Melanie Cole, MS (Host): Welcome to Better Edge, a Northwestern Medicine podcast for physicians. I'm Melanie Cole. And today, we're introducing you to Dr. Anita Asgar. She's an Adjunct Associate Professor of Cardiology and the new Section Head of Interventional Cardiology at Northwestern Medicine.

Dr. Asgar, it's such a pleasure to meet with you today so that we can let everybody know who you are. So, start a little bit about telling us how about yourself, how you came to Northwestern, your career path before. Tell us a little bit about yourself.

Anita W. Asgar, MD: Thanks, Melanie. I'm Canadian. I'm actually born and raised in Newfoundland, but I've spent the last 15 years working as an interventional cardiologist in Montreal at the Montreal Heart Institute. It's been a great experience working there. But when this opportunity came up to work at the Bluhm Cardiovascular Institute, I jumped at the chance to join this team.

Melanie Cole, MS: Tell us why, why did that excite you? What drew you to the Bluhm Cardiovascular Institute?

Anita W. Asgar, MD: It's a great question, and I guess it goes back to my family. So, my father was an ophthalmologist and trained and did his residency at in Chicago in the '60s and then, at the time, immigrated to Canada where we were born and raised, but it always had this dream of returning to Chicago. He passed away about 20 years ago, but it sort of always felt a little bit like my second home. I have family here. We used to come and visit in the summers.

So, I'd heard about the Bluhm Cardiovascular Institute and the amazing work they were doing in Cardiology and Cardiac Surgery. And so, when the opportunity came up, I became interested in and spoke to Dr. Pat McCarthy about joining the team.

Melanie Cole, MS: Can you tell us about clinical trials you're bringing with you to Northwestern? What are the first in-man devices you're developing?

Anita W. Asgar, MD: Yeah. So, my interest is valvular heart disease and in particular structural heart interventions, and we've had some experience doing early feasibility trials with new devices, and the ones I'm particularly interested in are tricuspid valve replacement, mitral valve replacement. We're also going to be bringing a trial of a new balloon-expandable TAVR device, which hopefully will be able to treat patients with smaller aortic valves and have better hemodynamic results. Some of the exciting trials we're going to be starting this year.

Melanie Cole, MS: That's really exciting, Dr. Asgar. And what about clinical research interests? You just mentioned devices and some research. Tell us a little bit more. Expand for any recent publications or interests outside of that.

Anita W. Asgar, MD: So actually, one of my primary interests is secondary mitral regurgitation, and in particular, moderate secondary mitral regurgitation. So, we do know that when you treat secondary MR, when it's severe, there are randomized controlled trials that have shown that that improves mortality and heart failure hospitalizations. But the challenge is these patients are quite sick and their prognosis, despite treatment, isn't optimal because their ventricles are already dilated.

One of the thoughts that I've been working on for the past several years is if we intervened earlier in patients who had moderate mitral regurgitation, would we be able to prevent some of the adverse remodeling and progression of the disease? And in fact, we looked at this in a registry called the Expanded Dataset, and we published this last year in JACC Heart Failure, and we looked at what are the differences when you treat patients with moderate mitral regurgitation and severe?

And in fact, what we found is the results are similar in terms of the results of decreasing mitral regurgitation, improving quality of life. But the really interesting thing we found is that you can actually cause the left ventricle to remodel more favorably when you treat patients with moderate MR than when you treat severe. So in the future, what I'm hoping is to run a randomized control trial, actually looking at treating patients earlier in their disease so that hopefully we can prevent progression of the disease and worsening heart failure.

Melanie Cole, MS: Dr. Asgar, tell us about your work with MitraClip. I heard that you performed quite a few of the MitraClip procedures in Canada.

Anita W. Asgar, MD: Yeah. So, we started the first clinical program in Canada actually in 2010. And we built it up over the past 14 years to become the largest program in Canada. We've enrolled in all the clinical trials. And right now, I'm just finishing up the Canadian guidelines, in fact, for the use of MitraClip or mitral transcatheter edge-to-edge repair and Tricuspid. So, that's been really an exciting part of my career, and it really got me interested valvular heart disease.

