Newswise — WINSTON-SALEM, N.C. – March 22, 2018 – As chief of cardiovascular medicine and executive director of the Heart and Vascular Center at Wake Forest Baptist Medical Center, David Zhao, M.D., works with a team of more than 50 expert physicians and surgeons plus other specially trained professionals who employ the most advanced devices and methods available to prevent, diagnose, treat and manage the full spectrum of heart and vascular conditions.
But high-quality cardiovascular care isn’t just about the latest medical products and procedures. While fully immersed in a world of cardiac MRI scanning, miniature wireless pacemakers, left atrial appendage closures, ventricular assist devices and transcatheter aortic valve replacement surgery, Zhao still brings a decidedly low-tech instrument – a stethoscope – with him when he sees patients. And he stresses that traditional qualities such as expertise and teamwork are essential in making the most effective use of what technology can provide.
“These days, having access to new technologies and treatments is essential to provide enhanced or improved care to the community,” Zhao said. “But skill, knowledge and experience, collaboration and technology together are the keys to better outcomes and better quality of life for patients.”
Expertise and collaboration are especially important in cardiovascular care as most of the advanced treatments – especially those addressing structural heart conditions – require the participation of different specialists, including interventional cardiologists, electrophysiologists, heart surgeons, vascular surgeons and anesthesiologists.
“These are complex procedures that call for a lot of teamwork by people with varied skills and experience,” Zhao said.
That’s especially true with the cardiac procedure of last resort, transplantation. Wake Forest Baptist’s heart transplant program is not one of the largest in terms of volume, performing 12 a year, but it has a 100 percent success rate and is one of only eight heart programs in the country to receive the highest score awarded by the Scientific Registry of Transplant Recipients, a national database of organ transplantation statistics.
Initiatives aimed at preventing heart and vascular problems need to involve collaboration across multiple disciplines, Zhao said.
“There are so many factors that can contribute to cardiovascular disease that don’t specifically involve the heart,” he said. “And a lot of those vary greatly from person to person, so you have to look at this from many perspectives.”
That’s why the Heart and Vascular Center has teamed with Wake Forest Baptist’s Diabetes and Endocrinology Center and the Sticht Center for Healthy Aging and Alzheimer's Prevention to develop a program in cardiovascular, metabolic and brain health that will provide patients with individualized prevention and prediction models.
“We’ve joined together because the prevention part is shared by all three areas,” Zhao said. “What we do is collect and analyze a combination of information – genetics, blood tests, scans, body mass index, family history, lifestyle habits – and put it all in one package so we can say to the patient your risk of having a heart attack or developing diabetes in X number of years is X, and here’s what you can do to reduce that risk by X percentage. It is very individualized.”
There is a high-tech element to this type of personalized, or precision, medicine, and Zhao has no doubt that digital technology’s role in health care will only become even more extensive over time.
“Computers can already do many of the things that we do better and more quickly,” he said. “The cell phone and other devices will be much more involved in your health than they are now, and they can and will be programmed with personalized information.”
Specifically regarding cardiovascular care, Zhao believes that advances in imaging technology will have the most significant impact.
“Our imaging capabilities have improved greatly over the years, from still pictures to moving pictures to 3-D images, but cardiac imaging is making the transition from illustrating anatomy to showing functionality – what the heart looks like when it’s working,” he said. “This completely changes how we can use images to assess, guide and monitor treatments, and as the technology evolves it will revolutionize how we diagnose, treat and prevent diseases.”
But Zhao will most likely keep his stethoscope on hand when seeing patients.
“It’s still useful,” he said. “You can hear things with it. And it puts you in physical contact with the patient, and that type of direct connection is still very important.”