Atrial fibrillation, or AFib, is a condition in which the heart’s upper chambers beat irregularly, often causing a rapid heartbeat. Some people with AFib also experience chest discomfort, shortness of breath or heart palpitations. Others may notice only mild fatigue during activity. And still others may feel no symptoms at all. AFib also increases the risk of stroke.

“That’s why it’s especially important to carefully manage AFib in the summer, when people may spend more time in the sun, lose fluids through sweating, and drink more alcohol on vacation, at barbecues and at other outdoor social gatherings,” said Archana Ramireddy, MD, a clinical electrophysiologist in the Smidt Heart Institute. “Older adults are especially affected by the heat, even if it may not seem obvious at first.”

In recognition of AFib Awareness Month in September—when Southern California often experiences some of its hottest weather—the Cedars-Sinai Newsroom spoke with Ramireddy about steps people with AFib can take to stay healthy.

What summer factors can trigger an AFib episode?

Hot weather can put added stress on the heart, but heat itself isn’t necessarily the primary concern. Dehydration is of special concern because people lose fluids through sweating. Older adults may be particularly susceptible to heat-related dehydration because the body’s ability to conserve fluids and regulate temperature can decline with age. Alcohol is another concern because it is a well-recognized trigger for AFib, and people tend to drink more during the summer while vacationing, spending time outdoors and attending social gatherings.

Should people with AFib drink plain water to stay hydrated, or do they need electrolytes?

Plain water is usually the best choice. Electrolyte drinks may be helpful in some circumstances, although individual needs vary based on heat exposure, activity level, how much a person has been sweating, and underlying health conditions.

What are the signs of dehydration?

Signs of dehydration can include dark urine, dizziness, dry mouth, fatigue, confusion and a rapid heartbeat. If symptoms are prolonged or severe, or if a person also is experiencing chest discomfort or shortness of breath, they should seek medical attention.

Is coffee off-limits for people with AFib?

One cup of coffee a day generally isn’t a concern. Even two cups may be acceptable, although for some patients I recommend switching extra servings to decaf or half-caf. It’s most important that people pay attention to their own bodies. If caffeine consistently triggers symptoms, cutting back is recommended. I’m far more concerned about the consumption of multiple energy drinks, because high doses of caffeine and other ingredients in these drinks can increase the risk of arrhythmias.

Is it safe for people with AFib to exercise in the summer?

I encourage regular exercise for my patients with AFib. If physical activity consistently triggers episodes, the underlying AFib should be evaluated and treated rather than simply avoiding exercise. That said, it’s best to avoid strenuous exercise during the hottest part of the day and to stay well-hydrated if outside in the heat. To combat overheating, seek air conditioning, drink plenty of water, take a cool shower or use cool towels.

What if a person thinks they may have AFib?

If a person has heart palpitations and isn’t sure what is causing them, capturing an episode can be key for diagnosis and treatment. This is where wearable devices, such as smartwatches, can play a role. If a device can record an ECG, or electrocardiogram, during an episode, a physician can review the tracing to determine whether it is consistent with AFib. Wearable devices have helped us identify more patients sooner, allowing us to begin treatment sooner. Preventing stroke is a major goal of AFib treatment. People who have been diagnosed with AFib should work with their healthcare team to determine whether further evaluation by a cardiac electrophysiologist is appropriate.

Read more from Cedars-Sinai Stories and Insights: Atrial Fibrillation—Know the Warning Signs

The multi-institutional study offers one of the clearest pictures of what happens during the earliest stages of disease. The findings could help researchers develop new ways to detect and prevent heart disease before plaque builds up inside arteries.

“We analyzed proteins and gene activity in coronary artery tissue from young adults who died of trauma and had no known coronary artery disease, and we found that more than half already had preclinical atherosclerosis,” said study first author Sarah Parker, PhD, an associate professor of Cardiology and Biomedical Sciences and co-director of the Proteomics and Metabolomics Core at Cedars-Sinai Health Sciences University. “This suggests that changes in cellular metabolism and communication begin before the inflammation long considered a hallmark of the disease.”

Published in the European Heart Journal, the study findings point to previously unrecognized molecular pathways—and a potential “master regulator” called MLXIPL—that could become targets for therapies aimed at preventing plaque from developing.

The Cedars-Sinai Newsroom spoke with Parker about the findings and how proteomics—the study of proteins—is helping researchers rethink the earliest stages of heart disease.

Why are proteins so important in understanding heart disease?

Proteins are the molecules that make cells function. They tell us how the body’s cells are responding to risk factors like cholesterol, blood pressure or smoking. Two people can have identical cholesterol levels, yet only one develops plaque. Proteins may help explain why. They provide a much more direct picture of what's happening inside the artery wall and may reveal why some people are more vulnerable to heart disease than others.

What did this most recent study reveal about the earliest stages of atherosclerosis?

Previous studies had shown that the earliest artery lesions can appear in the first decade of life. What we haven’t understood is what causes those early changes to progress into dangerous plaques that lead to heart attacks. In studying coronary artery tissue before people ever developed symptoms, we were able to capture some of the earliest molecular changes that appear to set the disease in motion. One of the biggest surprises was that we saw changes in cellular metabolism and communication before we saw the classic inflammatory signals traditionally associated with atherosclerosis.

To be clear, inflammation remains a defining feature of advanced atherosclerosis. What our study suggests is that important molecular changes begin much earlier. If we want to prevent plaque from forming, we need to understand those earliest changes—not just what happens after inflammation has already taken hold.

Explain MLXIPL, the potential ‘master regulator’ you identified.

We performed a master regulator analysis to identify the genes that may be coordinating these early events. Some of the regulators we found were exactly what we expected. But one stood out. MLXIPL is a transcription factor gene involved in cellular metabolism. Previous genetic studies have linked it to coronary artery disease through its role in the liver. Our findings suggest it may also play an important role directly within the artery wall. When we altered MLXIPL activity in lab-grown human artery tissue, we saw the protein changes we predicted. That makes it an exciting candidate for future therapies that interrupt disease before plaque develops.

How could these findings change atherosclerosis prevention?

Today, we estimate cardiovascular risk using factors such as high cholesterol, diabetes, smoking, age and family history. By the time plaque is visible on imaging, disease often is well underway. We hope to identify protein biomarkers in the blood that reveal what’s happening inside the artery wall much earlier. One day, a simple blood test could identify people who would benefit from preventive treatment before symptoms develop.

That said, our findings do not change current prevention recommendations. Managing cholesterol, blood pressure, diabetes, smoking, exercise and diet remain essential.

This study relied on a decades-long collaboration. Why was that essential?

This is a collaboration more than 20 years in the making. The project was spearheaded by proteomics pioneer Jennifer Van Eyk. (Van Eyk, PhD, is director of the Advanced Clinical Biosystems Research Institute in the Smidt Heart Institute at Cedars-Sinai and co-director of the Proteomics and Metabolomics Core.)

Our collaborators included investigators from many other institutions across the country. What began as a small group has grown into an ecosystem of investigators, trainees and collaborators. This kind of large-scale molecular study simply isn’t possible without that level of long-term partnership and shared expertise.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Under the new guidance, students in early education and kindergarten through first grade will have no weekly classroom screen time. Students in grades 2 and 3 will be limited to 1 hour and 40 minutes per week, with those in grades 4 and 5 limited to 2 1/2 hours, students in grades 6 through 8 limited to 6 hours per week, and high school students limited to 10 hours per week.

The limits include time spent on screen-based homework.

“Screen time is literally changing the trajectory of brain development. It’s growing the visual cortex at the expense of the areas responsible for language, reading and social skills,” said Jane Tavyev Asher, MD, pediatric neurologist and director of the Division of Pediatric Neurology at Cedars-Sinai Guerin Children’s. “Parents should actually be very delighted that their kids are going to have less screen time in the school setting, and they should view the school as working as their partner in helping with their child’s brain development.”

As the new policy takes effect this school year, the Cedars-Sinai Newsroom spoke with Tavyev Asher about why reducing screen time can benefit children’s brain development—and how parents can reinforce healthy screen habits at home.

Why were these new screen time policies needed?

Research continues to show that excessive screen time can affect how children’s brains grow and develop. During childhood, the brain is building important skills for language, reading, attention and social interaction. We want the brain to develop for reading, language and social skills. And screen time is really growing the visual cortex at the expense of all of the other parts of the brain.

Sharply reducing screen time at school can help create more opportunities for students to have active learning, conversation and deeper cognitive development in the long run.

Now that schools are seeing the neuroscience behind what screen time does to the developing brain, many are beginning to embrace this research and implement limits. They want what’s best for students’ brain development, just as parents do. At the end of the day, we’re all working toward the same goal: helping our children learn, grow and thrive.

Why is limiting screen time especially important during early childhood?

Early childhood is a critical period for learning to speak, read, write and develop social skills. During these years, the brain’s auditory and language centers are rapidly developing through conversation and human interaction.

For example, speech development begins around age 1, when children start learning how to speak. This process depends on the development of nerve signals and the continued growth of the auditory cortex, which develops significantly during the first few years of life. The auditory cortex is also the part that builds not just language but also social interaction.

Excessive screen use may interfere with these processes by overstimulating visual pathways while reducing opportunities for face-to-face communication, language development and recognizing social cues such as facial expressions and body language.

How can screen use affect brain development in middle schoolers?

Higher-level cognitive functions really begin to take off around age 12. This is when intellectual curiosity starts to develop. It’s a stage where children naturally begin making connections between ideas, such as reading one thing, connecting it to something else they’ve learned, asking questions, and wanting to find the answers. That’s exactly how we want their brains to develop.

But if everything is fed to them passively through AI or excessive screen-based learning, that part of the brain isn’t being exercised in the same way. They’re consuming information rather than actively thinking, questioning and making connections. It’s wonderful that our schools are finally coming to this realization and changing the way the curriculum is given to our children.

What screen time advice do you have for parents of high schoolers?

For a high schooler, I would try to keep the same guidelines in the home that you’ve done for the younger children. The reason for that is they still have that developing brain, and screen time is still very addictive.

I think at this age, they really do have the understanding as to why screens are not ideal for them. By the time they’re in high school, teenagers can understand the logic behind reducing screen time. This is the time when their intellect is developing. They can read the studies about it. As parents, this is also an ideal time to expose them to the studies that are showing what screen time addiction is doing to the brain in the long run.

How should parents approach smartphones for middle and high school students?

The smartphone is really the worst form of screen time because it is so easily accessible in the pocket. It’s easier to become addicted to that. So, it’s important to monitor how children access and use their smartphones.

There is so much social growth that happens in middle school. If you can just get the kids over that hump without a phone, then you can keep them from getting addicted to that phone.

There’s a program called “Wait Until 8th.” It’s a movement where parents sign a pledge to delay giving their child a smartphone until at least the end of eighth grade or until they’re 13 years old. When families make this commitment together, it creates a community where fewer kids have smartphones early on, which helps reduce the peer pressure to get one before they’re ready. It gives parents support in setting healthy boundaries and makes it easier for children to wait alongside their friends.

If you need to be in touch with your teenager, give them a simple flip phone that has no internet access. This way, they can call who they need to call. In some phones, you can also program who they call or receive calls from.

How can parents set and enforce screen time limits at home?

Parents have a huge influence on how children develop their relationship with screens. It’s much easier to not introduce screens than to set limits or take it away later in life. Instead of focusing only on taking screens away, parents can help children discover other activities, like reading, creative play, spending time outdoors and connecting as a family.

It’s important to point out that parents should model habits they hope to see by practicing healthy screen use themselves, since children are more likely to follow behaviors they observe at home.

Firstly, implement a no-screen-time rule at least two hours before bedtime. This will help kids avoid bright lights right before bed, promoting deeper sleep. Secondly, avoid screens during mealtime. Mealtime is a great time for the family to sit together and have conversations. There are so many positive studies about what family mealtime does for children’s social development and for their cognitive development.

Read more from Cedars-Sinai Stories and Insights: A Family Guide to Teens, Screens and Social Media

The designation from the condition’s oldest patient organization is awarded to programs with the infrastructure and experience needed to provide high-quality care to people with pulmonary hypertension, a type of high blood pressure that occurs in arteries of the lungs.

Pulmonary hypertension can make it difficult for blood to circulate through the lungs, forcing the heart to work harder. In severe cases, the condition can lead to heart failure. People with pulmonary hypertension often need care from several specialists.

The Cedars-Sinai Pulmonary Hypertension Clinic includes six physicians and one nurse practitioner. The pulmonary hypertension program combines cardiology and pulmonology, which allows patients to access multidisciplinary care from experts in the disease. Providers care for more than 250 patients each year and address multiple aspects of the disease, including diagnosis, medication management, symptom control and disease progression.

“At Cedars-Sinai, pulmonary hypertension specialists collaborate with colleagues in rheumatology, congenital heart disease, critical care medicine, lung transplantation and other specialties to create treatment plans tailored to patients,” said Yuri Matusov, MD, assistant professor of Medicine at Cedars-Sinai. “We are proud to care for an extraordinarily diverse patient population, some of whom come from very far away for their care.”

The association noted several outstanding aspects of the Cedars-Sinai Pulmonary Hypertension Clinic including:

• A team that collaborates and provides timely evaluation and management of people who are hospitalized and continues to provide consistent care when they leave the hospital.
• Monthly conferences with specialists in the Southern California region that allow for the review of complex pulmonary hypertension cases, knowledge-sharing and regional care coordination.
• For people with advanced disease, access to top-notch heart, lung and thoracic transplant programs.
• A research program led by doctors investigating potential treatments.

“We are honored for our clinic to have received this designation, the highest recognition available to pulmonary hypertension programs in the United States,” said Dael Geft, MD, assistant professor of Cardiology in the Smidt Heart Institute at Cedars-Sinai. “Ultimately, the greatest reward is helping our patients live longer, healthier and more fulfilling lives.”

Read more on the Cedars-Sinai Newsroom: Unique Cell-Based Approach for Pulmonary Arterial Hypertension Shown to Be Safe

Gilliam, 32, suffered sudden cardiac arrest, an electrical malfunction of the heart that causes it to abruptly stop beating. The odds were stacked against him: Sudden cardiac arrest kills about 90% of those who experience it outside of a hospital. Survival depended on a chain of people acting within minutes.

A fellow dancer immediately started CPR. Other dancers ran out of the dance studio in search of an automated external defibrillator (AED) and found one at a nearby dentist’s office. A speech pathologist who had just completed CPR recertification and happened to be nearby used the AED to revive Gilliam’s heartbeat.

Paramedics then rushed Gilliam to the Cedars-Sinai Emergency Department, where he had another cardiac arrest. Surgeons placed Gilliam on extracorporeal membrane oxygenation (ECMO), a form of advanced life support that temporarily took over the work of his heart, giving it time to recover—or, if necessary, bridging him to a transplant.

Cedars-Sinai experts say Gilliam’s case illustrates the importance of bystander CPR and quick medical response.

“The key to G’bari surviving sudden cardiac arrest was the fast-acting individuals who provided CPR, facilitated the use of an AED, and the Cedars-Sinai Emergency Department and cardiothoracic surgery teams who began ECMO within the hospital,” said Evan Kransdorf, MD, PhD, assistant professor of Cardiology in the Smidt Heart Institute and one member of Gilliam’s team of physicians and surgeons.

During cardiac arrest, blood stops circulating, explained Pedro Catarino, MD, a cardiothoracic surgeon in the Smidt Heart Institute at Cedars-Sinai.

“The cells of the body, particularly the brain, will die within a few minutes without circulation,” Catarino said. “Gilliam’s heart was in and out of a rhythm that doesn’t sustain circulation, so the surgery team put him on emergency life support.”

Gilliam’s heart had ceased working, so he was listed in the organ donation system. After 12 days on life support, Gilliam received the news every transplant candidate hopes for: A donor heart had become available.

“Heart transplantation offers a new chance at life for patients like Gilliam,” Catarino said. “Gilliam is an athlete and can look forward to going back to his career with a heart that has a long lifespan.”

A pathology report showed Gilliam had a severe form of hypertrophic cardiomyopathy, an inherited condition that causes the heart muscle to thicken so that the heart cannot contract and pump blood properly. The condition likely caused Gilliam’s sudden cardiac arrest, his medical experts say.

“Many people with hypertrophic cardiomyopathy don’t have symptoms, and athletes who are used to pushing themselves to be out of breath might not realize they have it,” Kransdorf said.

Geneticists in the Smidt Heart Institute tested samples of Gilliam’s heart and found that he had a genetic variant associated with hypertrophic cardiomyopathy. Experts encourage anyone with a family history to be screened for the condition, which affects about 1 in 500 people. Gilliam’s close family members are undergoing genetic testing.

Gilliam, whose credits include performing with Bad Bunny and on Jimmy Kimmel Live!, is now in physical therapy and preparing to return to dance.

“With dancing, it feels like I'm able to be my most authentic self and be the most vulnerable version of myself. It makes me feel alive,” he said.

Prior to his medical emergency, Gilliam’s schedule consisted of dance classes and gym training five days a week. He hopes to return to intense days and to continue teaching dance to elementary school students and choreographing dancers on TV and film sets. His mother and girlfriend are supporting him, as are many friends, family members and fellow dancers.

“What I learned from this experience is everyone should be trained in CPR because you never know what's going to happen,” Gilliam said. “Even more so, be a person of service. If you have the opportunity to help someone, do it.”

Read more from Cedars-Sinai Stories and Insights—Sudden Cardiac Arrest: Genetic Cause More Common in Younger People

A new study led by Karlstaedt and published in Circulation reports that a specific enzyme plays an important role in keeping the heart beating. The discovery could help scientists create drugs that mimic the enzyme’s role and help people with heart failure, a condition in which the heart becomes too weak to pump blood properly.  

Karlstaedt, assistant professor of Cardiology in the Smidt Heart Institute at Cedars-Sinai, has spent more than a decade studying heart metabolism—the chemical process that powers the heart. She spoke with the Cedars-Sinai Newsroom about her dedication to uncovering treatments for the millions diagnosed with heart failure every year.

How is the heart’s metabolism different from the metabolism of other parts of the body?

There are thousands of tiny molecules called metabolites—including amino acids, glucose and fatty acids—that act as an energy source to help cells function properly. The heart is the only organ that can use almost any metabolite.

The heart is also unique because it never stops beating. It's not like other muscles, which can rest. Fueling heart cells requires fine-tuned, organized chemical reactions. The system functions perfectly until something disrupts it, and metabolism is at its center. 

What was one of the major discoveries that led to your current work? 

My colleagues and I published a study in 2016 in which we discovered that the heart uses unusual fuel-processing routes to adapt to metabolites released by cancer cells. It’s like in a city where you have streets and traffic moves along those streets. If a construction site suddenly blocks a street, traffic finds another way around. The heart does the same thing.

We also found that in response to cancer-related metabolic stress, the heart suddenly started using an unusual enzyme called ATP-dependent citrate lyase, or ACL. This enzyme drives the process that creates fatty acids, something we didn’t think happened in heart cells. But when we blocked ACL, the heart could not pump well. That told us this enzyme might be much more important for the heart than previously thought.

Could you describe your recent discovery?

We found that when ACL slows down, heart function drops. To make this discovery, we studied heart tissue samples from people with healthy hearts and people with failing hearts. We also observed ACL in the hearts of laboratory mice. When ACL activity decreased, meaning it no longer efficiently produced fatty acids, the heart tried to adapt by taking up more sugar and rewiring parts of its metabolism. But those changes did not fully protect the heart. Instead, the heart had less available energy and did not pump as well.

To dig deeper, we used CardioNet, our computational model of heart metabolism. The model pinpointed another enzyme, IDH1, that compensates for the loss of ACL. When we reduced IDH1 in our model, the heart could pump better. We're now studying whether future heart failure therapies could target IDH1.

What do you hope to accomplish as this work progresses?

Heart failure can look similar from one patient to another, but the underlying metabolic changes may be different. We hope to use our computational model to predict which fuel pathways are disrupted in people with heart failure and which treatments can get the heart working better. We are not there yet, but this study is an important step toward understanding heart failure as a disease of both mechanics and metabolism.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

“The majority of people who have a sudden cardiac arrest outside of a hospital will die, so the best protection is being aware of risk,” said Kyndaron Reinier, PhD, MPH, associate director of Epidemiology in the Center for Cardiac Arrest Prevention in the Smidt Heart Institute at Cedars-Sinai and an author of both studies. 

