European Heart Journal (2014) 35, 331–337 doi:10.1093/eurheartj/eht564
‘Where everything comes together!’ European Society of Cardiology Congress 2014 Barcelona, Spain, 30 August – 3 September 2014, for all cardiologists
Innovation and the heart: spotlight of the Congress in 2014 This spotlight captures innovations in scientific discovery, in clinical practice, in discovery, in technology, in education, and, importantly, in applications to clinical care. Cardiology is evolving rapidly and it is critically important for us to keep up-to-date, not only in the areas of our special interests but also in what is happening elsewhere across the spectrum of cardiovascular disease. The ESC Congress in Barcelona will also highlight innovations in the scientific programme and in how it will be delivered. Based on the feedback from Congress participants in 2013, the interactive sessions and case-based formats were rated very highly, and in 2014 we will develop and expand these themes. The ‘Hub’ of the Congress provided a novel and innovative way of engaging with the audience, and this year we will have four circular and open-sided venues and these will be the setting for ‘Rapid Fire’ abstract sessions, as well as special tracks and other interactive sessions. The scientific exhibition provides an important opportunity for delegates to engage with participants from industry and to learn about the latest developments in diagnostic and therapeutic products and technology. In addition, we have a new development—Global Focus Sessions. These are interactive, built around case presentations or live cases, and with active audience participation. They are designed for clinical cardiologists across the spectrum of specialty interests. To complement Global Focus, we will have a new format of specialist-cased-based sessions, embedded in the Topic Villages, and designed for those with a specialist interest. A ‘Day with the Legends’ includes not only the named lectures but also the opportunity to interact with true legends, individuals who have changed the landscape of modern cardiology. There is much the clinical cardiologist, the trainee, and the researcher can learn. What made them do it, what lessons have they learned, and what may inspire leaders of tomorrow? You ask the Legend . . .!
Looking to the future The average age of ESC Congress participants is getting younger and in 2013 there were .3300 participants 35 years of age or less. Cardiologists of Tomorrow tracks have been a great success; purpose designed by ESC Cardiologists of Tomorrow, for cardiologists of tomorrow (even a session on how to survive your first night, as a trainee, on the Intensive Care Unit!). For the first time Cardiovascular Scientists of Tomorrow will have their own track in 2014. Sessions include key tips on the first successful grant application, the first paper published and, importantly, opportunities to develop the next career step.
Published on behalf of the European Society of Cardiology. All rights reserved. & The Author 2014 . For permissions please email: [email protected]
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Barcelona has proved to be an excellent venue for the ESC Congress and we will return in 2014. It is a city ‘Where Everything Comes Together’—a state of the art congress venue, a vibrant culture, an elegant lifestyle and a unique Catalan ambiance. Just what we will all need after a full day at the scientific congress!
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Global focus session The Multinational Congress of Cardiology
‘Villages’ of key cardiology themes How can the clinician keep up-to-date in his or her field and still know about the important developments across the spectrum of cardiovascular disease? The Topic Villages will provide the latest developments in your specialty of interest and in Central Village you will find the central themes and Global Focus sessions. Together these will ensure that we can keep our professional development at the forefront of clinical practice; 2014 ESC Clinical Practice Guidelines will be presented in Central Village; in addition, you have the chance to question the Guideline panels in Meet the Guideline Taskforce sessions. What do the new guidelines really mean and how do you implement them in clinical practice? New sessions called ‘Guidelines in Daily Practice’ have been designed and will be presented in each village; Meet the Expert sessions will be held as well. Another new type of session called Cases in Crossfire will be conducted, where challenging cases will be debated between an expert panel and the audience. In addition to the Basic Science Village, we are building on the ‘Science in Practice’ developed last year to give clinicians insights into developments in the future and to give scientists insights on where their innovations may be leading; these tracks will be hosted in the topic-related villages. By attending the Congress, we will earn 21 continuing medical education credits and, importantly, we have opportunities to interact
directly with experts and thought leaders through many interactive sessions. Why come to the Congress rather than read accounts of the sessions that appear online? The ESC Congress is a key opportunity for participants to engage with peers from other countries and to build networks and collaborations around the world—we have much to learn from each other! A second hand account of the Congress is never the same as being there and discussing what is’ new, directly questioning the presenters, and mulling it over with your friends! Although various summaries of Hotlines will appear online, you really need to be there to understand the significance of the new research and decide where it will really change clinical practice, or not! Remember Valentine’s Day! The 14th of February is the deadline for abstract submissions and this is a key opportunity to have your research discussed and to get feedback from international experts. The ESC Congress is the largest Cardiovascular International Congress and its true international nature provides exciting and innovative opportunities to be part of the multinational cardiology ‘family’. You have the choice: be part of the action and the breaking innovations or just sit on the sidelines!
