A patient’s life can change for the betterin a heartbeat. Even heart failure patients who
AN N UAL R E P O RT 2019
... can change the trajectory of cardiac care. have currently limited treatment options and a poor prognosis can gainnew hope from the workconductedat the Smidt Heart Institute. Through advances in areas such as minimallyinvasive procedures andcell therapy, weare forginga new trajectory in cardiac care thatpromises to have a global impact on heart health. Our researchers share a determination to help everyone who struggles with heart disease—including populationsthat have too long been neglected. This reports highlights some of our most recent accomplishments. With our hearts and minds focused on new approaches
HEARTS AND MINDS day, we challenge the status quo in cardiac care with confidence that the next big discovery is AT THE just around the corner. LEADING EDGE... to healing, we operateat the leading edge. Each
SMIDT HEART INSTITUTE
9 1 0 2 T R O P E R L AU N N A
STRAEH SDNIM DNA EHT TA G N I DA EL ...EGDE ETUTITSNI TRAEH TDIMS
... can change the trajectory of cardiac care. A patient’s life can change for the better in a heartbeat. Even heart failure patients who have currently limited treatment options and a poor prognosis can gain new hope from the work conducted at the Smidt Heart Institute. Through advances in areas such as minimally invasive procedures and cell therapy, we are forging a new trajectory in cardiac care that promises to have a global impact on heart health. Our researchers share a determination to help everyone who struggles with heart disease— including populations that have too long been neglected. This report highlights some of our most recent accomplishments. With our hearts and minds focused on new approaches to healing, we operate at the leading edge. Each day, we challenge the status quo in cardiac care with confidence that the next big discovery is just around the corner.
1
SMIDT HEART INSTITUTE 2019 ANNUAL REPORT
Dear Colleague,
What an incredible year this has been for the heart programs at Cedars-Sinai. • Thanks to a generous philanthropic gift from Eric and Susan Smidt, we are now the Smidt Heart Institute. • The Smidt Heart Institute was recognized by U.S. News & World Report as one of the nation’s top three programs for cardiology and heart surgery. • We perform more heart transplants than any other center, including 111 in FY18. Our outcomes continue to surpass benchmarks. • Our structural heart disease program targets all major heart valves with innovative interventions. New percutaneous approaches to closing a patent ductus streamline the care of newborns, while transcatheter valve replacements give new life to elderly patients too frail for conventional surgery. • We identified a new biomarker for heart failure with preserved ejection fraction (HFpEF), one of the leading enigmas in modern cardiac medicine. Meanwhile, our investigators have elucidated the mechanisms of sudden death in a preclinical model of HFpEF, which may help in understanding why this disease is so resistant to conventional therapies. • The Barbershop Study, conceived and executed here, validated a new paradigm for treating neglected populations at high risk for hypertension: Take testing and treatment to the patient, and they will respond. • The Barbra Streisand Women’s Heart Center continues to challenge our preconceptions regarding heart disease: It affects women at high rates and with different presentations than in men. The enclosed 2019 Annual Report tells the whole story. As always, we welcome your comments and questions. We would be particularly pleased to help you with any challenging patients you may wish to refer to us. Do not hesitate to contact me at heartinstitute@cshs.org or visit our website at cedars-sinai.org/heart.