Sudden cardiac arrest happens when a problem with the heart’s electrical system causes the heart to stop beating. It is different from a heart attack, which is caused by a lack of blood flow to the heart. More than 350,000 people experience sudden cardiac arrest outside of a hospital in the U.S. each year, and only about 10% survive. 

Experts know that people with low left ventricular ejection fraction, when the heart’s main pumping chamber is weak and pumps less than it should, are at higher risk for sudden cardiac arrest. But this marker has become less effective and other indicators are needed to capture more people at risk.

“More than two-thirds of people who have cardiac arrest don’t have low left ventricular ejection fraction, so using this marker alone misses too many people,” Reinier said. 

A study published in the journal Circulation: Arrhythmia and Electrophysiology reports that warning symptoms combined with clinical history could predict imminent sudden cardiac arrest. A second study, published in the Journal of the American Heart Association (JAHA), reports that having more than one cardiac event over time could signal rising risk. 

Reading Warning Symptoms

In the Circulation: Arrhythmia and Electrophysiology study, investigators used machine learning to identify combinations of symptoms and medical history that best predicted sudden cardiac arrest in the near future. 

The study included people enrolled in two separate, longstanding studies in Oregon and Ventura County, California, that were founded by Sumeet Chugh, MD, director of the Center for Cardiac Arrest Prevention in the Smidt Heart Institute. The investigators compared 364 people who called 911 when experiencing symptoms such as chest pain and survived sudden cardiac arrest, with 313 people who called 911 for similar symptoms but did not experience sudden cardiac arrest. 

The analysis found that people with sudden cardiac arrest were more likely to have a combination of shortness of breath and diagnosed coronary artery disease or heart failure than people who did not experience sudden cardiac arrest. Seizure-like symptoms without chest pain or shortness of breath were also more common in people who experienced sudden cardiac arrest.

The investigators also found that chest pain combined with coronary artery disease predicted imminent arrest in women, while chest pain combined with heart failure predicted it in men. 

Warning symptoms most often occurred at least 15 minutes prior to the sudden cardiac arrest, a time frame that would make it possible to call 911. In earlier research, the investigators found that 81% of people delayed their 911 call, reducing their chances of successful revival by ambulance paramedics. 

These findings could be used to create risk-predicting algorithms for use by urgent care and emergency medicine providers, the investigators said. “While more research is needed, such risk prediction algorithms have the potential to avoid 911 call delays following warning symptoms of sudden cardiac arrest,” said Chugh, vice dean and chief AI health research officer at Cedars-Sinai.

Tracking Risk Over Time

The JAHA study was carried out in the Observational Study of Cardiac Arrest Risk (O.S.C.A.R.) cohort at Cedars-Sinai, established by Chugh, that has been tracking the health of approximately 400,000 residents of Los Angeles County from 2017 onward. Of these, the investigators followed more than 6,700 people hospitalized at Cedars-Sinai for heart failure and more than 2,900 people hospitalized in the health system for acute coronary syndrome, when an artery blockage reduces blood flow to the heart. 

Investigators found that patients in both groups who experienced a recurrent cardiovascular event faced a higher risk of sudden cardiac arrest. 

Patients who had a second coronary artery blockage were more than three times as likely to experience sudden cardiac arrest as those without a recurrence. Patients who were hospitalized a second time for heart failure were nearly twice as likely to experience sudden cardiac arrest. Risk climbed with each additional heart failure hospitalization. The investigators compared the findings to what was found in participants of the Framingham Heart Study, which enrolled participants about 50 years earlier. The results were similar, however the heart failure result in that study did not reach statistical significance.

Reinier said that physicians should consider sudden cardiac arrest as being more likely when a patient is hospitalized for a heart issue a second time.

“This may mean running additional tests,” Reinier said. “It may mean educating the patient about what cardiac arrest is and the importance of having a family member who knows to call 911 and start CPR immediately if their loved one collapses.”

Moving Beyond Dead Ends

Chugh, senior author of both studies, said the combined findings point toward a more flexible approach to prediction.

“Near-term and long-term predictions are parallel approaches that can help us move past roadblocks we face in preventing death from this lethal heart event,” Chugh said.

Additional research, including studies in different populations, are needed to confirm whether the factors the investigators studied could be used in prediction tools, study authors said. 

Cedars-Sinai investigators continue to study predictors of sudden cardiac arrest, and their work includes using AI to study patterns in heart tests called electrocardiograms and looking for genetic causes. 

Additional Cedars-Sinai authors in the Circulation: Arrhythmia and Electrophysiologystudy include Harpriya Chugh, BS; Vishnu Kadiyala, MD; Arayik Sargsyan, MPH; Audrey Uy-Evanado, MD; Kotoka Nakamura, PhD; Elizabeth Heckard, MS; Marco Mathias, BS.

Other authors include Tristan Grogan, MS; David Elashoff, PhD; Angelo Salvucci, MD; and Jonathan Jui, MD, MPH.

Funding: Dr. Chugh was funded by the National Heart Lung and Blood Institute, National Institutes of Health.

Additional Cedars-Sinai authors in the Journal of the American Heart Association study include Marita Knudsen Pope, MD, PhD; Harpriya Chugh, BS, MSHS; Thien Tan Tri Tai Truyen, MD; Marco Mathias, BS; and Audrey Uy-Evanado, MD.

Other authors include Honghuang Lin, PhD; Dan Atar, MD, Nichole Bosson, MD, MPH, and Emelia J. Benjamin, MD, ScM

Funding: The Framingham Heart Study is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health. Dr. Benjamin is partially funded by The National Heart, Lung, and Blood Institute, National Institutes of Health.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

But one of the unwanted consequences of spending lots of time in the water is ear infections, commonly known as swimmer’s ear. The Cedars-Sinai Newsroom spoke to Abhita Reddy, MD, a pediatric otolaryngologist and head and neck surgeon at Cedars-Sinai Guerin Children’s, about what causes swimmer’s ear, how parents can protect their children, and how physicians diagnose and treat the condition.

What is swimmer’s ear?

Swimmer’s ear, properly known as otitis externa, is an infection of the ear canal where you often have drainage. You can have fluid sitting in the ear canal. Sometimes it looks like fluffy tissue that drains. It can cause discomfort and can also cause hearing impairment if left untreated.

What causes swimmer’s ear?

Swimmer’s ear occurs most commonly in the summertime when people are swimming in contaminated water like lakes or rivers, even sometimes in the ocean. We also see it a lot when people go surfing or do water sports, or when kids are going under water frequently or diving deep. Swimming in chlorinated or saltwater pools is less likely to cause swimmer’s ear.

How do you know if your child has swimmer’s ear?

Parents usually know when their child is getting an external infection like swimmer’s ear when they see drainage coming out of the ear, not something brown that looks like wax, but oftentimes it’s white or yellow, and it can smell bad. Swimmer’s ear is often associated with children having pain in their ear, and sometimes it can be associated with small children not letting you touch their ear, so if you tug at their ear or pull their ear it hurts a lot.

How does swimmer’s ear differ from other ear infections?

The biggest difference between a middle ear infection, known as otitis media, versus an outer ear infection, known as otitis externa, or swimmer’s ear, is that middle ear infections, which are behind the eardrum, do not have drainage coming out unless your child has ear tubes. Usually when children have middle ear infections they tug or pull at their ears, which makes it feel better. They also may develop a fever. The opposite is true with swimmer’s ear, or otitis externa, which hurts when you tug on the ear.

How are these infections treated?

Swimmer’s ear is often treated with ear drops because it’s very easy for the drops to get to the area where the infection is. With middle ear infections we often must treat it with antibiotics because unless you have ear tubes, it’s very hard for the drops to reach the infected area.

How can you prevent swimmer’s ear?

When parents ask me how to prevent their kids from getting swimmer’s ear, it often has nothing to do with swimming at all. I just tell them not to use cotton swabs such as Q-tips in their kids’ ears. When you use Q-tips in your children’s ear, it can offset the pH balance inside the ear canal, or cause small breaks in the canal skin, which can then increase the risk of getting ear infections. It is also helpful to consider using earplugs or swim caps for children. Parents can also try to dry the ear if the ear is very wet after a swim. Parents can use a hair dryer around a shoulder length away from their child’s ear on the lowest setting for about 10 seconds at a time, and that can dry out the ear canal and help prevent swimmer’s ear.

Read more from Cedars-Sinai Stories and Insights: How to Treat Sleep Apnea in Children

Shehata is a cardiac electrophysiologist, a doctor who specializes in diagnosing and treating problems with the heart’s electrical system. He has experience with a broad spectrum of heart rhythm disorders and also cares for people with heart failure and survivors of cardiac arrest.

“Over the past two decades, Dr. Shehata has emerged as a nationally recognized cardiac electrophysiologist and academic leader,” said Susan Cheng, MD, MMSc, MPH, chair of the Department of Cardiology in the Smidt Heart Institute. “His leadership will mean continued progress in this important field.”

As a researcher, Shehata has led groundbreaking clinical trials for new types of pacemakers and other technologies for treating heart rhythm disorders. He also studies ways that AI can be used to personalize care.

Shehata’s most recent research includes a trial of a new treatment for atrial fibrillation, which occurs when the upper chambers of the heart beat out of sync with the lower chambers of the heart. The treatment, pulsed field ablation, targets heart cells involved in an abnormal heart rhythm. The U.S. Food and Drug Administration approved several pulsed field ablation systems, including one studied by Shehata and other researchers, in 2024.

Shehata and colleagues have also studied leadless pacemakers, miniature devices that attach to the heart muscle and that, unlike traditional pacemakers, don’t require a battery and wires.

As division director, Shehata will oversee a program that provides research-backed care and trains new heart rhythm specialists. The program offers a two-year fellowship to medical school graduates seeking advanced knowledge and skills in electrophysiology.

“Through his leadership of the Interventional Electrophysiology Laboratory and the Clinical Cardiac Electrophysiology Fellowship Program, Dr. Shehata has expanded access to advanced therapies and enhanced the training of future electrophysiologists,” said Eduardo Marbán, MD, PhD, executive director of the Smidt Heart Institute and the Mark S. Siegel Family Foundation Distinguished Professor.

Shehata earned his medical degree from the University of California, San Diego, School of Medicine. He completed internal medicine residency training at UCLA and his cardiology fellowship training at Cedars-Sinai, where he was chief fellow. He also completed advanced fellowship training in cardiac electrophysiology at Cedars-Sinai. He served as faculty at UCLA before being recruited to join the cardiology faculty at Cedars-Sinai, where he is a professor of Cardiology.

U.S. News & World Report rates the Smidt Heart Institute a top 10 cardiovascular center in the U.S. and #1 in California.

Read more from Cedars-Sinai Stories and Insights: New AFib Treatment Helps Dad Regain His Heart Rhythm

Fires can leave behind more than visible damage. The lingering smoke and airborne contaminants from the recent warehouse fire in the Boyle Heights neighborhood in Los Angeles may continue to affect air quality for weeks or even months. Exposure to pollutants released during the fire and after it was extinguished can significantly increase the risk of developing respiratory problems and other health issues. 

While some people experience only temporary irritation, others, especially children, older adults, and those with underlying medical conditions or breathing issues, may face more serious or long-term health effects.

The Cedars-Sinai Newsroom recently spoke with Irina Dralyuk, MD, director of Pediatric Pulmonology at Cedars-Sinai Guerin Children's, about the health risks associated with fire and smoke exposure, who is most vulnerable and what people can do to protect themselves.

What are the health dangers following a fire like the warehouse fire in Boyle Heights?

Following a fire, air quality can be affected for an extended period of time. Fires release a variety of chemicals and fine particles into the air, and many of those substances may not be immediately identified as materials continue to burn and break down.

The first few weeks after a fire are generally the most concerning, but people should remain cautious for at least two to three months. For individuals with respiratory diseases, weakened immune systems or heightened sensitivity to environmental pollutants, the health effects can last much longer, potentially up to a year.

Who should be especially cautious following a fire?

Several groups are at higher risk, including infants and young children, especially babies born prematurely, older adults, people with weakened immune systems, and those with chronic lung conditions such as asthma, chronic obstructive pulmonary disease (COPD) or cystic fibrosis.

However, even people with healthy lungs should take smoke exposure seriously. Environmental hazards from a fire can trigger inflammation or respiratory problems in otherwise healthy individuals, so everyone should take steps to protect themselves when air quality is poor.

What precautions can people take after a fire?

One of the most effective ways to reduce exposure indoors is by using air purifiers. It's important to choose a purifier that's appropriately sized for the room and to replace filters regularly. Home HVAC [heating, ventilation and air conditioning] filters should also be changed according to manufacturer recommendations.

If possible, limit activities that bring smoky outdoor air into the home. During periods of poor air quality, consider using fans instead of air conditioning, as it typically draws outside air into your living space. When spending time outdoors, wear a well-fitting mask on days when air quality is poor, especially during the weeks and months following a fire.

When should people seek medical attention?

Even mild symptoms such as an itchy or scratchy throat, irritated eyes, or persistent coughing are signs that smoke may be affecting your body and should not be ignored.

People experiencing coughing, wheezing, shortness of breath or difficulty breathing should see a doctor or head to an urgent care. Depending on the symptoms, a doctor may recommend diagnostic tests such as a chest X-ray or lung function tests. Your doctor might also listen to the lungs and determine whether medications, including inhalers, nebulizer treatments or oral medications, are needed to reduce inflammation, open the airways and improve breathing.

Read more from Cedars-Sinai Stories and Insights: What Parents Should Know About Teen Vaping

His labored breathing and exhaustion prompted him to see his physician, who ordered a battery of tests. Aster’s diagnosis: A rare cancer called a neuroendocrine tumor was causing a condition called carcinoid heart disease, and causing his heart to fail.

With treatment at the Cedars-Sinai Neuroendocrine Tumor Multidisciplinary Clinic, Aster is now back on the trail, his bike, his board and the court.

“I went from wondering how long I have to live to understanding that this can be managed,” Aster said. “I feel better than I have felt in years.”

Aster’s symptoms came on slowly over several months: crushing fatigue, bloating, loss of appetite and swelling in his legs and feet. Blood tests ordered by his primary doctor were normal, but a CT scan showed tumors in his liver, which were eventually diagnosed as stage 4 neuroendocrine cancer.

“We received the diagnosis the day we dropped the youngest of our four kids off at college,” Orr said. “We had other plans, so we just had to reset.”

Unable to sleep the night they got the news, Orr—who Aster said was his caregiver and support throughout this difficult time and credits with helping save his life—spent hours online. She clicked her way to the Neuroendocrine Tumor Research Foundation. The organization, a resource for research funding, patient education and support, directed the couple to  the Neuroendocrine Cancer Foundation, which referred them to Cedars-Sinai and its multidisciplinary clinic.

“We were concerned about Ken’s neuroendocrine tumors, which had spread to his liver and were making it difficult for his stomach to work normally,” said Andrew Hendifar, MD, who leads the clinic and is a professor of Medicine at Cedars-Sinai. “But we knew from experience that his heart failure would have to be treated first. We didn’t have a minute to lose.”

Neuroendocrine tumors begin in neuroendocrine cells, which connect the nervous system with the hormone-producing endocrine system. They can occur anywhere in the body.

Aster’s began in his small bowel and produced a hormone called serotonin, which thickened two of his heart valves and caused them to leak. The condition is called carcinoid heart disease.

Prashanth Venkatesh, MD, assistant professor of Cardiology in the Smidt Heart Institute at Cedars-Sinai, is the cardiologist on the neuroendocrine team.

“The pulmonary valve, which sends blood from the heart to the lungs, is notoriously difficult to evaluate with standard imaging techniques because of its location in the chest and the relative rarity of pulmonary valve disease in adults,” Venkatesh said. “Significant pulmonary valve involvement in carcinoid heart disease is hence very easily missed.”

Venkatesh, a congenital heart specialist, often employs more extensive imaging techniques for patients born with structural heart defects. Aster’s results showed there was a leak in his pulmonary valve as well as a leak in his tricuspid valve. Both valves needed to be replaced.

“When there is a leaky valve, which we call regurgitation, some of the blood in the heart goes in the wrong direction,” said Raj Makkar, MD, vice president of Cardiovascular Innovation and Intervention at Cedars-Sinai and the Karsh Distinguished Chair in Interventional Cardiology in the Smidt Heart Institute. “With leaky pulmonary and tricuspid valves, the blood that is supposed to go into the lungs can leak back toward the upper chamber of the heart.”

Aster’s pulmonary valve was replaced via a minimally invasive procedure in which a catheter was threaded up through an artery in the groin to maneuver the valve into its proper place. Four weeks later, Makkar replaced Aster’s tricuspid valve using a similar procedure. 

“Patients with carcinoid heart disease are going through a lot because of the neuroendocrine tumor, and traditional valve replacement surgery puts them at higher risk for complications,” Makkar said. “We pioneered testing of transcatheter tricuspid valve replacement around five years ago, and this was the option we chose for Mr. Aster.”

To address the neuroendocrine tumors on Aster’s liver, Alexandra Gangi, MD, director of the Division of Surgical Oncology and co-director of the Neuroendocrine Tumor Multidisciplinary Clinc, chose another minimally invasive approach: tumor embolization.

“We accessed the tumors with a catheter, through the artery in the groin,” Gangi said. “This allows us to block off the blood flow to the specific arteries that feed the tumors. This starves the tumors, and results in shrinking and tumor control.”

So far, Aster has avoided surgery and chemotherapy because of the nature of neuroendocrine tumors and the expertise of his care team in sequencing his therapies based on his sypmtoms.

“I think the difference between metastatic neuroendocrine tumors and most other types of gastrointestinal cancers is that we’re playing the long game,” Gangi said. “We often do the least invasive thing and save more aggressive options for when we really need them. These tumors tend to recur, but prognosis is generally good and patients can live a long time with them.”

Additional treatment or surgical procedures might be on the horizon, but today, Aster is doing well.

“We feel very fortunate that we were able to identify this as early as we did and intervene in the way that we did,” Hendifar said. “A few years ago, even six months ago, Ken wouldn't have been a candidate for minimally invasive valve replacements. He would have required open-heart surgery, and I'm not sure if the outcome would have been as good.”

Aster describes his current health as “great.”

“I just started cycling again in January, 13 months after the second valve replacement,” Aster said. “Now I'm doing a 25-mile ride in the hills two or three times a week with no problem. My heart feels as normal as can be.”

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

The 52-year-old has always enjoyed a high-energy lifestyle, managing the intensity of producing films and television shows (Ladder 49, Flight Plan, Top Gear, Wheeler Dealers) by eating healthy, running and biking along the Los Angeles River. After his daughter was born in 2020, Nieminen assumed his constant exhaustion was the typical kind that comes with sleepless nights caring for a newborn. Still, he and his wife, Kaisa, found it odd that picking up his daughter left him depleted.

“My battery was constantly drained,” Nieminen said. “Being physically active all my life, it was quite alarming. Deteriorating this quickly when I’m just over 50 seemed sort of dramatic.”

Nieminen also noticed his heart seemed to beat too fast at times and occasionally it would skip a beat, so in 2023 he made an appointment with Cedars-Sinai cardiologist Ronit Zadikany, MD. Zadikany diagnosed him with atrial fibrillation, an irregular heart rhythm that occurs when the upper and lower chambers of the heart beat out of sync. The condition tends to worsen with time and can cause the heart to beat too slowly, too quickly or irregularly, impeding blood flow. Common symptoms include fatigue, heart palpitations, dizziness and reduced stamina. Left untreated, atrial fibrillation can cause a slew of cardiovascular complications—including stroke.

Nieminen’s cardiologist referred him to Christine M. Albert, MD, MPH, an expert in atrial fibrillation and chair of the Department of Cardiology in the Smidt Heart Institute. Albert recommended cardioversion, a procedure commonly used to reset the heart to a normal rhythm. The results made Nieminen feel like himself again, but only for a day. A second cardioversion combined with a medication known to work for many people also had temporary effects.

