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Lown Forum

The Lown Cardiovascular Center is pleased to welcome Wilfred Mamuya, MD, PhD, to our cardiovascular practice. Dr. Mamuya, who joined us on January 1, 2009, brings signicant clinical experience and expertise in cardiology, vascular medicine, and noninvasive cardiac imaging to the Lown Center. Equally important, he shares our strong commitment to patientcentered, preventive cardiovascular care. Born in Tanzania, Dr. Mamuya received his medical degree from Boston University, graduating summa cum laude, and also earned a PhD in biochemistry from BU. I rst met Dr. Lown and Dr. Graboys in the early 1990s when I was an intern at Brigham and Womens Hospital, Dr. Mamuya recalled. "I attended many clinical conferences at the Lown Center. That training conrmed for me that focusing on the individual, instead of the disease, is the optimal way to care for patients.





Lown Center welcomes Dr. Fred Mamuya

planning for a new vascular lab, which will add another dimension to the care and treatment of Lown patients. We will have the capability to conduct a range of non invasive diagnostic testing at the Lown Center, including vascular ultrasound," he noted. "This is useful in treating patients with vascular blockages and other issues relative to arterial weakness or disease. " Dr. Mamuya is looking forward to contributing to the research work of the Lown Cardiovascular Research Foundation, especially in the realm of the Lown Center's unique patientcentered care, in order to quantify how our approach to medicine benets the patient as an individual, and society as a whole.

"I welcome this opportunity to practice medicine with a profound emphasis on prevention and education, and lowcost and highly eective treatment." Dr. Fred Mamuya
His interests also extend to global health and the growing epidemic of cardiovascular disease in low and middle income countries. "I have long believed that the approach to patient care practiced at the Lown Center is both better for the patient and for the planet. Having grown up in Tanzania, I can see clearly that it's a sensible approach from a global perspective." He is committed to pursuing his interests in global health matters. I am eager to learn through ProCor, the Lown Foundation's global heart health initiative, how we can integrate our philosophy and sensible, eective style of patient care into the bigger, worldwide community. The message of the Lown Center is a message I embrace and believe in, and a message that the world needs to hear.

Dr. Mamuya has held appointments and been active on the sta of Massachusetts General Hospital and Cape Cod Hospital. He is board certied in cardiovascular disease, nuclear cardiology, and echocardiography, and he is Level III trained in cardiac computer tomography (CT). Dr. Mamuya's expertise in noninvasive diagnostic imaging complements the work of the Lown Center and contributes to our ongoing eorts to utilize the most advanced, appropriate diagnostic and treatment options for our patients. Dr. Mamuya is heading up the Center's


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Gala honors Dr. Lown Lown Scholars Program President's update Lown echo lab accredited Heart Hero Award: Tonga

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Lown Center NewsBeat New research initiative Planned giving Bernard Lown Peace Bridge



Honoring Dr. Bernard Lown

A celebration of medicine and humanity
Dr. Lown has been acclaimed during his lifetime for many achievements as a skilled physician, inspiring educator, pioneering clinical researcher, world peace advocate, Nobel Laureate, visionary inventor, and successful author. Nearly 500 people from all aspects of Dr. Lown's life gathered on September 13, 2008 at Boston's Seaport Hotel to celebrate his remarkable achievements. Christopher Lydon, host of the radio show Open Source, was Master of Ceremonies and the Atlantic Symphony Orchestra performed at the event. Distinguished speakers included John Bogle, Founder of the Vanguard Group; Dr. Lachlan Forrow, President of the Albert Schweitzer Fellowship and Past Board Chair and CEO of International Physicians for the Prevention of Nuclear War; and Dr. Harvey Fineberg, President of the Institute of Medicine.

Dr. Lown and his wife Louise. "Our marriage is now approaching a 62nd anniversary. For that alone I would be ready to relive my life. Louise has provided a moral compass." Below: Dr. Tom Graboys, President Emeritus, Lown Foundation; Cindy Smiegal, former patient of Dr. Graboys and supporter of the Lown Foundation; and Dr. Bernard Lown.