Sincerely, Eduardo Marbán, MD, PhD Mark Siegel Family Foundation Distinguished Professor and Director, Smidt Heart Institute Cedars-Sinai Medical Center
2
6 8 10 13 HEALING THE IMPOSSIBLY INJURED HEART
THE BEAUTY OF MINIMALISM IN CARDIAC CARE
GIVING NEGLECTED POPULATIONS A VOICE
METRICS
3
SMIDT HEART INSTITUTE 2019 ANNUAL REPORT
6 8 01 31 FO Y TUA EB EHT N I M S IL A M I N I M ERAC CAIDRAC
E HT G N IL A E H YLBISSOPMI TR A E H D E R U J N I
DETCELGEN GNIVIG SNOITA LUPOP ECIOV A
S C I RT E M
4
EHT FO YTUAEB M S IL A M I N I M CAIDRAC NI ERAC
F O RE B M U N L A N O I T N E VR E T N I D N A YG OL O I D R A C YG OL O I SY HP ORT CELE SE R U DE C ORP 8 10 2 N I D E M R OF R E P
5
SMIDT HEART INSTITUTE 2019 ANNUAL REPORT
HEALING THE IMPOSSIBLY INJURED HEART
NUMBER OF HEART TRANSPLANTS PERFORMED IN FY18, MORE THAN ANY OTHER HOSPITAL IN THE NATION, WITH BETTER-THAN-EXPECTED OUTCOMES
6
The future is no distant horizon to our
• We have a number of clinical
forward-thinking scientists. It is here
trials underway that use cells as
and now, in discoveries that enable us to
with advanced cardiovascular
heal the impossibly injured heart. Our investigators are pioneers in developing the power of cells and exosomes to reverse heart attack damage. We are also making progress fighting diseases such as Duchenne muscular dystrophy with novel cell approaches developed
therapeutic agents in patients disease who do not respond to conventional therapy. • Our researchers are examining which biomarkers can best provide information about how a patient responds when treated either with conventional or experimental therapies. • More than 1,000 patients have undergone transplants
here at the Smidt Heart Institute, which
at Cedars-Sinai since the
appear to improve both heart and
established in 1988.
skeletal muscle function for patients
Heart Transplant Program was
• From 2010 through 2014, our
with this devastating degenerative
comprehensive approach to
disorder. Even for the highest-risk
patients living more than a year
patients with advanced heart disease, we offer hope: Cedars-Sinai performs more heart transplants than any other medical facility in the nation, with better-than-expected outcomes. Using novel antirejection technologies, we routinely transplant organs into patients who would be rejected as candidates at most other centers. Our advanced heart disease program also offers the most state-of-the-art options available in cardiac support devices, both durable and temporary. All this innovation adds up to something of immeasurable value to critically ill patients: the gift of time.
7
SMIDT HEART INSTITUTE 2019 ANNUAL REPORT
care led to 91 percent of our after their heart transplant. This surpassed the projected survival rate determined by the United Network for Organ Sharing. • We’re developing more effective immunosuppression drug regimens with fewer side effects to fight organ rejection.
THE BEAUTY OF MINIMALISM IN CARDIAC CARE
TRANSCATHETER AORTIC VALVE REPLACEMENT
MITRACLIP
TRANSCATHETER PULMONARY VALVE REPLACEMENT
TRANSCATHETER MITRAL VALVE REPLACEMENT
INTRACORONARY STEM CELL INJECTION
NUMBER OF CUTTING-EDGE PROCEDURES PERFORMED IN FY18
PERCUTANEOUS LEFT VENTRICULAR ASSIST DEVICES
PERCUTANEOUS CLOSURE OF LEFT ATRIAL APPENDAGE OCCLUSION
EXTRACORPOREAL MEMBRANE OXYGENATION
8
597 221 17 28 14
56 116 60
Minimalists rocked the art world
• Our team has performed more
with their reductive vision. We’re
percutaneous mitral and aortic
doing the same in the medical world
U.S. medical center.
with our less-is-more approach to
valve procedures than any other
• Today, we can offer new hope
heart procedures. Our strides as a
to patients with the poorest
leader in performing percutaneous
demonstration that catheter-
mitral valve repairs and aortic valve
prognoses, thanks to the based repair of regurgitant mitral valves can improve
replacements make recovery so
survival and enhance quality
much faster, and outcomes so much
heart failure.
better, that traditional surgery is no longer required in many cases. We’re at the forefront of the next wave of clinical studies that may lead to less invasive, more effective techniques becoming part of routine clinical practice. The beauty of minimalism in modern heart medicine is that we can now offer new treatment
of life in patients with severe › We recruited more patients than any other institution to the mitral valve-repair study, conducted at 78 sites in the U.S. and Canada. › The remarkable results, reported recently in the New England Journal of Medicine, included significant reductions in death rates and hospitalizations as well as improved quality of life. • We bring the benefits of the most advanced minimally
options for people too elderly or frail
invasive techniques to patients
to endure open-heart surgery. We
training practitioners around the
are rewriting textbook medicine with a revolution in cardiac care that maximizes patients’ potential to heal and regain active lives.