Albert was determined to find Nieminen a treatment that would have long-term results. She suggested he might benefit from catheter ablation, a procedure that destroys cells and creates a small scar within the heart, breaking up or insulating the electrical signals causing the heart to beat out of sync. She connected him with Michael Shehata, MD, a cardiac electrophysiologist in the Smidt Heart Institute.

Shehata was leading a clinical trial investigating a new catheter ablation called pulsed field ablation. Rather than create scars, pulsed field ablation targets heart cells involved in an abnormal heart rhythm.

Nieminen underwent the procedure in January 2024.

“When other options fail, this procedure can be life-changing for patients,” Shehata said.

Pulsed field ablation is done by threading a catheter through a vein in a patient’s leg until it reaches the top chambers of the heart. Once in place, a cardiologist sends a high-voltage electrical impulse through the catheter. The energy penetrates cell walls and destroys specific heart cells, preventing abnormal signals from causing an irregular heartbeat. The procedure takes 30 to 60 minutes.

“The energy is delivered specifically to heart cells without injuring nerve cells, smooth muscle cells, or other, healthy cells,” said Shehata, who is also director of the Interventional Electrophysiology Laboratory at the Smidt Heart Institute. “For some patients with atrial fibrillation, this procedure may be safer than conventional ablation procedures that destroy small areas of heart tissue.”

Following U.S. Food and Drug Administration approval of several pulsed field ablation systems, the procedure is now available for use outside of a clinical trial.

Advances in treatment couldn’t come at a better time. Atrial fibrillation is the most common type of irregular heartbeat and deaths related to the condition have been increasing for more than two decades, according to the U.S. Centers for Disease Control and Prevention.

Today, Nieminen is back to long runs and cycling through his neighborhood. He also works with local organizations to advocate for safe walking and biking paths in Los Angeles. Most importantly, he can now lift his daughter into the air like the high-energy dad he is.

A device that was implanted to record Nieminen’s heart rhythm shows proof of his progress: He has been free from atrial fibrillation since getting pulsed field ablation.

“Don’t hesitate to share with your doctors when something feels off because you feel like you’re being a hypochondriac or you think it’s too insignificant to bring up,” he said. “As you get older, it’s especially important to listen to your body, eat right and stay active, and that doesn’t necessarily mean doing a 10K. Everything your mom would tell you growing up: Stay active, eat healthy, get sleep and get checkups with your doctor. Mom knew what she was talking about.”

Read more on Cedars-Sinai Stories and Insights: Back Into Rhythm | Adjusting to an AFib Diagnosis

Smidt Heart Institute cardiologist Janet Wei, MD, is one of the authors of a maternal health report from the National Academies of Sciences, Engineering, and Medicine, a nonprofit organization that reviews published research and provides advice to the U.S. government. Wei, associate professor of Cardiology and Biomedical Sciences, sat down with the Cedars-Sinai Newsroom to explain how pregnancy affects women’s hearts.   

How does pregnancy increase cardiovascular risk?

Pregnancy acts as a stress test for the heart and can uncover, or even worsen, problems like high blood pressure and diabetes. During pregnancy, the heart must work harder to support a growing fetus, and cardiac stress often continues after delivery.

Cardiovascular disease is the leading cause of pregnancy-related death in the U.S., yet most of these deaths are preventable. The National Academies of Sciences, Engineering, and Medicine report on maternal health highlights that although 57% of cardiovascular-related deaths occur between seven days and one year postpartum, preventive care is often focused on the prenatal and immediate postpartum period.

What are two takeaways from the report?

The committee reviewed published medical research and gathered input from a wide range of stakeholders, including clinicians, professional societies, advocacy organizations and patients.

Several takeaways became clear. The report recommends, for example, that clinicians treat pregnant women with chronic hypertension so that their blood pressure is reduced to less than 140/90 millimeters of mercury.  This is because consistently elevated blood pressure during pregnancy can cause pregnancy complications and increase a woman’s risk for developing cardiovascular disease.

The new guidelines also recommended that clinicians caring for patients with postpartum hypertension or other hypertensive disorders give their patients home blood pressure monitors and use a program that allows the patients to report their readings. This way, clinicians can adjust treatment and set clear thresholds for action. 

Cedars-Sinai is already doing this through a postpartum blood pressure monitoring program that sends patients home with a blood pressure cuff and allows them to transmit readings to their care teams. (Kimberly Gregory, MD, MPH, director of the Division of Maternal-Fetal Medicine at Cedars-Sinai, served as an adviser to the National Academies committee that created the maternal health report.)

How often should women visit a doctor in the year after giving birth?

How frequently a woman should see her doctor during the postpartum period depends on her cardiovascular risk. 

Not every woman can easily see a doctor or health specialist—especially in rural areas or when cost is a concern. Therefore, the National Academies report recommends the Health Resources and Services Administration use its telehealth, rural health and maternal health programs to reduce geographic, financial and system barriers to preventive cardiovascular services.

What can pregnant women do to protect heart health?

The National Academies created a resource for women that includes the following advice:

Share your history. Tell your healthcare team your family history of heart disease, especially early heart attacks or strokes, and your pregnancy history, including any past complications.

Keep postpartum follow-up appointments on your calendar. It’s important not to miss these appointments because risk for complications continues through the first year after delivery.

Take warning signs seriously—trust your instincts. If something feels wrong during pregnancy or after birth, seek care right away and tell providers that you’re pregnant or that you gave birth recently.

Read more from Cedars-Sinai Stories and Insights: High Blood Pressure—What Women Need to Know

At the crib side, a guitarist and singer serenades newborns hooked up to loud, beeping and flashing monitors. The sounds of gentle humming and guitar strumming do more than soothe a fussy baby—they stabilize vital signs, aid neurological and auditory development, and enhance the overall wellbeing of infants in the NICU.

“Music therapy is a clinical and evidence-based practice using music to address nonmusical goals,” said Laura Cellini, Guerin Children’s board-certified music therapist. “Listening to music can help lower and stabilize heart rate, improve oxygen saturation levels and support a more regulated, calming state for newborns.”

According to Cellini, research has shown that music therapy can also help reduce NICU stays by as many as 12 days.

During a typical session in the NICU, Cellini works one-on-one with each infant, tailoring the therapy to meet every baby’s individual needs. She carefully monitors each newborn’s response to the music, including signs of overstimulation, and adjusts her music accordingly.

The music therapy program was made possible through a generous donation from 14-year-old twins Joey and Ryder Corleto, who spent considerable time in the NICU at Cedars-Sinai shortly after birth. Wanting to give back to the Cedars-Sinai community, the siblings chose to dedicate their bar and bat mitzvah gifts to help launch the program.

Their mother, Melissa Corleto, vividly remembers the challenges of spending time in a noisy NICU with the twins.

“When they look back at pictures of themselves as babies, it’s hard for them to imagine that this is where they started—at just 2.5 and 3.5 pounds,” Melissa said. “The idea of giving back to the NICU really resonated with them. As a family, we decided this was the meaningful way they wanted to give back.”

Music has always played a major role in the twins’ lives. Ryder is an avid drummer, while Joey is a competitive dancer. The twins said it felt natural to use their funds to help launch a music therapy program, especially one designed to soothe babies and support early brain development.

The bedside therapy sessions are also a welcome change of pace for parents and medical staff.

“The NICU can be a very traumatic and stressful environment, and music therapy helps create a sense of calm for the babies, their families and even the staff,” said Ashley Richardson, RN, assistant nurse manager of the NICU at Guerin Children’s.

For Jason Park, whose son Logan Park has spent more than two months in the NICU, watching his baby remain calm and relaxed as Cellini sang and played music at his bedside brought a sense of much-needed comfort and relief.

“I think the music brings a lot of joy to parents, especially for families like ours who have been here in the NICU for a long time,” Park said. “When the session ended, I was actually sad to hear it stop.”

Read more from Cedars-Sinai Stories and Insights: Strengthening Children’s Health

The at-home monitoring device is designed to track early signs of asthma and provides clinicians with continuous or on-demand remote monitoring of lung sounds. The real-time data enables healthcare professionals to monitor a child’s condition between clinic visits and respond early if a child’s symptoms worsen.

The easy-to-wear device, called AeviceMD, was developed by Aevice Health, a Singaporean digital health company and a graduate of the Cedars-Sinai Accelerator program.

“I saw strong potential in this technology to support how we monitor and manage children with reactive airway issues like asthma outside of the clinical setting,” said Irina Dralyuk, MD, a pediatric pulmonologist at Guerin Children’s. “Being able to assess respiratory symptoms in real time, especially overnight, provides valuable information that can guide earlier intervention and help prevent more serious breathing complications.”

About 4.5 million children in the United States have asthma, making it one of the most common chronic pediatric diseases. Traditionally, doctors have monitored children with asthma through periodic clinic visits and caregiver-reported symptoms such as rapid breathing, chest congestion and breathing difficulties.

However, asthma symptoms often fluctuate widely between visits, and self-reported symptoms are often unreliable. This makes managing worsening symptoms between appointments very difficult.

The wearable stethoscope allows parents to utilize the device at home to record lung sounds and securely share recordings with their doctors. The data enables doctors to build a more complete picture of disease progression, track medication use and assess how patients’ symptoms evolve in response to their treatment plan.

“What we’re trying to do is prevent exacerbations, reduce hospitalizations and emergency department visits, and limit the need for interventions such as systemic steroid use to control asthma symptoms,” Dralyuk said. “Intervening early could decrease chronic inflammation and improve lung function and health over time.”

Children can wear the device, about the size of a half-dollar coin, on the chest for up to 10 hours a day. It is designed for use in children 3 and older.

“We built AeviceMD to make this kind of continuous symptom visibility possible. Having our technology deployed at a large, world-class health system like Cedars-Sinai validates our belief that there is a critical, unmet patient need,” said Adrian Ang, CEO of Aevice Health.

The device is the result of a multiyear collaboration with Cedars-Sinai that began in 2022 and included clinical input from physicians at Guerin Children’s. The collaboration included key regulatory milestones and a pilot program to evaluate the device’s effectiveness in pediatric respiratory monitoring. In 2023, the device received clearance from the U.S. Food and Drug Administration.

“This collaboration demonstrates the importance of providing clinical and operational support to help advance a company’s promising technology toward real-world patient benefit,” said Nirdesh K. Gupta, PhD, managing partner of Cedars-Sinai Intellectual Property Company. “It’s an exciting example of how innovation can directly impact care and improve the way we manage chronic conditions like asthma.”

Read more from Cedars-Sinai Stories and Insights: Common Breathing Problems in Kids and How to Treat Them

Neuro NICU is a specialized program that brings together multidisciplinary pediatric specialists to deliver advanced, coordinated care for newborns with complex neurological conditions. Housed within the Neonatal Intensive Care Unit at Cedars-Sinai, the program is designed to provide timely intervention during the crucial period of early brain development.

The Neuro NICU’s comprehensive, multidisciplinary model of care includes leading experts in neonatology, neurology, neurosurgery, neuroradiology and genomics. The staff also includes specially trained NICU nurses and social workers adept at deploying around-the-clock care tailored to the unique needs of newborns and their families.

“The newborn brain is fundamentally different from that of a child or an adult, which is why neurological care at this stage requires highly specialized expertise,” said David Rowitch, MD, PhD, deputy director for Research at Guerin Children’s. “Understanding how the developing brain responds to injury and how to interpret imaging in this context is critical. The Neuro NICU allows us to bring that expertise together in a coordinated way for each patient.”

The Neuro NICU team, led by co-directors Yolanda Brown-Madan, MD, and Xin Ye, MD, is equipped to treat patients with a wide range of neurological conditions, including neonatal seizures, stroke, severe congenital neurological disorders, brain malformations, as well as birth complications and traumatic injuries to the brain or the nervous system.

A defining feature of the Neuro NICU is the early integration of genomics, which allows the team to deliver precision gene therapies and genetic diagnoses to infants sooner. Guerin Children’s is among the first programs to offer rapid whole‑genome sequencing for babies in a NICU setting, with genetic results delivered in a matter of days.

Research at Guerin Children’s has shown that more than 40% of children seen by pediatric neurologists have an underlying genetic condition. Having genetic information readily available can directly influence clinical decisions and improve the ability to personalize care for vulnerable newborns.

“Our comprehensive approach in the Neuro NICU enables Guerin Children’s to deliver a seamless continuum of care as patients improve and grow beyond their stay,” said Shervin Rabizadeh, MD, MBA, chair of the Department of Pediatrics and deputy director of Guerin Children’s.

The Neuro NICU also employs state-of-the-art, infant‑specific technologies, including continuous video electroencephalography (EEG) monitoring, which provides real‑time data to help clinicians intervene quickly during critical moments.

That same level of technological capability extends beyond the unit. Designed to function as a regional center for neonatal neurological care, the Neuro NICU extends its reach to affiliated partners and hospitals in the greater Los Angeles area and beyond. Specialized neonatal transport services allow teams to initiate critical therapies before a baby arrives at Guerin Children’s.

“Our goal is to ensure that newborns receive the right care at the right time, regardless of where they begin their medical journey,” said Rangasamy Ramanathan, MD, director of the Division of Neonatology at Guerin Children’s. “Through advanced transport capabilities and virtual collaboration, the Neuro NICU allows us to support community hospitals and families across the region.”

Additionally, the program offers virtual consultations, enabling neurologists to guide care remotely and support physicians at referring hospitals.

“The launch of the Neuro NICU reflects Guerin Children’s’ commitment to advancing research‑driven, specialized, world-class pediatric care for the most vulnerable patients in greater Los Angeles and beyond,” said Ophir Klein, MD, PhD, executive vice dean of Children’s Health and executive director of Guerin Children’s.

Read more from Cedars-Sinai Stories and Insights: Making Strides in Treating the Smallest Heart Patients

annual meeting, April 24–27 in Boston.

The physician-scientists are available for interviews to discuss new research on improving care in neonatal intensive care units, quality improvement efforts and simulation training for neonatal transport and emergency newborn care.

“As Guerin Children’s continues to evolve as a premier destination for specialty pediatric care in Los Angeles, PAS 2026 is an important opportunity for our pediatricians to share scientific and clinical advances in lifesaving newborn medicine,” said Ophir Klein, MD, PhD, executive vice dean of Children’s Health and executive director of Guerin Children’s.

Simulation Workshops

Rangasamy Ramanathan, MD, MBBS, director of Neonatology at Guerin Children’s, and Mahmood Ebrahimi, MD, a registered diagnostic cardiac sonographer and clinical instructor in Pediatrics, will co-lead a hands-on simulation workshop on targeted neonatal echocardiography. The training focuses on using echocardiography to assess how patent ductus arteriosus, a congenital heart defect, affects blood flow in preterm infants. The workshop is scheduled for Friday, April 24, 10:30 a.m. to noon.

A second simulation workshop, co-led by Ebrahimi, will train clinicians in the use of point-of-care ultrasound (POCUS) for real-world neonatal emergencies and critical care scenarios. This session is scheduled for Friday, April 24, 6:30-8 p.m.

Guerin Children’s Experts Presenting Research at the Meeting

Manoj Biniwale, MD, director of NICU Clinical Research, Division of Neonatology at Guerin Children’s, will present research across multiple sessions on several topics, including clinical trial data evaluating different approaches to umbilical cord management in premature infants and a simulation training session to improve how healthcare providers learn and retain critical newborn resuscitation skills.

Kurlen Payton, MD, assistant director of Quality and Safety at Guerin Children’s, will present research on a multicenter quality improvement initiative that increased maternal breast milk use at discharge for very low birth weight infants, improving outcomes and health equity.

Kyle Willsey, DO, pediatric intensivist at Guerin Children’s, and Lauren Collins, RN, will present how simulation training and neonatal transport impact workload and outcomes among pediatric transport teams.

To arrange interviews with Guerin Children’s experts, contact Shishira Sreenivas at Shishira.sreenivas@cshs.org or 202-297-0220.

The study, “Real-World Outcomes of Transcatheter Tricuspid Valve Replacement: Analysis From the STS/ACC TVT Registry,” published in the Journal of the American Medical Association.

“These findings show that transcatheter tricuspid valve replacement is translating well from the clinical trial setting into routine practice across the United States,” said Raj Makkar, MD, vice president of Cardiovascular Innovation and Intervention at Cedars-Sinai, the Karsh Distinguished Chair in Interventional Cardiology in the Smidt Heart Institute, and corresponding author of the study. “In a large, older and medically complex patient population, we saw very high procedural success, near-complete elimination of tricuspid regurgitation, and rapid improvement in how patients feel and function.”

Tricuspid regurgitation occurs when the tricuspid valve does not close properly, allowing blood to flow backward in the heart. The condition is common in older adults and can lead to worsening heart failure symptoms, repeated hospitalization and increased risk of death.

Historically, open-heart surgery was often the only treatment option for this condition, but many older patients were not candidates because of age or other medical problems. Today, transcatheter tricuspid valve replacement offers a less invasive alternative in which doctors replace the damaged valve using a catheter, or tube, threaded through a blood vessel.

Researchers analyzed 1,034 attempted TTVR procedures performed between February 2024 and March 2025 at 82 medical centers across the U.S. The average patient age was 77.

The analysis found that more than 98% of patients had the valves successfully implanted. At 30 days post-procedure, more than 97% of patients had their condition improve to mild or minimal tricuspid regurgitation, and patients reported substantial improvement in symptoms, physical and social function, and quality of life.

Study authors note that early real-world outcomes were consistent with results from the TRISCEND II randomized trial of TTVR. Patients in this new study, however, experienced lower incidence of bleeding and heart block requiring electronic pacemaker implantation than patients participating in TRISCEND II. The current study also found that outcomes were generally consistent in patients with and without preexisting cardiac implantable electronic devices such as pacemakers, an important finding because these devices are common in patients with severe tricuspid valve disease.

“For patients with severe tricuspid regurgitation, treatment options have historically been limited, especially when surgery carries high risk,” said Aakriti Gupta, MD, assistant professor of Cardiology and study author. “What is especially encouraging here is that in real-world care, not just in a randomized trial, patients experienced meaningful improvement in symptoms and quality of life within only 30 days.”

Investigators said the results support the growing role of TTVR as a treatment option for patients with severe tricuspid regurgitation and highlight the importance of continued follow-up to understand longer-term outcomes.

Moody Makar, MD, associate professor of Anesthesiology at Cedars-Sinai, is also an author of the study.

Additional authors include Brian P. O’Neill, MD; Christina Lalani, MD; Rahul Sharma, MBBS; Pradeep Yadev, MD; Tiberio M. Frisoli, MD; Vinod Thourani, MD; Mackram F. Eleid, MD; James Lee, MD; Vasilis C. Babaliaros, MD; Christiane Haeffele, MD, MPH; Tanvir J. Bajwa, MD; Peter Flueckiger, MD; Robert J. Cubeddu, MD; Laura J. Davidson, MD; Ratnasari Padang, MBBS, PhD; Pedro Villablanca Spinetto, MD; Suhail Allaqaband, MD; Akhil Narang, MD; Mathew Williams, MD; Patrick Gleason, MD; Gilbert H.L. Tang, MD; Sahil Khera, MD; John P. Vavalle, MD; Isida Byku, MD; Jeremiah P. Depta, MD; Santiago Garcia, MD; Samir Kapadia, MD; Alan Zajarias, MD; Jake M. Chanin, MD; Susheel K. Kodali, MD; Howard C. Herrmann, MD; M. Andrew Morse, MD; George Petrossian, MD; Joseph A. Sivak, MD; Rebecca T. Hahn, MD; Yang Song, PhD; Martin B. Leon, MD; Robert W. Yeh, MD, MSc; Charles J. Davidson, MD.

The study was funded by Edwards Lifesciences.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

The findings, published in Science Translational Medicine, could one day improve management of heart failure, in which the heart fails to pump enough blood to meet the body’s need for blood and oxygen. Poor use of oxygen by the heart is an early indicator of heart failure, which affects nearly 7 million people in the U.S.

“Our study shows how MRI could be used to quickly and noninvasively determine heart oxygen use in the clinic,” said Hsin-Jung Yang, PhD, director of Cardiac Imaging Research in the Biomedical Research Imaging Institute and corresponding author of the study. “With further research and development, this advance could unlock new frontiers in early diagnosis, personalized therapy and next-generation treatments for heart failure.”

