2010 Hermann Blumgart Award Winner
"Congratulations to the recipient of the 2010 Hermann Blumgart Award…
Rory Hachamovitch, MD, MSc"
Blumgart Award Profile: Rory Hachamovitch, MD
Statistics show that as many as 80% of new freshmen change their major during their first year of college. It isn’t often, then, when someone gets to accomplish in adulthood what they dreamed of as a child. “I remember in kindergarten, we were asked to draw a picture of what we would be when we grew up. I drew a picture of a doctor with the traditional ‘little black bag’. I said ‘that’s what I would be when I grow up’. Even then, I thought it was a field where you could always be doing something good.” Those are the words of Rory Hachamovitch, MD, M.Sc.; 2010 Cardiovascular Council Blumgart Award Winner.
The son of an established physician in New York, Dr. Hachamovitch started his medical career with his M.D. at Albert Einstein Medical College in the Bronx in 1987. He went on to complete his medical residency at Cedars-Sinai Medical Center in Los Angeles and his Cardiovascular Disease fellowship at Beth Israel Hospital and Harvard Medical School in Boston. However, it was during his tenure as the Senior Research Fellow at Cedars-Sinai Medical Center in Los Angeles that he began to contribute in a dramatic way to the future of Nuclear Cardiology.
A series of important collaborative manuscripts beginning in 1995 addressed a number of emerging issues in relation to the role of myocardial perfusion imaging; incremental prognostic value, cost implications, gender-related treatment differences, and patients without known CAD, and translating results to pharmacologic stress were all addressed in original manuscripts. His 1998 publication in Circulation was the first to define a differential outcome of death versus MI from mildly abnormal MPI results (Circulation 1998; 97: 535-543). His work initiated the “less than 1% risk” mantra for a normal MPI scan that has stood the test of time in subsequent publications, including meta-analysis in the radionuclide imaging guidelines.
These studies only laid the groundwork for what he describes as his most important contributions to date. “As much as the earlier works may have meant at the time, our more recent studies are far more important”. Dr Hachamovitch specifically identifies these contributions as the concept that risk is contextual—the level of risk of any patient is a function of not only a test result, but also of the patient’s other characteristics. “We cannot realistically expect that any given size perfusion defect will be associated with the same level of risk in any patient. For example, if you report that on a particular study there is a defect representing 15% of the myocardium, is the level of risk the same if the patients is 40 years old as if they are 80? Do we really believe that it wouldn’t make a difference whether or not they have had prior revascularization or MI? Of course it does!” Dr Hachamovitch points out the important implications of this. “Any attempt to include estimates of risk as part of reporting requires us to consider all patient information, thus, we will need validated scores to permit physicians to this”. The other important contribution that Dr Hachamovitch identifies is the finding that myocardial perfusion imaging may be able to identify which patients will have enhanced survival with medical therapy as opposed to the use of revascularization. In a 2003 publication in Circulation, he along with a team of investigators from Cedars-Sinai Medical Center reported on a large series of patients who had undergone stress SPECT and were followed up for approximately 2 years. Those patients who had at least 10-15% of the myocardium ischemic had superior survival with revascularization compared to medical therapy, although is with little or no ischemia tended to have improved survival with medical therapy rather than revascularization. These findings were further confirmed in a series of publications from him and this group and have been confirmed by one publication from another group. If confirmed in future prospective randomized trials, Dr Hachamovitch said, these results could be the basis of what future patient treatment pathways will look like in the future as well as identifying solid ground upon which to justify our modality. Finally, he also points out that the preliminary findings from the SPARC trial may eventually become far more important contributions in any of his previous work.
Overall, he has contributed to over 150 Peer-reviewed reports, guidelines, editorials, reviews, and book chapters. His most recent work includes acting as co-Principal Investigator on the SPARC Trial (with former Blumgart Award winner Marcelo Di Carli), and an ongoing NIH “Challenge” Grant in Comparative Effectiveness research.
Dr. Hachamovitch has supported the SNM in a number of capacities; he has given numerous lectures for the scientific program and the Technologist Section, and served on the Scientific Program Committee. He has served on the Cardiovascular Council Board of Directors since 2004 and was Cardiovascular Council President in 2007.
“When I think about other winners of this award; great researchers like Marcus Schwaiger, Heinrich Schelbert, it really means a great deal to me. When I had the honor of presenting this award to Nagara Tamaki in 2009, I realized how incredibly special this is.”
The Cardiovascular Council Board of Directors congratulates Dr. Rory Hachamovitch for this, the latest of his many great achievements.
To view important components of the 2010 Blumgart lecture as a PDF, click here.