top of page
CHEP+ blue.png




This continuing professional
development activity has been designated as a University of Toronto Accredited program and
awarded with the following credit categories.

The College of Family
Physicians of Canada:
5.5 Mainpro+ credits

Royal College of
Physicians & Surgeons of Canada: 
5.5 Section 1 hours

For more information, please


Gillian Brunier at:

Managing the Complex Patient:
Treatment, and Follow-Up


Saturday, April 4, 2020

8:45 am – 3:15 pm

Info and Agenda (PDF)



We are pleased to host the second annual Circulate C-CHANGE Conference. This interactive and practical program is designed for family physicians, specialists, nurse practitioners, pharmacists, and other primary care practitioners with an interest in cardiovascular disease prevention and management.

This year’s conference is devoted to covering the C-CHANGE Guidelines, with updates from Hypertension, Obesity, and Cardiac Rehabilitation and the latest clinical trial results and challenges facing the care of multi-morbidity patients with complex conditions with a focus on heart failure.


We have heard strongly from health care practitioners against large meetings, as a precautionary measure regarding COVID-19. In an abundance of caution at this time to ensure the health and safety of all meeting participants, we will provide an online meeting only, so you can enjoy the program in the comfort of your home or office. 


Highlights Include:

  • Atrial fibrillation in the patient with CHF

  • Cardiovascular risk assessment, Management of Heart Failure

  • Medical and non-medical management of dysglycemia and dyslipidemia

  • Newest recommendations from Diabetes Canada, Hypertension Canada

  • New and emerging therapies for heart failure

  • Kidney disease in diabetes; management and prevention



Sheldon Tobe, MD and Rahul Jain, MD 


Richard Choi, MD, FRCPC

Staff Cardiologist at Unity Health Toronto


Lisa Dubrofsky, MDCM, FRCPC, FAHA

Clinical Associate, Division of Nephrology, Sunnybrook Health Sciences Centre

Michael Heffernan, MD, PhD, FRCPC, FACC

Director, Oakville Cardiologists Inc.
Staff Cardiologist, Oakville Trafalgar Memorial Hospital
Director, Heart Function Clinic, Oakville Trafalgar Memorial Hospital
Assistant Clinical Professor (adj), McMaster University

Dr Rahul Jain, MD, CCFP, MScCH (HPTE)

Family Physician and Hospitalist, Sunnybrook Health Sciences Centre
Assistant Professor, University of Toronto, Department of Family and Community Medicine 

Peter Liu, MD, FRCPC

Chief Scientific Officer/ Vice President, Research, University of Ottawa Heart Institute
Director, Cardiac Function Laboratory, University of Ottawa Heart Institute
Professor, Faculty of Medicine, University of Ottawa
Professor, Faculty of Medicine, University of Toronto

Robert Myers, MD, FRCPC

Cardiologist, Division of Cardiology, Sunnybrook Health Sciences Centre 
Assistant Professor, Department of Medicine, University of Toronto
Director of the Rapid Cardiology Assessment Clinic, Sunnybrook Health Sciences Centre

Paul Oh, MD, FRCPC

Scientist, Toronto Rehabilitation Institute (TRI)
Associate Professor, Department of Medicine, University of Toronto 
Medical Director, Cardiovascular Prevention and Rehabilitation Program
Research Division Head, Toronto Rehabilitation Institute (TRI)

Sol Stern, MD, MSc, MCFP

Family Physician, Argus Medical Centre
Oakville, Ontario

Dr. Sheldon Tobe, MD, MScCH (HPTE), FRCPC, FACP, FAHA

Nephrologist, Division of Nephrology, Sunnybrook Health Sciences Centre

Professor of Medicine, University of Toronto, Northern Ontario School of Medicine

Nephrologist Sunnybrook Health Sciences Centre

Subodh Verma, MD, PhD, FRCSC, FAHA

Professor and Cardiac Surgeon, University of Toronto
CRC Chair in CV Surgery, St. Michael's Hospital


At the conclusion of this program, participants will be able to:

  1. Apply the C-CHANGE Guidelines in their practice for improved patient care.

  2. Determine appropriate laboratory tests for the screening and management of patients with heart failure.

  3. Summarize the newest and emerging therapies and how they apply to renal and cardiovascular protection.



FORMAT: Each of the workshops are led by a trained facilitator. Sessions are 60-minute case-based interactive group workshops (45 minutes of presentation with discussion questions embedded throughout the case module to stimulate discussion of case presentation, labs, history, practice and data points; 15 minutes after for topic related Q & A).


Plenary Sessions include 10 minutes for Q & A




Appropriate Follow Up and Lab Testing for Patients with HFrEF and HFpEF
Upon completion, participants should be able to:

  • Describe the epidemiology of HFrEF and HFpEF and the relationship with hypertension.

  • Explain the natural history of HFrEF and HFpEF and the impact of traditional therapy with beta blockers, RAAS inhibitors, mineralocorticoid receptor antagonists, SGLT2i’s, and ARNI’s.

  • Describe the ideal ambulatory management of patients with HFrEF and HFpEF and the lab and imaging studies recommended after discharge. 

Approach to Atrial Fibrillation in Heart Failure
Upon completion, participants should be able to:

  • Describe the epidemiology and natural history of atrial fibrillation in heart failure.

  • Formulate a management plan for patients with heart failure and atrial fibrillation.

  • Describe a diagnostic testing regimen to assist with surveillance.

The New CACPR Guidelines - Health Behaviors, Change and Beyond
Upon completion, participants should be able to:

  • Explain the impact of cardiac rehab on patient outcomes after a cardiac event.

  • Describe the process for the CACPR clinical practice guideline.

  • Describe the highlights of the new CACPR clinical practice guideline. 

SGLT2 Inhibition in the Prevention and Treatment of Heart Failure
Upon completion, participants should be able to:

  • List the clinical trials that have evaluated prevention and treatment of heart failure in people with diabetes and those without diabetes with SGLT2 inhibitors.

  • Describe the clinical implications and practice guidelines supporting these clinical trial observations.

  • Appreciate the mechanism of the heart failure benefit with SLGT2 inhibitors.



CC 01:
CV Risk Reduction in T2DM-SGLT2i/GLP1 in Patients with DM and CVD

Upon completion of this case study, participants should be able to:

  • Describe the patient who should be treated with an SGLT2i or GLP-1 RA.

  • Explain the rational for this treatment and the potential benefits.

  • Describe the steps for initiating and monitoring therapy for patients with diabetes.

CC 02:

The C-CHANGE HF Recommendation for Patients with HFrEF:
How to introduce and manage an ‘ARNI’

Upon completion of this case study, participants should be able to:

  • Identify a patient with reduced ejection fraction heart failure with an indication for an ARNI.

  • Explain to a patient the mechanism and benefit of this therapy in addition to usual standard of care for HF.

  • Describe the steps for initiating and monitoring therapy for patients with reduced EF heart failure.

CC 03:

Renal Protection in Patients with Diabetes and Advanced Nephropathy

Upon completion of this case study, participants should be able to:

  • Describe advanced diabetic nephropathy and its consequences.

  • Explain the rationale for the management of advanced nephropathy and the potential benefits.

  • Describe how advanced nephropathy might be prevented.



For more information, contact:

Gillian Brunier at:

To be on our email list, contact us here. 

bottom of page