The current gold standard for measuring heart oxygen use, coronary sinus catheterization, requires threading a thin, flexible tube called a catheter from a patient’s neck or groin into the heart's main vein. The procedure, which takes 30 to 60 minutes and involves injection of a contrast dye to guide the catheter, is too invasive for routine heart oxygen monitoring.

MRI uses radio waves, a strong magnet and a computer to create detailed images of areas inside the body. Standard MRI can only produce clear images of the heart, which moves with every beat and every breath, if patients hold their breath at points during the exam. And in order to use these images to measure oxygen, doctors have to take multiple MRI scans—a process that takes several minutes—and draw blood at the same time.

“The system we designed addresses the motion of the heart,” Yang said. “Patients do not need to hold their breath, and it can give precise numbers within three minutes.”

The team proved the accuracy of its MRI method by using it to measure heart oxygen use in patients with and without heart failure, and comparing its readings to readings obtained by heart catheterization.

“Noninvasive testing that detects issues in the heart’s use of oxygen can provide an early warning that heart failure is developing,” Yang said. “Now that we have promising cardiometabolic therapies lined up, earlier detection may allow us to take steps to prevent and treat the condition.”

David Underhill, PhD, chair of the Department of Biomedical Sciences, said the study makes a major contribution toward improving healthcare for heart disease, the No. 1 cause of death.

“Along with its potential for saving lives through early intervention for heart failure, this accessible tool could offer new avenues for cardiac research,” Underhill said. “It could allow us to study patients who have risk for, but no symptoms of, heart failure without exposing them to catheterization, contrast or radiation.”

Additional Cedars-Sinai authors include Li-Ting Huang, Chia-Chi Yang, Archana Malagi, Xinqi Li, Ghazal Yoosefian, Xinheng Zhang, Ziyang Long, Xiaoming Bi, Janet Wei, Alan C. Kwan, C. Noel Bairey Merz and Debiao Li.

Other authors include Guan Wang, Henghui Zhang, Ranran Zhang, Hao Ho, Yuheng Huang, Michael D. Nelson, Anthony Christodoulou and Rohan Dharmakumar.

Funding: This work was supported by grants from National Institutes of Health (R01HL165211 to H.-J.Y. R01HL181091 to H.-J.Y., R01HL156818 to H.-J.Y., R01HL148788 to R.D., R01HL146158 to C.N.B.M., R01HL124649 to C.N.B.M., R01HL153500 to J.W., K23HL125941 to C.N.B.M., U54AG065141 to C.N.B.M., and U54AG094168-01 to C.N.B.M.), The Barbra Streisand Women’s Cardiovascular Research and Education Program to C.N.B.M., The Linda Joy Pollin Women’s Heart Health Program to C.N.B.M.,The Erika Glazer Women’s Heart Health Project to C.N.B.M., The Adelson Family Foundation to C.N.B.M., and US Department of Defense (HT94252510956 to H.-J.Y.).

Competing interests: C.N.B.M. serves as a director and holds stock in iRhythm. D. Li, A. G. Christodoulou, J. L. Shaw, Y. Xie, and C. Nguyen are inventors on US patent no. 10,436,871 (“Low-rank tensor imaging for multidimensional cardiovascular MRI”). H. J. Yang and C. C. Yang are inventors on a provisional US patent, US Prov 63/721,228 (PCT/US2025/055499, “Systems and methods for determining oxygen consumption using magnetic resonance imaging”). The other authors declare that they have no competing interests.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Pediatric interventional cardiology has had meaningful advances over the past decade that are changing how children with congenital heart disease are treated at

Congenital heart defects, which arise from abnormal or incomplete formation of the heart, valves and blood vessels, are among the most common birth defects worldwide. The condition affects approximately 40,000 babies each year in the United States.

From less invasive, catheter-based procedures to improved imaging and emerging technologies, innovations are helping reduce risk, shorten recovery times and expand treatment options for the smallest patients with heart problems.

The Cedars-Sinai Newsroom recently spoke with Stephen Nageotte, MD, MBA, an interventional cardiologist and director of the Congenital Catheterization Laboratory at Cedars-Sinai Guerin Children’s and the Smidt Heart Institute. Nageotte treats children and adults using minimally invasive procedures. He shared what’s new in the field and what families need to know:

What are the most significant advances you’ve seen in pediatric interventional cardiology in recent years?

Over the past five years, there have been major advances in three key areas:

• Premature patent ductus arteriosus [PDA] closure. It’s a congenital heart condition in which a connection between two blood vessels in an infant fails to close after birth. This can cause abnormal blood flow to the lungs and breathing difficulties, particularly in premature infants.
• Transcatheter pulmonary valve replacement, which is a minimally invasive procedure in which we replace a faulty heart valve using a catheter instead of surgery.
• PDA stenting. Sometimes babies have heart problems that limit blood flow to the lungs. We can keep a small vessel called the ductus arteriosus open by placing a tiny tube, or stent, inside it to improve blood flow.

All three procedures have evolved significantly and are allowing us to treat patients in less invasive ways, often replacing or delaying the need for surgery.

How has transcatheter PDA closure changed care for premature infants?

Transcatheter PDA closure has become an important option for premature infants with a hemodynamically significant PDA—meaning the vessel is causing strain on the heart and lungs. In fact, Evan Zahn, MD, of the Smidt Heart Institute, helped develop the device cardiologists use to close a PDA during a transcatheter procedure.

The procedure is quick and can be done at the bedside in the Neonatal Intensive Care Unit [NICU], which helps us avoid transporting fragile infants. Research also suggests many babies show respiratory improvement after closure, which may reduce complications associated with long‑term ventilation.

Who is typically a candidate for the transcatheter PDA closure?

These procedures are generally for premature infants who are showing signs that the PDA is affecting their health, such as needing increased respiratory support or showing enlargement of the heart. There’s no strict minimum weight requirement, and the focus is really on whether the PDA is having a meaningful impact on the baby’s heart and lungs. Transcatheter PDA closure is also performed on older kids and adults.

What impact has new device technology had on how these procedures are performed?

One recent advancement is an improved delivery system for PDA closure devices. The device, known as the Amplatzer Piccolo Delivery System, recently received FDA [Food and Drug Administration] clearance to treat premature infants with PDA, including babies weighing as little as 2 pounds. Previously, the procedure required exchanging multiple catheters during the case, which could introduce instability; the newer system allows physicians to navigate and deliver the device using a single, shorter, softer catheter, potentially improving patient stability and precision.

How has transcatheter pulmonary valve replacement expanded treatment options for patients?

The development of newer self‑expanding valves has significantly increased the number of patients who can receive pulmonary valve replacement through a catheter instead of surgery. These procedures are typically considered from late childhood through adulthood and are used for patients with pulmonary valve disease related to congenital heart conditions. Early outcomes have shown good durability and high success rates.

Imaging plays a big role in heart care. What improvements are making the biggest difference?

There have been significant advances in cardiac CT and MRIs. Imaging is faster, clearer and uses lower radiation doses than in the past. These tools help us better understand heart anatomy, blood flow and timing for interventions. There’s also growing interest in using virtual or augmented reality to create 3D heart models for procedure planning, allowing teams to better visualize anatomy before a procedure.

What should families know as they navigate a congenital heart diagnosis?

Early detection and screening are incredibly important, ideally before birth, so families can meet the care team and understand what to expect. At Cedars-Sinai we can identify a defect while a baby is still in the womb and will continue to care for the baby at birth, during childhood, and all the way through adulthood, so the patient never needs to transfer to another institution.

Congenital heart care is lifelong and truly a team effort. Families aren’t expected to understand every technical detail—our role is to guide them, answer questions and be there every step of the way. Building long‑term relationships with patients and families is one of the most meaningful parts of this work.

Read more from Cedars-Sinai Stories and Insights: Making Strides in Treating the Smallest Heart Patients

The discovery, published in Cell, has important implications for understanding how a wide variety of intestinal disorders may develop.

“Our research opens the door to treatments that focus on restoring key molecular signals in vulnerable regions of the colon,” said Ophir Klein, MD, PhD, executive director of Cedars-Sinai Guerin Children’s, executive vice dean of Children’s Health, and the David and Meredith Kaplan Distinguished Chair in Children’s Health. Klein is the senior author of the study.

Prior research has shown that the four sections of the colon—ascending, transverse, descending and sigmoid—have different functions and risks for disease, but it wasn’t clear why these variations exist.

In this study, the investigators showed that the identity of distinct regions of the colon are regulated by the gut microbiome. They identified nicotinic acid, a molecule produced by certain bacteria in the gut microbiome, as a main driver of these regional differences in the colon’s sections. Nicotinic acid, also known as niacin, part of the vitamin B3 family, helps the body convert food into energy and supports the health of cells.

The researchers compared laboratory mice with and without a microbiome. They found that production of nicotinic acid by bacteria in the upper colon activates a protective mechanism in colon cells. In mice without a microbiome, minimal nicotinic acid was produced, and cells in the upper colon became more vulnerable to damage and disease.

Investigators also studied human colon tissue samples. They found that the different sections of the human colon showed regional characteristics similar to patterns observed in mice. And in samples from human patients with Crohn’s disease— a type of bowel disease in which abnormal immune system activity causes inflammation—this protective mechanism was reduced.

“Our work highlights the importance of studying host microbiome interactions with careful attention to specific colon regions, rather than treating the colon as a uniform organ,” said Jeremie Rispal, PhD, a postdoctoral scholar at the University of California, San Francisco, and the first author of the study. “We learned that the microbiome controls regional differences and tissue protection.”

Further study will be needed to confirm the precise mechanisms behind this protective effect and to determine how these findings might be used in new therapies for intestinal disorders.

Additional Cedars-Sinai authors include Manasa Vegesna, Dedeepya Vaka, and Dario Boffelli .

Other authors include Jasmine R. Garcia, Brisa Palikuqi, Seung Woo Kang, Coralie Trentesaux, Juan Du, Nicola R. Realini, Paige N. Spencer, James M. Gardner, Annika Hausmann, Michael G. Kattah, and Ken S. Lau.

Funding: This work was funded by NIH U01DK103147 from the Intestinal Stem Cell Consortium (to O.D.K. and D.B.), RC2-DK140862 (to O.D.K. and D.B.), R01DK103831 (to K.S.L.), F31DK127687 (to P.N.S.), T32HD007502 (in support of P.N.S.), T32CA119925 (in support of S.K.), the Leona M. and Harry B. Helmsley Charitable Trust G-1903-03793 (to the VUMC Gut Cell Atlas of which K.S.L. is a member), the Stanley Cohen Innovation Fund (to K.S.L.), the Benioff Center for Microbiome Medicine (to J.R.), and the PZ00P3_223765 SNSF Ambizione grant (to A.H.). Organoid work was supported by funding from the Kenneth Rainin Foundation and NIH R01 DK14167. The Kattah Lab has received research support from Eli Lilly. J.R. was supported by the Bakar Aging Research Institute postdoctoral fellowship and the Bettencourt Schueller foundation.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Throughout her career, Cheng has maintained National Institutes of Health funding for research aimed at uncovering the drivers of cardiovascular aging. She has authored more than 450 scientific studies, many appearing in high-impact journals, including JAMA, Circulation and The New England Journal of Medicine.

Cheng identified differences in how males and females develop elevated blood pressure and demonstrated how people vary in their responses to COVID-19 vaccines over time. Her research has garnered multiple awards and contributed to Cedars-Sinai’s reputation as an international leader in biomedical sciences.

“Dr. Cheng is the perfect leader to build and enrich our already flourishing Department of Cardiology,” said Shlomo Melmed, MB, ChB, dean of the Medical Faculty and executive vice president of Medicine and Health Sciences. “We welcome her to this academic leadership role and look forward to the contributions she will make in strengthening the Smidt Heart Institute.”

Cheng, who succeeds Christine M. Albert, MD, MPH, has served on the editorial boards of major professional journals and on leadership committees for the American Society for Clinical Investigation, the American Heart Association and the American College of Cardiology.

She founded the largest COVID-19 clinical research program on the West Coast at the outset of the pandemic in 2020. More recently, she has led research to investigate the public health effects of the 2025 Los Angeles wildfires.

Cheng has mentored dozens of junior faculty members in cardiology, anesthesiology, neurology, obstetrics and oncology, taking special pride in advising early-career investigators as well as high school and college students.

“I look forward to supporting the Smidt Heart Institute’s talented clinicians and researchers as they work to improve the lives of those affected by cardiovascular disease,” Cheng said.  

Cheng received her bachelor’s degree from Harvard College and her medical degree from McMaster University in Canada, as well as a master of medical science degree from the Massachusetts Institute of Technology and a master of public health degree from Harvard University. She completed her internal medicine training at Johns Hopkins University and cardiology training at Brigham and Women’s Hospital, where she served as associate director of the Cardiovascular Imaging Core Laboratory.

In her new role, Cheng will lead strategic clinical, research and educational growth for the Department of Cardiology. As the new department chair, she will hold the Stephen R. Corday, MD, Distinguished Chair in Cardiology.

“Dr. Cheng has strengthened our institution and made many meaningful contributions through her research laboratory since joining Cedars-Sinai seven years ago,” said Eduardo Marbán, MD, PhD, executive director of the Smidt Heart Institute and the Mark Siegel Family Foundation Distinguished Chair. “We are excited for her to continue developing our world-class cardiology department.”

Read more from the Cedars-Sinai Newsroom: Cedars-Sinai Reports Heart Attacks, General Illness Spiked After LA Fires

“Too often, when a young woman has heart disease symptoms, a physician will ignore those symptoms and tell her that she needs to lose weight,” said Bairey Merz, director of the Barbra Streisand Women’s Heart Center in the Smidt Heart Institute at Cedars-Sinai. “That’s because heart disease symptoms in women can be very different from what men experience. So it’s crucial that women know what to look for.”

Although heart disease is the leading cause of death among women in the U.S., according to the Centers for Disease Control and Prevention, most heart disease research has been conducted on men. And even though rates of heart disease and heart attacks are increasing among women 35 to 54 years old, they are less likely to receive evidence-based treatments such as statins and more likely to be told they are “too young” to have heart disease, Bairey Merz said.

“These delays and dismissals have had serious consequences,” she said. “The Women’s Ischemia Syndrome Evaluation [WISE] study that I led for the National Heart, Lung, and Blood Institute helped us better understand that heart disease doesn’t always look the same in women. That insight ultimately pushed the field to rethink and improve how we diagnose and treat it.”

Despite these advances, women with heart disease are still more likely to be misdiagnosed, underdiagnosed or undertreated—sometimes delaying care that could save their lives.

“The good news is that heart disease is largely preventable,” Bairey Merz said. “And for women in particular—who may not experience obvious symptoms or whose symptoms are subtle—knowledge is a powerful prevention tool.”

To explain what women should watch for, the Cedars-Sinai Newsroom spoke with Bairey Merz about what women can do to protect their hearts and advocate for the healthcare they need.

What are some of the biggest myths about heart disease?

Many people believe that heart disease primarily affects men, that heart attacks always involve crushing chest pain, or that cancer is the top cause of death. In reality, heart disease kills more women than all cancers combined, yet fewer than half of women recognize it as their greatest health threat.

While men tend to develop cardiovascular disease earlier, women are more likely to experience poorer outcomes.

Why are heart attack rates increasing among younger women?

For decades, heart attack death rates declined sharply, thanks to improved research, standardized treatment guidelines, and widespread use of effective medications and procedures. While heart attack deaths are still much lower than they once were, the increase in heart problems among younger adults is concerning.

Researchers are looking into exact causes for the increase, but we know that contributing factors include low levels of physical activity and prolonged sedentary behavior, rising rates of diabetes and obesity, chronic stress, and environmental exposures such as air pollution.

What does a heart attack feel like for women?

The so-called “Hollywood heart attack”—tingling in the left arm that leads to sudden, crushing chest pain—is common in men and can occur in women as well. But many women experience subtler symptoms, including shortness of breath, nausea, unusual fatigue, back or jaw pain, or chest discomfort that doesn’t feel severe or dramatic.

Because these symptoms don’t match common expectations of a heart attack, they may be overlooked or dismissed. Anyone experiencing them should seek medical care immediately.

What causes heart attacks in women?

An increasing number of heart attacks are occurring in people without significant blockages in the major coronary arteries, a pattern seen more often in women. While men’s heart disease more commonly involves blockage in large arteries, women are more likely to experience dysfunction of the heart’s smaller blood vessels. This condition—called ischemia with no obstructive coronary artery disease [INOCA]—can cause reduced blood flow to the heart even when major arteries appear clear.

Even women who are physically fit can develop INOCA. In the past, if a woman had heart attack symptoms but a “normal” angiogram showing clear major arteries, her condition might not have been recognized. Continued awareness and ongoing education around INOCA are helping clinicians better diagnose and treat these patients.

What is a normal heart rate for women?

A normal resting heart rate for most adults is between 60 and 100 beats per minute, according to the American Heart Association. Because women’s hearts are typically smaller, their resting heart rate may run slightly higher than men’s. Women should consult their doctor if their resting heart rate is below 60 or above 100 beats per minute when not exercising.

How can women protect heart health and prevent heart disease?

Heart disease develops silently over decades. While heart disease can be managed with highly effective treatments, prevention is the most powerful strategy.

An estimated 80% of heart disease cases are preventable with lifestyle modifications. These include staying current with annual screenings and knowing cholesterol, blood pressure and blood sugar levels; exercising at least 30 minutes daily; breaking up prolonged sitting because a sedentary lifestyle is considered as strong a risk factor as smoking; managing stress; getting seven to nine hours of sleep; avoiding smoking; and following a nutritious diet.

A Mediterranean-style, largely plant-based diet rich in fruits, vegetables, nuts, beans, whole grains, olive oil and lean proteins is recommended. Parents are encouraged to help ensure their children make healthy food choices, too.

Heart health isn’t about deprivation. It’s about building lifelong habits that prevent disease before it starts.

Read more on the Cedars-Sinai Blog: High Blood Pressure—What Women Need to Know

Reid had been diagnosed with heart failure at Cedars-Sinai after experiencing fatigue and shortness of breath. The condition occurs when the heart is too weak to pump enough blood throughout the body, causing fluid to build up.

Reid told Good Morning America co-anchor Michael Strahan he initially dismissed his symptoms. He urged others—especially people of color—to seek medical care when something feels wrong.

“A lot of times, we don’t go because we don’t want the bad news, or we’re too busy just hustling, trying to make it from day to day,” Reid said. “And we … feel like we don’t got time, or we’ll get over it. Well, you might not.”

Jones told Good Morning America that during a follow-up visit, it was clear medications were no longer controlling Reid’s condition.

“He came in very swollen again,” she said, “and that is a little unusual in somebody who’s been started on treatment.”

DiChiacchio told Good Morning America that bloodwork revealed the condition was worsening and Reid needed an immediate heart transplant.

“So when we think about status for a heart transplant,” DiChiacchio said, “he was very high on that list because of how ill he was and really dealing with a kind of life or death situation.”

Days later a donor heart became available, and DiChiacchio and team successfully completed the transplant.

 Reid told Strahan he is grateful for a second chance at life.

“This thing is … a beautiful life,” he said. “And, you know, I wanna be around for it.”

According to the Centers for Disease Control and Prevention, 6.7 million U.S. adults have heart failure. Risk factors include high blood pressure, diabetes and coronary artery disease, though regular exercise, adequate sleep and proper nutrition can lower risk.

Click here to watch the entire segment of Good Morning America.

“The natal teeth were little paper-thin teeth that fell out right away, as they didn’t have well-developed roots. And, where I had natal teeth, I had no secondary teeth later in life,” said Graham, a retired professor of Medical Genetics and Pediatrics and former director of the Division of Clinical Genetics and Dysmorphology at Cedars-Sinai. “The condition is called tooth agenesis.”

Tooth agenesis can pose challenges such as difficulty breastfeeding, confidence issues due to missing teeth and costly out-of-pocket expenses for dental work.

Graham experienced those challenges firsthand. Correcting his missing teeth required extensive dental implants, procedures that continued well into adulthood. And as a teen active in sports, he frequently required repairs to fix chipped teeth.

The puzzling condition affected five generations of Graham’s family, beginning with his maternal grandfather. Graham’s mother wore false teeth for much of her life, and several of her siblings showed signs of the condition. Two of his three sons were born with natal teeth, and a granddaughter is also affected.   

