Advertise on podcast: Parallax by Ankur Kalra

In this episode of Parallax, host Dr Ankur Kalra is joined by Dr Adam DeVore (Duke University School of Medicine, US) to discuss the management of patients with newly diagnosed heart failure with reduced ejection fraction (HFrEF) and the persistent risk of sudden cardiac death during the early phase after diagnosis. The discussion explores strategies for initiating and optimising guideline-directed medical therapy, approaches to risk stratification using imaging and clinical assessment, and the evolving role of wearable cardioverter defibrillators while patients await recovery or evaluation for ICD therapy. The faculty also review key findings from the SCD-PROTECT study and their implications for real-world clinical practice. This series is supported by ZOLL and is intended for Health Care Professionals.

In this episode of Parallax, Dr Ankur Kalra welcomes Dr Anjali Tiku Owens, Associate Professor of Medicine and Director of the Hypertrophic Cardiomyopathy Center at the University of Pennsylvania, for an in-depth discussion on one of the greatest unmet needs in hypertrophic cardiomyopathy (HCM): the treatment of symptomatic non-obstructive HCM. Together, they explore the complex pathophysiology driving symptoms in these patients, the limitations of traditional therapies, and the evolving understanding of chronotropy, inotropy and lusitropy in clinical decision-making. Dr Owens also shares insights from recent clinical trial data presented at ESC Congress 2025, highlighting emerging sarcomere-targeted therapies, including aficamten and the investigational agent EDG-7500. The conversation examines how these novel approaches may reshape treatment paradigms, improve functional capacity and address longstanding therapeutic gaps for patients with non-obstructive HCM, while offering a preview of where the field may be headed next. Questions and comments can be sent to "[email protected]" and may be answered by Ankur in the next episode. Host: @AnkurKalraMD and produced by: @RadcliffeCardio Parallax is Ranked in the Top 100 Health Science Podcasts by Million Podcasts.

In this insightful episode of Parallax, Dr Ankur Kalra welcomes Dr Robert Riley, Director of Interventional Cardiology at Overlake Medical Center in Bellevue, Washington, for a masterclass on the contemporary management of complex PCI. Drawing on more than a decade of experience, Dr Riley explores how the field has evolved beyond technical success alone, with greater emphasis on patient selection, shared decision-making and aligning procedural goals with individual patient outcomes. The conversation takes a deep dive into the assessment and treatment of calcified coronary lesions, with a particular focus on the challenge of nodular calcium. Dr Riley shares his practical approach to intravascular imaging, lesion preparation and plaque modification, discussing when to utilise atherectomy, intravascular lithotripsy (IVL) and OPN balloons. He also highlights his growing use of drug-coated balloons in de novo lesions and provides insights into tailoring DAPT duration based on individual patient risk. For interventional cardiologists seeking actionable strategies to optimise outcomes in complex PCI, this episode offers invaluable clinical pearls from an experienced operator. How should operators approach heavily calcified lesions? When is atherectomy necessary, and where does IVL fit into modern practice? What role will drug-coated balloons play in the future of complex PCI? Questions and comments can be sent to "[email protected]" and may be answered by Ankur in the next episode. Host: @AnkurKalraMD and produced by: @RadcliffeCardio Parallax is Ranked in the Top 100 Health Science Podcasts by Million Podcasts.

In this insightful episode of Parallax, Dr Ankur Kalra welcomes Dr Kim Smolderen, Professor of Medicine and Psychiatry at Yale University and psychologist at Yale New Haven Hospital, for a conversation on the growing field of cardiovascular psychology. Together, they explore how psychological well-being, medical trauma and social determinants of health influence cardiovascular outcomes, and why integrating these factors into routine cardiovascular care is essential for delivering truly patient-centred medicine. Dr Smolderen discusses the evidence linking anxiety, depression and PTSD to longer hospital stays, repeat procedures and increased healthcare utilisation. She shares her vision for creating "healing eco-systems" that bridge traditional clinical silos, bringing psychology and cardiology together through integrated care pathways, psychosocial risk assessment and trauma-informed care. The discussion also examines the business case for cardiovascular psychology, from reducing readmissions and emergency department visits to improving efficiency and enhancing the patient experience. As cardiovascular psychology continues to gain momentum globally, this episode highlights how whole-person care can benefit both patients and providers. Questions and comments can be sent to [email protected] and may be answered by Ankur in the next episode. Host: @AnkurKalraMD and produced by: @RadcliffeCardio Parallax is Ranked in the Top 100 Health Science Podcasts by Million Podcasts.

