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The Mary Clinckett Alumni Award, named after the Alumni's principal founder, is given annually for exceptional contributions by Heart Institute nursing, administrative, support, or volunteer personnel. The 2004 recipient is Christine Struthers, an Advance Practice Nurse currently with the Institute's Cardiac Telehealth program.  AGM highlight - Alumni Vice-president Gene Szabo presents nurse Christine Struthers with the Mary Clinckett Alumni Award. The award was presented at the 2005 Annual General Meeting in June. The following is the citation presented with the winner's nomination by her colleagues: "Please accept this letter as a nomination of Christine Struthers for the University Ottawa Heart Institute Alumni Award. A long-time, hard-working, innovative, Advance Practice Nurse, Christine has consistently demonstrated her clinical expertise and commitment to improving patient services throughout her 20 years at the Heart Institute." "The common thread of her work has been in ensuring the needs of patients and their families are met in numerous applications or roles. Christine built the Transplant and Heart Failure Programs and created patient support groups for both. Very recently, she has embraced the challenge of improving our role in Telehealth. She has, in four months, successfully obtained funding, built and rekindled relationships with 28 partner hospitals, and is developing our E-Health Centre." "Aside from her clinical expertise, Christine is always willing to go the extra mile. For many years she was the conduit between transplant patients, their families and the Heart Institute. She was always keenly aware of the sensitivities and needs of both. For many years Christine organized the Annual volleyball match between staff and organ recipients to generate awareness and interest in organ donation. Many Telethon stories or background interviews were founded on her guidance and expertise. Despite the challenge of live television, she has agreed to host an hour of the upcoming (2005) Telethon." "Christine has proven herself as a pioneer, being one of the first at the Heart Institute to achieve the Advanced Practice Nurse designation and the one who can be relied on to develop, create, refine and deliver any service or program put before her. Christine has always been an enthusiastic champion of our patients and also of the Heart Institute. She is an incredible role model and as such merits consideration for the award."
The Nineteenth Annual General Meeting on June 7 wrapped up another active year for your Alumni. While the AGM is an annual milestone for an organization, a special milestone was recognized - the retirement of Lynn Lanigan from active participation on the Alumni Board of Directors after many years of service, including six years as President and Past-President. On behalf of all the Alumni, I extend our very best wishes to Lynn as she adjusts to her reduced level of activity. Two other retiring directors were also thanked for their service - Gordon Noble and Sue German. Because she was close to the action as Manager of the Cardiac Reference Centre, Sue provided an important liaison with the Institute, coordinating the identification of needed equipment that met the Alumni's funding criteria. We welcome the new Directors - John Herzog, Ann Stolarik, and Lise Martens, who actually joined the Board in September and was confirmed at the AGM. Special thanks go to our two most recent speakers. Firstly, to Dr. Marino Labinaz for so clearly and comprehensively explaining the Ottawa Code STEMI project at the Spring Lecture. Dr. Labinaz certainly made it clear to me that if I think that I am having a heart attack, the best action to take is to call 911. Secondly, to Dr. Robert Roberts who, having agreed to speak at the AGM, found himself flying home from Los Angeles that afternoon. Dr. Roberts came directly from the Ottawa Airport to Capone's, arriving just as we were about to start the meeting. Following dinner, he gave an update on renovations and new and exciting plans and activities at the Heart Institute. Summaries of Dr. Labinaz's and Dr. Roberts' presentations are on other pages in this Bulletin. Upcoming events that you may wish to make note of:
by Hugh Spence I learned many things at the Heart Institute's rehab program after my cardiac crisis a few years ago, but one thing that really stuck with me was the statement: "We don't have a 'Drano' for the heart." The nurse lecturer was informing my class that there was no known medical potion that would unplug already clogged arteries; and we then went on to learn how diet and lifestyle changes could help things from getting any worse, artery-wise. It was with some amazement, then, that I learned at Dr. Robert Roberts' Alumni-sponsored lecture last fall that among the many medical miracles foreseen for heart care was a plaque clearing treatment for the coronary arteries. Indeed, according to Dr. Roberts, that and other genetics-based preventatives and cures would, in the very near future, eliminate heart disease altogether. Powerful stuff. Why any delay at all? The Pomaroli legacy Giovanni Pomaroli, born over 220 years ago, amazingly but quite naturally bequeathed to his decendants in the northern Italian village of Limone Sul Garda a genetic protection he had against cholesterol-related heart disease and stroke. Researchers in the 1980s found that the 38 residents of the little village had a significantly reduced level of heart disease, despite being at quite high risk (elevated triglyceride levels and very low HDL.) In studies at the University of Milan, it was discovered that these people all carried a unique form of "good" cholesterol, given the name ApoA-I Milano, that appeared to be unusually potent in stripping plaque from their arteries. Through bioengineering, an experimental drug was made from this special protein and tested on a group of heart patients in the U.S., with really promising results - an average of 4% reduction in artery wall plaque after just five weekly injections - and no side effects. This was what is called a "proof of concept" study, to be followed by many more clinical trials looking at such things as the optimal dosage. Estimates vary as to when the treatment might get U.S. FDA approval and become clinically available, the earliest being next year, the latest 2008. It is to be hoped that the drug then gets "fast tracked" by Canadian regulators if it is not already under evaluation here. I can hardly wait. What with my very effective statin pill every day, and a regular shot of the new cardio-draino, I might at least be able to cut out that disgusting ground flax seed!
