The Three Musketeers of Heart Health

Transcript generated by AI.

Announcement: 0:00

Welcome to MedEvidence, where we help you navigate the truth behind medical research with unbiased, evidence-proven facts hosted by cardiologist and top medical researcher, Dr. Michael Koren.

Dr. Michael Koren: 0:11

Hello, I'm Dr. Michael Koren, the executive editor of MedEvidence, and I have a unique privilege today to talk with Dr Mustafa Kirk, who's a surgeon in Chicago, and he's a super interesting guy, and I say that because not all cardiothoracic surgeons are interested in cardiovascular prevention and Mustafa is one of those people that is interested in prevention. So I'm super interested to talk to him a little bit about that, how he came to that perspective, and, secondly, he's had an interesting journey in his career path that hopefully he'll share with us. So, mustafa, welcome to MedEvidence!

Dr. Mustafa Kurkluoglu: 0:51

Thank you very much for having me here today.

Dr. Michael Koren: 0:54

Yeah, I'm excited about our conversation. So, as you know, a lot of the people that view these podcasts are people in the medical profession and they're really interested in knowing the professional pathway of our guests. So why don't you tell us how you ended up becoming a cardiothoracic surgeon in Chicago and your pathway to get there?

Dr. Mustafa Kurkluoglu: 1:14

Yeah. So first of all, my journey started, as usual, in medical school and I remember at some point in medical school I watched the surgery, cardiothoracic surgery and when I saw that the heart has stopped there, so it says, oh, I want to do this, no, it attracted my attention. And then, after medical school, I went into cardiothoracic surgery training.

Dr. Michael Koren: 1:39

-quick question Did you have family members who are physicians or it was just something that you became interested in as you were growing up?

Dr. Mustafa Kurkluoglu: 1:47

No, actually no family member, I just you know no family member, I just you know, didn't know actually what to do. But after going to the medical school and trying the medical field, I became interested more and more every day. So it was just something I was drawn to maybe. And after watching the surgery, and then I wanted to do this, I said in my mind, and then I first started the training in Turkey and then I did the fellowship training in Washington D. C., especially in congenital heart surgery, the birth defects of the heart, and then pediatrics as well. So, and then I moved to back to Turkey.

Dr. Mustafa Kurkluoglu: 2:33

I wanted to start a program, in fact, for the babies which has congenital heart defects, and we achieved good results there. In fact we were on the program which were doing these kind of procedures in some region, and then after a while but you know, things initially work well, but after a while it became very difficult for me to maintain that and then, because I was the only surgeon there, I burned out literally. Maybe most of our colleagues are living the same here and then I moved back to Chicago. Now I'm yeah.

Dr. Michael Koren: 3:17

Are you doing congenital surgeries in Chicago or not?

Dr. Mustafa Kurkluoglu: 3:21

Yeah, I work in transplant team now.

Dr. Michael Koren: 3:23

We're doing heart transplants.

Dr. Mustafa Kurkluoglu: 3:25

I exclusively work in the transplant team. Sometimes we do congenital heart surgery, so exclusively in transplants.

Dr. Michael Koren: 3:37

Interesting. So in my experience, people that have had that career path aren't necessarily interested in cardiovascular prevention, particularly the mechanisms of atherosclerosis. So tell me about that journey a little bit. How did you get interested?

Dr. Mustafa Kurkluoglu: 3:54

Yeah. So actually the thing started with myself, because I was not. Yeah, because I initially, you know, when I was in my 40s, I was not feeling well and you know I was not able to keep up my daily responsibilities. You know, it was very difficult for me I mean getting out of bed, you know it's. So I searched for ways to fix it. I mean I was thinking what pill can fix my situation? So, and then I talked to a friend who introduced me to the you know some other things that I can do and I really tried that and it worked. It was just antioxidants and nitric oxide, increasing nitric oxide and, you know, addressing inflammation, and those things really worked.

