tips for buying healthier foods to reduce fat, sugar and salt, which are associated with a higher risk for obesity, heart attack and diabetes.

Want to eat better? Grocery shop like a cardiologist.

Susan Smyth, MD, PhD

Susan Smyth, MD, PhD

Written by Susan Smyth, MD, PhD, the medical director of the UK Gill Heart & Vascular Institute.

Many of us vowed to eat healthier foods in the new year but don’t know how to begin. Here are some tips for healthy grocery shopping that’ll help you reduce the amount of dietary fat, sugar and salt in your diet, which can help prevent obesity, heart attack, diabetes and other diseases.

Start in the produce section

Make your meal healthier by substituting foods with lots of color from natural sources (not artificial colors) for foods that are white or brown. Start in the produce section with fresh fruits and veggies, which are high in vitamins and fiber and low in fat. Be sure to check labels on processed foods like guacamole or prepared salads with dressing; they may contain high amounts of fat, sodium and/or sugar.

Tips for dairy and deli

In the dairy section, stick with low-fat options where possible. Beware of flavored yogurts, which can contain as much as half of the recommended daily allowance of sugar. Recent research indicates that eggs are fine in moderation, but check with your doctor first.

At the butcher shop, lean meats like chicken and fish are the healthiest options. Processed meats, like lunch meat or hot dogs, contain high amounts of sodium.

Choose wisely in the bakery

The bakery department can be tricky. While breads and other baked goods can have a place at your dinner table, the hidden sugars and sodium in bread might surprise you. Just two slices of packaged white sandwich bread may account for as much as a quarter of your recommended daily sodium intake. Instead, select breads made from whole grains, which can lower your LDL (bad cholesterol) and decrease the risk of diabetes by almost a third.

Spend less time in the interior aisles

The interior aisles of the grocery store are treacherous. Almost everything in a plastic wrapper is highly processed and loaded with fat, salt, sugar or all three. If you spend a lot of time in the middle aisles, do a lot of label-reading and look for healthier substitutes. Plain canned beans in water are a good choice, as are some nuts and dried fruit. Also, be aware of serving sizes per package: for example, canned soups are sometimes advertised as low sodium – but if the serving size is half a can, and you’re accustomed to eating a full can of soup, you’ll be getting double the dose of sodium.

Consider frozen options

In the frozen food aisle, frozen veggies without added sauces and fruits without added sugar can substitute for fresh varieties. Choose low-fat ice cream over regular versions. And be very careful of frozen pizzas, dinners and snacks, which can be loaded with sodium.

Perhaps the easiest way to eat better is to make a grocery list that emphasizes naturally colorful foods – the more vegetables, the better — and stick to it.

Next steps:

Gill’s Moliterno named editor of prestigious cardiovascular journal

David Moliterno, MD, FACC

The American College of Cardiology has named Gill Heart Institute’s Dr. David J. Moliterno, the new editor-in-chief of JACC: Cardiovascular Interventions.

Moliterno is the Jack M. Gill Chair and professor of the Department of Internal Medicine at UK. He is also a member of the interventional cardiology faculty at the UK Gill Heart Institute. He has been involved with numerous investigational studies in cardiovascular medicine over the last two decades, with a primary research interest in acute coronary syndromes.

“Interventional cardiology is an ever-growing and exciting subspecialty in cardiovascular medicine that is essential to treating our sickest patients,” said Moliterno. “I am honored to be the next editor of  JACC: Cardiovascular Interventions at a time when so many important advancements are occurring in the field.”

JACC: Cardiovascular Interventions covers interventional cardiovascular medicine and is ranked among the top ten cardiovascular journals for its scientific impact.

Moliterno has been an active member of the ACC, including as a member of the Board of Governors, Strategic Education Committee, and the Interventional Section Leadership Council.

Moliterno’s term will begin in March.

Next steps:

Research shows genetics may cause people to crave salty foods. Salt is a major culprit of cardiovascular disease, and research like this can help treat it.

