Jennifer Mieres

• MD, FACC, FAHA, FASNC
• Professor at Northwell Health formely North Shore-LIJ Health System

Background Discrimination and harassment are common in cardiology but data on its impact are limited. Objectives This study sought to identify the prevalence and impact of workplace mistreatment among U.S. cardiologists overall and when engaged in clinical and academic work. Methods The American College of Cardiology conducted an online survey of...

Background: The prevalence of atrial fibrillation is reported to be lower in women, however it remains unclear if this is a biological phenomenon or social construct representative of limited access to healthcare resources. Catheter ablation (CA) is considered first line therapy for patients with symptomatic atrial fibrillation; however, women are...

Introduction: Supraventricular tachycardias (SVT) are the most frequently encountered arrhythmias in pregnancy, however, their clinical significance is unclear. Hypothesis: We report the prevalence, describe the management and explore the association between SVT and adverse obstetric outcomes in women with structurally normal hearts. Methods: This...

Purpose To evaluate awareness about cardiovascular (CVD) risk among a racially and ethnically diverse cohort of health system employees. Design Cross-sectional study. Setting Voluntary survey of health system employees during an annual CVD awareness and screening event. Subjects 759 health system employees. Measures We performed initial CVD scr...

Background Obesity is a major risk factor for cardiovascular disease, with differential impact across populations. This descriptive epidemiologic study outlines trends and disparities in obesity‐related cardiovascular mortality in the US population between 1999 and 2020. Methods and Results The Multiple Cause of Death database was used to identify...

Specific causes of mortality among various types of health care professionals (HCPs), including those characterized by age, gender, and race, have not been well described. The National Occupational Mortality Surveillance data for deaths in 26 US states in 1999, 2003-2004, and 2007-2014 were queried to address this question. Proportionate mortality...

Cardiovascular disease is the leading cause of death in women, yet differences exist among certain racial and ethnic groups. Aside from traditional risk factors, behavioral and environmental factors and social determinants of health affect cardiovascular health and risk in women. Language barriers, discrimination, acculturation, and health care acc...

Rationale and Objective Chronic Kidney Disease (CKD) is associated with an increased risk of cardiovascular (CV) mortality, but there are limited data on temporal trends disaggregated by sex, race, and urban/rural status in this population. Study Design Retrospective observational study Setting and Participants The Centers for Disease Control WON...

Purpose of Review Research on sex and gender aspects cardiovascular disease has contributed to a reduction in cardiovascular mortality in women. However, cardiovascular disease remains the leading cause of death of women in the United States. Disparities in cardiovascular risk and outcomes among women overall persist and are amplified for women of...

Rationale: Cardiovascular disease remains the leading cause of death in women. To address its determinants including persisting cardiovascular risk factors amplified by sex and race inequities, novel personalized approaches are needed grounded in the engagement of participants in research and prevention. Objective: To report on a participant-cen...

Inclusion and equal representation of women in cardiovascular imaging trials are essential to provide insight into the factors impacting women's heart health and outcomes. Despite heart disease being the leading cause of mortality for women in the United States, women have been underrepresented in cardiovascular clinical trials, including imaging t...

Women in Cardiology (WIC) sections have emerged as an important leadership, career development and advocacy forums for female cardiologists. Over the last three decades, their strength has grown from small groups to large sections within volunteer science organizations. In addition to providing a sense of community and promulgating the principles o...

Background - Social influencers of health (SIOH) namely race, ethnicity and structural inequities are known to affect the incidence of out of hospital sudden death (OHSD). We sought to examine the association between SIOH and the incidence of OHSD in the diverse neighborhoods of New York City (NYC) during the first wave of COVID-19 epidemic. Method...

Since its beginnings in the early 1970s, clinical nuclear cardiology has evolved substantially, gaining both technical sophistication and enhanced imaging capabilities. In parallel to these developments, an extensive literature supporting its clinical utility and cost-effectiveness has developed. Current single-photon emission computed tomography (...

Clinical Case • Download : Download full-size image A 54-year-old immigrant South Asian woman presents with a strong family history of diabetes mellitus type II (DM) and premature coronary artery disease (CAD). She is a vegetarian and her diet consists of lentils, naan bread, rice, curries and stews, and occasional “fast food” when out of the home...

In this book, the importance of mentorship, its best practices, and different facets of mentorship across medical education come into focus. This chapter offers a more nuanced perspective on the unique context of mentoring individuals from groups that are underrepresented in medicine (URiM), especially the skills and knowledge needed for successful...