"In this 50 year romance with patients, I learned much of what I know from them." Dr. Bernard Lown, September 13, 2008

photo courtesy David Glaser

Dr. Harvey Fineberg, President, Institute of Medicine, and John Bogle, Founder, Vanguard Group and Lown Foundation supporter, were among the evening's distinguished presenters. Below: Dr. Walter Willett, Chair, Department of Nutrition, Harvard School of Public Health, and Gail Willett.

The morning after the gala, more than 40 cardiologists who received fellowship training at the Lown Cardiovascular Center gathered for a reunion brunch with Dr. Lown, Lown Group physicians, and current and former sta. Fellows came from all parts of the United States and Canada, as well as from Australia, Brazil, Germany, Israel, and Saudi Arabia. During the Fellows Brunch, many read personal tributes to their teacher and mentor.
A limited edition DVD of the Celebration of Medicine and Humanity, featuring Dr. Lown's speech and tributes by distinguished speakers, is available to the Lown community for a taxdeductible contribution of $150. To learn more, contact: Julia Pivniouk, Foundation Assistant 617 732 1318 x3805 or jpivniouk@partners.org



Lown Scholars Program addresses heart health in developing countries

A new professorship and scholarship program honoring Dr. Lown was announced at the September 13 gala. The Bernard Lown Cardiovascular Scholars Program at the Harvard School of Public Health will train health practitioners in public health strategies to prevent cardiovascular disease in the developing world. In low and middleincome countries, cardiovascular disease (CVD) is reaching epidemic proportions as people migrate to urban settings and adopt new lifestyles that include processed foods and tobacco use, and that are increasingly sedentary. Without prevention, CVD threatens to overwhelm the health care systems of emerging economies. Dr. Lown has been enormously generous to Harvard School of Public Health as a researcher, scholar, and friend, and is an inspirational role model for me," stated Dr. Barry Bloom, former Dean of the Harvard School of Public Health, who announced the new program. "His vision to bring young physicians and scholars from developing countries to learn and carry out research under the tutelage of outstanding professors so they can prevent cardiovascular disease is a prescient contribution to address the coming epidemic of cardiovascular disease in the developing world. As teacher and mentor, throughout his career Dr. Lown has trained hundreds of young physicians and scholars from developing countries, where the Lown Center's non invasive, patientcentered approach is both aordable and eective. The Lown Scholars program is a realization of that vision.

President's update
Vikas Saini, MD
Change is in the air. We have a new US President with a mandate for change, an unprecedented worldwide economic crisis, and a troubled healthcare system. Institutions around the globe are experiencing uncertainty. Yet in every crisis there is opportunity, and we are determined to use the current situation to strengthen and extend our work. The message of the Lown Group has always been that attention to prevention and astute medical management are of primary importance, and that costly invasive procedures should be reserved as a last resort. In these challenging times, this message is key to resolving the healthcare crisis. In 2004 we published a landmark study demonstrating excellent health outcomes among a sample of our patients. We have recently relaunched a followup study of the same patients (see page 6) which will make a unique contribution to medical knowledge because of the study's time span. Other changes are described in this issue of the Forumthe addition of Dr. Fred Mamuya to our Group; the celebration honoring Dr. Lown in September 2008; and the children's heart health program in Tonga which received ProCor's Louise Lown Heart Hero Award. As we respond strategically to everchanging healthcare and scal environments, some of our earlier plans have necessarily changed. We are committed to ongoing communication with you, both within and beyond the Lown Center's walls. The Lown Forum will be published more frequently and upcoming issues will include new features and topics, such as nutrition, suggested by our readers. As part of an eort to highlight our Groups vision and philosophy, we are forming a new Patient Advisory Committee to work with us to increase our visibility locally, nationally, and globally. The Committee is in the formative stage, and I invite you to contact us if you are interested in learning more or participating. We are committed to the start of an exciting era at the Lown Center which will move our longstanding commitment to providing our patients with the best medical care possible into new and larger arenas.
To learn more about our Patient's Advisory Committee, contact: Claudia Kenney, Foundation Administrator 617 732 1318 x3355 or ckenney@partners.org

Dr. Barry Bloom, former Dean, Harvard School of Public Health, announced the Bernard Lown Cardiovascular Scholars Program at the September 13 gala event, "A Celebration of Medicine and Humanity."



