Meet Peter Eckman, M.D., part of the new generation of cardiovascular physician-scientists continuing to further the University of Minnesota’s decades-long leadership in heart research and care.
It’s a humbling experience to have patients put their lives in your hands, Eckman admits, but that trust inspires him to keep improving care for each patient he sees. And with interests in heart transplantation and mechanical circulatory support devices, he’s proud to work at the home of many of the world’s first open-heart surgeries and the invention of the world’s first battery-operated wearable pacemaker.
“Peter Eckman epitomizes the clinician-scientist,” says Robert F. Wilson, M.D., director of clinical cardiology. “He is an outstanding physician who asks questions and designs studies to improve clinical medicine. This ability to meld clinical medicine to research and innovation is what drives medicine forward and improves patient outcomes.”
Born in Duluth, Eckman graduated from Gustavus Adolphus College with a bachelor’s degree in physics. He received his medical degree and completed his residency and general cardiology fellowship at the University of Minnesota. Following a fellowship in advanced heart failure and cardiac transplantation at the Cleveland Clinic, Eckman joined the University of Minnesota faculty, in 2009. He is focused on the role of mechanical circulatory support for heart failure and how heart failure patients may benefit from cell therapy.
Read on as Eckman answers questions about his past, present, and future in medicine.
When did you first become interested in medicine?
“I always considered medicine a possibility, mainly because I have had several physicians in my family, but for a long time, medicine was not my primary interest. I was a physics major in college and thought that I would be an engineer, but by about my junior year, I realized I didn’t want to sit hunched over a desk with a piece of paper and a calculator solving equations. I was more interested in working with people, and medicine seemed like the best way to combine my interests in science and people.”
What drew you to the field of cardiology?
“As an intern I would have said, ‘I am not going to be a cardiologist!’ It seemed to me then that every call was an emergency—low blood pressure, chest pain, shortness of breath, ventricular tachycardia, and so on. It was a bit intimidating, and I thought, ‘I don’t want to be dealing with emergencies all the time.’
Over the course of my training, I learned that not every episode of chest pain means someone needs to be whisked to the cath lab. Once I had more perspective, cardiology became less intimidating and more appealing. My interest was piqued during an elective outpatient rotation when we observed exercise stress tests. I quickly realized it was more interesting to shadow the cardiologists, learn about reading echocardiograms, and talk to them about patients. I was impressed by all the modalities they had to work with, everything from echocardiography to nuclear cardiology to coronary angiography, and by all the treatment options—everything from pills to stents to pacemakers to open-heart surgery.
It struck me as an area that had richness, despite being focused on a single organ system. That appealed to me. I also liked that cardiologists saw inpatients and outpatients, gave critical care, and treated people of all ages. I like that variety and the critical care component.”
What is the key to effective patient-physician relationships?
“I think honesty is critical. It’s important that we physicians be honest and forthright with patients about what we think, what we know, [and] most importantly what we don’t know—and that when we need help, we are humble enough to ask for assistance from our colleagues.
I also think it’s important that patients be honest with us about whether or not they are taking their medications and following our advice because often we will make recommendations assuming that patients are following our prescription.”
What are your research interests?
“I am particularly interested in patients with advanced heart failure who need advanced circulatory support, such as left ventricular assist devices (LVADs). As a fellow, I had my eyes opened about this therapy. Profound heart failure often is concurrent with renal failure, and seeing patients literally transformed from being profoundly debilitated to vigorous with therapy was amazing, and I knew I wanted to be a part of that.
What’s exciting to me about this area is that there is still so much for us to learn. We don’t know the best way to determine the speed on the ventricle assist device, [and] we’re still optimizing our understanding of when to implant [and] when not to implant, and as the risks and potential side effects of this therapy continue to decrease, we may reach a point where this technology largely replaces heart transplant.
I am also interested in the underlying biology of these relatively nonpulsatile pumps. When cardiopulmonary bypass was invented at the University of Minnesota about 50 years ago, considerable debate ensued about whether or not nonpulsatile blood flow is biologically important. Only in the last couple of years have we had a sufficient population of patients with long-standing relatively nonpulsatile blood flow and implanted with VADs to determine the benefits. This is an indication of how much we need to learn about the human cardiovascular system and whether or not the blood vessels expect pulsatility to function normally and what are the consequences of less pulsatility even if the flow is much better. Questions about the biology of less pulsatile flow are an area that I think the University of Minnesota is well-positioned to answer.”
Who inspires you?
“My colleagues continuously inspire me. I am proud to be at an institution where open-heart surgery and pacemakers were invented. I am excited to work with so many colleagues who are passionate about taking care of patients and advancing knowledge in their fields.
I am also inspired by my patients. These are people who are incredibly sick, may be dying, and come to us for help. They put their lives in our hands, and that is a humbling experience. Their trust gives me a lot of energy to be the best physician I can be and help improve our understanding of illness.”
Where do you see yourself in 10 years?
“My son will be a teenager, and helping to guide him will be a big part of my life. I also anticipate that in 10 years the University of Minnesota will have made further substantial contributions to the field of VAD support, and I hope that I will have been a major part of that.”
What does the University of Minnesota Cardiovascular Program mean to the Twin Cities?
“I think the University of Minnesota Cardiovascular Program has been a critical foundation for cardiology and medical practice, and an economic engine for Minnesota and the world. The impact that our discoveries have had on medical care over the last 50 years cannot be overstated. Although we can’t predict what will be next, I think we need to have faith that continued striving to fulfill our mission as academics will reap further significant benefits for the health of the people of Minnesota and beyond.”