Melanie Cole, MS: Now, as Section Head of Interventional Cardiology, for such an esteemed institution as Northwestern, what are your goals for the future of the Bluhm Cardiovascular Institute?

Anita W. Asgar, MD: It's a great question. And I think one of the important things, you know, the Bluhm Cardiovascular Institute is also a system, and there's other hospitals associated. And one of my priorities is really going to be integrating all these other hospitals into the system, collaborating more, providing support to grow their structural programs across the system.

I'd also like to focus on increasing efficiency and streamlining processes for both referring physicians and patients and trying to reduce wait times for patients from referral to intervention. And finally, I think it's important to participate more in research trials, particularly the early feasibility and new devices so that we can continue to be on the cutting edge of science for interventional cardiology.

Melanie Cole, MS: Now, I love my next two questions, Dr. Asgar, because it's going to give us an insight into you as a person. How would you describe your approach to care? What's your philosophy of care? For referring physicians listening and they're looking at the Bluhm Cardiovascular Institute, what do you want patients and referring physicians to know about how you approach disease, wellness, and care for the whole person?

Anita W. Asgar, MD: So, I would say that my approach to care really centers on five key things. And the first thing is really patient-centered and approaching care based on what the patient needs, individualizing treatment, including individualizing devices according to the patient's condition, and doing that really based on what the current evidence is, and tailoring that treatment plan to meet the unique needs of each of the patients.

I would say the second thing is really multidisciplinary collaboration. I think it's very important for delivering optimal patient care that we're able to have a collaborative environment with a multidisciplinary team of cardiologists, surgeons, imaging specialists, nurses, and other healthcare professionals so we can deliver the best care possible.

The third thing is really innovation and quality. I'm very excited about new devices and where they fit in the patient treatment plan and, of course, delivering optimal quality to patients so we can get them the result they need.

Communication and trust would be another thing. I think it's very important, particularly when you're new to a system, to build trust with the referring positions and patients. And communicating well to both so that everybody feels like they're getting the information they need and that patients can get care, but also are very comfortable with their treatment plan and they understand where their treatment is going.

And I would say, finally, the most important thing is continuous improvement. You know, when we're doing patient care, when we're delivering programs, when we're treating patients and their families, as well as collaborating with physicians, it's really learning from what we've done in the past and continuing to improve so that we can deliver the care and the service to patients and referring physicians as best as possible.

Melanie Cole, MS: Dr. Asgar, what do you do for fun? Tell us a little bit about your family and life outside of work. What are some things that people and your colleagues may not know about you?

Anita W. Asgar, MD: One of my favorite activities is actually reading. I'm an avid reader. I have hundreds upon hundreds of books, quite an extensive library. And I just love to sit down with a great cup of coffee and read. That's one of my favorite activities. And other than that is running. And so, I'm excited be able to explore the area, particularly around the lake, get out there and start running and learn the city on my feet.

Melanie Cole, MS: And lastly, for referring physicians, and I want to thank you for telling us all about yourself and for referring physicians, which patients would you like to be referred to you? And what would you like the key takeaways from our introduction to you for referring physicians to be?

Anita W. Asgar, MD: So, my interest is namely valvular heart disease. I believe that's where I excel. And, you know, I think that I can provide excellent care for patients who have valvular heart disease, who need an intervention. And so, I would suggest, referring physicians, if you have a patient that has valvular heart disease and you're concerned about whether or not they may need an intervention, please feel free to send those patients to me. I like to work collaboratively with my imaging specialists and my cardiac surgeons so that we can develop this team approach and select the best therapy for patients.

Melanie Cole, MS: Thank you so much, Dr. Asgar, for joining us today. and to refer your patient or for more information, please visit our website at breakthroughsforphysicians.nm.org/cardiology to get connected with one of our providers. That concludes this episode of Better Edge, a Northwestern Medicine podcast for physicians. I'm Melanie Cole.