Lown echocardiography lab receives ICAEL accreditation

The Lown Centers echocardiography lab recently received accreditation from the Intersocietal Commission for the Accreditation of Echocardiography Laboratories (ICAEL). "This accreditation recognizes our physicians' and sonographers' dedication, training, expertise, and commitment to quality, commented Dr. Craig Vinch, Medical Director of the Lown Centers Echocardiography Lab, after receiving the Certicate of Accreditation. The Lown Center began to use echocardiography in the 1980s as a valuable adjunct in our noninvasive diagnosis and management of patients. Along with careful listening and examination to assess a persons symptoms, ultrasound pictures of the heart muscle and valves help guide appropriate care. "Over the years, we've held patientcentered care paramount, and the accreditation recognizes that we are also keeping in step with current echocardiography standards," said Dr. Vinch. Mary LancasterPijar, the echo labs Technical Director, and Dr. Vinch are proud that the Lown model of patientcentered care suuses a persons experience from the front door, through the echo lab, and on into meetings with nurses and physicians.

Children's program in Tonga receives 2008 Louise Lown Heart Hero Award
ProCor, the Lown Foundation's global program promoting heart health in the world's poorest countries, awarded the 2008 Louise Lown Heart Hero Award to the Rheumatic Heart Disease Prevention Program in Tonga. The winning project was initiated by Tongas sole pediatrician in order to screen primary school children for rheumatic heart disease and provide early, eective treatment for those who are aected, said Dr. Brian Bilchik, ProCors director. Developing countries account for 95% of Dr. Toa Fakakovikaetau and volunteers who the deaths assist her in screening Tongan schoolchildren worldwide each year from rheumatic for rheumatic heart disease. heart disease, which generally aects children, adolescents, and young adults. According to a recent study, Tonga has the highest prevalence (conrmed by echocardiogram) of rheumatic heart disease in the world. The Louise Lown Heart Hero Award recognizes innovative grassroots approaches to cardiovascular health in developing countries. The Tonga program received a $2,000 award and, equally valuable, global visibility that can help attract funding and other support. The award was established in 2007 by Dr. Bernard Lown to honor his wife, Louise, and her lifelong commitment to the rights and wellbeing of others as a social worker, activist, and writer. A review committee of cardiology and public health experts chose this year's winner from applications from 14 countries. The Louise Lown Heart Hero Award was presented to Dr. Toakase Fakakovikaetau by Tongas Deputy Prime Minister and Minister of Health, the Honourable Dr. Viliami Tau Tangi, who noted, Often, our doctors rst encounters with these children are when they are already quite ill. It costs millions of dollars to refer them overseas for open heart surgery. For many this is not aordable, and for others the treatment is not eective.
For more information about ProCor and the Louise Lown Heart Hero Award, visit www.procor.org or contact: Catherine Coleman, Editor in Chief (617) 7321318 x3332 or ccoleman5@partners.org

Mary LancasterPijar, Dr. Fred Mamuya, Dr. Craig Vinch, Gabe Galambos, and Tracy Griths in the Lown Center's echo lab