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There is huge international enthusiasm for participation in the ESC Congress and the Congress Programme Committee has had to select 400 sessions from the very large number of submissions for the planned symposia. We will also have over 30 joint sessions with other major cardiovascular organizations from around the world. Cardiology is an international community and we have much to learn from each other. Although the clinical settings differ around the world, we face similar challenges and similar cardiovascular disease processes. None of our healthcare systems has all the answers, but perhaps we each can share innovations that improve our understanding of the underlying science, innovations in therapies and how they are applied, and innovations in how we balance risks vs. benefits of new developments. We will have experts and key opinion leaders from 60 nations and healthcare professionals from all the continents in symposia and in original research presentations. The ESC is a truly global community.
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New European Heart Journal International Editorial Board members 2014 The European Heart Journal welcomes two new Board Members from Portugal and one from Korea
Prof. Lino Manuel Martins Gonc¸alves, MD, PhD, FESC
Adelino Leite-Moreira is full professor of Physiology, Pathophysiology and Cardiothoracic Surgery at the Faculty of Medicine of the University of Porto (FMUP), Portugal, and is also Head of the Department of Physiology and Cardiothoracic Surgery and the Coordinator of the Cardiovascular R&D Center of the same institution. He also has an appointment as senior cardiothoracic surgeon at the affiliated University Hospital Sa˜o Joa˜o in Porto, Portugal. Besides these positions, he has accumulated different management duties at the University. He graduated as a physician in 1989 at FMUP and trained as a research fellow from 1991 to 1994, at the Department of Physiology, the University of Antwerp in Belgium, where he developed his interest in the field of diastolic function and heart failure with preserved ejection fraction. It was in this field that he defended his PhD thesis in 1997. In 2003 he completed his clinical training as cardiothoracic surgeon at Hospital Sa˜o Joa˜o. Since then he has been concentrating his clinical activities in adult cardiac surgery. He has a special interest in surgical and technical innovation and holds particular expertise in the fields of reconstructive mitral and aortic valve’ surgery, aorta and aortic root surgery, as well as in total arterial off-pump coronary artery bypass graft surgery. Besides cardiac surgery, diastolic function, and heart failure, his research interests also include right ventricular function and pulmonary hypertension. His double appointment in the fields of Physiology and Cardiothoracic Surgery has been crucial for the translational nature of his research, clearly facilitating the bench-to-bedside and back approach. Over the years, he has authored or co-authored almost 200 full papers in well-recognized international journals and was granted with .3 million Euros on competitive calls for research. He has also been awarded several major scientific prizes. His future endeavours are mainly focused on increasing the level of scientific and technological innovation and excellence in Portugal, with a special emphasis in the promotion of translational and clinical research. His scarce free time is spent with his family and friends, particularly with his wife and three children with whom he enjoys long walks in the countryside, and in mountain climbing.