Eric D. Breton
The 19th Annual General Meeting and dinner of the Ottawa Heart Institute Alumni was held at Capone's Restaurant on June 7, with guest speaker Dr. Robert Roberts, Institute president. Apart from Dr. Roberts' very informative talk on Institute developments since he assumed office just over a year ago, the highlight of the evening was the presentation of the annual Alumni awards. This year there were two winners of the prestigious Wilbert J. Keon Award for excellence among fellows and residents training at the Heart Institute; and one for the highly regarded Mary Clinckett Alumni Award for exceptional contributions by Institute nursing, administrative, support or volunteer personnel. Dr. Don Beanlands, Deputy Director General of the Institute, presented the initial Keon prize to Dr. Michael Froeschl, chief resident in the Division of Cardiology. Following this, Dr. Thierry Mesana, Chief of Cardiac Surgery, called upon Dr. Alexander Kulik, chief resident in the Division of Cardiac Surgery, to receive the second Keon award of the evening. The Mary Clinkett prize went to Christine Struthers, Advance Practice Nurse, Cardiac Telehealth program, and was presented by Alumni Vice-president Gene Szabo. The only special business to be dealt with at the meeting was a vote to dissolve the Wilbert J. Keon fund, effectively freeing up the accumulated capital for other purposes in support of the Heart Institute. On the retirement of directors Lynn Lanigan, a past president, Gordon Noble, and Sue German, R.N., two new directors were elected to the Alumni board: retired management consultant John Herzog; and Anne Stolarik, Advance Practice Nurse in the Institute's Cardiac Surgery Division. Award winners  
At the 2005 Alumni Annual General Meeting, Dr. Robert Roberts, President and Chief Executive Officer of the University of Ottawa Heart Institute, presented an update on renovations and new initiatives at the Institute. The following is a summary of his speaking notes. [Summary contributed by Alumni President Denny Doucette]
Reference Centre Project: Electrophysiology Laboratory - using the first electrophysiology mapping equipment in Canada, a computer precisely guides the catheter through the arteries (equipment and renovations $4.8 million); completion June 2005. Regional Referral Centre - the triage information and communications focal point for cardiovascular care for the region. Includes the day unit, ambulatory care and a 20-room outpatient facility, a chest xray facility and a 10-bed coronary care unit ($18 million); completion September 2005. Existing Cardiac Catheterization Laboratory, replacement equipment ($1.9 million); completion September 2005. Proposals for funding: A Fast CT, which is an acceptable alternative to catheterization for diagnosis of chest pain, screening for atypical chest pain, preoperative coronary assessment for noncoronary and non-cardiac cases, post-operative assessment of bypass grafts, and diagnosis and prevention of heart disease. Advantages include: procedure time of 15 minutes performed on an out-patient basis; non-invasive procedure reducing risk to the patient; no postprocedure monitoring is required and the patient can return to the referral centre within hours; decreased hospitalization; and with a potential of 4,000 procedures a year, a reduction in the wait list. (construction and equipment estimate $3 million). Research update: A Research Committee, chaired by Dr. Ruth McPherson, has been established; the first endowed fellowship allocation was made, setting up the Cardiology Research Fellowship for $1 million; research space has been allocated. Recent recruitment: Biostatistician Team - Dr. George Wells, PhD, three PhD research assistants and an administrative assistant; Basic Science - Dr. Alex Stewart, PhD, University of Pittsburgh, and Dr. Patrick Burgon, PhD, Harvard University. Core Pathology Laboratory, Wet Research Laboratory space ($749,000); completed. An Animal Positron Laboratory has been established, for which the only positron camera dedicated to cardiac research was purchased ($500,000). For the core pathology facility, a confocal microscope that can obtain high resolution images and 3-D resolutions beneficial to both clinical and research was purchased ($417,000). In addition to the Cardiology Research Fellowship, these future investments in research and education have been made: Art for the Heart Dr. Roberts closed his presentation with a series of charts showing the current and forecast demands on the Heart Institute that are behind the drive for the upgrade and expansion of facilities:
by Dr. Marino Labinaz The very informative lecture on STEMI was one in a continuing series sponsored by the Alumni. It was held in the Foustanellas Auditorium, April 26. Dr. Labinaz opened his presentation with a few definitions and an explanation of the particular heart attack (myocardial infarction) that is called a "STEMI". This short form is an acronym for ST segment Elevation Myocardial Infarction. It is identified on an electrocardiogram (ECG) as elevation of the "ST segment" (a particular blip on the trace,) which indicates an arterial blockage that can result in severe damage to the heart muscle (myocardium) if blood flow is not restored fairly soon after the onset of pain. Reperfusion, (restoring blood flow,) the salvaging of as much of the myocardium as possible and the restoration of the contractile function of the heart chambers, is best achieved by PCI (Percutaneous Coronary Intervention,) commonly known as angioplasty. This is the mechanical enlargement of a narrowed coronary artery, generally involving the insertion of a stent. Drugs that dissolve clot in blood vessels (fibrinolytics, also known as clot-busters or "lytics",) can also be used for reperfusion but they are not as effective as PCI. When a STEMI is diagnosed, the objective is to restore heart function as quickly and as fully as possible. The goal is to achieve reperfusion within 60 to 90 minutes to minimize heart muscle damage. While this is the optimal time, beneficial results can result up to 12 hours after the onset of symptoms. Primary PCI, i.e., immediately performing a PCI, is the best treatment of a STEMI. When the patient cannot be taken to a catheterization laboratory quickly enough, lytics will be administered. The application of lytics prior to a planned PCI is known as a facilitated PCI. To bring persons experiencing STEMI to the Heart Institute so that a primary PCI can be done with minimum delay, the Ottawa Code STEMI program was set up. When paramedics respond to a 911 call and find a person experiencing severe chest pain, an ECG is taken on the spot. If a STEMI is diagnosed, the paramedics notify the Heart Institute and give an estimate of the time of arrival. A "Code STEMI" is broadcast on the intercom to alert the staff. The paramedics take the patient directly to the catheterization lab where a team is waiting. In off hours, the Communications Centre notifies the on-call interventional cardiologist and cath lab team. Dr. Labinaz described the coordination among the various organizations in Ottawa and praised the willingness of the practitioners to participate, all of which was essential if Code STEMI was to be a success. First, hospitals in the City of Ottawa agreed that the paramedics, having diagnosed a STEMI, could go directly to the Heart Institute, rather than to the nearest ER, as required by Ontario regulations. Emergency Medical Services (EMS) supported the training of paramedics to use ECGs to diagnose a STEMI. Finally, to make Code STEMI available on a 24-hour, seven-days-a-week basis, interventionists and the cath lab teams agreed to be on call. The evolution of treatment of heart attack patients since the development of coronary care units in the 1970s, and the introduction of clot-busters reduced the mortality rate in the 30 days following an incident from about 25%, to 8-10%. Now, with PCI, the 30-day mortality rate is 2-3%. When the patient can be transported to the Heart Institute within 60 to 90 minutes of onset, primary PCI is the optimum treatment. Within the city, the rapid response of the paramedics has been a significant factor in achieving the timing targets. (Incidentally, a 911 call is strongly recommended rather than self-transport to a hospital ER because of direct transport to the Heart Institute when a STEMI is diagnosed.) The median time intervals for Code STEMI were:
A study conducted at the Ottawa Heart Institute, the CAPITALAMI, concluded that:
The success in implementing the Heart Institute's STEMI program has been due to the methodical approach taken. Dr. Labinaz noted that Primary PCI was implemented for:
He sees the challenge in the region being:
Dr. Labinaz's recommended state for STEMI-related cardiac care:
[The foregoing was prepared by Alumni President Denny Doucette, and reviewed in draft by Dr. Labinaz.]
The Ottawa Heart Institute Alumni Inc. presents a free lecture "Genetic Risk Factors for Coronary Heart Disease"
Please call 761-4370 soon, to indicate your wish to attend this popular lecture as seating is limited.
The Bulletin is published in Ottawa by the Ottawa Heart Institute Alumni Inc., a not-for-profit corporation located at 40 Ruskin Street. It is distributed free to members of the Ottawa Heart Institute Alumni and contains information on health and other matters of interest to members. Contents do not necessarily reflect the opinion of the Board of Directors nor does the Ottawa Heart Institute Alumni Inc. nor the producers nor the printers and distributors of the publication assume any responsibility for opinions expressed. All communications and contributions should be sent to the address below. PUBLICATIONS MAIL AGREEMENT NO. 40045889 RETURN UNDELIVERABLE CANADIAN ADDRESSES TO: Bulletin Editor email: alumni@ottawaheart.ca Editor: Hugh J.M. Spence Contents are copyrighted and may not be reproduced without permission. The Bulletin is intended for general information only and is not a substitute for medical advice or treatment for specific conditions. You should seek medical advice for any specific health issues and consult your physician before starting a new fitness regime.
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