In this insightful episode of Parallax, Dr Ankur Kalra is joined by Dr Barry Borlaug, Professor of Cardiology at Mayo Clinic and one of the world's leading experts in cardiac haemodynamics, for a comprehensive discussion on the evolving landscape of heart failure with preserved ejection fraction (HFpEF). Together, they explore the complexities of diagnosing and managing a syndrome that continues to challenge clinicians. Dr Borlaug explains why exercise right-heart catheterisation remains the gold standard for uncovering "hidden" HFpEF, particularly in patients with normal resting filling pressures, and provides a detailed overview of the Mayo Clinic's invasive exercise testing protocol. The conversation also traces the evolution of HFpEF phenotyping, from the traditional hypertensive patient to the increasingly recognised obesity-driven phenotype, highlighting the role of systemic inflammation, visceral adiposity and disease progression across the HFpEF spectrum. Dr Borlaug outlines what he describes as the modern therapeutic backbone for HFpEF in 2026, reviewing the evidence supporting SGLT2 inhibitors, mineralocorticoid receptor antagonists including finerenone, and incretin-based therapies such as semaglutide and tirzepatide. Looking ahead, he discusses emerging investigational approaches including sotatercept, the challenges facing device-based therapies, and the importance of identifying HFpEF mimics such as cardiac amyloidosis and hypertrophic cardiomyopathy to ensure patients receive the most appropriate treatment. Questions and comments can be sent to "[email protected]" and may be answered by Ankur in the next episode. Host: @AnkurKalraMD and produced by: @RadcliffeCardio Parallax is Ranked in the Top 100 Health Science Podcasts (#48) by Million Podcasts.

In this episode of Parallax, Dr Ankur Kalra is joined by Ms Claudia Garbrecht, psychologist specialising in psycho-cardiology and organisational health. Together, they explore the critical “heart–brain connection,” examining the high prevalence of anxiety and depression among patients with cardiovascular disease and the bi-directional relationship between mental health and cardiac outcomes. The discussion reframes traditional risk by highlighting the clinical importance of psychological distress, social isolation and behavioural factors in shaping cardiovascular risk and recovery. The conversation also turns to clinician wellbeing, with Ms Garbrecht outlining the impact of burnout, workplace stress and organisational culture on both physician health and patient outcomes. From the physiological effects of stress to the influence of communication and framing in consultations, this episode offers practical, time-efficient strategies to enhance patient interactions and reinforce positive behaviour. Dr Kalra reflects on applying these insights in practice, while Ms Garbrecht emphasises a fundamental principle: clinicians must prioritise their own wellbeing to deliver optimal care. Questions and comments can be sent to "[email protected]" and may be answered by Ankur in the next episode. Host: @AnkurKalraMD and produced by: @RadcliffeCardio Parallax is Ranked in the Top 100 Health Science Podcasts (#48) by Million Podcasts.