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Lino Manuel Martins Gonc¸alves is a Chief of Clinic at Coimbra University Hospital, Portugal, where he works as a senior invasive cardiologist. A native of Portugal, he obtained his MD in 1984 and in the same year received a Master’s in Cellular Biology. His postgraduate training was also in Portugal, after which he worked as a visiting associate at the National Institutes of Health’s Cardiology Branch, Bethesda, USA, from 1997 to 1998. The Portuguese Medical Association certified him as a Cardiologist in 1992 and in 2001 he became a fellow of the European Society of Cardiology. Lino Gonc¸alves is associate professor of Cardiology with full responsibility for the teaching of cardiology. Additionally, he is a member of the Scientific Council of the University of Coimbra Medical School. He has held several positions in the Portuguese Society of Cardiology; first as assistant secretary, then as vice-president (three terms of 2 years). He was also Board Member of the PCI Working Group of the Portuguese Society of Cardiology and President of the 33rd Portuguese Congress of Cardiology (2012). Finally, he was Director of the National Center for Data Collection in Cardiology for 5 years. Besides these activities for the Portuguese Society of Cardiology, he is a member of the Portuguese National Ethics Committee for Clinical Research, and is co-director of the Harvard Medical School CSRT Programme in Portugal. In European Affairs, Prof. Gonc¸alves has been on several committees in institutions related to education, accreditation, and certification, such as Secretary of the UEMS—Cardiology Section, EBAC chairman, ESC Board member, Education Committee member, Web Committee member, Chair of the ESCeL platform Task Force, Chair of the ESC Search Engine Task Force, Editor-in-Chief of the ESC Congress Reports, ESC Spokesperson on CME/Accreditation/Certification, EAPCI Board Member, and Chair of the EAPCI Education and Training Committee. He acts as reviewer for 10 journals including the European Heart Journal, has received 21 scientific awards, and has published 58 papers in international peer-reviewed journals and 85 papers in Portuguese journals. Prof. Gonc¸alves’ main research interests are coronary artery disease, interventional cardiology, angiogenesis, and stem cells.
Prof. Adelino Leite-Moreira, MD, PhD, FETCS
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Prof. Seung-Jung Park, MD, PhD, FACC
has been the principal investigator of many international multi-centre trials conducted in the Asan Medical Center, Seoul, Korea and has authored or co-authored over 360 original, peer-reviewed research articles published in numerous journals including EHJ, Circulation, NEJM, JACC, and the American Journal of Cardiology. He has also contributed as an editorial board member to several international journals with a high impact factor, including JACC, Cardiovascular Interventions, and the American Journal of Cardiology, Catheterization and Cardiovascular Interventions. Dr Park has been dedicated and passionate in educating the young generation of cardiologists. As part of the education process, he has been organizing the Asan Medical Center Interventional Cardiology Training Program since 2009 and helping young interventional cardiologists especially in the Asia Pacific region to develop their clinical knowledge and skills. Dr Park received the Ethica Award at EuroPCR in 2005, the highest honour of the European cardiovascular intervention academies and, in 2008, received the Career Achievement Award for his contribution to coronary intervention at TCT, USA. In 2011, he was awarded the Best Impression of Science and Technology presented by Ministry of Education, Science and Technology, Republic of Korea. Andros Tofield
Changing times in Cardiology II
Interview with Prof. Panos Vardas, President of the European Society of Cardiology Cardiology is one of the fastest paced specialties in medicine. In this second of two articles, Dr Shouvik Haldar interviews Prof. Panos Vardas, to ascertain his view on the ever changing landscape of Cardiology from a personal and societal perspective. Change is the only constant (from ‘all entities move and nothing remains still’ Heraclitus, 401 BC)
(1) Modern cardiology owes much of its success to important technological advances alongside evolving procedural Panos Vardas (credit Sam C. Rogers) techniques. What do you see as important advances that are on the horizon for cardiology? It is true that some of the most significant developments in cardiovascular medicine in the last 30 years are strongly connected with the evolution of interventional techniques. Interventional cardiologists perform angioplasty, stenting and, recently, transcutaneous aortic valve implantation, and cardiac electrophysiology using a wide spectrum of ablation techniques. On the other hand, we should acknowledge that, in the last few years, we have reached a plateau, with no exceptional achievements in our field. What I expect as a radical advance, not only in cardiovascular medicine, but also in medicine as a whole is the development of tissue engineering. Regretfully, despite the spectacular progress in tissue engineering and three-dimensional tissue printing, these are not expected to be clinically available very soon. We should, nevertheless, acknowledge that they are an impressive advance to be gradually developed in the next two decades. (2) In the recent adverse economic climate, there has been declining industry funding and sponsorship for cardiologists and cardiology trainees to attend conferences. How has the European Society of Cardiology (ESC) acknowledged this and what measures have been taken to support cardiologists to attend important conferences such as the ESC Annual Congress?