Craving salty foods? Blame your parents

Gia Mudd

Gia Mudd, UK College of Nursing

Written by Jennifer Smith, a doctoral student in the UK College of Nursing, and Gia Mudd-Martin, an associate professor in the UK College of Nursing.

A sprinkle over a baked potato or a teaspoon to flavor a pot of chili might seem innocent to the average dieter, but salt is a major culprit of cardiovascular disease in America. Some people have a proclivity for sweet foods, such as candy, confectionery treats or ice cream. Others, however, need salty foods to satiate their palates, often snacking on potato chips, making meals of foods high in preservatives or supplementing recipes with extra doses of salt.

Leading research from UK Nursing

Science is showing a person’s desire for salty foods might be ingrained in his or her genetic makeup. A recent study conducted by our research team at the UK College of Nursing indicated that genetic variations in taste perception might influence dietary patterns associated with cardiovascular disease. Our team examined the TAS2R38 gene variant, which influences bitter taste. In a sample of more than 400 people at high risk for cardiovascular disease, we found that individuals with the enhanced bitter taste perception genotype were more likely to consume higher than the recommended amount of daily sodium than people without the genotype.

Further research to better understand this and other genetic influences on taste might one day allow healthcare providers to develop more targeted approaches to support reduced sodium intake in people who are genetically predisposed to consume salty foods. Our understanding of the genetic connection to dietary behavior will pave the way to more advanced practices and opportunities for prevention.

How you can manage salt intake

In the meantime, it is important to note that everyone should monitor salt and sodium intake to reduce risk of cardiovascular disease. The American Heart Association recommends eating no more than 2,300 milligrams of sodium per day and ideally limiting sodium to no more than 1,500 milligrams per day for most people. Research shows we can train our palates to adapt to a low-sodium diet. Here are a few tips:

  • Keep a journal of your salt intake so you know when you’re exceeding your limits.
  • Salt is hidden in many of the basic foods we purchase, including bread, cereal and canned soups. Start reading labels so you can pinpoint foods high in sodium.
  • Learn to cook with minimal amounts of salt and to instead flavor foods using herbs and spices.
  • Instead of buying packaged foods, which are typically packed with sodium and preservatives, opt for home-cooked meals that only need small portions of salt.

Salt lovers — don’t think you must deprive yourselves to prevent cardiovascular disease. By consciously managing the amount of salt in your diet, you will find you can still enjoy salty foods and sodium in smaller portions. Consider salty foods a treat, much like dessert.

Next steps:

  • Limiting salt is just one step you can take toward a more heart-healthy diet. Learn more about making better food choices.
  • You can make a difference by participating in a UK HealthCare research study. Learn more.
Clinical trials participant Tom Wall turned to the Gill Heart Institute to get his high blood pressure in check

Gill patient takes control of his health by joining clinical trial

Sixty-three-year-old Tom Wall had had enough.

His high blood pressure had persisted for more than 20 years. His diabetes was worsening. He’d gone from a prescription of just one drug, to two, then to three, and finally four. He’d taken early retirement from his job as a bank equipment repairman because he had trouble climbing into his van. Then, when he had trouble getting to his beloved garden at his farm in Nicholasville, he decided to take control.

“The garden is down the hill from the house, and I couldn’t get down there unless I rode my tractor,” Wall said. “I have a 5-year-old granddaughter, Avery, and I love to spend time with her. I know those drugs don’t work forever, and if I didn’t do something about my health, I wouldn’t be around to watch Avery grow up.”

Wall cut all sugar and carbs from his diet and did as much exercise as he could tolerate. He scoured the internet for information that could help him lose weight and get healthy. Over several months, Wall lost 100 pounds. He was able to come off his diabetes medicine, but his blood pressure remained stubbornly high.

“Consistently high blood pressure — also called hypertension — damages the tissues of the artery walls,” said Dr. Khaled Ziada, an interventional cardiologist at the UK Gill Heart Institute. “If left untreated, hypertension can lead to serious medical problems like stroke and even death, particularly in people who also smoke or have high cholesterol and/or diabetes, as Tom did.”