Lown Cardiovascular Center N e w s B e a t

Dr. Charles M. Blatt presented Antidepressants and Anxiolytics Increase Risk of Atrial Fibrillation in Patients with Coronary Artery Disease at the 29th annual Scientic Session of the Heart Rhythm Society in San Francisco in May 2008. Dr. Blatt also presented Declining Anxiety Level Improves Prognosis in Patients with Coronary Artery Disease at the 57th Scientic Session of the American College of Cardiology in Chicago in March 2008. Dr. Bernard Lown published Prescription for Survival: A Doctors Journey to End Nuclear Madness in July 2008. Prescription for Survival chronicles Dr. Lown's antinuclear activities through the Cold War years and culminates with the 1985 Nobel Peace Prize. Dr. Lown has been featured in numerous radio interviews, including PRIs The World, as well as several public and television appearances in Massachusetts and nationwide. For more information, visit Dr. Lowns website, www.bernardlown.org, or read his blog at http://bernardlown.wordpress.com. Dr. Brian Z. Bilchik, ProCor Director; Dr. Vikas Saini, LCRF President; and Dr. Arun Chockalingam, Chair of ProCor's International Advisory Council (left to right), participated in the CDC's Sixth Annual National Forum for Heart Disease and Stroke Prevention. The conference, "At the Nexus of Heart Disease and Stroke Prevention," took place in Washington, DC in March 2008. ProCor was among 80 national and international organizations attending. Dr. Bilchik is ViceChair of the National Forum's Communication Implementation Group. Dr. Thomas B. Graboys published Life in the Balance: A Physicians Memoir of Life, Love, and Loss with Parkinsons Disease and Dementia in April 2008. His book was reviewed in the New York Times; other media attention included ABCs Good Morning America and NPR radio. For more information, including upcoming events, visit www.tomgraboys.com. Dr. Shmuel Ravid coauthored Eect of statin dose on incidence of atrial brillation: Data from the Pravastatin or Atorvastatin Evaluation and Infection TherapyThrombolysis in Myocardial Infarction 22 (PROVE IT TIMI 22) and Aggrastat to Zocor (A to Z) trials, which was published in the American Heart Journal, Volume 155, Issue 2. Dr. Vikas Saini, LCRF President, and Catherine Coleman, Editor in Chief of ProCor, presented a poster session at the 2008 World Congress of Cardiology in Buenos Aires, Argentina in May 2008. The abstract of the presentation, Information poverty as a risk factor for cardiovascular disease: AshantiProCor Project to Increase CVD Knowledge and Practice Among Health Workers, was published in Circulation. More than 17,500 people from 100 countries attended the conference. ProCor also hosted a dinner for its editors and International Advisory Council members. Dr. Barbara Roberts, LCRF board member and ProCor's Women's Heart Health Editor, was recently named one of "America's Top Doctors for Women" by Women's Health magazine, and a cover story about her was published in the Rhode Islandbased Jewish Voice and Herald on December 12, 2008. In addition, a Chinese edition has been published of Dr. Roberts' book, How to Keep from Breaking Your Heart: What Every Woman Needs to Know About Cardiovascular Disease, and a second edition of the English version, incorporating new advances that have occurred since 2004, was published in October 2008.



Lown Foundation launches new research initiative

The Lown Center's approach to cardiac care, emphasizing "doing more for the patient and less to the patient," has many benets. People prefer medical care that utilizes the latest advances in cardiovascular knowledge while remaining true to the "lost art of healing." It's costeective as well. Dr. Lown recently noted in an article about the US healthcare crisis: "What is largely ignored is the commodication of illness that America's marketoriented healthcare system fosters. As is true in business, the underlying intent is maximizing protability rather than promoting patient well being. Unnecessary tests and procedures are encouraged."1 Lown patients also appear to live longer, healthier lives. In 2004, the Lown group published data that showed excellent outcomes among patients while avoiding unnecessary surgeries and invasive testing.2 Lown researchers are now updating the original data on approximately 700 patients. "What makes this research unique is the long period of followup. There aren't many studies looking at the long term followup of people who are medically managed," noted Dr. Vikas Saini. "Also, for the rst time, we will be able to compare our approach to national benchmarks and in the process provide a muchneeded perspective on contemporary US cardiovascular practice. " Two new research sta have joined the Lown Foundation and are working on the project. Deepa Aggarwal, research biostatistician, received her MSc in mathematics from Punjab University in India and her MS and PhD in statistics at Michigan State University. Padraig Carolan, research assistant, graduated from University of Notre Dame in 2004, where he worked on several research projects.