9
SMIDT HEART INSTITUTE 2019 ANNUAL REPORT
far beyond Cedars-Sinai by world to perform these highly specialized procedures.
GIVING NEGLECTED POPULATIONS A VOICE
NUMBER OF WOMEN ENROLLED IN CEDARSSINAI’S WARRIOR PROJECT, THE LARGEST CLINICAL TRIAL EVER TO STUDY WOMEN WITH SIGNS AND SYMPTOMS OF ISCHEMIA, BUT NO OBSTRUCTIVE CORONARY DISEASE
10
Deep expertise across all specialties enables the Smidt Heart Institute to improve prognosis and quality of life for a broad spectrum of patients— including the most underserved populations. Among those at highest risk are African-American men, who are affected more by dangerously high blood pressure than almost any other group in the world. Distrust of doctors tends to be a barrier to treatment, so we designed and executed a clinical trial involving 52 black-owned barbershops across Los Angeles. Barbers were trained to measure blood pressure, and to offer their hypertensive customers on-site management by Cedars-Sinai pharmacists, along with a cut and shave. It worked. We saw major drops in blood pressure and positive changes in health habits. We’re also advancing knowledge of female-pattern heart disease to reverse decades of neglect of women as subjects in mainstream heart research. And we’re creating ingenious techniques to correct congenital heart defects in our tiniest patients—premature babies not much larger than the palm of a hand.
11
SMIDT HEART INSTITUTE 2019 ANNUAL REPORT
• The Los Angeles Barbershop Blood Pressure Study involved 319 black male barbershop patrons with systolic blood pressure of 140 mm Hg or greater. On average, their systolic blood pressure dropped from 153 mm Hg at the start of the study to 126 mm Hg after six months. And more than 63 percent of participants brought their blood pressure below the recommended 130/80. • The Barbra Streisand Women’s Heart Center’s WARRIOR project is the largest clinical trial ever to study women who have symptoms of ischemic heart disease but whose arteries appear clear on standard tests. • Our researchers have broadened knowledge of the factors that heighten a woman’s risk, such as adverse pregnancy outcomes, estrogen deficiency and premature menopause. • We’ve launched a pilot study and research registry of Takotsubo syndrome, or broken-heart syndrome, a largely reversible but potentially life-threatening condition that occurs almost exclusively in women. • The Smidt Heart Institute’s Guerin Family Congenital Heart Program treats patients from intrauterine life through adolescence—and across adulthood. Our experts have led development of a technique for navigating a tiny device through a catheter into a vessel of a premature baby’s heart to treat a life-threatening congenital heart condition called patent ductus arteriosus. This research could revolutionize cardiac care for preemies.