Graham had a strong hunch that it was an inherited genetic condition. That curiosity ultimately shaped his career. Graham pursued genetics in medical school, driven in part by a desire to understand the condition affecting his family. Years later, he began a formal search for the responsible mutation.

After more than 12 years of research, the mystery has finally been solved.

In a study published in the International Dental Journal, a team of investigators led by Graham and his longtime Cedars-Sinai colleague Pedro Sanchez, MD, identified a mutation in the KDF1 gene as the likely root cause of natal teeth. While natal teeth are relatively common and occur in approximately 1 in every 1,000 newborns, KDF-1-related multiple natal teeth with tooth agenesis is quite rare.

Finding the Gene Mutation

Finding the mutation was not a simple task. For Graham’s first attempt in 2013, he ran tests on DNA samples he collected from affected and unaffected family members. But the genetic testing tools available at the time were not advanced enough to comb through the 20,000 genes in the human genome.

“In order to make a gene discovery, you have to know it's there, and you have to know what it does,” Graham said. “The same gene can give rise to different genetic diagnoses. And how it does that, it's not always clear.”

Years later, as Graham prepared for retirement, Sanchez, Graham’s mentee and director of Pediatric Medical Genetics at Cedars-Sinai Guerin Children’s, encouraged him to revisit the research.

Sanchez credits Graham with inspiring his own path into genetics. Over the years, the two developed a close professional and personal bond, even co-authoring medical textbooks.

“I know him, I know his family, and I'm the same age as his kids,” Sanchez said. “Knowing this condition had affected them for generations without closure, I felt there was a missing piece. The tools had evolved, and I believed we could work together and find an answer.”

A Detailed Look Into DNA

When Sanchez revisited Graham’s family data with fresh eyes and newer genetic tools, he took a more targeted approach and focused on collecting DNA samples from four family members: Graham and one affected son, as well as Graham’s wife and one unaffected son, who served as controls.

This time, Sanchez deployed whole genome sequencing, a comprehensive test that analyzes a person’s entire DNA sequence.

“I treated them just like a family we see in our clinic,” Sanchez said. “We ended up doing a focused exam, and we sequenced all four of them.”

The strategy worked.

The team pinpointed a mutation in the KDF1 gene, which is known to play a role in epidermal development, including structures like skin and teeth.

The finding doesn’t offer a cure for tooth agenesis, but it opens doors to earlier diagnosis, improved counseling for families and a pathway for research into potential treatments. It may also strengthen advocacy efforts for dental insurance coverage.

For Graham, however, the impact is more than scientific. After decades of questions, the answer is finally in hand, bringing a sense of closure to a family that dealt with this trait for generations. Sanchez said he’s honored to be part of the solution.

“Dr. Graham, as a mentor, taught me to be a physician,” Sanchez said. “It's really nice that he was able to share the findings with his family and finally give the gene variant that has affected them for generations a name.”

Read more from Cedars-Sinai Stories and Insights: How Do Your Genes Fit? Cracking the Code on Breast Cancer Risk

The new study, called BLOOMS (Babies’ Longitudinal Outcomes, Omics and Milestones Study), launched last year with the goal of recruiting approximately 1,000 infants admitted to neonatal intensive care units (NICUs) at Cedars-Sinai and another 1,000 infants admitted to NICUs across three National Health System (NHS) hospitals in the United Kingdom. In addition to Guerin Children’s, BLOOMS brings together an international research team led by investigators at the University of Cambridge in the U.K. and collaborators in Singapore from the Agency for Science, Technology and Research (A*STAR).

Using genomics to address urgent health needs of the sickest, most vulnerable babies in the NICUs, the research aims to predict future health complications that might affect children’s school readiness by age 5.

“The study is part of the ambition at Guerin Children’s to integrate genomics into care across the lifespan,” said David H. Rowitch, MD, PhD, the principal investigator of BLOOMS and deputy director of Research at Guerin Children’s. “With the support of the Wellcome Trust funding and global collaboration across three countries, we are opening new pathways to better understand the challenges associated with NICU admission so that we can effectively support every child’s full potential.”

While most institutions in the consortium can perform whole genome sequencing to identify genetic risks, Cedars-Sinai’s unique expertise in proteomics—advanced tools to study the structure and function of proteins in real time—provides further valuable insights. Cedars-Sinai investigators aim to use proteomics to identify early disease biomarkers that might predict health and neurodevelopmental conditions that affect school readiness.

Having early access to often overlooked yet vital information about at-risk NICU babies could significantly aid in mitigating future health and developmental challenges by understanding disease origins and in driving targeted treatments.

The study will incorporate the outcome of school readiness, a common assessment tool in the U.K. typically used to measure a child’s physical, cognitive, social and emotional development for integrating into the formal schooling system. This important predictor of early life-course trajectory may be positively influenced by early medical and educational interventions.

“By early identification of school readiness issues such as a learning disability—especially in NICU babies—we can enable medical teams to potentially implement timely interventions, including precision medicine approaches based on genetic makeup to improve the life trajectory for these children,” said Catherine Aiken, MD, chief lead investigator of the study and an academic clinical lecturer in the Department of Obstetrics and Gynaecology at the University of Cambridge.

The study will follow the recruited children until they reach the age of 5, with results expected to be reported by 2033.

“International collaboration is key to advancing research and solving global health challenges,” said Neerja Karnani, PhD, deputy director at A*STAR Bioinformatics Institute and senior principal investigator at the A*STAR Institute for Human Development and Potential (A*STAR IHDP).  

Singapore’s participation in BLOOMS, supported by A*STAR BII’s expertise in secure data analytics, will create opportunities to integrate and align early childhood development initiatives and strategies with the U.K.

By pooling diverse genetic data from the participating institutions, the investigators hope to initiate a paradigm shift in diagnosing and treating early childhood diseases, moving toward a more proactive approach to addressing pediatric health complications on multiple continents as early as possible. 

“The BLOOMS study is a testament to Cedars-Sinai's unwavering commitment to advancing pediatric care through leading-edge research,” said Shlomo Melmed, MB, ChB, executive vice president of Medicine and Health Sciences and dean of the Medical Faculty at Cedars-Sinai. “By participating in this global collaborative effort, we are enhancing our understanding of genomics and improving long-term health outcomes for newborns and their families.”

Read more from Cedars-Sinai Stories and Insights: A Map of Disease Beginnings

Pediatric epilepsy affects nearly 470,000 children in the United States, making it the most common childhood brain disorder. There are many types of epilepsy, including Dravet syndrome, a rare and severe form of the condition, caused by a specific genetic mutation that typically begins in the first year of life. It affects 1 in 15,700 children and significantly impacts quality of life.

“Dravet syndrome is the most common genetic epilepsy disorder we see in children that requires specialized care and attention,” said Deborah Holder, MD, program director of Pediatric Epilepsy at Guerin Children’s. “Awareness is critical so families and healthcare providers can recognize the early signs and seek the right interventions.”

With November marking Epilepsy Awareness Month, the Cedars-Sinai Newsroom recently spoke with Holder to learn more about Dravet syndrome, early signs of seizures to watch for, how genetics play a role and why increased awareness and early detection can be life-changing.

What is Dravet Syndrome?

Dravet syndrome is a type of epilepsy that presents in childhood. It's predominantly caused by a mutation in a gene, specifically a sodium channel gene called SCN1A, which is one of the genes that impact how the brain works. It usually starts with seizures in childhood. Most children have their first seizure, usually between one year and 18 months, although it can start as young as six months.

What are the Symptoms of Dravet Syndrome?

Patients with Dravet syndrome typically present with seizures triggered by high fevers, which can be caused by illness, infection or fever occasionally following vaccination. Early seizures are often hemiclonic, meaning they involve rhythmic motor activity on one side of the body. A seizure may occur on the left side of the body the first time and then on the right side of the body the next time. 

A doctor will see a patient come in with these very long, often prolonged seizures, which we call status epilepticus. Such seizures require significant intervention with lots of medications and hospital care.

Children with Dravet syndrome face multiple challenges, including developmental difficulties that may lead to behavioral disorders, delayed language and speech issues, nutrition and sleeping difficulties and abnormalities in gait and walking. Additionally, the condition can affect other parts of the body, such as the heart.

How is Dravet Syndrome Diagnosed?

Because Dravet syndrome is one of the most common genetic epilepsy disorders in children, it’s important to perform genetic testing early. Identifying the underlying mutation allows us to make an accurate diagnosis. Evaluating the child’s seizure patterns and seizure type also helps us gather the information needed to choose the right medications to bring seizures under control.

The challenge with Dravet syndrome lies in the way it affects a child’s genetics. Although patients may appear to have long focal seizures, the medications typically used for focal seizures can actually make their condition worse. This is why it’s really important that we make the genetic diagnosis so we can treat the gene mutation, instead of the seizure type. It’s also important to note that

Is Dravet Syndrome an Inherited Disorder?

Dravet syndrome is not usually inherited from the parents. Many people hear “genetic disorder” and assume it occurs when the gene is passed down from the mother or father, but most genetic epilepsies are what we call “de novo,” meaning the mutation occurs for the first time in the child and is not connected to family history. Even if the parents are completely healthy, a child can be diagnosed with Dravet syndrome. In other words, any baby could potentially be at risk.

How is Genetic Testing Performed for Dravet Syndrome?

Genetic testing now is very easy. We just do a cheek swab. We don't even have to do a blood test. For pediatric patients, we typically do what's called whole exome sequencing, which really sequences all of the genomes we're familiar with today. Instead of doing a panel where we look at the most common genes that cause epilepsy, we really sequence everything. This way, we don't miss any of the genes that we are currently aware of, including SCN1A, the gene that causes Dravet syndrome.

How Do You Treat Dravet Syndrome?

Several anti-seizure medications are specifically approved for Dravet syndrome, including cannabidiol (CBD), which has been formally studied and found effective to manage the condition. However, medications don’t work for everyone, so other approaches can help.

Diet therapy, such as the ketogenic diet—a high-fat, low-carb diet that puts the brain into ketosis—can be very effective. We typically combine medication and diet therapy for the best results.

Additionally, there are several devices and rescue therapies available to help stop prolonged seizures and reduce hospital stays for children with Dravet syndrome. The vagus nerve stimulator is a device commonly used for Dravet syndrome. We place a wire along the vagus nerve, which is a nerve that runs along the neck. The device is designed to continuously monitor the heart rate and, when it detects a rise in heart rate and seizure activity, it sends signals to the brain to both prevent and stop seizures in its tracks.

Currently, there are also a few clinical trials exploring gene-modifying therapies. These approaches aim to directly target the underlying genetic cause, potentially controlling Dravet syndrome more effectively and improving the quality of life for children.

Read more on the Cedars-Sinai Blog: Personalized Epilepsy Treatment for Each Child

, marks a major step toward bringing automated echocardiography reports into patient care.

An echocardiogram uses ultrasound to create images of the heart and the results are analyzed by cardiologists or sonographers trained to read the results.

“Our AI model addresses a critical need,” said David Ouyang, MD, adjunct assistant professor in the Smidt Heart Institute at Cedars-Sinai and co-corresponding author of the study. “Many hospitals and clinics, especially in rural areas, do not have cardiologists or sonographers on staff. By generating accurate automated reports for physicians, we could improve access to this important diagnostic technology.”

The AI model investigators created, called EchoPrime, is a type known as a foundation model. These models are trained on massive datasets and can perform multiple tasks, including assessing ultrasound images and evaluating clinical report text. EchoPrime was trained on greater than 10 times more data than prior AI foundation models for echocardiography, making it the largest such model to date, according to the investigators. EchoPrime analyzes ultrasound images, then produces a verbal summary of heart function and structure meant to assist clinicians in diagnosing a patient.

The team trained EchoPrime on more than 12 million videos paired with cardiologists’ written interpretations of the tests. They then tested the model on data from Kaiser Permanente Northern California, Cedars-Sinai Medical Center, Stanford Health Care, Beth Israel Deaconess Medical Center in Boston, and Chang Gung Memorial Hospital in Taiwan. The investigators found that EchoPrime outperformed other foundation models for interpreting echocardiograms and matched or exceeded the performance of AI models designed to perform a single ultrasound task. It was also able to detect rare diseases of the heart.

The investigators are now conducting randomized clinical trials that compare reports generated by EchoPrime with those produced by cardiologists and sonographers. The goal is to confirm the accuracy of the model and ensure it is useful to cardiologists.

“This remarkable study from Dr. Ouyang and colleagues builds on several years of AI-enhanced imaging science at Cedars-Sinai,” said Sumeet Chugh, MD, vice dean and chief artificial intelligence health research officer at Cedars-Sinai. “EchoPrime is a unique foundational model that could potentially democratize AI-powered echocardiography interpretation on a global scale.”

Other Cedars-Sinai authors include Milos Vukadinovic, I-Min Chiu, Debiao Li and Susan Cheng.

Other authors include Xiu Tang, Neal Yuan, Tien-Yu Chen, Paul Cheng and Bryan He.

Funding: D.O. discloses National Institutes of Health NHLBI grants R00HL157421, R01HL173526 and R01HL173487.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Eduardo Marbán, MD, PhD, executive director of the Smidt Heart Institute at Cedars-Sinai, will give the George E. Brown Memorial Lecture at the American Heart Association Scientific Sessions 2025 in November in New Orleans. The Association created this lecture in 1935 to honor the memory of clinician and researcher George E. Brown, MD, and every year selects a distinguished scientist to share advances in cardiovascular science. Marbán will present “Discovery Arc From Cell Therapy to Novel Noncoding RNA Drugs.” Marbán’s laboratory was the first to isolate and culture human heart cells capable of repairing damaged tissue.

Also at Scientific Sessions, Jennifer Van Eyk, PhD, director of Basic Science Research in the Barbra Streisand Women’s Heart Center, will be honored with the 2025 Council on Basic Cardiovascular Sciences Distinguished Achievement Award.

Van Eyk, the Erika J. Glazer Chair in Women’s Heart Health, is an international expert in clinical proteomics, the study of proteins in the body and how diseases affect those proteins. Her work has shown that proteins surpass genes as a source of real-time insights on what’s happening—and what is going to happen—inside the body. Much of her research focuses on how heart disease affects men and women differently at the molecular level.

“It is a privilege to see Dr. Van Eyk honored by the Association for nearly three decades of work in cardiovascular research,” said Marbán, the Mark Siegel Family Foundation Distinguished Chair. “This recognition reflects her profound impact on science and patient care, and we commend her for her commitment to excellence as she continues to pioneer earlier detection for conditions such as cardiovascular disease.”

Among Van Eyk’s most recent efforts is the development of remote blood sampling, which allows people to mail in samples for analysis and leads to faster, more personalized health assessments.

“This award highlights the incredible progress we’ve made in using proteomics to understand heart disease,” said Van Eyk, director of the Advanced Clinical Biosystems Research Institute and professor of Cardiology, Biomedical Sciences and Pathology and Laboratory Medicine. “By studying proteins, we’re moving closer to detecting conditions like heart failure before symptoms appear. Our goal is to make early diagnosis as simple as mailing in a blood sample.”

Ananth Karumanchi, MD, professor of Medicine and director of the Renovascular Research Center, is the recipient of the Association’s 2025 Excellence Award for Hypertension Research—one of the highest honors in the field. Karumanchi, the Medallion Chair in Vascular Biology, received the Excellence Award for Hypertension Research at the American Heart Association Hypertension Scientific Sessions in September in Baltimore. The award honors scientists whose work has significantly advanced understanding and treatment of high blood pressure and related conditions.

Karumanchi’s work focuses on hypertension during pregnancy. His particular focus is preeclampsia, a serious blood pressure condition that can be fatal and increases a woman’s risk of heart disease, heart failure and stroke later in life. He is currently leading an international team studying how the placenta impacts heart health in mothers and infants. The project builds on Karumanchi’s earlier work, which pinpointed a protein in the blood that could help doctors detect preeclampsia earlier.

“I’m honored to have received this award from the American Heart Association,” Karumanchi said. “It underscores the dedication of our team as we work to better understand and treat hypertension and preeclampsia and improve cardiovascular health for mothers and babies.”

Jiun-Ruey Hu, MD, MPH, a fellow in interventional and structural cardiology in the Department of Cardiology, has also been selected as an Association award recipient. He will be recognized at this year’s Scientific Sessions as the winner of the 2025 Kidney in Cardiovascular Disease Educational Tools Contest.

Hu mentored a medical student (Sara Pollanen) in creating a digital tool to help clinicians treat patients with cardiorenal syndrome, a complex condition involving the heart and kidneys. Hu previously won the award from the Association in 2022 while completing his first fellowship at the Yale School of Medicine.

“The Cedars-Sinai Health Sciences University congratulates our faculty members on their well-deserved recognition from the American Heart Association,” said Shlomo Melmed, MB, ChB, executive vice president of Medicine and Health Sciences and dean of the Medical Faculty. “Their prestigious honor awards and novel discovery presentations reflect the finest in cardiovascular science and clinical care.” 

The 2025 Scientific Sessions meeting is chaired by Joanna Chikwe, MD, the Irina and George Schaeffer Distinguished Chair in Cardiac Surgery in the Smidt Heart Institute.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

As chair of the Association’s Scientific Sessions 2025 Program Committee, Joanna Chikwe, MD, has led a redesign of the program to reflect both the challenges and the extraordinary advances shaping cardiovascular medicine and science today. Under her direction, the sessions will showcase pivotal late-breaking clinical trials that address major questions in the management of atrial fibrillation, valvular heart disease, heart failure and coronary disease.

A national leader in mitral valve reconstruction and robotic cardiac surgery, Chikwe is chair of the Department of Cardiac Surgery at Cedars-Sinai.

“It is an honor to guide this year’s American Heart Association programming and ensure that rigorous science is at the forefront of the meeting,” said Chikwe, the Irina and George Schaeffer Distinguished Chair in Cardiac Surgery. “It will be wonderful to participate alongside dozens of faculty members and trainees from Cedars-Sinai.”

Chikwe will lead a session on advances in the management of mitral and tricuspid valve disease and will chair a session about robotic innovations in valvular heart disease surgery.

Also at the meeting, Eduardo Marbán, MD, PhD, executive director of the Smidt Heart Institute, will present “Discovery Arc From Cell Therapy to Novel Noncoding RNA Drugs,” the George E. Brown Memorial Lecture. The Association’s Council on Basic Cardiovascular Sciences selected Marbán for this honor, which was established in 1935 in memory of clinician and researcher George E. Brown, MD.

In addition, Christine M. Albert, MD, MPH, chair of the Department of Cardiology, will participate in a discussion of the late-breaking science presentation “Dilemmas in Antithrombotic Therapy in AF Care Post Procedures.” Albert’s own research focuses on the epidemiology, risk stratification and prevention of sudden cardiac death and atrial fibrillation.

Janet Wei, MD, the Erika J. Glazer Chair in Women's Cardiovascular Research, Education and Innovation, will also discuss a late-breaking science presentation: “Approaches to Ischemic Heart Disease Before, During and After Hospitalization.”

Select Cedars-Sinai Experts

Several other Cedars-Sinai experts will be available for media interviews prior to and throughout the meeting.

Sumeet Chugh, MD, vice dean and chief artificial intelligence health research officer, will give a main tent talk on how generative AI can reduce clinician burden and enhance workflow. He can comment on AI research and how he is applying AI to study arrhythmias.

Joseph Ebinger, MD, associate professor of Cardiology and director of the Coronary Intensive Care Unit and Clinical Analytics, can discuss hypertension care and research.

Dominic Emerson, MD, associate director of the Cedars-Sinai Comprehensive Transplant Center and associate professor of Cardiac Surgery, can share advances in heart and lung transplantation, and evolving strategies for tricuspid valve endocarditis.

Aakriti Gupta, MD, interventional cardiologist and assistant professor of Cardiology, can discuss advances in valve disease treatment for young and moderate-risk patients.

Rose Tompkins, MD, director of the Adult Congenital Heart Program, can discuss the lifelong care of people born with a heart condition.

Media Contact

To arrange media interviews, contact Stephanie Cajigal—who will be onsite at #AHA25—at stephanie.cajigal@cshs.org or via mobile and What’s App: (United States) +1-347-806-2938.