Problem Racism and bias are fundamental causes of health inequities, and they negatively affect the climate of academic medical institutions across the United States. Approach In 2019, the Zucker School of Medicine and Northwell Health piloted a virtual reality (VR) racism experience as a component of professional development for medical school an...

be seen as miniature toolboxes to perform Physics experiments. In this paper, we present three different experimental optics designs mainly based on the light meter of a smartphone. One is aimed at the precise study of Malus law and other effects associated to linearly polarized light, the second allows quantifying the energy distribution of diffra...

Smartphones may be seen as miniature toolboxs to perform Physics experiments. In this paper, we present three different "optics workbenches" mainly based on the light meter of a smartphone. One is aimed at the precise study of Malus law and other effects associated to linearly polarized light, the second allows quantifying the light intensity distr...

Heart Centers for Women (HCW) developed as a response to the need for improved outcomes for women with cardiovascular disease (CVD). From 1984 until 2012, more women died of CVD every single year in comparison with men. Initially, there was limited awareness and sex-specific research regarding mortality or outcomes in women. HCW played an active ro...

Socioeconomic status (SES) has a measurable and significant effect on cardiovascular health. Biological, behavioral, and psychosocial risk factors prevalent in disadvantaged individuals accentuate the link between SES and cardiovascular disease (CVD). Four measures have been consistently associated with CVD in high-income countries: income level, e...

Hypertension accounts for 1 in 5 deaths among American women, posing a greater burden for women than men, and is among their most important risk factors for death and development of cardiovascular and other diseases. Hypertension affects women in all phases of life, with specific characteristics relating to risk factors and management for primary p...

Substantial advances and insights in medical technology and treatment strategies, and the focus on sex-specific research have contributed to a reduction in cardiovascular mortality in women. Despite these advances, ischemic heart disease (IHD) remains the leading cause of cardiovascular morbidity and mortality of women in the Western world. Advance...

Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of acute coronary syndrome, myocardial infarction, and sudden death, particularly among young women and individuals with few conventional atherosclerotic risk factors. Patient-initiated research has spurred increased awareness of SCAD, and improved diagnostic capabiliti...

In this review, we highlight the need for innovation and creativity to reinvent the field of nuclear cardiology. Revolutionary ideas brought forth today are needed to create greater value in patient care and highlight the need for more contemporary evidence supporting the use of nuclear cardiology practices. We put forth discussions on the need for...

Evolving knowledge of sex-specific presentations, improved recognition of conventional and novel risk factors, and expanded understanding of the sex-specific pathophysiology of ischemic heart disease have resulted in improved clinical outcomes in women. Yet, ischemic heart disease continues to be the leading cause of morbidity and mortality in wome...

The aims of the current statement are to refine the definition of quality in cardiovascular imaging and to propose novel methodological approaches to inform the demonstration of quality in imaging in future clinical trials and registries. We propose defining quality in cardiovascular imaging using an analytical framework put forth by the Institute...

The present review synthesizes evidence and discusses issues related to health care quality and equity for women, including minority population subgroups. The principle of “sameness” or women and men receiving equitable, high-quality care is a near-term target, but optimal population health cannot be achieved without consideration of the unique, ge...

This document from the American Society of Nuclear Cardiology represents an updated consensus statement on the evidence base of stress myocardial perfusion imaging (MPI), emphasizing new developments in single-photon emission tomography (SPECT) and positron emission tomography (PET) in the clinical evaluation of women presenting with symptoms of st...

Rationale and objectives: Although multiple studies have shown excellent accuracy statistics for noninvasive angiography by coronary computed tomographic angiography (CCTA), most studies comparing nuclear imaging to CCTA were performed on patients already referred for cardiac catheterization, introducing referral and selection bias. This prospecti...

Declines in cardiovascular deaths have been dramatic for men but occur significantly less in women. Among patients with symptomatic ischemic heart disease (IHD), women experience relatively worse outcomes compared with their male counterparts. Evidence to date has failed to adequately explore unique female imaging targets and their correlative sign...

The decades-long research focus on the pathophysiology of coronary artery disease (CAD) has provided insights into sex-specific factors that are uniquely important in the noninvasive diagnosis of myocardial ischemic syndromes in women. Evidence gained from the landmark WISE (Women’s Ischemic

A PBS documentary about training physicians of the future for the delivery of health care that fosters a patient partnership. Emmy Award-winning documentary filmmaker David Grubin, son of a general practitioner, focuses his cameras on New York’s Hofstra North Shore-LIJ School of Medicine to highlight its innovative approach to medical education. Th...

