Daniel S. Berman, MD, FACC, leader, innovator in noninvasive imaging

His research has led to a better understanding of imaging modalities, including cardiac CT, PET and SPECT.

Considered one of the founding fathers of nuclear cardiology, Daniel S. Berman, MD, FACC, has helped to further the effect of noninvasive imaging modalities for more than 30 years.

Berman is chief of cardiac imaging and nuclear cardiology at the Cedars-Sinai Heart Institute, Los Angeles, and the S. Mark Taper Foundation Imaging Center, a division of Cedars-Sinai. He is also a professor of imaging at Cedars-Sinai and a professor of medicine at the David Geffen School of Medicine at UCLA.

Daniel S. Berman, MD, FACC Chief of Cardiac Imaging and Nuclear Cardiology at the Cedars-Sinai Heart Institute, Los Angeles, and the S. Mark Taper Foundation Imaging Center Professor of Imaging at Cedars-Sinai Professor of Medicine at the David Geffen School of Medicine at UCLA Member, Imaging section of Cardiology Today’s Editorial Board.

For years, he has helped to spearhead the concept of “multimodality cardiac imaging” and has established the largest and most extensively studied patient database in cardiac imaging, analyzing information from more than 60,000 patients. This database incorporates 400 variables per patient and has led him and his team to develop models that predict the likelihood of severe cardiac events. Throughout his career, he has received more than $23 million in research grants, written more than 500 original manuscripts, 110 book chapters and edited or co-edited five books.

In an interview with Cardiology Today, Berman said he was optimistic about the future of CV health in the United States, but there are a number of important factors that need to improve for his optimism to turn into reality.

What do you enjoy doing when you’re not practicing medicine?

I enjoy being with my family and friends, watching sports on TV, skiing and reading. I also enjoy movies and symphonic music.

If you hadn’t gone into cardiology or medicine, what would you have done?

Nephrology would probably have been my choice. I got into a branch of cardiology in which I’m doing diagnostic testing extensively with a reduced amount of time for patients. A greater amount of patient contact and involvement in management would have been fulfilling.

What would you consider one of your biggest successes in your specialty?

I was at the cutting edge of the development of the evidence that supports the use of noninvasive testing in cardiology, initially in the field of nuclear cardiology and more recently in cardiac CT and cardiac MRI.

Regarding my published work, I’m most proud of the series of articles related to the prognostic applications of nuclear cardiology procedures and how they can be used across a broad spectrum of clinical settings. When I started in nuclear cardiology, I estimate that there may have been about 100 studies a year done in the United States, and it was clearly a research tool used in few medical centers for patient care purposes. Now, the use of stress imaging has become a mainstream part of the clinical care of patients with known or suspected CAD around the world.

What is the last book you read / art collection you saw / music you purchased? Why, and what did you think of it?

The Vermeer exhibit at the National Gallery of Art and the career-wide collection of Gauguin paintings were the last art exhibits I saw. Metamorphosis by Kafka was the last book I read, which was fascinating and also an easy read because it’s a series of short pieces. It’s kind of an in-depth look on an unusual psychological view of life. I also just recently saw a beautiful production of West Side Story in Los Angeles.

Whom do you most admire, and what would you ask that person if you had 5 minutes with him/her?

Moses. His clarity of thought made such a unique contribution to the moral code by which we live. There is an incredible brilliance to his thinking that I would like to understand.

What is the best advice you’ve ever received?

One piece of advice is: You can do anything you want to do, all you have to do is decide. Another was from my colleague in college, Rick Sukov, who said, “Life is not a dress rehearsal.” I think often about that one, but I haven’t done too well with it.

Whom do you consider your mentor?

Dean T. Mason, MD, who was the head of cardiology at UC Davis when I was there. First, he was someone who furthered the concept of you can do whatever you want to do. He showed me it was possible to make a contribution to academic medicine, which is something I hadn’t considered until he came along. He was also the head of a team of cardiologists at the institution that taught me the importance of teamwork. He sat with me one-on-one in developing the concepts of research projects, analyzing data, writing abstracts and manuscripts. He provided me an experience that I’ve used throughout my career in my approach to papers and working with trainees.

What kind of diet and exercise regimen do you have?

Since Robert Zelis, MD, expounded on the role of cholesterol in atherogenesis in the 1960s, I’ve been on a low-cholesterol diet, eating a tremendous amount of egg whites as a perfect protein. I’ve probably eaten more egg whites than anyone in the world, but my current diet is pretty close to vegan; it’s vegan plus fish. And all of that is because I believe we are what we eat and that a healthy diet is excellent for prevention of a wide variety of diseases. I’m glad to report there is no calcium in my coronary artery.

My exercise program has not been as adequate. I’ve been able through my diet to stay around my ideal body weight, but I don’t exercise enough. What I do is walk fast where I’m going and I walk quite a bit and occasionally lift weights and use the treadmill.

What do you think will have the biggest influence on cardiology in the next 10 years?

It is the widespread application of principles of prevention of disease. We are right now able to prevent about 70% of heart attacks or premature death from CAD, and we will get that to 90% to 95%. CAD is currently the No. 1 or nearly the No. 1 cause of death of men and women, and we will make tremendous inroads in reducing the frequency of premature death of heart attacks. It will come from a combination of much more broad spread application of prevention, a greater knowledge regarding who benefits from prevention, improved medical therapies of patients with known disease and better selection of patients who can benefit from revascularization procedures. The main reason these will become so broadly accepted and implemented will be because multiple randomized clinical trials will have documented the evidence to support their routine application.

What is your favorite travel destination?

For vacationing, it’s Lizard Island off the coast of Australia. It’s a glorious island, one of the few islands on the Great Barrier Reef in which you have few guests and coral reefs surrounding the island that are so numerous that each guest for a day has a different beach with no one there. In terms of where I would like to go, it is Nepal. Many years ago, I was able to see a tremendous beauty of the mountains and the land. Also, Thailand, “the land of the smiling people,” is a wonderful place to visit.

What is your favorite restaurant?

A Japanese restaurant in Los Angeles called Matsuhisa. The restaurant is all over the place now, but I knew Nobu Matsuhisa before he had his own restaurants and have enjoyed his creative masterpieces of fusion foods throughout 3 decades. – by Brian Ellis