To kick-start some Halloween magic, excited parents picked out outfits specially hand-sewn by Cedars-Sinai volunteers to accommodate the hospital’s littlest patients, bringing big smiles and a touch of normalcy in an otherwise stressful time.

“It’s hard to be in the NICU,” said Alva Pantig Gregorio, a clinical social worker who helps parents navigate their child’s stay in the NICU. “Celebrations can be difficult to keep up with when you’re at the hospital with a fragile baby. So, we bring the baby’s first Halloween to them.”

The babies’ costumes, all inspired by children’s books, included pumpkins, a watermelon, a snowman, a caterpillar, an ear of corn and a peanut, complete with a matching hat.  

Lauren Masciarelli’s son, Wesley, surprised everyone by being born two months early, and the doting mom was thrilled to pick out a classic first Halloween costume for her newborn.

“I always liked being a pumpkin as a kid, and I joked with my husband that his first costume next year could be a pumpkin. So, when I saw this, I had to go for it,” Masciarelli said. “This costume is the best quality costume I think he'll ever have in his life.”

Each outfit is lined with Velcro and tailored to accommodate the tubes, wires and other medical equipment. Parents get to take the keepsake costumes home to remember their baby’s first Halloween.

Dana Guerin, director of the Shapell Guerin Family Foundation, stopped by the NICU to join in on the fun celebration.  She was touched by the staff’s and volunteers’ dedication, exceptional care and attention to detail.

“It’s very clear that there is so much hard work and so much love that goes into this event,” Guerin said. “They go the extra mile to bring vulnerable babies, their families and the community together for a day to remember.”

Read more on the Cedars-Sinai Blog: Helmet Safety for Your Kids

“We continue to expand the number of clinicians, surgeons and physician-scientists coming together to address the most challenging heart conditions,” said Eduardo Marbán, MD, PhD, executive director of the Smidt Heart Institute. “As our program grows, we remain committed to delivering care guided by extensive research.”

Fetal Cardiology

Mark Sklansky, MD, is a leader in fetal echocardiography, the detailed evaluation of the heart prior to delivery. He is medical director of Pediatric and Fetal Cardiology Outreach in the Smidt Heart Institute and Guerin Children's, where he uses ultrasound to identify heart conditions before birth and brings his expertise to the broader community.

Prenatal detection of heart problems allows fetal cardiologists, in partnership with obstetricians, maternal-fetal medicine specialists and neonatologists, to create a treatment plan for when the baby is born. In some cases, pediatric cardiac interventionalists, working with maternal-fetal medicine specialists, can perform a minimally invasive procedure to correct the heart defect before birth. In other cases, newborns can undergo lifesaving surgery or catheter-based therapies within hours after delivery.

Prior to joining Cedars-Sinai, Sklansky founded the Children’s Heart Center at UCLA where he was also chief of Pediatric Cardiology. He has authored or co-authored more than 100 scientific papers, including the American Heart Association’s scientific statement on the diagnosis and treatment of fetal cardiac disease.

Cardiac Surgery

Laura DiChiacchio, MD, PhD, is director of Extracorporeal Membrane Oxygenation, a form of life support that temporarily does the work of a person’s heart or lungs.

DiChiacchio also directs the Ex Situ Perfusion Program. Under DiChiacchio’s leadership, the team uses specialized machines to keep donor organs alive outside of the body and to improve the function of thoracic organs following transplantation. The team also conducts translational research on thoracic organ recovery and reconditioning. 

DiChiacchio is a cardiac surgeon who focuses on adult heart and lung transplantation. DiChiacchio completed a fellowship in thoracic transplantation and mechanical circulatory support in the Smidt Heart Institute Department of Cardiac Surgery and a fellowship in cardiothoracic surgery at the University of Utah.

Organ Preservation

As director of Heart and Lung Protection and Management, Yoshikazu Suzuki, MD, procures donor organs for patients awaiting transplant, ensuring safety and reliability through each step. He uses the latest technologies to ensure organs are well-preserved, and he is tasked with creating an accessible database of donor hearts and lungs.

Previously, Suzuki was clinical associate professor in the Division of Cardiovascular Surgery at the Perelman School of Medicine at the University of Pennsylvania.

Pediatric Interventional Cardiology

Stephen Nageotte, MD, is an interventional cardiologist, an expert in using minimally invasive procedures to diagnose and treat children and adults born with a heart condition. These procedures involve using a thin, flexible tube called a catheter to view the heart and repair anatomical abnormalities, such as narrowed blood vessels or an unclosed hole in the heart. Nageotte directs the Congenital Catheterization Laboratory in the Smidt Heart Institute and Guerin Children’s. 

Nageotte joins Cedars-Sinai from Loma Linda University Children’s Hospital, where he was director of the Pediatric Cardiac Catheterization Laboratory and an associate professor. Nageotte also conducts research and has authored several peer-reviewed papers on congenital heart disease and treatments.

The Smidt Heart Institute’s cardiology, heart and vascular surgery programs are rated in the top 10 in the U.S. and #1 in California by U.S. News & World Report.

Read more from the Cedars-Sinai Blog: Why Accreditation Matters in Choosing a Congenital Heart Program

The researchers will use stem cells to improve the effectiveness of oral tissue grafting—a procedure thousands of patients undergo each year in which tissue is transplanted from another part of the mouth to improve or repair trauma from significant tissue loss. In about 1 in 4 patients, the grafts fail due to various factors, including lack of blood supply to the graft, infection and poor healing.

The study is funded by a new five-year $5.7 million grant from the National Institutes of Health (NIH) and supports a multidisciplinary team from Guerin Children’s, Virginia Commonwealth University (VCU) and the University of California, San Francisco (UCSF).

"Our goal is to deepen our understanding of the oral mucosa and to learn how to enhance mouth tissue healing,” said Ophir Klein, MD, PhD, co-principal investigator of the study, executive director of Guerin Children’s and executive vice dean of Children’s Health at Cedars-Sinai. “We plan to turn stem cells into personalized oral tissue grafts that we hope will improve outcomes for patients.”

Oral mucosa is the soft tissue lining the inside of the mouth, including the cheeks, gums and tongue. It serves as a protective barrier against bacterial infection and injury, aiding in essential functions like speaking, chewing and swallowing.

For the preclinical research, the team will grow oral tissue in the lab using induced pluripotent stem cells—adult cells that are reprogrammed into cells that can be turned into virtually any cell type—from laboratory mice. The team hopes to be able to produce, in any needed amount, personalized living grafts with blood vessels that closely resemble natural oral tissue.

“Using advanced bioengineering tools, we can create complex tissues with tiny blood vessel networks that build themselves in a short period of time,” said Zev Jordan Gartner, PhD, co-principal investigator on the study and professor of Pharmaceutical Chemistry at the UCSF School of Pharmacy.

This method, Gartner said, will help the team design custom tissue grafts that could potentially be used in any part of the mouth.

Kevin Matthew Byrd, DDS, PhD, co-principal investigator on the study and assistant professor in the Philips Institute for Oral Health Research at the VCU School of Dentistry, said the research could potentially transform reconstructive care for head and mouth injuries.

“By customizing grafts to fit individual patient needs, we are advancing toward more personalized and effective dental treatments,” Byrd said. “This research has the power to notably improve care quality and establish new dental health standards.”

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

pediatric specialists will join their peers at the American Academy of Pediatrics (AAP) 2025 National Conference & Exhibition Sept. 26-30 in Denver and will be available to comment on breaking news from the conference.

“In just a few short years, Guerin Children’s has assembled a robust roster of world-class pediatric specialists,” said Ophir Klein, MD, PhD, executive vice dean of Children’s Health and executive director of Guerin Children’s. “In our state-of-the-art facility in the heart of Los Angeles, we’ve created a pioneering healthcare destination with physicians and scientists who deliver exceptional multidisciplinary care and drive innovative research to address childhood diseases—from the womb through adulthood.”

One of these experts, neonatologist Theodora Stavroudis, MD, will serve as chair-elect of the AAP Section on Simulation and Innovative Learning Methods. At the conference, Stavroudis will present original research on neonatal resuscitation.

Guerin Children’s will also have a booth in the exhibit hall—Booth 1738—to showcase the institution’s research, medical education programs and clinical innovations.

Some of the Guerin Children’s experts available for interviews include:

Adolescent Health
Michelle Escovedo, MD, adolescent health specialist

Behavior and Development
Cesar Ochoa-Lubinoff, MD, director of Developmental-Behavioral Pediatrics

Cardiology
Evan Zahn, MD, co-director of the Guerin Family Congenital Heart Program
Richard Kim, MD, director of Pediatric and Congenital Heart Surgery

Ear, Nose and Throat
Gene Liu, MD, director of Academic Otolaryngology at Cedars-Sinai

Epilepsy
Deborah Holder, MD, program director of Pediatric Epilepsy 

Gastroenterology
Shervin Rabizadeh, MD, MBA, chair of the Department of Pediatrics and associate director of Guerin Children’s

General Surgery
Eugene Kim, MD, pediatric surgeon-in-chief and deputy director of Guerin Children’s

Genetics 
Pedro Sanchez, MD, director of Pediatric Clinical Genetics
Saquib Lakhani, MD, director of Guerin Children's Early Detection Program
Mustafa Khokha, MD, director of Guerin Children's Genetics Research Center
Joyce So, MD, PhD, chief genomics officer at Cedars-Sinai

Infectious Disease
Priya Soni, MD, assistant professor of Pediatrics

Neurology
Jane Tavyev Asher, MD, director of the Division of Pediatric Neurology

Neurosurgery
Moise Danielpour, MD, director of Pediatric Neurosurgery

Oncology
Leo Mascarenhas, MD, director of Pediatric Hematology and Oncology

Orthopedics
David L. Skaggs, MD, director of Pediatric Spine and Pediatric Orthopaedics at Guerin Children’s

Plastic Surgery
Victor Chien, MD, director of Cleft and Craniofacial Surgery

Contact: 
To arrange interviews with Guerin Children’s specialists, contact Shishira Sreenivas at shishira.sreenivas@cshs.org or 202-297-0220.

So brings more than 15 years of leadership experience in research and clinical care to her new role. She will spearhead Cedars-Sinai’s growing genomics initiatives and serve as a strategic leader for the integration of genomics into clinical practice while overseeing genetics and genomics services across the Cedars-Sinai Health System.

“We are excited to welcome Dr. So to Cedars-Sinai, knowing her exceptional expertise and leadership in clinical genetics will be a significant asset to the burgeoning prenatal, pediatric and adult genetics programs,” said Shlomo Melmed, MB, ChB, executive vice president of Medicine and Health Sciences and dean of the Medical Faculty at Cedars-Sinai. “Her appointment will ensure Cedars-Sinai remains at the forefront of genomic endeavors, benefiting and transforming the lives of our patients.”

So has joined Cedars-Sinai from the University of California, San Francisco (UCSF), where she was chief of the Division of Medical Genetics and medical director of Adult Genetics. She was also director of the institution’s designation as a National Organization for Rare Disorders Rare Disease Center of Excellence. During her tenure, she developed a comprehensive genetics program that included the launch and rapid growth of UCSF’s Adult Genetics and Preventive Genomics Clinic; the expansion of multidisciplinary specialty services in cardiovascular, neurogenetic and cancer genetics; and the implementation of innovative e-consult and telehealth services to improve access to genetic care.

So earned her bachelor’s degree with high distinction in molecular biology and molecular genetics and her medical degree from the University of Toronto. She completed her medical genetics residency at the university’s Hospital for Sick Children and earned her doctorate in molecular genetics from the Max Planck Institute for Molecular Genetics in Berlin and completed a postdoctoral research fellowship in psychiatric genetics at the Centre for Addiction and Mental Health in Toronto.

“I am honored to join Cedars-Sinai as the inaugural chief genomics officer to advance the fields of genetics and genomics with the goal of enhancing patient care and health outcomes,” So said. “Together with our talented team of investigators and clinicians, we will push the boundaries of what is possible in genomic medicine for the benefit of our patients, their families and the wider community.”

So’s current research focuses on optimizing genetic diagnosis and treatment strategies for adults with complex neurodevelopmental, neuropsychiatric and neurological conditions. She also is deeply committed to quality and continuous improvement in the delivery of genetics and genomics clinical services.

“Dr. So’s appointment reinforces our commitment to advancing precision medicine and making leading-edge genomic care accessible to all our patients through all stages of life,” said Ophir Klein, MD, PhD, executive vice dean of Children’s Health and executive director of Guerin Children’s. “We are excited to expand our research and clinical capabilities under her leadership.”

Read more on the Cedars-Sinai Blog: Do Children Need Genetic Testing?

“This novel program brings Cedars-Sinai’s exceptional expertise in heart care to a unique population: professional athletes and athletically minded individuals,” said Eli Friedman, MD, who has been appointed director of the Sports Cardiology Program.

The Sports Cardiology Program is part of the Department of Cardiology chaired by Christine Albert, MD. It is an extension of the sports medicine expertise already offered by Cedars-Sinai, where physicians serve as medical advisers for several elite sports teams. Cedars-Sinai also is the Official Medical Provider for the LA28 Olympic and Paralympic Games. 

“We offer specialized care for people who exercise and are concerned about heart health, whether or not they have been diagnosed with heart disease,” Friedman said. “Exercise and athleticism are wonderful priorities, but it’s important to ensure safety in those at risk.” 

The program also will evaluate athletes for heart conditions, and it can screen people for heart issues before they participate in a sport.

Friedman brings substantial experience to his new role. Before joining Cedars-Sinai, he was medical director of Sports Cardiology at Baptist Health South Florida in Miami and director of Sports Cardiology at the Miami Cardiac & Vascular Institute.

He has also been team cardiologist for more than a dozen professional and college sports organizations. Friedman has authored several scientific papers on athletes’ heart care and conducts research on cardiac conditions in athletes—as well as a genetic heart condition called hypertrophic cardiomyopathy, the most common cause of sudden cardiac arrest in young athletes. 

“Our region is among the most sports-conscious in the world. By building on our considerable strengths to establish the Sports Cardiology Program, the Smidt Heart Institute reaffirms its commitment to our community, and to LA28,” said Eduardo Marbán, MD, PhD, executive director of the Smidt Heart Institute and the Mark S. Siegel Family Foundation Distinguished Professor. “Under Dr. Friedman’s leadership and experience, we will build an outstanding program, helping athletes to continue doing what they love most.”

Read more from the Cedars-Sinai Blog: Can Exercise Make You Sharper and Happier?

Led by interventional cardiologist Raj Makkar, MD, the six-and-a-half-year award from the Patient-Centered Outcomes Research Institute (PCORI) will fund a multi-center clinical trial of patients 50 and older who were born with a bicuspid aortic valve, a condition in which the aortic heart valve has two flaps regulating the flow of blood rather than the normal three. People with this condition typically develop aortic stenosis, when the aortic valve becomes so narrow that it impedes blood flow out of the heart.

Bicuspid aortic valve is the most common congenital heart condition, affecting approximately 2% of people, but little data exists comparing current treatments.

Heart valve disease can cause subtle symptoms at first but progress to heart failure if not diagnosed and treated early. Both surgery and transcatheter procedures are currently used to treat aortic stenosis. Transcatheter procedures use a thin, flexible tube called a catheter to reach the damaged valve. They are considered minimally invasive and are often recommended for patients who are at high risk for complications during surgery.

“Transcatheter aortic valve replacement has changed the paradigm for nonsurgical treatment of aortic stenosis, but it needs to be studied more rigorously in patients with bicuspid aortic valves,” said Makkar, a principal investigator of the study and vice president of Cardiovascular Innovation and Intervention at Cedars-Sinai. “We look forward to addressing this important evidence gap with this PCORI-funded randomized controlled trial in collaboration with our esteemed co-investigators.”

Patients with bicuspid aortic valve stenosis enrolled in the clinical trial will be randomly assigned to have their aortic valve replaced via open-heart surgery or by a transcatheter procedure. Investigators will review results from both groups to understand which option results in better health outcomes.  

The inaugural director of the Karsh Division of Interventional Cardiology, Makkar is an authority in minimally invasive approaches to treating heart valve disease.

“The Smidt Heart Institute at Cedars-Sinai is a leader in both heart surgery and minimally invasive heart procedures,” said Eduardo Marbán, MD, PhD, executive director of the Smidt Heart Institute at Cedars-Sinai and the Mark S. Siegel Family Foundation Distinguished Professor. “This study reflects our commitment to advancing heart research and care.”

“This research is a prime example of how Cedars-Sinai fosters innovation and brings leading-edge and clinically effective research directly to patient care,” said Shlomo Melmed, MB, ChB, Cedars-Sinai's executive vice president of Medicine and Health Sciences and dean of the Medical Faculty. “The findings from this clinical trial will help doctors globally advise their patients born with a bicuspid aortic valve on the best and safest approach for treating their cardiac condition.”

The award has been approved pending completion of a business and programmatic review by PCORI and issuance of a formal award contract. PCORI is a non-profit organization with a mission to fund research designed to provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed health care decisions.

Read more on the Cedars-Sinai Newsroom: $35M Gift Creates Karsh Division of Interventional Cardiology

Cedars-Sinai experts recommend getting the flu shot starting in September before flu season begins as early as November. They say vaccination is the most powerful tool to avoid influenza-related hospitalizations or worse. As many as 130,000 people in the U.S. died from the flu last year, according to estimates from the Centers for Disease Control and Prevention.

“By getting the flu shot, you’re not only protecting yourself, you’re protecting your family and vulnerable members of the community who would suffer a more serious illness,” said Jonathan Grein, MD, director of Hospital Epidemiology at Cedars-Sinai and associate professor in the Department of Medicine.

Although vaccination is the best way to prevent the flu, Grein also recommends washing hands thoroughly and often, avoiding others who are sick, and wearing a mask when not feeling well to avoid spreading an illness to others.

The Cedars-Sinai Newsroom spoke with Grein and other Cedars-Sinai specialists about this year’s flu shot recommendations, how to manage flu symptoms and where to seek care during a flu illness.

Who Should Get the Flu Shot?

There are no significant changes to flu shot recommendations this year, Grein said. The vaccine is still advised for eligible adults, teens and children more than 6 months old, according to the Centers for Disease Control and Prevention. Those 65 and older are still encouraged to get a high-dose flu vaccine if available because it elicits a stronger immune response, and older adults’ immune systems weaken with age.

“If a high-dose flu shot is not available, older individuals should receive a standard dose, rather than skipping the shot,” Grein said. “It’s critical for older adults to protect themselves.”

Children 6 months to 8 years old who have never received a flu vaccine should receive two doses, spaced four weeks apart, said Priya Soni, MD, a pediatric infectious disease specialist at Cedars-Sinai Guerin Children’s.

“Ideally, parents should vaccinate their children before the end of October to ensure protection before peak flu season,” Soni said.

Cedars-Sinai primary care physicians and pediatricians are now offering flu shots to patients during scheduled visits. Patients who have been treated by a Cedars-Sinai primary care provider in the past 16 months can schedule a vaccination appointment through My CS-Link at locations in Beverly Hills, Marina del Rey, Santa Monica, Los Feliz, Playa Vista and Tarzana.

How to Treat Flu Symptoms

Like other upper respiratory infections, flu symptoms include nasal congestion, fever, body aches, cough, sore throat and fatigue. Most people with mild symptoms will improve at home with fluids, a pain reliever such as Tylenol and rest, Grein said. Those at high risk of more serious infection—older adults, immune-compromised individuals and others with chronic health conditions—should speak with their physician soon after symptoms appear to find out whether an antiviral medication like Tamiflu would be right for them.

Those with more severe symptoms—a very high fever, loss of appetite or inability to keep fluids down—should see their physician or visit urgent care, said Jonathan Weiner, MD, chair of the Cedars-Sinai Medical Group’s Department of Primary Care and Acute Care Medicine.

Life-threatening symptoms like difficulty breathing should immediately be addressed in the nearest emergency department.

Flu Treatment for Children

Mild flu symptoms in children look similar to those of an adult and will likewise improve with fluids, rest, and Tylenol or ibuprofen, Soni said. She cautioned against giving children aspirin because of the risk of contracting Reye’s syndrome, a rare but serious illness linked to aspirin. Higher-risk children might need an antiviral treatment prescribed by a physician.