In this week’s episode of Parallax, Dr Ankur Kalra is joined by Dr Chris Maroules, National Director for Cardiac Imaging at SimonMed and co-director of Innovation Health. Together, they explore why coronary CTA, now a Class 1 recommendation in the 2021 ACC/AHA chest pain guidelines, has become the standard first-line non-invasive test, and why proficiency in cardiac CT is essential for cardiology trainees in 2026. The conversation shifts from traditional risk scores to direct disease assessment, highlighting the power of coronary CTA to identify and quantify plaque burden. Dr Maroules discusses high-risk plaque features, the limitations of calcium scoring, and the evolving role of FFRCT, before outlining a future of AI-enabled screening and precision prevention. He concludes with practical advice for fellows, encouraging Level 2 certification to stay ahead in an increasingly imaging-driven field. Questions and comments can be sent to "[email protected]" and may be answered by Ankur in the next episode. Host: @AnkurKalraMD and produced by: @RadcliffeCardio Parallax is Ranked in the Top 100 Health Science Podcasts (#48) by Million Podcasts.

In this episode of Parallax, Dr Ankur Kalra is joined by Dr Matthew Budoff, Professor of Medicine at the David Geffen School of Medicine at UCLA and a leading authority on preventive cardiology and cardiac imaging. Together they examine the role of cardiac CT in detecting silent atherosclerosis, and ask whether imaging should displace traditional risk scores in routine practice. Dr Budoff makes the case for the coronary calcium score as the foundation of personalised cardiovascular care, arguing that population-based risk factors often fail at the individual level. He weighs the calcium score against CT angiography in primary prevention - covering cost, radiation, the uncertain significance of trivial plaque, and the risk of inappropriate stenting in asymptomatic patients - while noting that symptomatic patients warrant CCTA first-line. He also addresses elevated Lp(a) with a zero score and the case for CCTA in younger high-risk patients, before outlining his scalable, score-tiered approach to therapy, drawing on data from the VESALIUS trial. Is the calcium score ready to replace traditional risk scores? When should imaging guide therapy, and when should it be deferred? Questions and comments can be sent to "[email protected]" and may be answered by Ankur in the next episode. Host: @AnkurKalraMD and produced by: @RadcliffeCardio Parallax is Ranked in the Top 100 Health Science Podcasts (#48) by Million Podcasts.

In this episode of Parallax, Dr Ankur Kalra is joined by Professor Ron Blankstein, a leading authority in preventive cardiology and cardiac imaging at Harvard Medical School and Brigham and Women's Hospital, Boston. Together they trace the remarkable journey of cardiac computed tomography (CT) from a niche diagnostic test to an indispensable pillar of contemporary cardiovascular practice. Professor Blankstein shares the moving story behind his new textbook, a companion to the legendary Braunwald's Heart Disease, recounting his personal collaboration with the late Dr Eugene Braunwald, who initiated the project and remained meticulously involved in its development until his passing. How has cardiac CT reshaped the diagnosis and management of coronary disease? What does the future of plaque analysis and photon-counting technology hold? And why should every cardiology fellow now consider CT essential to their training? Questions and comments can be sent to "[email protected]" and may be answered by Ankur in the next episode. Host: @AnkurKalraMD and produced by: @RadcliffeCardio Parallax is Ranked in the Top 100 Health Science Podcasts (#48) by Million Podcasts.

In this episode of Parallax, Dr Ankur Kalra welcomes Dr Eunice Dugan, a graduating interventional and structural heart disease fellow at the Cleveland Clinic, as she prepares to transition into independent practice in Fort Wayne in the summer of 2026. Dr Dugan reflects on how early mentorship shaped her decision to engage with the American College of Cardiology during fellowship, and what professional societies can offer beyond the clinical environment — from expanding skill sets and building lasting networks to driving meaningful change. She shares how her role as a local FIT representative led her to organise a widely attended webinar helping fellows navigate the new interventional cardiology match. The conversation also tackles the attrition challenge that affects many early-career cardiologists in their first three to five years of practice: Dr Dugan, now transitioning into the ACC's Early Career Council, discusses the "fog" of establishing a new career and makes the case for cultivating a specific project during fellowship as a professional anchor through the pressures of a new post, relocation, and family life. She also speaks to her advocacy for women in cardiology, including championing open discussion around family planning and reproductive strategies — topics that remain underaddressed in the field. Questions and comments can be sent to [email protected] and may be answered by Ankur in the next episode. Host: @AnkurKalraMD and produced by: @RadcliffeCardio Parallax is Ranked in the Top 100 Health Science Podcasts (#48) by Million Podcasts.