A PBS documentary about the importance of patient centered partnership in health care delivery . In Rx: The Quiet Revolution, you’ll travel across America to discover a quiet revolution happening in medicine. From Maine to Mississippi, Alaska to California, see physicians, nurses and other healthcare professionals placing the patient at the center...

Over the past decade, an emerging clinical research focus on cardiovascular (CV) disease (CVD) risk in women has highlighted sex-specific factors that are uniquely important in the prevention and early detection of coronary atherosclerosis in women. Concurrently, a 30% decrease in the number of female deaths from CVD has been observed. Despite this...

In the past two decades, focused research on women at risk for cardiovascular disease (CVD) has helped to clarify our understanding of some of the sex-specific factors that are important in the prevention and early detection of coronary atherosclerosis with a resultant 30 % decrease in the number of women dying from CVD. In spite of these advances,...

Heart disease is the #1 killer of women and a major contributor to morbidity and disability. This statement cannot be repeated enough and is often neglected. In 2008, there were 9,127,416 cardiovascular deaths in women worldwide, accounting for 33.2 % of all deaths in women. Coronary artery disease (CAD) differs in symptom presentation, diagnosis,...

In recent decades, there has been an appropriate focus on ensuring gender equity in the quantity and quality of evidence to guide female-specific, optimal management strategies for suspected and known ischemic heart disease (IHD). The evolving evidence supports a multifactorial pathophysiology of coronary atherosclerosis that includes obstructive c...

The lack of standardized reporting of the magnitude of ischemia on noninvasive imaging contributes to variability in translating the severity of ischemia across stress imaging modalities. We identified the risk of coronary artery disease (CAD) death or myocardial infarction (MI) associated with ≥10% ischemic myocardium on stress nuclear imaging as...

In June 2011, the U.S. DHHS announced the nation’s first “National Prevention Strategy.” Called for under the ACA, the comprehensive plan, aims to help increase the number of Americans who are healthy at every stage of life. Its vision is working together to improve the health and quality of life for individuals, families, and communities by moving...

There is a wealth of evidence about the role of a variety of diagnostic testing modalities to define coronary artery disease (CAD) risk in women presenting for evaluation of suspected myocardial ischemia. The exercise electrocardiogram (ECG) is the core index procedure, which can define risk in women capable of performing maximal exercise. Stress i...

The North shore-LIJ health system serves a geographic area that encompasses more than 7 million people. It is one of the largest and most diverse organizations in metropolitan New York. As surrounding communities have become more diverse, the North Shore-LIJ Health System (NSLIJHS) has recognized the need to cultivate diversity. NSLIJHS leadership...

The Office of Diversity, Inclusion and Health Literacy (ODIHL) at the North Shore-LIJ Health System in Long Island, New York, USA (NSLIJHS) spearheaded this improvement work. The NSLIJHS serves a geographic area that encompasses more than 7 million people and is one of the largest and most diverse organizations in metropolitan New York, with more t...

Evolving knowledge regarding sex differences in coronary heart disease has demonstrated that the prevalence, symptomatology, and pathophysiology of coronary atherosclerosis vary between genders. Women experience higher mortality rates and more adverse outcomes after acute myocardial infarction than men, despite a lower prevalence of obstructive cor...

Early identification of coronary artery disease (CAD) among symptomatic women is critical given their worse outcomes as compared to men. We evaluated the value of the Morise score, a simple clinical risk score, for the assessment for CAD as determined by computed tomography coronary angiography (CTCA) and compared it to the Diamond-Forrester risk a...

Significant advances in medical treatment, medical technology, and the focus on sex‐specific research have contributed to a reduction in cardiovascular mortality in women. Despite these advances, coronary artery disease (CAD) is the leading cause of cardiovascular death of women in the Western world. In the past 2 decades, the focused research on w...

Background: Exercise treadmill stress myocardial perfusion imaging (MPI) with single photon emission computed tomography is commonly used to evaluate the extent and severity of inducible ischemia as well as to risk stratify patients with suspected and known coronary artery disease (CAD). Failure to reach adequate stress, defined as not attaining a...

There is a paucity of randomized trials regarding diagnostic testing in women with suspected coronary artery disease (CAD). It remains unclear whether the addition of myocardial perfusion imaging (MPI) to the standard ECG exercise treadmill test (ETT) provides incremental information to improve clinical decision making in women with suspected CAD....