Soni explained that children 2 and younger run a high risk of dehydration, so their parents should make sure they drink and eat enough. She also advised parents to watch for signs that their child’s symptoms might be escalating.

“If a child is struggling to breathe, or showing signs of severe fatigue, vomiting or dehydration, they should be seen promptly by their physician or in the emergency department,” Soni said.

Where to Get Care for the Flu

For children and adults with milder symptoms, a virtual visit through a mobile app like Cedars-Sinai Connect is a great first step to get reassurance or guidance on the best treatment options, Weiner said.

“A physician or other provider can see you, assess how sick you appear and determine if you need to be seen in person or if you can manage your illness at home,” said Weiner, who treats patients in person and via Cedars-Sinai Connect. “If we determine that you need to see your Cedars-Sinai primary care physician or you need to go to urgent care for your symptoms, your provider will see the notes from your virtual visit in your chart because we all share the same Cedars-Sinai medical record.”

If a flu test is needed to rule out other illnesses or for a Tamiflu prescription, Cedars-Sinai Connect providers can order one through a streamlined visit at one of Cedars-Sinai’s urgent care locations. Patients also can get an over-the-counter test at their local pharmacy. Weiner said it’s good to know if you have the flu so you can avoid spreading the illness to others. People are contagious a day before symptoms start and up until their fever has resolved and symptoms are improving—as long as five to seven days after getting sick.

If symptoms do not improve, other causes of upper respiratory tract infections need to be ruled out, which could require in-person treatment, Weiner said. He emphasized that an in-person appointment also is recommended for patients with underlying conditions, high fever, trouble keeping food and liquids down, and for anyone who is having trouble breathing.

Read more on the Cedars-Sinai Blog: Flu and RSV: How to Protect Yourself Now

.

The Cedars-Sinai Newsroom recently spoke with Jane Tavyev Asher, MD, director of the Division of Pediatric Neurology at Cedars-Sinai Guerin Children’s, about how screens affect children and teens differently depending on their age, and what parents can do to set healthy boundaries for screen time.

What is the recommended amount of screen time for children in different age groups?

Before the COVID-19 pandemic, the American Academy of Pediatrics had fairly strict guidelines: no screen time at all for children under age 2, and minimal exposure for ages 2 to 5. Ideally, screen time should be under an hour a day. For ages 5 to 11 and older, less than two hours per day.

Since the pandemic shifted much of our education and social lives online, we've had to adapt those guidelines a bit. Still, research continues to support limiting screen time to less than two hours a day for older children as well. Exceeding that amount has been associated with increased risks of anxiety, depression and other emotional challenges.

How can excessive screen time affect young children’s developing brains?

The general consensus among developmental pediatricians is that children under age 3 should have little to no screen exposure. That’s because their brains are in a critical stage of development, with key processes like myelination, the biological process that speeds up the nerve transmission to the brain, and neural pathway formation actively taking place.

When a young brain is exposed to too much screen time, it can overstimulate the visual cortex—the part of the brain that processes images—at the expense of the auditory cortex, which is vital for developing social skills and language. Ideally, we want their early learning to be grounded in real-world, interactive face-to-face experiences—not passive viewing.

How does screen time via social media impact brain development in teenagers?

Adolescence is a time when the brain is deeply focused on social development and seeking acceptance from peers. Before social media, that feedback loop was limited to in-person interactions with a small group of peers. But now, through apps and platforms, teens are exposed to a constant, amplified stream of approval or disapproval on a much larger scale.

That amplification can be harmful. It places undue stress on the adolescent brain, increasing the risk of social anxiety, low self-esteem and even depression.

Does the type of screen make a difference?

Yes, the type of screen can make a difference. A lot of what’s called “educational content” is often just labeled that way for marketing purposes, without clear evidence that it's truly educational. Watching content on a TV screen is generally safer—it’s farther from the eyes and doesn’t strain the neck or vision as much as phones or tablets.

Also, the platform matters. Streaming services like YouTube often auto-play endless content using algorithms to keep kids hooked. There’s no clear stopping point. In contrast, traditional TV typically airs for a set duration, which naturally limits screen time and reduces the risk of overconsumption.

How does screen-based learning in school affect brain development?

We’ve found that when students read something from a book, they tend to retain the information better than when they read the same content on a screen. We don’t fully understand why that is, but it does suggest that traditional learning methods still hold an important place.

That said, screens can be very helpful when used purposefully. For example, watching a video demonstration of a complex science experiment can be far more effective than trying to imagine it from a textbook. In classroom settings, it’s best when screens are used collectively, as part of a group lesson with discussion led by the teacher, rather than having each student isolate on their own individual device.

Are some children more vulnerable than others to the negative effects of too much screen time?

Yes, certain children are especially sensitive. Children with attention-deficit hyperactivity disorder, or ADHD, symptoms can become overstimulated by video games and may struggle even more with attention. Similarly, children experiencing anxiety or depression, or children who face social challenges may be more prone to negative effects from screen exposure, especially if they’re using it as an escape or replacement for in-person interaction.

In these cases, screen time should be monitored closely, and alternative, healthy outlets should be prioritized.

What are some practical tips for parents to set healthy screen time limits?

One of the most beneficial things parents can do is to ensure their children get at least two hours of physical activity each day, ideally outside. This supports not only their physical health but also their energy levels, focus and even vision.

Another important tip is to delay giving your child a smartphone for as long as possible. There’s a movement called “Wait Until 8th” that encourages parents to hold off until at least after eighth grade. The longer you can wait, the more time your child has to build a strong foundation of social and emotional development without the added pressures of smartphone use.

Read more on the Cedars-Sinai Blog: Does My Child Need Growth Hormone Therapy?  

Wei Gao, PhD, director of Neuroimaging Research and professor of Biomedical Sciences and Imaging; Jane Tavyev Asher, MD, director of the Division of Pediatric Neurology at Cedars-Sinai Guerin Children’s; and David H. Rowitch, MD, PhD, deputy director of Research at Cedars-Sinai Guerin Children’s, sat down with the Cedars-Sinai Newsroom to talk about their work.

Mapping Infant Brain Development

Gao said that besides primary motor connections, social-emotional connections are among the first an infant’s brain makes, and that these connections ladder up to other levels of intelligence.

“The first year is where you need to pay very special attention to the social-emotional development of the baby,” Gao said. “You want to provide sensitive support to the baby so the baby can develop a secure attachment with you as a caregiver. That has long-term impacts to their later achievements and quality of life.”

Social-emotional development is the key piece that integrates the core hierarchy of brain development, Gao said. It starts with sensory and motor regions to ensure early survival, then progresses to higher-order cognitive areas to develop more sophisticated social and emotional regulation skills, which are critical for mental wellbeing, learning and adaptation.

Gao and his team previously created one of the first detailed maps of connections established between different regions of the brain during the first two years of life. They aim to better understand typical brain growth trajectories, as well as how risk factors—including maternal health, prenatal exposures to harmful substances, and family environment—can influence brain growth and a child’s development.

The investigators are now conducting the Healthy Brain and Child Development study, which will follow more than 7,000 children from birth to 10 years old. Regular conversations with caregivers and imaging of the children’s brains will help investigators correlate development of brain connections with other factors in a child’s life.

“We want to use advanced imaging as a tool to detect deviations as early as possible so that we can hopefully bring them back to the normal trajectory,” Gao said.

The Effects of Screen Time During Babyhood

Tavyev Asher is a pediatric neurologist who collaborates with Gao. She said a baby’s brain develops sensory abilities first, followed by language and social skills—a process that can be derailed by screen time.

Before the age of 12, the auditory and the visual areas of the brain are being fine-tuned, but looking at a screen develops only the visual cortex of the brain, Tavyev Asher said. The auditory cortex, which supports social interactions, develops through in-person interaction.

“Real life moves at a much slower pace than the rapidly flipping images on a device or screen,” Tavyev Asher said. “The brain is developing its communication patterns in those first few years of life, so you are training that brain exactly what it needs for its future. If you're exposing that brain to a screen, that brain thinks it needs to be able to pay attention to these rapidly changing images but not to the slower things of the real world.”

To make sure language, hearing and social skills develop, Tavyev Asher urged parents and caregivers to prioritize face-to-face interaction with their babies. She also said that early screen time can affect a child’s later learning skills, including reading and writing proficiency.

“Reading comprehension, reading speed, reading fluency and memorization are all going to be enhanced if you're reading from an actual book rather than on the screen,” Tavyev Asher said. “The single most important thing that parents can do for their children right now is to keep them off screens between the ages of 0 and 3.”

The Importance of Genetics

Rowitch, a neonatologist, developmental neuroscientist and expert on pediatric neurological disease, said that genetic tests developed over the past 10 years can analyze all 3 billion base pairs, the letters that make up a person’s genetic code. These tests can offer crucial information on an infant’s brain development as well as the child’s future mental and physical health.

“We find that almost 80% of babies with a genetic condition exhibit a neurological manifestation,” Rowitch said. “For example, that could be weakness of the muscles, seizures or a structural abnormality of the brain that we identify by MRI. It is important to understand and capture these conditions to ensure the correct diagnosis and treatment.”

Pairing genetic testing with a map of normal brain development such as the one created by Gao can help clarify how genetic conditions change development patterns, Rowitch said. This could be especially true for babies born preterm.

“We want to be able to anticipate future health or neurodevelopmental problems,” Rowitch said. “The earlier we detect alterations, the sooner we can intervene to improve the child's developmental trajectory.”

Detecting serious genetic conditions at birth also could have implications for a child’s school readiness and long-term health outcomes.

“Together, these studies emphasize the importance of early brain development. If we understand how genetics affects school readiness, that starts to open up another set of questions,” Rowitch said. “How can we make a child school-ready who might otherwise be in a high-risk category? If we can bring together genetics, brain mapping and cognitive assessment, we can create interventions that can help every child reach their potential.”

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

The prestigious national honor bestowed annually by the medical association recognizes Sanchez’s outstanding contributions to pediatric medicine, his leadership in advancing health equity and his unwavering dedication to the Hispanic community. And Sanchez himself credits his Hispanic cultural roots and values for leading him to a career in medicine.

“It is truly humbling to be recognized by the National Hispanic Medical Association,” said Sanchez, who is also the director of Pediatric Medical Genetics at Guerin Children’s. “Growing up in a Hispanic household, I learned that the foundation of healing is planted at home and nurtured by trust, respect, culture and faith. As a clinical scholar and physician-scientist, I am reminded every day that our work reaches far beyond the clinic.”

Sanchez will be recognized at the association’s 28th annual conference, “Uniendo Voces: Advancing the Future of Latino Health,” on June 7 in Anaheim, California. Established in 1994, the nonprofit organization represents more than 50,000 licensed Hispanic physicians in the United States.

“At Guerin Children’s, ensuring that children and families from California and beyond receive personalized, inclusive care is a top priority,” said Shervin Rabizadeh, MD, MBA, deputy director of Guerin Children’s and chair of the Department of Pediatrics. “Sanchez has played a leading role in developing culturally responsive pediatric genetic services.”

Sanchez said the award highlights the importance of integrating cultural understanding into every aspect of medical care.

“As pediatric geneticists, we care for some of the most vulnerable members of our community— children and families navigating rare and complex conditions,” said Sanchez. “By building trust, improving access and mentoring the next generation of clinicians, we help create a healthcare system that not only treats disease but honors the unique culture, stories and heritage of all patients.”

Sanchez’s leadership roles are wide-reaching. Most recently, he was named as the Advisory Committee Chair for the American College of Medical Genetics and Genomics Engage, Equip, and Empower (E3): Genomics Pathways Program. The program seeks to inspire and prepare the next generation of leaders in genetics and genomics by providing early exposure to the field to high school, community college and undergraduate students from underrepresented backgrounds.

“Sanchez’s work reflects Guerin Children’s mission to improve bench-to-bedside healthcare for all communities,” said Ophir Klein, MD, PhD, executive vice dean of Children’s Health and executive director of Guerin Children’s. “This award is a fitting tribute to his compassion, expertise and commitment to care for our youngest patients.”

Read more on the Cedars-Sinai Blog: Do Children Need Genetic Testing?

 In 2021, Emerson and a team of Cedars-Sinai surgeons performed the world’s first robotic lung transplant. Since then, the medical center has completed the most robotic lung transplants in the world. The innovation uses tiny incisions to reduce pain, complications and recovery time.

Emerson, associate professor of Cardiac Surgery in the Smidt Heart Institute at Cedars-Sinai, will further strengthen and unify the thoracic and abdominal transplant arms of the Comprehensive Transplant Center, which ranks among the top 10 in the U.S. by volume. Emerson was also recently appointed program director of the Accreditation Council for Graduate Medical Education thoracic surgery residency and fellowship programs at Cedars-Sinai, an important role overseeing the education and training of junior surgeons. 

“Dr. Emerson’s leadership helped guide our teams to perform more transplants in 2024 than we ever have before, all while achieving exceptional patient outcomes,” said Irene Kim, MD, director of the Cedars-Sinai Comprehensive Transplant Center and the Esther and Mark Schulman Chair in Surgery and Transplantation Medicine.

Emerson will continue as associate surgical director of Heart Transplant and Mechanical Circulatory Support, director of Robotic Cardiac Surgery, and director of the Accreditation Council for Graduate Medical Education Fellowship Program. In addition, Emerson is on the editorial board of The Annals of Thoracic Surgery.

“It’s an honor to help give the opportunity for a longer life to the many people around the world who are desperate for a heart or lung transplant, as well as those patients in need of specialized cardiac surgery,” Emerson said.

Emerson’s research lab focuses on advanced machine perfusion techniques that better preserve and reduce damage to organs before they’re transplanted, which can boost success rates and improve the rates of transplants. His most notable contributions include a landmark study of lung transplantation for end-stage COVID-19 lung disease, published in the New England Journal of Medicine, and a national analysis of how devices that assist the heart called LVADs can improve outcomes in older adult patients, published in the Journal of the American College of Cardiology. Additionally, Emerson and Cedars-Sinai colleagues are leading the creation of a multi-institutional registry to better understand the benefits of robotic lung transplant.

“Dr. Emerson has been a remarkable colleague and role model for the cardiac surgery team,” said Joanna Chikwe, MD, professor and chair of the Department of Cardiac Surgery and the Irina and George Schaeffer Distinguished Chair in Cardiac Surgery in the Smidt Heart Institute. “He also is a patient, kind and gifted teacher, training many surgeons who have gone on to lead successful transplant programs.”

Emerson’s research has been published in more than 100 peer-reviewed publications and journals, including the New England Journal of Medicine, Circulation, Journal of the American College of Cardiology, Journal of Thoracic and Cardiovascular Surgery, The Annals of Thoracic Surgery, European Journal of Cardio-Thoracic Surgery, The Journal of Heart and Lung Transplantation, and Circulation: Heart Failure.

Emerson earned his undergraduate degree and medical degree from the University of Washington. He completed his general surgery residency at Georgetown University Hospital and completed fellowships in cardiothoracic surgery and thoracic transplantation at Cedars-Sinai. He joined the Cedars-Sinai faculty in 2019.

Read more on the Cedars-Sinai Blog: The Wait for a New Heart

, whose research into sudden cardiac arrest has led to novel methods of predicting the usually fatal condition, has been promoted to vice dean and chief artificial intelligence health research officer at Cedars-Sinai.

Chugh was also honored recently with the Heart Rhythm Society’s 2025 Distinguished Scientist Award for clinical science. The award was presented April 26 during Heart Rhythm 2025 in San Diego. 

“This award recognizes Dr. Chugh’s dedication to understanding sudden cardiac arrest and preventing this deadly emergency,” said Eduardo Marbán, MD, PhD, executive director of the Smidt Heart Institute at Cedars-Sinai.

The Distinguished Scientist Award is given to an investigator who has made a lasting impact on patient care and the field of heart rhythm research. Chugh has dedicated his career to improving prediction and prevention of sudden cardiac arrest, a heart rhythm disorder that causes the heart to stop and often leads to instant death. He has published more than 275 scientific papers.

“I’m grateful to the Heart Rhythm Society for this recognition of our work and accept it on behalf of my colleagues and mentees at Cedars-Sinai,” said Chugh, the Pauline and Harold Price Chair in Cardiac Electrophysiology Research. “Our team is motivated to make a real impact on this deadly condition.”

According to the American Heart Association, more than 356,000 out-of-hospital cardiac arrests occur each year in the U.S. Nearly 90% of them are fatal.

Chugh’s team discovered a new method for identifying the best candidates for the implantable defibrillator, a lifesaving intervention. They also combined data from emergency responders, medical records and biological samples to predict imminent sudden cardiac arrest within hours to days of warning symptoms. Their work has improved identification of people at risk and led to the term “near-term prevention” of sudden cardiac arrest.

Chugh is also a leader in artificial intelligence research, which he has harnessed to improve prediction of sudden cardiac arrest.

In his new role as vice dean and chief artificial intelligence health research officer, Chugh will oversee the translation of AI research into clinical trials and patient care. He will lead the new Artificial Intelligence in Medicine Research Center (AIMRC), which will help departments and institutes incorporate AI into their research.

“Dr. Chugh is a foremost investigator in both heart rhythm and AI research,” said Jeffrey Golden, MD, executive vice dean for Research and Education at Cedars-Sinai. “His use of AI to assess the risk for sudden cardiac arrest has the potential to advance the field and save lives. We are eager for him to broaden his AI research experience to all areas of clinical care at Cedars-Sinai.”

In 2024, Chugh received the Distinguished Scientist Award for clinical science from the American College of Cardiology. He is a member of the American Society for Clinical Investigation and the Association of American Physicians, and is past president of the Association of University Cardiologists and the Cardiac Electrophysiology Society.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Coronary artery disease occurs when cholesterol deposits build up in the walls of the heart’s arteries, leading to formation of plaques that begin as areas of inflammation. When inflamed plaques grow large, they become prone to rupture, which can cause heart attack. Evolocumab is in a class of drugs called PCSK9 inhibitors that can dramatically reduce cholesterol.

“This discovery has important implications for understanding how evolocumab improves cardiovascular outcomes,” said Daniel S. Berman, MD, director of Cardiac Imaging in the Department of Cardiology in the Smidt Heart Institute at Cedars-Sinai and principal investigator of the study published in JACC: Cardiovascular Imaging.

Investigators administered evolocumab to 47 patients, all of whom had substantial buildup of noncalcified plaque in their coronary arteries. This type of plaque is regarded as higher risk than calcified plaque because it is softer and more likely to rupture and cause harm.

Before and 18 months after treatment with evolocumab, investigators studied inflammation in the coronary arteries using radioactive sodium fluoride and imaging with positron emission tomography (PET). They also used coronary computed tomography angiography (CCTA) coupled with a novel artificial intelligence quantitative method developed at Cedars-Sinai to measure changes in inflammation and plaque volumes in the coronary arteries.

The scans showed that, on average, plaque inflammation decreased and noncalcified plaque became smaller with evolocumab.

“Most attention has been placed on the cholesterol-lowering effects of PCSK9 inhibitors,” said Donghee Han, MD, a Cedars-Sinai internal medicine resident who is also a researcher in Berman’s laboratory and joint first author of the study. “Our findings demonstrate that reducing inflammation may be an important mechanism for reducing the risk of heart attack with these powerful drugs.”

Other Cedars-Sinai authors include Rebekah Park, Heidi Gransar, Mark Hyun, John D. Friedman, Sean W. Hayes, Louise E. J. Thomson, Alan C. Kwan, Prediman K. Shah, Sarah Wetzel, Chloe Findling, Piotr J. Slomka and Damini Dey. Other authors include joint first author Evangelos Tzolos, Matthew Budoff, Jacek Kwiecinski and co-senior author Balaji K. Tamarappoo.

This study was supported in part by NIH grants 1R01HL148787-01A1 and R35HL161195, the Dr. Miriam and Sheldon G. Adelson Medical Research Foundation and Amgen Inc.  