In this episode of Parallax, Dr Ankur Kalra is joined by Dr Kendra Grubb, Vice President and Chief Medical Officer for Structural Heart Interventions at Medtronic and former cardiac surgeon and professor at Emory University. Dr Grubb discusses her career journey from being an active clinician to a leader within the medical device industry, elaborating on the philosophy behind her choices and the concept of scaling impact beyond the operating theatre. This leads the discussion into an analytical dissection of the Evolut low-risk trial, with Dr Grubb explaining how the evolution of procedures such as cusp overlap and pre-dilation have made a world of difference in terms of improving results concerning paravalvular leaks and pacemaker implantations as well as comparing current long-term reintervention data to older methods. Other topics in this podcast include sex disparity in structural heart disease, specifically the issues around the diagnosis and treatment of female patients with fibrotic, low flow-low gradient aortic stenosis. Dr Grubb ends with her thoughts about the future direction of the field, which entails a comprehensive transcatheter/surgical approach towards mitral and tricuspid diseases, in addition to incorporating AI and robotics in precision valve therapy. Questions and comments can be sent to [email protected] and may be answered by Ankur in the next episode. Host: @AnkurKalraMD and produced by: @RadcliffeCardio Parallax is Ranked in the Top 100 Health Science Podcasts (#48) by Million Podcasts.

In this episode of Parallax, Dr Ankur Kalra is joined by Dr Michelle Kittleson, Professor of Medicine and Advanced Heart Failure Cardiologist at Cedars-Sinai Medical Center, for a clinically rich breakdown of her standout trial picks from the 2026 ACC Annual Scientific Sessions. Dr Kittleson brings her characteristic precision to four landmark studies spanning heart failure and atrial fibrillation. She unpacks the SPIRIT HF trial — a negative study of spironolactone in HFpEF that, she argues, does not consign the drug to the shelf — and explains why its high discontinuation rate and pandemic-era disruptions complicate the headline result. For clinicians managing cost-conscious patients, her take on spironolactone as a practical alternative to finerenone is a perspective worth hearing. The conversation turns to the CADENCE trial, a Phase 2 study of sotatercept in Group 2 pulmonary hypertension secondary to HFpEF — a phenotype Dr Kittleson treats with particular caution given the risks of misdirected pulmonary vasodilator therapy. She offers measured optimism about what these early results might mean for future treatment of HFpEF-related lung remodelling. Dr Kalra and Dr Kittleson also enter the ongoing debate around left atrial appendage closure, weighing the contrasting conclusions of the CLOSURE AF and CHAMPION AF trials against each other — and against a shared conviction that anticoagulation remains the standard of care for the vast majority of patients with atrial fibrillation. Finally, they examine the STEMI Door to Unload trial, a cautionary study in indication creep: the microaxial flow pump that proves life-saving in cardiogenic shock offered no infarct-size benefit in haemodynamically stable STEMI patients — and came with a meaningful increase in bleeding and vascular complications. Dr Kittleson also shares her stepwise outpatient algorithm for a new HFpEF diagnosis, from ruling out mimics such as cardiac amyloidosis to sequencing SGLT2 inhibitors, MRAs, GLP-1 agonists, and ARNIs based on individual patient profile. The episode closes with a discussion of her new column for NEJM Voices, where she writes on the art of medicine. Questions and comments can be sent to [email protected] and may be answered by Ankur in the next episode. Host: @AnkurKalraMD and produced by: @RadcliffeCardio Parallax is Ranked in the Top 100 Health Science Podcasts (#48) by Million Podcasts.