Resistant hypertension

Hypertension is a chronic condition in which the systolic blood pressure (the top number in the measurement that your health care provider gives you) exceeds 140 mmHg and/or the diastolic blood pressure (the bottom number) exceeds 90 mmHg.

Although it’s normal to experience minor fluctuations throughout the day, one in three Americans experience high levels of blood pressure (exceeding 140/90) even without activity or stress. Wall’s was 170/110 on good days, and as high as 200-210 on bad ones. Blood pressure that high is called a “hypertensive crisis.”

Ziada explains that patients can sometimes lower their blood pressure on their own by eating a balanced low-salt diet and adopting healthy lifestyle habits such as losing weight, exercising more, stopping smoking and reducing stress.

When these changes aren’t enough, there are numerous drug therapies that can be used separately or in combination to lower blood pressure. Sometimes, however, hypertension persists despite lifestyle changes and medications. Wall fell in this unfortunate group of people with what’s called “resistant hypertension.”

He returned to the internet for information.  Then, one day, he saw an ad for a clinical trial called SPYRAL at the Gill Heart Institute. He called the number immediately.

A new way to treat high blood pressure

The SPYRAL trial is exploring a novel approach to treat hypertension by manipulating the sympathetic nervous system signals that contribute to high blood pressure. The sympathetic nervous system regulates the vital functions of the body by connecting the brain to major organs such as the heart, kidneys and blood vessels. If the sympathetic nerves connecting the kidney to the brain are overactive, blood pressure rises.

SPYRAL uses a minimally invasive method to pulse small doses of energy through a catheter placed in the renal artery just outside the kidney itself, potentially decreasing the sensitivity of nerves lining the walls of the kidney arteries and reducing the signals that cause hypertension. There are only 24 sites testing SPYRAL worldwide; UK was one of the first 10 sites to be selected for this important research.

Wall’s blood pressure was too high to qualify for SPYRAL at first, so he worked with Dr. Ziada and his team to lower his systolic blood pressure to 150 before being eligible for inclusion in the study.

SPYRAL is what’s called a randomized, double-blind study, which means that only half of study participants actually receive the treatment while the other half receives a placebo, or “dummy” treatment. Furthermore, neither the patient nor the doctor who follows the patient knows who receives the treatment and who doesn’t. If initial data after 12 months indicates that SPYRAL does, in fact, lower blood pressure, the treatment will be offered to the patient in the study who initially received only placebo treatment.

According to Alexandra Hull, one of the SPYRAL study coordinators, being in a research study has benefits, even if you aren’t selected to receive the test treatment.

“The Gill has the most sophisticated heart care in this region, so when you come here you’re getting the best of the best,” she said.  “If you’re in a research study here, you might be selected to receive the test treatment, or you might not. But even if you’re not, you’re getting the best standard of care this region has to offer.”

Tom takes control of his health

In the meantime, Wall has returned to his farm, built a fort for his granddaughter, and continues to work towards his goal to lose another 50 pounds. He’s hopeful that he received SPYRAL the first time around, but if not he says he’ll jump at the chance to get it if it’s proven effective.

He also encourages everyone to take control of their own health and ask their doctor about new treatments that can help once all other options are exhausted.

“I appreciate the opportunity they’ve given me,” he said. “I don’t feel like a guinea pig at all, and everyone here has been great.”

Check out our video for more about Tom’s story and the clinical trials taking place at Gill.

Next steps:

  • For more information about the SPYRAL study, call 859-323-5259 or email h.shinall@uky.edu.
  • The Gill Cardiology Clinical Research Center facilitates research that impacts all aspects of heart health. Learn more about the center and view open and ongoing clinical trials.
The implantable WATCHMAN device may help reduce risk of stroke for those with atrial fibrillation.

New device may reduce risk of stroke for Afib patients

Written by Dr. John C. Gurley, director of the Structural Heart Program at UK HealthCare’s Gill Heart Institute.