pohsrebraB selegnA soL ehT • devlovni ydutS erusserP doolB p o h s r e b r a b e l a m k c al b 9 1 3 doolb cilotsys htiw snortap r o g H m m 0 4 1 fo e r u s s e r p rieht ,egareva nO .retaerg deppord erusserp doolb cilotsys fo trats eht ta gH mm 3 51 morf ret fa gH mm 621 ot yduts eht 3 6 naht erom dnA . shtnom xis thguorb stnapicitrap fo tnecrep eht woleb erusserp doolb rieht . 08/031 dednemmocer s’nemoW dnasiertS arbraB ehT • tcejorp ROIRRAW s’retneC traeH reve lairt lacinilc tsegral eht si evah ohw nemow yduts ot traeh cimehcsi fo smotpmys raeppa seiretra esohw tub esaesid .stset dezidradnats no raelc evah srehcraeser ruO • eht fo egdelwonk denedaorb s’namow a nethgieh taht srotcaf ycnangerp esrevda sa hcus ,ksir ycneicfied negortse , semoctuo .esuaponem erutamerp dna dna yduts tolip a dehcnual ev’eW • obustokaT fo yrtsiger hcraeser traeh-nekorb ro ,yhtapoymoidrac elbisrever ylegral a ,emordnys gninetaerht-efil yllaitnetop tub tsomla srucco taht noitidnoc .nemow ni ylevisulcxe nireuG s’etutitsnI traeH tdimS ehT • margorP traeH latinegnoC ylimaF eniretuartni morf stneitap staert dna—ecnecseloda hguorht efil strepxe ruO .doohtluda ssorca a fo tnempoleved del evah ynit a gnitagivan rof euqinhcet otni retehtac a hguorht ecived s’ybab erutamerp a fo lessev a gninetaerht-efil a taert ot traeh dellac noitidnoc traeh latinegnoc sihT .susoiretra sutcud tnetap ezinoitulover dluoc hcraeser .seimeerp rof erac caidrac 12
seitl aiceps ll a ssorca esit rep xe peeD ot etu titsnI t r aeH tdimS eht selbane efil fo y til auq dn a sison gorp evorpmi —stneitap fo mu rtceps daorb a rof dev resrednu tsom eht gnidulcni tseh gih ta esoht gnom A .snoitalupop ohw ,nem n acirem A-n acir f A er a ksir ylsuoregn ad yb erom detceff a er a yn a tsoml a n aht erusserp doolb h gih tsu rtsiD .dlrow eht ni puor g rehto reirr ab a eb ot sdnet srotcod fo dn a den gised ew os ,tnemtaert ot gni vlovni l airt l acinilc a detucexe ssorca spohsrebr ab den wo-kcalb 25 deni art erew srebr aB .selegn A soL ot dn a ,erusserp doolb erusaem ot sremotsuc evisnet rep yh rieht reffo i aniS-sr adeC yb tnemegan am etis-no dn a tuc a hti w gnol a …stsicamr ahp spor d rojam was eW .dekrow tI .evahs segn ahc evitisop dn a erusserp doolb ni gnicn avda osl a er’eW .stibah htl aeh ni t r aeh nret tap-el amef fo egdelwon k tcelgen fo sedaced esrever ot esaesid m aertsni am ni stcejbus sa nemow fo gnitaerc er’ew dn A .hcr aeser t r aeh tcerroc ot seuqin hcet suoinegni tseinit ruo ni stcefed t r aeh l atinegnoc hcum ton seibab eru tamerp—stneitap .dn ah a fo ml ap eht n aht regr al
TOTAL
NONINVASIVE DIAGNOSTICS
167,605 167,019 137,968 137,571
ADVANCED IMAGING
CARDIAC CATHETERIZATIONS
ELECTROPHYSIOLOGY
CARDIOTHORACIC SURGERIES
13
FY17
ALL PROCE DU R E S
FY18
14,532 14,450 11,553 11,146 2,140 2,382
SCIRTEM
1,412 1,470