Leave a legacy: Planned giving

Naming the Lown Foundation in his will, a longtime friend and benefactor of the Lown Foundation, Mr. Sandy Goldstein, expressed his thoughts this way, The Lown Cardiovascular Centers work in patient care and cardiovascular research, to me, is most admirable and greatly appreciated. Therefore, and especially in these tough economic times, it is a personal blessing for me to cap more than 30 years of supporting the work of the Center with a bequest in my will. Each year, thousands of individuals like Sandy contribute time, talent, and money to a broad spectrum of charitable organizations. According to Giving USA 2008, the yearbook on philanthropy, charitable giving in the United States was estimated to be more than $306 billion in 2007. Why, even in dicult economic times, do so many give so much? There is no one answer, and the personal reasons for making a charitable donation can be as diverse as the individuals themselves. There is, however, one clear incentive for making a charitable donation, and that reason rests with the US tax laws. Those laws recognize the role of charitable organizations in meeting the needs of the public and intentionally encourage charitable giving. This approach provides individuals who make a charitable donation with options that minimize the tax implications of their gifts, and, at the same time, allow them to secure maximum allowable benets for themselves and their loved ones. A carefully planned gift to the Lown Cardiovascular Research Foundation will not only support our research, education, and outreach eorts, but may also provide you and your family with signicant income and estate tax benets. Some of these benets may include: Immediate federal income tax deduction for all, or a portion, of the value of the gift. Elimination of capital gains tax at the time of the transfer if the asset is in the form of securities or real estate that has appreciated in value. Income for life paid to you and/or another beneciary, such as your spouse or another family member. Increased income if a gift is made to a lifeincome plan that produces a higher yield than the donated asset, which is often the case with securities. Protection of your assets. Reduced tax burden (now and in the future). A planned gift can take many forms including: Bequest: This is by far the most common form of planned giving. Many people choose to name charities in their will.

Padraig Carolan, research assistant, and Deepa Aggarwal, research biostatistician 1 Bernard Lown, Time Spent with Patients a Critical Factor in the National Health Care Crisis. ProCor (www.procor.org). 2 LongTerm Outcomes of Optimized Medical Management of Outpatients With Stable Coronary Artery Disease. American Journal of Cardiology, February 1, 2004.



Not only is this great support for the Lown Foundation, but it also serves heirs and loved ones through a potentially signicant savings on estate tax. Life insurance/life income: This is also a simple way to remember the Lown Foundation. A life income gift allows you to transfer assets to the Lown Foundation yet continue to receive the income from the cash, stock, or other property contributed. For example, if you own a life insurance policy that is no longer needed, you can receive a charitable deduction by gifting the policy to the Lown Foundation. If the policy has a cash value, you can take a charitable deduction approximately equal to the cash value at the time of the gift. If you continue to pay annual premiums, those payments will become tax deductible each year. Charitable Remainder Trust: This trust allows you to create an instrument which will generate income. After death, the trust goes to the Foundation, saving heirs the estate taxes. Charitable Lead Trust: This trust establishes an income stream that is available to the Lown Foundation. The trust itself eventually returns to you or your family. Lead trusts can save families future estate taxes or give the donors charitable deductions on income over a given period of time. Gifts of Securities/Real Estate: Gifting appreciated stock or other marketable securities oers a twofold tax savings. Not only do you avoid paying capital gains tax on the increased value of the holding, but you also receive a tax deduction for the full market value of the security. As with the gifting of securities, the charitable donation of real estate oers double tax savings: the avoidance of capital gains tax coupled with the ability to deduct the full market value of the property. You can deed the home to the Foundation but retain the right to live in it for life and receive a tax deduction for the present value of the gift. This vehicle is a good option for older homeowners. Each planned giving arrangement has its own unique benets and whether the gift is made with cash or other assets, the benets can make this type of philanthropy a very attractive winwin. If you have questions or would like to learn more about planned giving, we'll be happy to meet with you, your nancial advisor, and/or your attorney, about the type of gift which makes the best sense for you and your family.
To receive a free, reproducible information sheet on planned giving, or to learn more about ways of supporting the work of the Lown Cardiovascular Research Foundation, contact: Vikas Saini, President (617 732 1318 x3355).

