HOC Faculty On the Hot Seat: Part 1
Welcome back to MedscapeLIVE! Cardiology E-News. This issue we tap into Medscape Going Back to the Heart of Cardiology thought leaders, who candidly weigh in on:
- Most critical new advance
- Most controversial new treatment option
- Most reliable treatment
- Most important thing they tell cardiology mentees
- Topic they’d like to see addressed at the 2026 HOC
- Best recent advance in chronic heart failure therapies, and
- Critical new cardiology-related advance they’ve recently adopted into practice
Make sure to also check out this issue’s Pulse, with articles from the Journal of the American Heart Association, Circulation, European Heart Journal, Journal of the American College of Cardiology, Cardiology News, and New England Journal of Medicine.
Thank you to these doctors for sharing their time and expertise. Don’t forget to register for Medscape’s Going Back to the Heart of Cardiology. And Part 2 of The Hot Seat will be published and sent to you next quarter. Please contact me at colleen@cmhadvisors.com with any comments and/or suggestions! –Colleen Hutchinson
Check out some highlights for the 2026 Going Back to the Heart of Cardiology!
Going Back to the Heart of Cardiology Fellow Program - Applications Now Available
We are inviting cardiology fellows from US programs to participate and attend the 6th Annual Going Back to the Heart of Cardiology, January 30-February 1, 2026, at the Fontainebleau Miami Beach. Through the Fellow Program MedscapeLIVE! will provide a complimentary registration to the conference, meals as indicated on the program agenda and cover up to three (3) nights hotel stay at Fontainebleau Miami Beach. Click here for more information.
HOC Faculty On the Hot Seat
Participant faculty bios can be found by clicking here!
Most critical new advance in my area of cardiology treatment:
Dr. Belardo: GLP-1 receptor agonists and dual GIP/GLP-1 agonists for cardiometabolic risk.
Dr. Butler: SGLT2 inhibitors and GLP-1RA.
Dr. Masri: MAPLE-HCM phase III trial showing that metoprolol is harmful as a first-line monotherapy in patients with obstructive hypertrophic cardiomyopathy (HCM), where it led to reduction in exercise capacity and an increase in natriuretic peptide tests (NT) proBNP, among other things.
Dr. Kittleson: For amyloidosis: acoramidis and vutrisiran; for HCM: mavacamten and aficamten; and for heart failure with preserved ejection fraction (HFpEF): GLP-1R/GIP agonists.
Dr. Morris: Rapid evolution in drug delivery technology and evolving lipid therapeutics.
Dr. O’Donoghue: I am most excited about the lipoprotein a (Lp(a))-lowering therapeutics that are in development! They are remarkably effective at lowering Lp(a). We should be hearing results from phase 3 testing next year!
Dr. Garshick: The use of IL-1 inhibitors for the treatment of pericarditis. (My practice mainly consists of patients with an underlying inflammatory or autoimmune condition.)
Dr. Brown: My area is clinical lipidology, so I am excited about the FDA approval for olezarsen for the rare but previously difficult to treat familial chylomicronemia syndrome (FCS), with a second agent, plozasiran, being reviewed now by FDA. I am also excited to see the outcome trials for Lp(a) lowering therapies. We should see the first outcome trial for pelacarsen that lowers Lp(a) about 80% in February of 2026, which, if effective, will be a game changer in prevention.
Critical new cardiology-related advance I’ve recently adopted into practice:
Dr. Masri: GLP-1 agonists.
Dr. Kittleson: Vutrisran for ATTRv-CM if neuropathy.
Dr. Belardo: Semaglutide 2.4 mg GLP-1 RA to reduce major adverse cardiovascular events (MACE) in adults with BMI ≥27 and established atherosclerotic cardiovascular disease (ASCVD), without diabetes (SELECT Trial).
Dr. Morris: ApoC3 inhibition for familial chylomicronemia syndrome/severe hypertriglyceridemia to reduce the risk of pancreatitis.
Dr. O’Donoghue: Slowly but surely, I’m learning how AI tools can help me in clinical practice.
Dr. Garshick: Exercise stress-PET with flurpiridaz.