Dr. Mustafa Kurkluoglu: 4:52

And when I felt it in myself, so and I tried to learn more about it, and then when I learned more, I saw that. So we saw see the plaques pretty late, and when people come to us, it's almost, you know, their options are very limited. However, the plaques start with the basic three mechanisms. So one of them is oxidative stress, one of them is endothelial dysfunction and one of them is inflammation. So if we can address those issues at first place, before something happens, we can fix the problem and they don't have to have the complex treatments and stuff like that.

Dr. Mustafa Kurkluoglu: 5:38

Sure. Yeah that increased my attention on the subject.

Dr. Michael Koren: 5:44

So, out of curiosity, which medications slash supplements were you using that were antioxidants that helped you feel better personally?

Dr. Mustafa Kurkluoglu: 5:53

Yeah, first of all, I used nitric oxide, increasing Like I was using a noni fruit which I took on an empty stomach, and I used antioxidants, kind of a small fruit juice, antioxidant support and with multivitamins. And then I used omega-3 to address inflammation, with vitamin D and E as well. So this helped me.

Dr. Michael Koren: 6:28

Did you remove anything from your diet during that process?

Dr. Mustafa Kurkluoglu: 6:33

Yeah, further along the way I moved, but initially I did not because I did not know that actually at that time the metabolic dysfunction part. But then when I went into that part, I saw that metabolic problems and then which actually is coming out of the food that we eat in general, and so I had to.

Dr. Mustafa Kurkluoglu: 6:57

You know, yeah.

Dr. Michael Koren: 7:00

lot of processed foods, as you know a lot of processed foods, as you know, are pro-inflammatory, so sometimes it's what you remove rather than necessarily the supplements you're taking. But interesting journey. So break it down a little bit more for our listeners and viewers, and especially for those who are not of a medical background. So when you say things like oxidative stress, what do you mean? Listeners and viewers, and especially for those who are not of a medical background? So when you say things like oxidative stress, what do you mean? I mean you talk about endothelial dysfunction. Give people a little bit more of a sense for what that all means.

Dr. Mustafa Kurkluoglu: 7:30

Yeah, that's a good question. So, first of all, oxidative stress is a mechanism that we see In medical school we learn in a cellular basis, but we don't know in general, we don't see the big picture there. So I think you know oxidative stress is basically the damage of the cells by the free radicals. So free radicals are electrons basically just wandering around and just damaging the other cells and it is just like rusting in the body. However, you know it's a continuous process and it can be prevented by antioxidants. Antioxidants are natural defense mechanisms of the body. Like I mean, when you think that there are oxidative foods, there are antioxidant foods. So some foods increase the oxidation, some foods increase this process of oxidative stress and some foods decrease it, but not only foods. But I also delved into that. The stress is actually increasing the oxidative stress, the normal stress that you're having your day-to-day life,

Dr. Michael Koren: 8:45

The psychological, yeah, yeah.

Dr. Mustafa Kurkluoglu: 8:47

Yeah, it's one of the- Actually, stress is a predictor of heart disease that we don't see and nobody can, you know, assess it in a regular doctor-patient relationship. We just look at the numbers and, you know, prescribe some medications, but we don't assess the stress level of the patient or the individual. So the stress is another, you know, problem that's causing the oxidative stress as well. So these are the molecular basic mechanism and the second mechanism is endothelial dysfunction.

Dr. Mustafa Kurkluoglu: 9:24

The endothelium is the inner layer of arteries, as you know. So endothelium is known as one of the, by surface area, the largest organ Because it can cover like five ten score distance when you lay it on the ground. And then, for example, we have blood vessels which carries blood to every part of our body and our blood vessels can, if you stretch the blood vessels and add them, end to end, you can encircle the world two and a half times. So we have enormous web of blood vessels and the inner lining is covered with endothelium. And endothelium, protecting the endothelium, is the first defense mechanism against heart attacks.

Dr. Mustafa Kurkluoglu: 10:12

And there's a molecule which is a miracle molecule, I say, and it was the first founders after small molecule have gotten Nobel Prize in medicine 1998. And it's called nitric oxide. Nitric oxide is the natural protector of endothelium and it opens up blood vessels. It relaxes the smooth muscles within the blood vessels so that blood can easily flow, the smooth muscles within the blood vessels so that blood can easily flow. And and, by the way, it's natural and it's, it doesn't require a synthetic medication, in fact, for the body to produce it, although there are some synthetic medications, but it's. You can use it the natural way.

