ACR on Air Podcast

Pericardial Disease is couched between two medical disciplines: Cardiology and Rheumatology, and those with these conditions visit medical professionals viewing their treatment through one lens or the other. This episode addresses the shifting reality that pericarditis and myocarditis are no longer separate silos but rather takes the broader view of inflammatory heart disease. We’ll examine how rheumatologists should be thinking about pericardial disease, when we should get involved, how diagnosis and imaging fit in, plus the evolution of treatment.

Dor Lotan, MD – Dor Lotan, MD, is an Assistant Professor of Medicine at Columbia University Irving Medical Center and NewYork-Presbyterian in New York. He is an advanced heart failure cardiologist with specialized expertise in heart transplantation, mechanical circulatory support, cardiogenic shock, and cardio-rheumatology.

Dr. Lotan founded and serves as Medical Director of the Center for Pericardial and Myocardial Diseases at Columbia University Medical Center, where he developed a multidisciplinary program that brings together rheumatology, cardiology, advanced imaging, and cardiac surgery to care for patients with inflammatory heart disease. The Columbia program is recognized among the leading centers in the United States for pericardial diseases and has been acknowledged by the American Heart Association Pericarditis Initiative as one of the top sites in the country.

Dr. Lotan has focused on pericardial disease for more than a decade, beginning with close collaboration with global leaders in the field. He has authored numerous papers and book chapters, participated in clinical trials, and served as an international principal investigator to help advance the field of pericardial disease. He is internationally recognized and frequently invited to lecture and educate the next generation of clinicians on pericardial diseases.

In addition, Dr. Lotan serves as Medical Director of the Centralized Heart Failure Management Program across NewYork-Presbyterian. He is also a Director of the Myocarditis Foundation, helping advance awareness and research in myocarditis, and serves as an Associate Editor for Circulation: Heart Failure Journal.

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For years, myositis treatment has relied on broad immune suppression with drugs like steroids, methotrexate, and rituximab—but what if we could target the disease more precisely? Inflammatory myopathies are not a single condition, but a group of biologically distinct syndromes with different clinical features and immune pathways. As our understanding evolves, so does the potential for more personalized, targeted therapies. In this episode, we’re joined by Julie J. Paik, MD, MHS, to discuss how this shift could reshape the future of myositis treatment.

Julie J. Paik, MD, MHS – Julie J. Paik, MD, MHS, is an Associate Professor of Medicine in the Division of Rheumatology. She completed her undergraduate degree at the Johns Hopkins University and medical degree at George Washington University School of Medicine. Thereafter, Dr. Paik pursued her internal medicine residency at UCLA-Cedars-Sinai/West LA VA medical center, where she served an additional year as chief resident. She then completed fellowship training in rheumatology at Johns Hopkins and then transitioned to the faculty.

Dr. Paik’s clinical and research interests are focused on neuromuscular manifestations of autoimmune diseases, particularly in the areas of myositis and scleroderma. To fortify her methodologic strengths during fellowship training and advance her research interests, Dr. Paik completed a Masters in Clinical Investigation at the Johns Hopkins Bloomberg School of Public Health.

The focus of Dr. Paik’s current research efforts is in determining the mechanisms of muscle disease in scleroderma. Whereas her clinical practice is focused on the broad range of autoimmune and inflammatory muscle disease in rheumatology, there is a particular emphasis on the neuromuscular manifestations of scleroderma.

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In this episode, we discuss the growing workforce challenges in rheumatology with Christopher D. Estes, NP. Chris shares how he entered the field, the training he received early in his career, and how he developed expertise in musculoskeletal ultrasound. The conversation explores how advanced practice providers (APPs) can help address rheumatology workforce shortages by expanding access to care—seeing new patients, managing follow-ups, and working both collaboratively and independently within a practice. Chris also discusses training pathways for new APPs, common misconceptions practices may have, and how investing in APP development may be an important strategy for the future of rheumatology care.