Dr. Butler: More focus on prevention.
Dr. Brown: Use of olezarsen, early a-fib ablation, and arrhythmia-detecting portable sleep apnea testing devices.
Most important thing I tell cardiology mentees:
Dr. Masri: To develop a patient-centered practice and dive deep into the data behind drugs or devices used in that practice.
Dr. Kittleson: Before you order a test, have a plan for a positive, indeterminate, or negative result—or else don't order it!
Dr. Belardo: Always anchor decisions in guidelines and high-quality evidence.
Dr. Morris: Preventive cardiology careers will have the greatest impact on reducing morbidity and mortality from cardiovascular disease!
Dr. O’Donoghue: Don’t overcommit. Choose projects wisely and put everything you have into doing them well.
Dr. Garshick: Be reliable and don’t overpromise.
Dr. Butler: There has never been a better time to practice cardiology than today.
Dr. Brown: Remember that the way that you influence others has nothing to do with what they think of you, but everything to do with how they feel about themselves when in your presence!
Most reliable treatment in my clinical armamentarium:
Dr. Garshick: Statins.
Dr. Belardo: Statins.
Dr. Morris: Statins.
Dr. Masri: Diuretics, cardiac myosin inhibitors, daratumumab, and ATTR-CM targeted therapies.
Dr. Kittleson: Quadruple therapy for HFrEF.
Dr. Butler: SGLT2 inhibitors.
Dr. O’Donoghue: The beauty with lipid-lowering therapy is being able to show a patient how dramatically their LDL cholesterol has improved. It’s nice to show patients that what they are doing is working.
Topic I’d like to see addressed at the 2026 HOC:
Dr. Masri: Genetic cardiomyopathies, gene therapies, amyloidosis.
Dr. Kittleson: Sarcoidosis, myocarditis, and pericarditis.
Dr. Belardo: Cardiometabolic disease prevention—integrating obesity, diabetes, and CVD management.
Dr. Morris: Strategies for improved implementation of evidence-based guidelines.
Dr. O’Donoghue: Clinicians struggle so much with duration of DAPT. There are so many areas of controversy! It’s always a good topic to dive into.
Dr. Garshick: Cardiovascular kidney metabolic (CKM) syndrome.
Dr. Butler: Heart failure prevention.
Dr. Brown: Lp(a): Is it a modifiable risk factor?
Most controversial treatment option in cardiology medicine:
Dr. Masri: Digitoxin, iron infusions in heart failure.
Dr. Kittleson: LAAO.
Dr. Belardo: How to counsel male patients presenting on testosterone therapy who are at risk for or have ASCVD. The challenge lies in framing a truly evidence-based risk-benefit discussion: symptomatic improvements must be weighed against limited long-term cardiovascular safety data. Current RCTs show mixed findings, and longer outcome studies are needed to clarify ASCVD risk.
Dr. Morris: From the public health perspective—vaccines in CVD (not controversial for clinicians)
Dr. O’Donoghue: Use of beta blockers after myocardial infarction.
Dr. Garshick: Colchicine for the prevention of CVD.
Dr. Butler: Tricuspid valvular interventions.
Dr. Brown: Renal artery ablation and angioplasty.
Most critical advance(s) in chronic heart failure therapies (drugs to devices):
Dr. Masri: Targeting transthyretin amyloidosis as an underlying cause of heart failure, which opens the path for targeting specific underlying causes of heart failure.
Dr. Kittleson: Quadruple therapy for HFrEF, SGLT2i/MRA/GLP-1R/GIP agonists for HFpEF.
Dr. Belardo: Quadruple therapy (ARNI, MRA, SGLT2i, beta-blocker).
Dr. O’Donoghue: It’s been exciting to see effective therapies emerge over the past decade. I think the addition of SGLT2 inhibitors have been a game changer.
Dr. Garshick: SGLT2 inhibitors.
Dr. Butler: The power of combined quadruple therapy for HFrEF.
Dr. Brown: Use of SGLT-2 Inhibitors.
The Pulse
JACC Special Focus Issue: Cardiac Amyloidosis
Medical Intelligence Quiz: Coffee consumption and heart failure
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