Dear Doctor
It has been 14 years since I rst came to see you. As I'm sure you remember, I had a blocked artery and had been advised to have a bypass operation. A friend advised me to run it by the Lown Center before I did something that drastic. That brought me to you, one of the best trips I've ever taken. You said that with a change of life habits, such as exercising regularly, eating properly, and taking beta blockers, I would do ne. You were right! As I look back over these 14 years, I realize that I did not limit my activities in any way. Exercising and eating healthy became a way of life, and at 81 years I feel in excellent health. I just wanted to share these thoughts with you. Gratefully, a Lown Center patient

Lown Cardiovascular Research Foundation For more than 30 years, the Lown Cardiovascular Research Foundation has promoted a humane and costeffective model of cardiac care that advocates prevention over costly, invasive treatments and restores the relationship between doctor and patient.
Board of Directors Nassib Chamoun Chairman of the Board Vikas Saini, MD President Bernard Lown, MD Chairman Emeritus Thomas B. Graboys, MD President Emeritus Patricia Aslanis Charles M. Blatt, MD Janet Johnson Bullard Joseph Brain, SD Carole Anne McLeod C. Bruce Metzler Barbara H. Roberts, MD Ronald Shaich Robert F. Weis Advisory Board Martha Crowninshield Herbert Engelhardt Edward Finkelstein William E. Ford Renee Gelman, MD George Graboys Barbara Greenberg Milton Lown John R. Monsky Jeffrey I. Sussman David L. Weltman CONTACT US

Lown Cardiovascular Research Foundation

21 Longwood Avenue Brookline MA 02446 (617) 7321318 www.lownfoundation.org Lown Cardiovascular Center Brian Z. Bilchik, MD Charles M. Blatt, MD Wilfred Mamuya, MD, PhD Shmuel Ravid, MD, MPH Vikas Saini, MD Craig S. Vinch, MD Lown Forum Editor Catherine Coleman Contributors Carole Nathan Craig Vinch, MD Editorial/production support Claudia Kenney Julia Pivniouk
c2009 Lown Foundation Printed on recycled paper with soybased ink.



Bernard Lown Peace Bridge dedicated in Lewiston, Maine

The Bernard Lown Peace Bridge, which crosses Maine's Androscoggin River to connect the cities of Lewiston and Auburn, was dedicated on October 17, 2008. The bridge honors Dr. Lown, who arrived in Lewiston in 1933 at the age of 13 when his family escaped rising antiSemitism in their home country of Lithuania. To commemorate the event, Governor John E. Baldacci proclaimed October 17, 2008 as Dr. Bernard Lown Day in the state of Maine. The communitywide celebration included speeches by local dignitaries, performances by local students, and marching bands from Lewiston and Auburn's high schools that led Dr. and Mrs. Lown across the bridge to the ribbon cutting. "The bridge is especially meaningful to me as a physician," Dr. Lown remarked. "To be an eective doctor, one must be able to connect with another human being. To connect is to build a bridge. It is a prerequisite to fostering trust and mandatory for healing the aicted. It is key to exposing and grasping the deeper human ache." In Lewiston, Dr. Lown learned the English language; fell in love with Louise, his wife of 62 years; and chose a medical career under the mentorship of a local physician. Dr. Lown credits Lewiston with instilling his lifelong commitment to activism when he witnessed a shoe worker being attacked during a labor strike. Since then, "I have retained a permanent sense of outrage against unfairness and injustice."
Read Dr. Lown's speech and articles about the dedication on his website, www.bernardlown.org.

Allen Harvie, who spearheaded the Bridge project over 25 years ago, spoke at a ceremony that preceded the dedication. The Edward Little Middle School choir also performed for Dr. and Mrs. Lown and several hundred supporters at the FrancoAmerican Heritage Center.

John Jenkins, Mayor of Auburn; Louise Lown; Fred Lown; Dr. Bernard Lown; Laurent F. Gilbert, Sr., Mayor of Lewiston; Al Harvie (left to right). Granite monuments at each end of the bridge display an engraved portrait of Dr. Lown and list his achievements.

Dr. Lown crosses the bridge after the ribboncutting ceremony with Dr. Vikas Saini, President, Lown Cardiovascular Research Foundation, joined by family, friends, and community members.

Lown Cardiovascular Research Foundation 21 Longwood Avenue Brookline, Massachusetts 024465239

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