Dr. Mustafa Kurkluoglu: 10:57

And the third mechanism is inflammation. Inflammation is, as you know, the battle between the body and the foreign objects. However, the body can sometimes use inflammation against its own cells and that causes the damage its own cells and that causes the damage. So, as you mentioned, inflammatory foods, these are also a big problem in today's society, I believe, and it can be a reason why heart attacks are increasing, because no one, you know almost very few people, talk about these mechanisms and very few people know about them.

Dr. Michael Koren: 11:41

Right, yeah, so interesting. You know, one of the challenges is that clearly these mechanisms that you discussed are mechanisms that are very important to atherosclerosis but there's still a debate about how to prevent those mechanisms from taking hold of our vasculature and some of the clinical trials that I've done have had sort of mixed results. So I remember as a young cardiologist I was very eager to recommend vitamin E and then we looked at vitamin E in clinical trials and it really didn't help as an antioxidant. I actually worked in a lab during college, in medical school and the famous actor Clint Eastwood actually came to the lab because he was interested in some of the theories about free radicals and oxidative stress.

Dr. Michael Koren: 12:31

And you said very nicely how we have these extra electrons that cause damage to our cells and we have some internal mechanisms to prevent that damage from causing a huge problem. And at that time we were studying SOD sodium oxygen dismutase as an intrinsic antioxidant and seeing whether or not it could be medicalized and we had some interesting animal models that looked at that. But it was very hard to show that worked in day-to-day human life and for our patients. So such an interesting issue, and it's both something that we should be thinking about in terms of those food substances that actually cause these problems, and doing more work and high-level clinical trial work looking at different antioxidants to see if they make a difference and I don't know if you agree with that concept, but somebody that has a lot of clinical trial work, I'm very eager to do more of these dietary studies and studies that look at things like antioxidants.

Dr. Mustafa Kurkluoglu: 13:32

Yeah, absolutely. And in today's world, you know, in the system that we're in right now, very few studies are being done, except the drugs and which are related to drugs or some new drugs or anything like that, because they are the ones which can be patented and which can be labeled and which can be sold at high prices. But the natural solutions are they're cheap, they're easy, so they are not being dwelled on or they're not being. They're not much studies being done about that, those things, because I don't know the exact, you know it's. There are many reasons. Actually, we cannot just point a single reason, but this is the issue now.

Dr. Michael Koren: 14:21

One of the reasons could be is that the manufacturers of nutritional products and food products don't want to spend the money to do the clinical trials to look at it critically, knowing that it's possible that the studies will not show that their product is successful at preventing atherosclerotic complications. So that's the trade-off there is. The pharmaceutical industry definitely is developing higher-priced products, but they are spending the money on the research to determine what works, and I know that there have been certainly studies looking at nitric oxide enhancing drugs and whether or not they make a difference, and again, those studies have had sort of mixed results. But it's an interesting dilemma. I wish there was more nutritional research that looked at some of these issues.

Dr. Mustafa Kurkluoglu: 15:07

Yeah, I agree.

Dr. Michael Koren: 15:10

Yeah, certain proteins, I believe, have been theorized to be nitric oxide producing agents and enhance the concentration of nitric oxide at the endothelium level, and so those are the type of things that would be super interesting. Like L-carnitine, do you ever look at that or use that?

Dr. Mustafa Kurkluoglu: 15:33

I haven't used it, but I've seen it. L-carnitine yeah, it's one of the enhancers.

Dr. Michael Koren: 15:40

Yeah, yeah, it's interesting. I have treated some patients with that that have chronic ischemic conditions that are not amenable to revascularization. So it's again an example of something that I wish had more well-conducted clinical research evidence, because it's very fascinating from a theoretical standpoint. So this has been a fabulous discussion, so tell us a little bit more about your intentions on getting the word out. I know that you're very passionate on this issue, so talk to us about how you're helping people understand these mechanisms of atherosclerosis and how you want to articulate your message.