In this fascinating episode of Parallax, Dr Ankur Kalra is joined by Dr Benjamin Levine, Director of the Institute for Exercise and Environmental Medicine and a pioneering figure in the field of space cardiology. Together, they explore the remarkable cardiovascular adaptations that occur in microgravity, and what they are teaching clinicians about treating patients on Earth. Dr Levine unpacks the haemodynamic realities of spaceflight, from the counterintuitive finding that central venous pressure actually drops to zero in microgravity, to the physiologic cardiac atrophy that results when the heart no longer pumps against gravitational load. He shares how this research has transformed the understanding and treatment of POTS, reframing it not as a disorder of the autonomic nervous system, but as a consequence of reduced stroke volume - and how horizontal exercise training borrowed directly from astronaut countermeasure programmes is now changing clinical practice. The conversation also turns to the emerging cardiovascular risks of long-duration spaceflight, including earlier onset atrial fibrillation, upper body venous thrombosis, and the intracranial pressure dynamics underlying spaceflight-associated neuro-ocular syndrome. Dr Levine discusses the Astro-CHARM risk score, NASA's approach to coronary calcium screening, and the forthcoming scientific statement on cardiovascular management in tactical athletes. Questions and comments can be sent to [email protected] and may be answered by Ankur in the next episode. Host: @AnkurKalraMD and produced by: @RadcliffeCardio Parallax is Ranked in the Top 100 Health Science Podcasts (#48) by Million Podcasts.

In this special TIO Congress edition of Parallax, Dr Ankur Kalra is joined by two of interventional cardiology's most influential voices: Professor Roxana Mehran, incoming President of the American College of Cardiology and Co-Course Director of TIO, and Professor Nicholas Van Mieghem, TIO Course Director. The conversation spans the evolution of online medical education, sex-specific differences in cardiovascular disease, and the challenge of translating clinical evidence into everyday practice. The guests explore sex as a biological variable across valve disease, plaque formation, and left ventricular remodeling, address the underdiagnosis of microvascular dysfunction in women, and examine persistent access barriers for female and non-white patients despite advances in trials such as SMART and RHEA. Professor Van Mieghem adds insights on modern TAVI planning and lifetime valve management, while Professor Mehran shares promising data on Factor XI inhibitors and the case for simplifying antithrombotic regimens. The episode closes on clinical inertia - with intravascular imaging uptake in the US still at just 12–15% despite a Class 1 indication, Professor Mehran outlines her ACC presidential vision: closing the gap between evidence and bedside practice, and reversing the troubling rise in cardiovascular morbidity and mortality. Questions and comments can be sent to [email protected] and may be answered by Ankur in the next episode. Host: @AnkurKalraMD and produced by: @RadcliffeCardio Parallax is Ranked in the Top 100 Health Science Podcasts (#48) by Million Podcasts.

In this episode of Parallax, Dr Ankur Kalra speaks with Dr Sameed Khatana, Assistant Professor of Medicine at the University of Pennsylvania and clinical cardiologist at the Philadelphia VA Medical Center. Their conversation examines the growing connection between environmental factors and cardiovascular health. Dr Khatana explains why conditions like air quality and temperature represent important determinants of cardiovascular outcomes. He shares observations from his Philadelphia practice: patients unable to exercise outdoors during extreme heat, medication challenges for those on diuretics during heatwaves, and economic pressures that force difficult choices between cooling costs and other necessities. The discussion explores both clinical interventions and systemic solutions, including programs like LIHEAP (Low Income Home Energy Assistance Program) and municipal heat action plans. Dr Khatana presents research showing that vulnerable populations—particularly older patients with multiple cardiovascular risk factors—face disproportionate impacts from environmental stressors. Dr Khatana encourages cardiologists to engage with this evolving aspect of patient care, advocating for collaboration between professional societies, environmental scientists, and policymakers to develop effective strategies that support cardiovascular health in changing environmental conditions. Questions and comments can be sent to "[email protected]" and may be answered by Ankur in the next episode. Host: @AnkurKalraMD and produced by: @RadcliffeCardio Parallax is Ranked in the Top 100 Health Science Podcasts (#48) by Million Podcasts.