Dr. John Gurley

Dr. John Gurley

A new implant device may be a breakthrough for reducing the stroke risk for atrial fibrillation (Afib) patients. The WATCHMAN Left Atrial Appendage Closure (LAAC) provides a new option for patients with non-valvular Afib, who may require an alternative to long-term use of blood thinners.

UK HealthCare was among the first centers in the world to implant the WATCHMAN as an investigational device through a clinical trial in 2005. The device is now FDA-approved in the U.S. and more widely available.

Those with Afib are at a higher risk for stroke

Currently, about 5 million Americans are diagnosed with atrial fibrillation, the most common cardiac arrhythmia, where the upper chambers of the heart (atrium) beat too fast and with irregular rhythm (fibrillation). But having an irregular heartbeat is not the only challenge facing these patients. The condition causes them to be at a higher risk of experiencing a stroke – in fact, five times more likely compared to those without atrial fibrillation.

Because the heart does not beat properly in atrial fibrillation patients, blood may not fully pump out of the heart, causing it to pool and then clot in a pouch in the heart’s left atrial appendage. In some cases, the blood clots can break loose and travel in the bloodstream to the brain, resulting in a stroke.

Along with putting patients at a greater risk of experiencing a stroke, these types of strokes caused by atrial fibrillation often are fatal or very disabling.

Finding a new way to treat Afib

In the past, the most common treatment to reduce the risk of stroke in these patients has been to have them take a blood-thinning medication called warfarin. However, despite their effectiveness, taking blood thinners for long periods of time can be difficult for patients because it isn’t always well-tolerated and it presents a significant risk for bleeding complications. Overall, about half of atrial fibrillation patients appropriate for warfarin go untreated because of their inability to tolerate or adhere to the medication.

For patients seeking an alternative to warfarin, the WATCHMAN implant offers a treatment option that could free them from the challenges of long-term blood-thinning therapy. The catheter-delivered heart implant is a one-time procedure that usually takes about an hour.

During the procedure, the implant is designed to close off the left atrial appendage to prevent blood clots from entering the bloodstream that potentially could cause a stroke for higher risk patients with non-valvular Afib.

Once the left atrial appendage is closed off, patients may, over time, be able to stop taking warfarin.

Next Steps

What is atrial fibrillation?

What is atrial fibrillation? Our expert Dr. Ted Wright explains.

In honor of Atrial Fibrillation Awareness Month, we sat down with the UK Gill Heart & Vascular Institute’s Dr. Ted Wright to discuss the condition, how it’s treated and what you can do if you have it.

Watch our conversation with Dr. Wright below.

Atrial fibrillation, also known as AFib, is a type of irregular heartbeat. If left untreated, it can increase a person’s risk for stroke and heart failure.

Dr. Ted Wright

Dr. Ted Wright

Dr. Wright is a heart surgeon at the UK Gill Heart & Vascular Institute. He is UK’s leading expert in atrial fibrillation treatment and is the only doctor in the region performing the Mini-MAZE procedure, a surgical treatment for people with the condition.

Check out the first video in our interview series below where Dr. Wright explains what AFib is and how it’s diagnosed. Be on the lookout for more highlights from our conversation with Dr. Wright in the coming days.

Next steps:

  • The UK Gill Heart & Vascular Institute is a leader in diagnosing and treating abnormal heart rhythms, including AFib. Learn more about Gill’s Heart Rhythm Program.
  • Check out our Q&A with Dr. Wright about heart disease and African-Americans.
Jim Lester was in end-stage heart failure, but a doctor from the same hometown helped him to trust in a heart procedure that eventually saved his life.

Hometown connection leads to life-saving heart procedure

Jim Lester encourages others to listen to his heart. As you adjust the stethoscope’s earpieces and lean in, you hear an electronic whir and zing reminiscent of a video game. The sound that startles others makes Lester laugh. Apparently this is not the first time he’s unleashed this parlor trick.