Christopher D. Estes, NP – Christopher D. Estes, NP, is a RhMSUS certified nurse practitioner working in the Rheumatology Musculoskeletal Ultrasound Clinic at Massachusetts General Hospital in Boston, MA. As an advocate for advanced practice providers in rheumatology and musculoskeletal ultrasound, he sits on the American College of Rheumatology's Ultrasound Planning Subcommittee, Association of Rheumatology Professional's eLearning Subcommittee, the Gout Support Group of America's Medical Advisory Committee, and has been a speaker and musculoskeletal ultrasound scanning instructor for several educational workshops across the United States. He has particular interest in advancing the APP's role in rheumatology and point-of-care ultrasound.

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In this episode, we explore the paradox of gout—one of the most biologically understood and treatable diseases in medicine, yet still among the most poorly controlled chronic conditions in practice. With effective therapies readily available, why do patients continue to cycle through painful flares, start and stop medications, and return to clinics and hospitals in a pattern that feels like a recurring failure? We unpack the complex interplay between biology, patient behavior, medication adherence, and health system barriers, asking whether the problem lies in the disease itself or in how care is delivered. As new treatments emerge, we also question whether innovation alone can solve the problem—or whether lasting change requires fixing the systems struggling to fully use the tools already at hand.

John D. FitzGerald, MD, PhD, MBA – John D. FitzGerald, MD, PhD, MBA, is a rheumatologist and Clinical Chief of Rheumatology whose research focuses on improving care for patients with gout and other crystalline arthritides, including CPPD disease. He is the lead author of the American College of Rheumatology Gout Guidelines and Quality Improvement Measures and collaborates on innovative diagnostic and monitoring technologies, including a wearable uric acid sensor and a lens-free polarized microscope to detect gout and pseudogout crystals. His work also examines the relationship between gout, cholesterol, and atherosclerosis, as well as broader quality-of-care, outcomes, and health policy research, including musculoskeletal ultrasound standards. Dr. FitzGerald earned his MD from Tufts University and his PhD in Health Services from UCLA, where he also completed his residency and rheumatology fellowship, and has served on the UCLA faculty since 1999 while caring for patients across multiple Los Angeles–area sites, including the VA and RAND.

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In this episode, we explore antiphospholipid syndrome (APS) with Dr. Yu (Ray) Zuo, MD, MS, beginning with a clear, clinically grounded explanation before diving into the personal and scientific journey that drew him to this notoriously complex disease. Along the way, Dr. Zuo shares a case that forever changed how he understands APS, then takes us inside his latest Arthritis & Rheumatology study, where machine learning reveals hidden patterns that may reshape how we think about patients and risk. The conversation moves from bedside to bench and back again, tackling what AI can—and can’t—do for rheumatology, where APS research is headed next, and what early investigators need to know to build impactful careers.

Dr. Yu (Ray) Zuo, MD, MS – Dr. Yu (Ray) Zuo, MD, MS, is the Edward T. and Ellen K. Dryer Early Career Professor of Rheumatology and an Assistant Professor in the Division of Rheumatology at the University of Michigan. His research focuses on the pathogenic role of neutrophil extracellular traps and infection-associated autoimmune responses in thromboinflammatory diseases, including antiphospholipid syndrome, vasculitis, juvenile dermatomyositis, and COVID-19.

Dr. Zuo has authored more than 57 peer-reviewed publications, with work published in leading journals such as Circulation, Blood, Science Translational Medicine, JAMA Cardiology, and Arthritis & Rheumatology. His research is supported by the NIH, the Rheumatology Research Foundation, the American Nephrology Research Foundation, and the Frankel Cardiovascular Center.

In recognition of his scientific contributions, he received the 2024 Young Physician Scientist Award from the American Society for Clinical Investigation. In addition to his research, Dr. Zuo is a highly regarded clinician-educator and recipient of the 2024 Joe McCune Excellence in Clinical Teaching Award. He was recently named an Alfred Taubman Institute Emerging Scholar and serves as the Associate Director of the Michigan Antiphospholipid Syndrome Program.

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