Dr. Mustafa Kurkluoglu: 16:29

Yeah, first of all, I wanted to communicate these things because I wanted to help people before they present to a hospital, because what I see every day is that people are presenting in very difficult conditions, even for heart transplants. Most of them are for ischemic heart disease, which is preventable. And you know, even people receiving heart transplants or people who are receiving complex treatments like bypass surgery, everything, are not fully satisfied with the results, because this is a temporary solution. In fact, the bypass surgery or other surgeries, we put extra blood vessel in the distal part, in the farther part along the line, so you make an extra way, let's think about this, and so it does not fix the underlying mechanism and it can occlude as well. So prevention, an ounce of prevention is better than a gallon of treatment. That's my model, and, so, if you can just stick to simple things and do some research, some of your own research, make your own routine and you can even get some personalized help from people who are in this information and so that you can set yourself for a healthier life, I believe.

Dr. Michael Koren: 18:02

Absolutely, absolutely. So I know that you're working on a book. Why don't you tell our audience a little bit about that, and when they can expect it and what to look for?

Dr. Mustafa Kurkluoglu: 18:12

Yeah, actually, my book is coming out soon. It will be on Amazon Three Muscketeers of Heart Health. So it's basically I wanted to explain the three protective mechanisms which we can address the heart attacks, heart disease, before they even present. So I wanted to mention those three mechanisms in my book. I just resemble it into the movie Three Musketeers, and so it's the three mechanisms, like. One of them is the endothelial dysfunction and nitric oxide, one of them is inflammation and oxidative stress. So if you can have a chance to read the book, you will see the strategies to prevent those mechanisms before they

Dr. Michael Koren: 19:05

So interesting,

Dr. Michael Koren: 19:06

yeah. Will there be any dietary information or your recommendations about the use of supplements or pharmaceuticals?

Dr. Mustafa Kurkluoglu: 19:14

Yeah, I don't want to go deep into the dietary recommendations, but with simple ones, and I personally believe that the making things complex will not work, because people do not, cannot just fit into their busy schedule. They cannot just cook foods a couple of hours, you know, just try to eat healthy. They just eat whatever they can find. But if you can prevent certain foods, if you can prevent just a couple of foods to take out of your diet, you can be well ahead of most people. That's my belief and I don't. So I'm not recommending diet in detail or, you know, exercise even. You have to do cardio, this and this, but you can just put small exercise routine, what I call exercise snacks in your day, and that's also helpful and so well. I want to be as simple as possible and as scientific as possible. So these are my two edges that I want to keep while doing this.

Dr. Michael Koren: 20:22

Fascinating. So it's going to be called the Three Musketeers of Atherosclerosis by Dr Mustafa Kirk. Is that correct?

Dr. Mustafa Kurkluoglu: 20:30

Yeah, three Musketeers of Heart Health is the name of the book.

Dr. Michael Koren: 20:35

Yeah, Very nice. Well, we'll look out for it for sure, and I can't wait to read it myself. So fascinating, fascinating stuff. Anything else you want to add to our discussion? So far, mustafa? I think it's been really, really valuable for the listeners.

Dr. Mustafa Kurkluoglu: 20:51

Nothing else. Thank you for having me again. And one thing I mentioned is that if someone is watching this podcast, I think they are on a wellness journey. They want to be better. They don't want to be- Because I think you are. If someone is watching this, you are ahead of the game, because most people are not thinking of that and most people think that, oh, if I have something, I go to the doctor and they fix. But it's not working that way.

Dr. Michael Koren: 21:20

Yeah, I would agree with that 100%. MedEvidence listeners and viewers are way ahead of the rest of the pack.

Dr. Mustafa Kurkluoglu: 21:27

Yeah.

Dr. Michael Koren: 21:27

And we want to keep them there. So thank you for helping us and helping our audience, and we're all working together towards a healthier lifestyle. Again, this is Dr Michael Koren and Dr Mustafa Kirk signing off for MedEvidence on another fascinating discussion about heart health. Thank you so much.

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