Just two weeks prior, Lester was gravely ill, in end-stage heart failure, the result of a lifetime of repeated heart attacks (three), blood clots (four) and a stroke. His ejection fraction – a measure of the heart’s ability to pump blood – was less than 20 percent. A healthy person’s EF sits in the 50 to 70 percent range.

Lester remembers the conversation with Alexis Shafii, his physician at the Gill Heart Institute. “Dr. Shafii was straight to the point,” Lester remembers. “He said that I had to have an LVAD in order to survive.”

A left ventricular assist device, or LVAD, is a mechanical device that helps a weakened heart pump blood. “An LVAD doesn’t replace the heart,” said Dr. Maya Guglin, medical director of Mechanical Circulatory Support at the UK Gill Heart Institute. “It just helps it do its job.” However, Guglin was cautious. Implanting an LVAD requires open heart surgery and a lifetime of maintenance. It’s not a good fit for every patient.

A common connection

Lester was afraid of surgery. He kept asking whether there were any pills that could help him instead of this strange-looking machine. Then he met Sarah Branam, one of the three LVAD coordinators at the Gill.

“The team asked me to do some education with Jim, since he was very standoffish about the idea of having an LVAD,” Branam said. “I started discussing with him what his fears were with the LVAD, I just wanted to help relieve his concerns. And I always say, ‘Where are you from?’ and when he said, ‘Maysville, Kentucky,’ I was like, ‘Well, funny thing, so am I!'”

They bonded instantly. Lester knew Branam’s “Papaw,” Clarence Branam, and then knew he could trust Sarah. She understood Lester’s fear of the unknown, but she could also share her experiences with many patients with LVADs.

“I got to see patients go from being in the ICU, and being as sick as they are, to see them with quality of life: the stamina, no oxygen tank, being able to walk farther, getting back to what they wanted to do… it was just amazing,” Branam explained.

“I was awful scared, but after talking to Sarah and finding out she comes from Maysville, why, everything leveled out,” Lester said tearfully. “This little thing came in, and she would answer any questions I had, and took all my fears away.”

Even better: Lester qualified for a clinical trial to implant a new version of an LVAD called HeartMate 3.

The power of advanced medicine through clinical trials

According to Guglin, the HeartMate 3 is a tremendous improvement from its predecessor with a longer battery life, smaller profile and engineering that minimizes the potential for complications like blood clots and GI bleeds.

“That the Gill was included in this major clinical trial was a coup for us,” Guglin said. “It’s a signal that the cardiology world recognizes our expertise, our professionalism and our teamwork.”

And, Guglin adds, this also helps fulfill the heart institute’s academic mission, since high-profile trials like that for the HeartMate 3 expose Gill trainees to the newest available technology – technology that could become standard treatment by the time they are in their own practice.

On Aug. 8, Lester was implanted with the HeartMate 3. Everyone noticed immediately how improved he was.

“The biggest thing I saw about Jim before the surgery was how hard he was struggling to breathe. And the day after the breathing tube was pulled out, he did not need supplemental oxygen,” Branam said.

“It felt like I was getting too much oxygen,” Lester laughs.

A new lease on life

After a couple of weeks of recovery and therapy, Lester was discharged. What will he do with this new lease on life?

“Well, I aim to go home, sit on my front porch, watch the traffic go up and down the street, and hug my wife,” Lester said.

Lester was the Gill’s first HeartMate 3 patient, but three others followed within 10 days. This phase of the trial is now closed, but the UK will be involved in the next phase, a “Continued Access Protocol” that permits all qualifying patients to receive the HeartMate 3 while FDA approval is pending.

Based on her initial involvement with the HeartMate 3 trial, Guglin has great hopes for the device.

“It’s an amazing feeling when you come to see the patient next morning after the surgery and their skin color is different and there is life in them,” she said. “And when they are being discharged 10 days or two weeks later it’s gratifying to see how much they improved on your watch because of the intervention you were able to offer.”

Next Steps