Center for Integrated and Novel Approaches in Vascular-Metabolic Disease (CINEMA)
The Need for Integrated Cardiovascular-Metabolic Care
The highest quality care of patients with obesity and diabetes necessitates a multidisciplinary team approach and requires a far greater degree of collaboration than other diseases. The chronicity of these health problems, complexity of diagnosis and treatment, and traditional siloes of various specialists results in delayed, fragmented and high-cost care delivery that begs for an alternate model. The treatment of cardiovascular complications of metabolic disorders typified by type 2 diabetes is at the top of health care spending and at the heart of the near-term health care affordability crisis. One of the barriers has been the failure to intervene in early disease.
A New Approach
University Hospitals Harrington Heart & Vascular Institute has established the novel Center for Integrated and Novel Approaches in Vascular-Metabolic Disease (CINEMA), which brings together multiple University Hospitals disciplines in a unique platform to advance the understanding and treatment of cardiac and vascular complications of metabolic disease. UH CINEMA leverages existing system partnerships, resources and investments, and builds on years of collaborative experience among UH principal investigators and clinical care providers.
UH CINEMA’s focus is at the intersection of vascular disease, type 2 diabetes and obesity. Given that the major consequence of metabolic disorders are cardiovascular complications such as coronary, cerebrovascular and peripheral artery disease, these are necessarily a priority for the team. However, other rare metabolic diseases with vascular manifestations with scope for cure are also included in the center.
Referred patients have a single appointment health assessment to review questions about their metabolic condition (diabetes), along with screening for kidney disease, heart disease and related risk factor management (blood pressure, cholesterol and triglycerides, smoking, diet and exercise). Multiple specialists then review the assessment and share combined treatment recommendations to lower potential risk for diabetes-related heart and kidney complications.
Cardiometabolic Risk Factors
Metabolic Risk Factors
Non-Traditional Cardiovascular Risk Factors
Traditional Cardiovascular Risk Factors
Strong Scientific Leadership
UH CINEMA includes some of the world’s foremost experts in clinical care of diabetics with cardiovascular complications, prevention and therapy of vascular-metabolic disease, translational research and implementation science.
- Clinical Trials and Implementation Science:
There are currently more than 10 clinical trials at UH Cleveland Medical Center that directly address patients with type 2 diabetes and involve novel devices for percutaneous intervention, wound care and drug approaches. In addition, there are multiple trials targeting metabolic complications of type 2 diabetes throughout the University Hospitals system. Implementation of what is “already known” to better the care of type 2 diabetic patients with cardio-metabolic complications is central to what UH CINEMA aims to accomplish.
- Personalized Approaches for Management of Type 2 Diabetes:
Identification of the type 2 diabetic at risk for future cardiovascular and metabolic complications is an immensely important goal for each patient. UH CINEMA is at the national forefront of leading edge technologies to help resolve individual risk in patients with type 2 diabetes – to determine whether they are at risk and to utilize these approaches in risk stratification and treatment. These include advanced imaging approaches and other personalized methods. CLARIFY is the world’s largest program with a living registry on calcium scoring made available to patients to help determine if they are at risk.
- Translational Science Unit (TSU):
A newly created translational science unit interfaces with all clinical and basic science programs, particularly with the Vascular Center and recently opened Center for Advanced Heart and Vascular Care (CAHVC) of UH Harrington Heart & Vascular Institute. The CAHVC provides unique opportunities to cross-fertilize imaging to address fundamental questions in metabolic disorders including early diagnosis and treatment of vascular diseases with real-time intervention. This unit provides the necessary infrastructure for investigator-initiated studies.
- Training Programs:
There are multiple UH training programs, including fellowships that provide opportunities for those interested in vascular-metabolic diseases.