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Michelle Kittleson, MD, PhD, director of Post Graduate Medical Education in Heart Failure and Transplantation, received the American College of Cardiology 2025 Distinguished Teacher Award. Richard Wright, MD, an advanced heart failure and transplant cardiologist and board chair of Pacific Heart Institute, an affiliate of Cedars-Sinai, received the Master of the ACC Award. And postdoctoral researcher Andrew Lin, MBBS, PhD, under the mentorship of Damini Dey, PhD, professor of Biomedical Sciences at Cedars-Sinai, is the co-recipient of the Jagat Narula Award for Outstanding Scholarship from JACC: Cardiovascular Imaging.

“Congratulations to Dr. Kittleson, Dr. Wright and Dr. Lin on this notable recognition from the ACC and JACC,” said Christine Albert, MD, MPH, chair of the Department of Cardiology and the Lee and Harold Kapelovitz Distinguished Chair in Cardiology. “We are proud of their substantial contributions to all aspects of cardiovascular medicine that encompass education, research and clinical care. It’s gratifying to see them receive recognition from their peers for their pioneering leadership in the field.”

The Distinguished Teacher Award recognizes a fellow of the ACC who has demonstrated innovative, outstanding teaching characteristics and compassionate qualities and has made major contributions to the field of cardiovascular medicine.

Kittleson, a professor of Cardiology, also is associate editor of the JACC. She is widely known as a participant in national educational efforts, including helping develop evidence-based cardiomyopathy and heart failure guidelines. She also is known for fostering an active and engaged social media community, sharing cardiology-related discussion points, questions and pearls of wisdom with followers.

“I’m humbled and grateful to be among the cardiovascular physicians and researchers nominated for and receiving this recognition from the American College of Cardiology,” Kittleson said. “Teaching is of great interest to me, and I consider it a privilege to teach new physicians as well as the public. As an academic medical center, we want our teaching to go far beyond the walls of Cedars-Sinai.”

The Master of the ACC Award honors fellows of the ACC who are consistent contributors to the goals and programs of the college and who have provided leadership in important college activities, serving with distinction for at least 15 years and providing leadership on various programs and committees.

Wright has served as president of the California Chapter of the ACC. He is a highly regarded lecturer and was co-author of the U.S. guidelines on management of patients with heart failure. He also is a previous recipient of the Specialist of the Year Award from the California Chapter of the ACC.

“The ACC is known for its pronounced focus on setting new standards in cardiovascular medicine,” Wright said. “I’ve enjoyed and learned much from my peers as part of the ACC over many years.”

Lin’s research focuses on coronary plaque phenotyping using coronary computed tomography and artificial intelligence techniques.

The Jagat Narula Award for Outstanding Scholarship was awarded to Lin and Márton Kolossváry, MD, PhD, based on their manuscript, “Coronary Plaque Radiomic Phenotypes Predict Fatal or Nonfatal Myocardial Infarction: Analysis of the SCOT-HEART Trial,” published in 2024 in JACC: Cardiovascular Imaging.

“I pursued cardiovascular research to be at the forefront of innovation and help advance evidence that improves care for patients with coronary heart disease,” Lin said. “I’m especially grateful to JACC for recognizing our research into ways to better predict heart attack risk.”

As the mentor for Lin and Kolossváry, Dey also expressed gratitude to JACC for recognition of their research and added, “We are committed to continuing important investigations into new ways of predicting and preventing heart attacks.”

ACC President Cathleen Biga, MSN, extended congratulations, saying, “These heart experts have each demonstrated exceptional work that will further the ACC’s mission to transform cardiovascular care and improve heart health for all.”

In addition to the awards presented at the ACC’s Annual Scientific Session, the California Chapter of the ACC named C. Noel Bairey Merz, MD, director of the Barbra Streisand Women's Heart Center, the 2024 Elliot Rapaport Cardiologist of the Year. Bairey Merz received the award at a Chapter meeting in January.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

“For very young children, use simple explanations when answering their questions,” Hedrick said. “With older children, you want to be honest and open, directly answering questions and using as simple language as possible.”

Playtime can help children express themselves and feel a sense of control. One example, Hedrick said, is focusing on the positive aspects of knowing fire safety.

“For children who haven’t lost their homes but are affected by the fires, involve them in age-appropriate fire drills,” she said. “Or allow other types of play to be related to the fire, because a lot of times it’s easier for kids to express their feelings through play than by outwardly saying, ‘I'm feeling scared.’”

Building simple forts with pillows, blankets and sheets can be a beneficial play activity for children of all ages—even some middle schoolers, Hedrick said.

“The parent can get inside the fort with them and talk about feelings, as the child may feel safer there,” she said.

It also can be helpful for parents to model how to express feelings.

“A parent could say something like, ‘I noticed I was feeling a little scared today; are you feeling scared?’ This gives their child a chance to talk about feelings of fear, anger, sadness,” she said.

Alternatively, when the child says they’re angry, sad or scared, parents should acknowledge those emotions.

“It’s important not to say, ‘You don't have to feel sad or scared or angry,’” Hedrick said. “It's better to say, ‘Of course, that’s how you’re feeling and it’s perfectly normal. At the same time, there are things we can be grateful for—let’s talk about some of those.’”

Tweens and teens especially may find journaling helpful, as well as art, physical activities and supportive connections with their peers.

“Reminders that there is hope, and that the family will get through this together, are important,” Hedrick said.

Read more on the Cedars-Sinai Blog: Art Therapy Helps Children Cope With Trauma

The Cedars-Sinai Newsroom spoke to two infectious disease specialists—Jonathan Grein, MD, director of Hospital Epidemiology, and Priya Soni, MD, a pediatric infectious disease specialist at Cedars-Sinai Guerin Children’s—to get the facts about how to protect yourself and your family.

Why is measles so dangerous?

Priya Soni, MD: Many people think that measles is just a rash, but it can be life threatening. One in 5 children who develop measles end up in the hospital. One in 20 children develop pneumonia, and this is the leading cause of measles-related deaths. In addition, 1 in 1,000 children can develop a rare complication of brain swelling—encephalitis—that can cause permanent brain damage.

How does measles spread?

Jonathan Grein, MD: Measles is one of the most infectious diseases that we know of, and it's spread very easily through the air, particularly for people who are not immune or have not received the vaccine. It's so infectious that you don't even need to be in the same room at the same time with someone who has measles to potentially get infected.

What are the telltale signs of measles?

Grein: The symptoms of measles can begin like any other viral illness. You may feel feverish, have muscle aches, headaches, very nonspecific symptoms. Patients may then go on to develop cough, runny nose, sometimes redness of the eyes. That all precedes the classic rash that you may be familiar with that typically starts on the face and spreads throughout the body. I think it’s important to know that it is possible to be infectious several days before that rash begins, which is one of the real challenges with trying to control measles from being spread person to person.

What should you do if you think your child has measles?

Soni: If you think your child has measles, the first thing to do is call your pediatrician, but do not go directly to their offices or the Emergency Department without speaking to someone on the phone first. The virus is extremely contagious, so you want to call ahead to let the healthcare providers know what’s going on. Showing up without calling ahead can cause other children in the waiting room to be infected. In addition, you should immediately isolate your child from other children, especially infants who are less than a year of age, as they may not have protection from the virus. You should also isolate your child from any immunocompromised family members.

How is measles treated?

Grein: The treatment for measles is solely supportive. There is no specific measles treatment, but you want to try to control the fever and make sure the patient is hydrated and resting in isolation.

How do we protect against measles?

Soni: Vaccination is the best protection against measles. The MMR vaccine, which is inclusive of measles, mumps and rubella, is 97% effective after two doses. It's one of the most effective vaccines that we have. And it protects children in outbreak situations and other vulnerable community members as well.

Typically, the first dose of the measles vaccine is given at 12-15 months of age. The second dose is given around 4-6 years of age.

If your child is 6-12 months old, they can receive an early dose of the measles vaccine if they're in a high-risk situation such as an outbreak or if they’ve been exposed to the virus. This additional dose that's given earlier than the recommended schedule does not count toward their two-dose series.

Do adults need to get vaccinated against measles?

Grein: Most adults will not need an additional booster dose if they were previously vaccinated. There is a small number of adults who may have received a different version of the measles vaccine between 1963 and 1967. This vaccine was later found to be less effective, and it doesn't provide as long-lasting immunity as the current vaccine. So if you did receive that vaccine, it is recommended that you receive a booster dose with the current MMR vaccine to achieve appropriate immunity.

Read more on the Cedars-Sinai Blog: Why Some Vaccines Last A Lifetime and Others Don't 

A former pack-a-day smoker, Shaw fits the profile of someone at risk for an aneurysm, even though he quit smoking more than two decades ago. That’s because current and former smokers are significantly more likely to develop an aortic aneurysm than nonsmokers. High blood pressure and family history are also risk factors.

The danger can go hidden because aneurysms don’t typically cause symptoms, although they can sometimes lead to indigestion, as was the case for Shaw, or more subtle issues. If an aneurysm keeps growing, it can burst—most people in whom this happens die from internal bleeding. That’s why vascular surgeons urge people like Shaw to get imaging tests that can help physicians find an aneurysm.

“If you have a family history of an aortic aneurysm, or you are a smoker, you should be screened,” said Cedars-Sinai vascular surgeon Elizabeth Chou, MD.

Chou explained that people at risk can see a primary care doctor, a cardiologist or a vascular surgeon for an imaging test such as an ultrasound or CT scan. Studies report that among people who get screened, about 3%-8% are diagnosed with abdominal aortic aneurysm.

An electrician and handyman who likes to stay active, Shaw had choices to make to prevent life-threatening rupture: minimally invasive catheter-based surgery or open surgery through an incision?

When Shaw met Chou, he learned his best option for his condition and lifestyle was an open surgery, where Chou and team would create an incision in the abdomen, sew a tube to the healthy parts of the aorta, and remove the aneurysm.

For people who have a smaller aortic aneurysm, a vascular surgeon will recommend an annual CT scan to see if it grows.

“Some aneurysms do not grow for many years,” said Chou, who is also assistant professor of Vascular Surgery in the Smidt Heart Institute at Cedars-Sinai. “Some people may never need surgery or any sort of repair, only routine monitoring.” She added that research is underway to help physicians understand why some aneurysms grow and some stay the same.

If an aneurysm reaches a certain size—about 5 ½ centimeters in men and 5 centimeters in women—a vascular surgeon typically recommends surgery.

Some patients may benefit from a minimally invasive surgery, during which a catheter is threaded through an incision in a patient’s groin until it reaches the aneurysm. The surgeon positions a tube in the area of the aneurysm and relines the aorta and aneurysm to divert blood flow into the relined aorta and away from the aneurysm. This option is usually recommended for patients who are older, frail, and generally wouldn’t recover well from an open surgery.  Some people also choose this option because they prefer a less invasive approach and are willing to undergo annual follow-ups to make sure the relining remains intact.

Shaw felt confident in Chou’s recommendation for an open surgery

“I live on a ranch,” he said. “I toss around bales of hay and 50-pound bags of horse feed. I need to be totally well. Anything other than a completely replaced artery was not acceptable because of my lifestyle.”

Chou said the most important part of the process is for patients to understand what the aneurysm is and how it affects their life.

“There are pros and cons to open surgery, minimally invasive surgery, and watching and waiting,” she said. “Our utmost priority is ensuring that each patient is comfortable with their decision. What we want people to know is that they need to be screened, and we will take the next steps together.”

After almost a week of recovery in the hospital and four weeks of recovery with light activity at home, Shaw returned to horseback riding on his ranch in Santa Maria, California.

“This could have ruptured at any time,” he said. “I was a walking time bomb. Now I’m totally healthy.”

Read more on the Cedars-Sinai Newsroom: Smidt Heart Institute Opens Aortic Surveillance Clinic

Children with Duchenne typically lose the ability to walk by age 12 and die at a young age, commonly because their heart becomes so weak it can no longer pump blood.

“When we discovered he had Duchenne muscular dystrophy, I really felt like the sky had fallen down. I mean, that was my world,” Jayasuriya said from her home in Newport Beach, California, where she lives with her husband and Dusty.

Duchenne is caused by a mutation on the X chromosome and mostly affects boys. Jayasuriya was determined to find a potential treatment for her son and the approximately 20,000 other children diagnosed with Duchenne around the world each year.

Jayasuriya read a 2011 article in The Economist that described how Eduardo Marbán, MD, PhD, executive director of the Smidt Heart Institute at Cedars-Sinai, was studying how heart stem cells might repair heart damage. A light bulb went off. She requested a meeting with Marbán and the two forged a mission-filled friendship.

In 2013 Jayasuriya raised $150,000 through her organization, Coalition Duchenne, to fund preliminary research. Now 32, Dusty stands to potentially benefit from a cell therapy created from research Marbán has pursued for decades and that his mother helped fund.

The U.S. Food and Drug Administration (FDA) is currently evaluating deramiocel, a cell product that is based on Marbán’s discoveries. If approved, deramiocel would be the first treatment for the heart damage that often kills young people with Duchenne muscular dystrophy.

Children with Duchenne first show problems with walking or moving their arms. Their heart deterioration isn’t obvious until the heart is close to failing.

“The heart is turning into leather inside their chest,” Marbán said. “They're not aware of it until they're much older because the heart has some reserve, but it ends up being heart failure that accounts for most of the deaths from Duchenne.”

Marban is scheduled to discuss his work at a Feb. 25 FDA virtual workshop on cell therapies. The workshop is open to the public and attendees must register here. Marban's presentation is part of a four-scientist panel, “Cell Therapies for Niche Indications: Clinical Insights and Future Directions.”

The Research Begins 

More than 20 years ago, Marbán became interested in using pluripotent stem cells, which can turn into almost any cell in the body, to reprogram heart cells to generate an electrical pulse in people with abnormal heart rhythms—a biological pacemaker. However, given their propensity to migrate and create tumors, such stem cells were not realistically ready for clinical testing. Marbán and colleagues then turned their attention to isolating from the adult human heart a special type of cell capable of repairing damaged tissue.

“The dogma at the time was that once the heart is injured, it's permanent and it doesn't recover,” Marbán said.

In his laboratory, then at Johns Hopkins University, Marbán developed a technique, starting with a small human heart biopsy, to enable heart cells to self-assemble into microscopic clusters called cardiospheres. He and his team further cultured cardiospheres so that they would dissociate into cardiosphere-derived cells or CDCs. The CDCs could be grown in a laboratory and given back to the patient from whose heart they were taken.

When Marbán joined Cedars-Sinai in 2007 as the inaugural director of the Smidt Heart Institute, he began translating his basic work on CDCs into therapeutic studies in patients. Clinical trials showed heart attack patients who received infusions of their own CDCs into their hearts had some regrowth of healthy heart muscle. Curiously, additional research revealed it wasn’t the cells themselves that did the repair.

Ahmed Ibrahim, PhD, MPH, once a PhD student in Marbán’s lab who is now assistant professor of Cardiology at Cedars-Sinai, discovered that CDCs secrete tiny fat droplets called exosomes. These exosomes are full of molecules that support heart repair. This revelation meant that rather than biopsy a patient's heart, grow the cells and inject those cells into the same patient a month later, investigators could use donor hearts to prepare thousands of doses of CDCs that could be available “off the shelf.” Donor hearts are typically donated for transplantation but may be used for research if they cannot be used for a suitable recipient for technical reasons.

Duchenne and Heart Disease

Jayasuriya piqued Marbán’s interest in Duchenne heart disease. He began to study the effects of CDCs in laboratory mice with a genetic defect mirroring that in Duchenne patients. Working with Marbán, Smidt Heart Institute Assistant Professor Russell Rogers, PhD, discovered that CDCs worked well in Duchenne mice when given intravenously, leading to clinical trials in patients with Duchenne. The research verified CDCs could improve heart and muscle function in boys and young men with Duchenne.

The biotechnology company Capricor Therapeutics licensed Marbán’s technology and conducted additional clinical trials that led the company to apply for FDA approval of CDCs, now known as deramiocel, in December 2024. If deramiocel is approved, patients with Duchenne could receive an intravenous infusion of the therapy every three months.

“Our hope is that this therapy will meaningfully slow the progression of the disease and extend patient lives,” Marbán said.

Investigators in Marbán’s laboratory group are continuing to study what makes exosomes from CDCs potent.

“CDCs work by secreting tiny vesicles packed with genetic material,” Rogers said. “We are looking into the possibility that some of this genetic material may be effective when delivered on its own.”

For Dusty, who has lived longer than most people with Duchenne, the potential therapy is a chance to save his heart.   

“This is great news for older people with Duchenne like me,” he said. “This could make a true difference and impact on my life.”

Jayasuriya said the approval would be a game changer. She encourages parents of children with a rare disease like Duchenne not to give up hope.

“There may be something that works for another condition that can actually work for the condition your child has,” she said. “You just never know. There are no rules.”

Read more on the Cedars-Sinai Newsroom: Cell-Derived Therapy May Help Repair Abnormal Heart Rhythm

“To see this level of investment in women’s heart health is remarkable,” said Arthur J. Ochoa, JD, senior vice president of Advancement and chief advancement officer at Cedars-Sinai. “Philanthropists like Erika Glazer are changing the face of healthcare and bringing advanced care to so many of our patients.”

Glazer’s journey into heart care began in 2013, when she established the Erika J. Glazer Chair in Women’s Heart Health. The funds generated by the chair’s endowment supported the work of Jennifer Van Eyk, PhD, an expert in the study of proteins whose research focuses on sex differences in heart disease. Van Eyk is director of Basic Science Research in the Barbra Streisand Women’s Heart Center in the Smidt Heart Institute at Cedars-Sinai, director of the Advanced Clinical Biosystems Institute and professor of Cardiology, Biomedical Sciences and Pathology and Laboratory Medicine.

“Science is an uncharted territory,” said Glazer. “I wanted to help ensure that women were not left behind when it comes to heart health and research.”

Glazer further widened her philanthropic focus in 2016 when she established the Erika J. Glazer Chair in Women’s Cardiovascular Health and Population Science, currently occupied by Susan Cheng, MD, MPH, MMSc, director of the Institute for Research on Healthy Aging and division director of Population Health Sciences in the Smidt Heart Institute at Cedars-Sinai.

Then in 2023, Glazer funded her third chair at Cedars-Sinai—the Erika J. Glazer Chair in Women’s Cardiovascular Research, Education and Innovation. The inaugural chairholder is Janet Wei, MD, FACC, associate medical director of Cedars-Sinai’s Biomedical Imaging Research Institute, director of the Cardiovascular Disease Fellowship program in the Smidt Heart Institute, and associate professor of Cardiology and Biomedical Sciences at Cedars-Sinai. 

Righting a Wrong

Glazer’s philanthropic inspiration was sparked by her growing awareness of the underrepresentation of women in heart research, coupled with the need for greater gender equity in the United States.

“Women’s heart disease impacts everyone, in that all of us have a mother, a sister, a daughter, and/or a wife,” said Glazer, who at age 16 spent time interning at Cedars-Sinai—known then as Cedars of Lebanon—in the cardiology laboratories. “We must do more, we must do better, and we must do it now.”

While she considered a career in healthcare, Glazer opted to join her father, Guilford Glazer, in real estate development.

Glazer has made a name for herself in the male-dominated fields of construction and sports. A successful equity investor, she currently is a co-owner of the NBA’s Golden State Warriors.

“If it’s your passion, nothing should stand in your way,” Glazer said.

In addition to aiding Cedars-Sinai’s mission to attract and retain exceptional investigators, in 2016, Glazer also pledged $7.2 million for the Erika J. Glazer Women’s Heart Research Initiative at the Barbra Streisand Women’s Heart Center to support investigations into heart failure with preserved ejection fraction (HFpEF), a type of heart failure that primarily affects women.

“We are increasingly thankful to Erika Glazer—our colleague, our friend and our partner—for helping us to uncover the secrets of women’s heart health and disease,” said C. Noel Bairey Merz, MD, FACC, director of the Barbra Streisand Women’s Heart Center, and the Irwin and Sheila Allen Chair in Women’s Heart Research. “She is a doer, and she is changing the face of heart disease for women and men.”

A Champion for Women

Wei, the newest chairholder supported by Glazer, is awed by the woman behind its creation.

“I’m honored to join an inspiring group of women leaders who have benefited from the vision and generosity of Erika Glazer,” Wei said. “She is a champion for women’s heart health and is providing opportunities for my colleagues and me to advance the research, education and innovations that will save lives.”

 Read more from Discoveries: Women’s Health and Sex Differences—Research Update