SMIDT HEART INSTITUTE 2019 ANNUAL REPORT
METRICS
14
167,613 167,019
TOTAL
NONINVASIVE DIAGNOSTICS
137,968 137,571
ADVANCED IMAGING
CARDIAC CATHETERIZATIONS
ELECTROPHYSIOLOGY
CARDIOTHORACIC SURGERIES
15
FY17
14,532 14,450 11,553 11,146 2,140 2,382 1,4201,470
SMIDT HEART INSTITUTE 2019 ANNUAL REPORT
ALL PROCE DU R E S
FY18
CAR DIAC CATH E TE RIZ ATIO NS
FY18
11,553 FY17
11,146 FY16
10,477
PROCEDURE
FY16
FY17
FY18
Angiography
5,896
6,388
6,575
1,637
1,844
2,072
483
579
597
174
199
221
Percutaneous Coronary Intervention Transcatheter Aortic Valve Replacement (TAVR) MitraClip Transcatheter Pulmonary Valve Replacement (TPVR) Transcatheter Mitral Valve Replacement (TMVR)
10
9
17
11
26
28
18
5
3
Valvuloplasty Adult Aortic Valvuloplasty (AVP) Peds AVP
2
2
0
Adult Mitral Valvuloplasty (MVP)
4
3
5
Adult Pulmonary Valvuloplasty (PVP)
1
2
0
Peds PVP
1
3
4
Carotid Angiography/Carotid Stent
42
16
17
1,250
1,136
1,050
13
17
14
613
599
631
Percutaneous Alcohol Septal Ablation for Hypertrophic Cardiomyopathy
20
11
19
Percutaneous Closure of Paravalvular Leak
14
13
14
Adult Atrial Septal Defect (ASD)
17
21
27
Peds ASD
10
11
9
Adult Patent Foramen Ovale (PFO)
Endomyocardial Biopsy Intracoronary Stem Cell Injection/Therapy Intravascular Ultrasound
Percutaneous Closure of Septal Defects
17
24
44
Peds PFO
2
0
3
Adult Ventricular Septal Defect (VSD)
11
6
1
4
2
1
Adult Patent Ductus Arteriosus (PDA) Peds PDA
10
7
13
Percutaneous Left Ventricular Assist Devices
60
57
56
Percutaneous Closure of Left Atrial Appendage Occlusion
141
121
116
16
45
16
10,477
11,146
11,553
Coronary Reactivity Testing TOTAL
16
CUT TING - E DG E PROCE DU R E S
FY18 1,193
FY17 1,132
FY16 1,053
PROCEDURES
FY16
FY17
FY18
483
579
597
174
199
221
10
9
17
TMVR
11
26
28
Intracoronary Stem Cell Injection/Therapy
13
17
14
Adult Atrial Septal Defect (ASD)
17
21
27
Peds ASD
10
11
9
Adult Patent Foramen Ovale (PFO)
TAVR MitraClip TPVR
17
24
44
Peds PFO
2
0
3
Adult Ventricular Septal Defect (VSD)
11
6
1
60
57
56
Percutaneous Left Ventricular Assist Devices Percutaneous Closure of Left Atrial Appendage Occlusion Extracorporeal Membrane Oxygenation (ECMO)
ADVANCE D IMAG ING
TOTAL
516 |||||| |||||| |||||| |||||| ||||||||| |||||||||||||||||||||||||||||||||
|||||| | ||||||| |||||| |||||||||| ||||||| |||||||||||||||||||||||||||||
|||||| |||||| ||||||| ||||||| |||||||||| ||||||||||||||||||||||||||||||
121
116
62
60
1,053
1,132
1,193
MAGNETIC RESONANCE (MRI, MRA, MRV)
4,369 NUCLEAR CARDIOLOGY (SPECT EXAMS AND MRV) 1,660 NUCLEAR CARDIOLOGY PET EXAMS 7,987 CARDIAC CT EXAMS TOTAL 14,532
||||| |||| |||||| |||||| |||||||| |||||||||||||||||||||||||||||||||||||
PROCEDURE Nuclear Cardiology PET Exams Cardiac CT Exams Magnetic Resonance (MRI, MRA, MRV) Nuclear Cardiology (SPECT Exams and MRV) TOTAL
17
141 104
SMIDT HEART INSTITUTE 2019 ANNUAL REPORT
