When he was a cardiology fellow, Gaurang Vaidya, MD, faced a persistent question while providing care for heart failure patients – how much extra water is in the patient’s body?
The answer to that question is important in determining treatment at bedside, but the standard procedure for measuring the extra water volume is either invasive or requires dedicated training in using imaging tools.
Dr. Vaidya is now an assistant professor of medicine at the University of Kentucky College of Medicine. With guidance and support from the Myocardial Recovery Alliance (MYRA) – and its principal investigators Emma Birks, MD, PhD, and Ken Campbell, PhD – he recently conducted a pilot trial to test an easier alternative: a portable ultrasound.
The results were promising, and they garnered national attention.
“Many people see the utility of being able to do a bedside assessment of a patient’s volume status using an ultrasound without requiring an invasive means of putting a catheter through their vein into the heart to measure pressure,” Dr. Vaidya said. “They see the simplicity and how this can advance patient care.”
Dr. Vaidya’s clinical trial tested the accuracy of using a portable ultrasound to measure a patient’s right atrial pressure and determine whether that patient has excess water and is congested. For a typical patient who undergoes a vein assessment, an ultrasound would show the vein collapsing during inhalation and expansion during exhalation. For a patient who is congested, that vein remains similar in diameter throughout respiration.
Dr. Vaidya used an iPad connected to the ultrasound, which allowed for a portable assessment at the patient’s bedside, and in less than five minutes. The clinical trial examined patients who were scheduled to undergo right heart catheterization, allowing researchers to compare results and test the accuracy of ultrasound with direct invasive parameters.
Study results were presented at the American College of Cardiology, and the abstract was selected among the top of those submitted at the American Society of Echocardiography. Dr. Vaidya is working with the UK Center for Clinical and Translational Science (CCTS) to potentially expand the trial to additional institutions.
“This is a big deal because Dr. Vaidya’s ultrasound technique has the potential to lower financial costs, as well as make it safer for the patients and better for their care,” said Dr. Campbell, professor of medicine. “All of these factors are really important.”
Dr. Vaidya credits much of his success to his mentors. When Dr. Vaidya was training in Louisville, Dr. Birks was program director for advanced heart failure patient care – and a “major reason” why he decided to pursue his clinical specialty. “She realized my potential right when I was a cardiology fellow,” Dr. Vaidya said. “She opened the doors for the kind of career that I have right now.”
When Dr. Birks took her position at UK, she not only put in a good word for Dr. Vaidya to join the faculty, but also connected him to the UK College of Medicine’s Alliance Research Initiative and MYRA.
“Dr. Vaidya has demonstrated exceptional skill in his field and an unwavering commitment toward improving heart health for his patients,” Dr. Birks said. “Early into his career, he has already made a tremendous impact.
Meanwhile, Dr. Campbell, a new mentor Dr. Vaidya met at UK, has connected him to faculty around the world who share his research interests. Both mentors have provided opportunities for Dr. Vaidya to present his work and attend national and international conferences.
Through his experiences, Dr. Vaidya, a clinician and clinical researcher at heart, has developed a passion for scientific discovery and how his work can find solutions that go from the bench to the bedside. To him, it is a natural evolution.
“I don’t think I went into my career thinking that I would be involved in cross-sectional research,” Dr. Vaidya said, “but I knew that the answers to my curiosity can only be answered through translational research."
MAY 25, 2023
MAY 24, 2023