Much of our understanding of gender differences in chest pain was derived from noncontemporary reports. The aim of the current report was to compare the frequency of chest pain by measures of ischemia in 824 women with suspected myocardial ischemia prospectively enrolled in a clinical trial of exercise testing with electrocardiography (ETT-ECG) alo...

Heart failure (HF) is a leading cause of adult hospitalization, morbidity, and mortality. We evaluated the influence of myocardial ischemia and left ventricular ejection fraction (LVEF) on outcomes in patients who were hospitalized with new onset HF. We prospectively recruited 201 consecutive patients hospitalized for a first episode of HF from 17...

Significant progress in research has been made in the areas of sex-specific aspects of cardiovascular disease. Despite these advances, coronary artery disease (CAD) is the leading cause of death of women in the Western world. Over the past decade, the focused research on women at risk for ischemic heart disease has helped to clarify our understandi...

The prevalence of obesity and diabetes mellitus continues to increase in the United States. Minority populations are disproportionately affected by obesity, with studies showing increased prevalence in the African American community.1,2 Obesity and the associated complications that can result, including diabetes and cardiovascular disease, are one...

The IMAGING in Heart Failure study was a prospective, multi-national trial designed to explore the role of single-photon emission computed tomographic (SPECT) myocardial perfusion imaging (MPI) as an initial investigative strategy in patients hospitalized with new-onset heart failure. We recruited 201 patients (age 65.3 +/- 14.5 years, 43% women) h...

A preliminary report on medical radiation exposures to the US population based on publicly available sources of data estimated that the collective dose received from medical uses of radiation has increased by >700% between 1980 and 2006.1 Computed tomography (CT) has had an annual growth rate of >10% per year and accounted for ≈50% of the collectiv...

Coronary artery disease remains the leading cause of morbidity and mortality in women. The optimal non-invasive test for evaluation of ischemic heart disease in women is unknown. Although current guidelines support the choice of the exercise tolerance test (ETT) as a first line test for women with a normal baseline ECG and adequate exercise capabil...

Over the last decade, the increased research focus on cardiovascular imaging for the identification of patients at risk for and with significant coronary artery disease (CAD) has augmented clinician awareness and ability to properly risk stratify and categorize patients. Cardiac imaging has now become a technique not only for assessing patients wit...

Although multiple studies have shown excellent accuracy statistics for non-invasive angiography by 64-CCTA, most studies comparing nuclear imaging with CCTA were performed on patients already referred for cardiac catheterization, introducing verification and referral bias. This prospective trial evaluated the diagnostic accuracy of 64-row CCTA to d...

Background: The PICTURE Trial evaluated the accuracy of 64-CT coronary angiography (CCTA) & MPI to invasive coronary angiography (ICA) for the detection of obstructive CAD. CCTA included an evaluation of Coronary Artery Calcium. The objective of this substudy was to evaluate the combination of measures of ischemia & atherosclerosis, with MPI & CAC...

Research from the last decade has revealed gender-specific differences in the presentation, manifestation, and diagnosis of coronary heart disease (CHD). There are dear gender differences in mortality. Fully 64% of women (vs. 50% of men) who die suddenly from CHD did not have classic warning symptoms. Moreover, 38% of women (vs. 25% of men) die wit...

Significant progress has been made toward increasing awareness of the risks of heart disease in women and in the area of sex-specific cardiovascular research. Yet, coronary artery disease remains the leading cause of death of women in the western world. Over the last decade, the increased research focus of women at risk for ischemic heart disease h...

Noninvasive cardiac imaging can be used for the diagnostic and prognostic assessment of patients with suspected or known coronary artery disease. It is central to the treatment of patients with myocardial infarction, coronary artery disease, or acute coronary syndromes with or without angina. Radionuclide cardiac imaging; echocardiography; and, inc...

The aim of this study is to prospectively evaluate the clinical value of electrocardiographically gated single-photon emission computed tomographic myocardial perfusion scintigraphy (MPS) imaging in a cohort of postmenopausal women with symptoms suggestive of ischemic heart disease. Forty-six postmenopausal women with no history of coronary artery...

Cardiovascular disease (CVD) is the leading cause of death of women in the United States and most of the developed world. The latest available data from the World Health Organization indicate that 16.6 million people around the globe die of CVD each year. World deaths from coronary heart disease (CHD) in 2002 totalled 7.2 million. One in seven wome...

Cardiovascular disease is the leading cause of mortality for women in the United States. Coronary heart disease, which includes coronary atherosclerotic disease, myocardial infarction, acute coronary syndromes, and angina, is the largest subset of this mortality, with >240 000 women dying annually from the disease. Atherosclerotic coronary artery d...