FY16
FY17
FY18
1,725
1,679
1,660
6,495
7,101
7,987
452
555
516
5,072
5,115
4,369
13,744
14,450
14,532
CAR DIOTH O R ACIC SU RG E RIE S
PROCEDURES Coronary Artery Bypass Grafting (CABG) (Isolated) Mitral Valve (MV) Procedures, including CABG* MV Replacement MV Repair Aortic Valve (AV) Procedures, including CABG* AV Replacement AV Repair CABG with Valve Replacement/Repair CABG with Other Non-Valve Procedure
154
146
163
206
188
227
66
61
95
140
127
132
260
243
233
208
203
211
52
40
22
53
71
63
9
8
12
18
14
16
51
93
96
104
62
60
64
32
23
Electrical
205
178
160
Myocardial
33
36
37
Pericardial
11
14
22
23
24
28
Other Noncardiac Thoracic Aortic Surgery
307
239
160
Heart Transplant
128
119
111
Total Artificial Heart
20
3
9
1,646
1,470
1,420
TOTAL
|||||| | ||||||| |||||| |||||| |||||||||| ||||||||||||||||||||||||||||||
||||| ||||| ||||||| ||||||| ||||||||| |||||||||||||||||||||||||||||||||
||||| ||||| |||||| ||||||||| ||||||| ||||||||||||||||||||||||||||||||||
E LEC TRO PHYSIO LOGY
FY18
Ventricular Assist Device
Congenital
CLINICAL TRIALS
FY17
Lung Transplant
ECMO
18
FY16
686
ELECTROPHYSIOLOGY STUDIES
636
BLATION PROCEDURES (SUPRAVENTRICULAR TACHYCARDIA A (SVT)/OTHER SVT/ATRIAL FIBRILLATION/A-FLUTTER)
818
PACEMAKER AND CARDIOVERTER DEFIBRILLATOR IMPLANTATION TOTAL
2,140
||||| ||||| |||||| |||||| |||||||| ||||||||||||||||||||||||||||||||||||
38
SOON TO ENROLL
193
ENROLLING
82
FOLLOW-UP PHASE
TOTAL
313
OUTCO M E S
HEART ATTACK
30-DAY RISK-STANDARDIZED MORTALITY RATE
8.9 %
Cedars-Sinai
13.2 % National
HEART FAILURE
30-DAY RISK-STANDARDIZED MORTALITY RATE
6.4 %
Cedars-Sinai
11.7% National
In data comparing hundreds of major hospitals nationally, Cedars-Sinai has the lowest mortality for myocardial infarction and heart failure. SOURCE Hospital Compare | All Hospitals | Measure Date Range: July 2014–June 2017
19
SMIDT HEART INSTITUTE 2019 ANNUAL REPORT
S E M OCT U O
KCATTA TRAEH
YAD- 03 DEZIDRADNATS-KSIR ETAR Y TILATROM
%2 . 31 l a n o it a N
% 9. 8
i a ni S -s r a d e C
ERULIAF TRAEH
YAD- 03 DEZIDRADNATS-KSIR ETAR Y TILATROM
%7. 1 1 l a n o it a N
%4. 6
i a ni S -s r a d e C
7102 enuJ - 4102 yluJ :egnaR etaD erusaeM | slatipsoH llA | erapmoC latipsoH ECRUOS
20
3
NOITAN EHT NI
3 4
8 9
9
01
31 51
51
51 61
8102
7102
6102
5102
4102
3102
2102
1102
0102
90 02
8 0 02
traeh dna ygoloidrac rof gniknar lanoitan s’etutitsnI traeH tdimS ehT ”.91–8102 slatipsoH tseB“ s’ tropeR dlroW & sweN . S .U ni 3 .oN ot esor yregrus
21
SMIDT HEART INSTITUTE 2019 ANNUAL REPORT
SGNIK NA R
SA D E K NA R POT EHT FO ENO
RANKINGS
RANKED AS ONE OF THE TOP
3
IN THE NATION
3 4
8 9
9
10
15
15
15
2010
2009
2008
13
2011
2012
2013
2014
2015
2016
2017
2018
16
The Smidt Heart Institute’s national ranking for cardiology and heart surgery rose to No. 3 in U.S. News & World Report’s “Best Hospitals 2018–19.”
22
International Patent Applications
ISSUED
FILED
220 36
|||||| | ||||| ||||||| ||||||| |||||||||| ||||||||||||||||||||||||||||||
||||| |||||| ||||||| ||||||| ||||||||| ||||||||||||||||||||||||||||||||
INTELLECTUAL PROPERTY
FILED
||||| ||||| ||||||| ||||||| ||||||||| |||||||||||||||||||||||||||||||||
R E SE ARCH FU N DING
United States Patent Applications
ISSUED
156 44
12
$15,796,970
FEDERAL AND STATE
$11,659,770
OTHER PEER-REVIEWED
$6,339,648
INDUSTRY TOTAL $ 33,796,388
|||||| | ||||||| ||||| |||||||||| ||||||| ||||||||||||||||||||||||||||||
FY16
FY17
FY18
Federal and State
$10,066,567
$12,907,576
$15,796,970
Other Peer-Reviewed
$13,079,293
$11,641,843
$11,659,770
$6,383,146
$6,535,409
$6,339,648
$29,529,006
$31,084,828
$33,796,388
Industry TOTAL
PEER-REVIEWED ARTICLES
Copyright Registrations
FY16 457
FY17 467
23 SMIDT HEART INSTITUTE 2019 ANNUAL REPORT
FY18 471
NO N INVASIVE DIAG NOSTIC S
ECHO STUDIES 2D Echocardiogram Complete With Doppler With or Without Contrast Rest and Stress Echocardiogram and CV Stress Test and Dobutamine Echocardiography With or Without Contrast Transesophageal Echocardiography With or Without Contrast; May Include 3D Imaging Intima-Media Thickness (IMT) Study TOTAL
Cardiovascular Monitoring Services (Holter Monitor, BPM, Mobile Cardiovascular Telemetry) Tilt Table Cardioversion Pacemaker/Implantable Cardiac Defibrillator (ICD) Device Interrogation and Programming Enhanced External Counterpulsation (EECP) Therapy TOTAL
INPATIENT DISCHARGES
GRAND TOTAL
OUTPATIENT VISITS
FY17
FY18
24,483
27,026
27,226
985
1,126
1,109
3,905
3,750
3,785
36
14
26
29,409
31,916
32,146
89,489
98,423
99,816
3,100
3,850
2,101
55
40
50
396
426
400
2,078
2,360
2,820
766
556
635
95,884
105,655
105,822
125,293
137,571
137,968
OTHER HEART RHYTHM PROCEDURES Electrocardiogram
FY16
6,138
FY17
FY18
6,805
7,215
FY18
34,801 FY17
32,687 FY16
31,907
FOR MORE INFORMATION, PLEASE VISIT CEDARS-SINAI.ORG/HEART 24
FY16
ETUTITSNI TRAEH TDIMS
.dvlB ylreveB 0 078 noilivaP secneicS htlaeH decnavdA 0 063A etiuS 8 4 0 0 9 A C , s e l e g n A s oL 0 033-324- 0 1 3 t raeh/ude.ianis-sradec gro. shsc@ etutitsnit raeh
NO N INVASIVE DIAG NOSTIC S
ECHO STUDIES 2D Echocardiogram Complete With Doppler With or Without Contrast Rest and Stress Echocardiogram and CV Stress Test and Dobutamine Echocardiography With or Without Contrast Transesophageal Echocardiography With or Without Contrast; May Include 3D Imaging Intima-Media Thickness (IMT) Study TOTAL
FY17
FY18
24,483
27,026
27,226
985
1,126
1,109
3,905
3,750
3,785
36
14
26
29,409
31,916
32,146
89,489
98,423
99,816
3,100
3,850
2,101
55
40
50
396
426
400
2,078
2,360
2,820
766
556
635
95,884
105,655
105,822
125,293
137,571
137,968
OTHER HEART RHYTHM PROCEDURES Electrocardiogram Cardiovascular Monitoring Services (Holter Monitor, BPM, Mobile Cardiovascular Telemetry) Tilt Table Cardioversion Pacemaker/Implantable Cardiac Defibrillator (ICD) Device Interrogation and Programming Enhanced External Counterpulsation (EECP) Therapy TOTAL
GRAND TOTAL
FY16
6,138
OUTPATIENT VISITS
INPATIENT DISCHARGES
FY16
FY17
FY18
6,805
7,215
FY18
34,801 FY17
32,687 FY16
31,907
SMIDT HEART INSTITUTE
FOR MORE INFORMATION, PLEASE VISIT CEDARS-SINAI.ORG/HEART
8700 Beverly Blvd., Advanced Health Sciences Pavilion, Suite A3600, Los Angeles, CA 90048 310-423-3300 | cedars-sinai.edu/heart | heartinstitute@cshs.org