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Dr Seung-Jung Park is Chairman of the Heart Institute of Asan Medical Center and a Professor of Medicine at the University of Ulsan College of Medicine, Republic of Korea. He has also been serving as Chairman of the CardioVascular Research Foundation since 2002, and as a course director, he has been organizing the annual conference, CardioVascular Summit-TCTAP, which has been one of the leading interventional cardiology meetings in the Asia Pacific region for about two decades. Dr Park has been a pioneer in the field of left main intervention and an expert in the use of stents. He was the first doctor in Korea to perform a stenting intervention for angina pectoris. Additional areas of expertise are complex PCIs (long lesions, bifurcation and tandem lesions PCI functional approach). His current research interests focus on ‘Integrated Use of FFR and IVUS’ Functional Approach for Current PCI. Through a variety of clinical activities and researches, Dr Park has devoted himself to the development of interventional cardiology. He
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Creating your own virtual patient with CircAdapt Simulator Dutch researchers have produced software for simulating cardiovascular dynamics for teaching and improving patient care Researchers from Maastricht University Medical Center have launched the first release of the CircAdapt Simulator. This freeware application enables you to simulate cardiovascular system dynamics in a wide variety of physiological and pathophysiological circumstances. The CircAdapt Simulator can be downloaded free of charge from www. circadapt.org and is compatible with both Windows and Mac OS X.
shunts, if present, are displayed graphically (Figure 1). The application makes the complex dynamic behaviour of the cardiovascular system accessible to a wide audience in a user-friendly fashion. In addition to use in education and research, the simulator may also be a promising tool for the cardiologist analysing real clinical cases.
What is CircAdapt Simulator?
From educational to fundamental research tool
The interactive CircAdapt Simulator simulates cardiovascular haemodynamics in real-time. Dynamic tracings of blood pressures, volumes, and blood flow velocities in the heart, blood vessels, valves, and
The CircAdapt model of the human heart and blood vessels forms the core of the Simulator.1 Initially, this model was designed for teaching purposes, to show the importance of the physical laws of mechanics
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The ESC has not acknowledged this declining industry funding as a significant problem, particularly when taking into consideration that attendance at our recent 2013 Congress in Amsterdam reached record numbers. No doubt, traditional European participation remains relatively stagnant or has a slight decline in contrast to the increasing international participation. In parallel, industry sponsors a greater number of satellite symposia and other educational activities. Not only have the ESC central and ESC Associations been offering a significant number of fellowships to support younger cardiologists, they have also offered free registration to their congresses. Following our central decision, each National Society now has the right to provide 25 free registrations for cardiologists under the age of 35. This decision was enthusiastically received. (3) Owing to changes in industry rulings, there is a changing relationship between industry and cardiology. How do we as cardiologists better engage with industry and what plans does the ESC have to do so? Industry has always been a major contributor to continuous medical education despite some concerns occasionally raised. Unfortunately, in ESC member countries with huge deficits in their economies CME cannot be supported by National Healthcare systems or doctors themselves. Both industry and the cardiovascular communities of the ESC have generally been making enormous efforts to comply with the new rules while co-existing in educational and research projects. Nowadays, this collaboration is more transparent and innovative and effective ideas are always financially supported by the Industry. (4) The ESC has made significant progress in its educational agenda in recent years, and now has an impressive annual programme of events. You have been instrumental in this development. What are the key factors necessary to ensure that both individual educational events and the programme as a whole are a success? The Brussels project, or the European Heart Agency as it is now called, aims to cover a number of traditional or evolving needs and develop ideas. We are working close to the EU strategy and policy centres to prevent and treat cardiovascular and cerebrovascular diseases. In cooperation with other disciplines, we set up the Biomedical Research Alliance, which focuses on systematically promoting biomedical research in Europe. In parallel, the European Heart Agency has developed the European Heart Health Institute with different units as well as the European Heart Academy. In the first, among the others, a Heart Health policy observatory will be created, monitoring realities in cardiovascular medicine in our 56 member countries. As for the European Heart Academy, it will promote postgraduate medical education in collaboration with selected Universities.
336 and fluid dynamics in understanding cardiovascular physiology. From the beginning the founding father of the CircAdapt, Prof. Theo Arts chose a modular design for the model. Valves, blood vessels, cardiac cavities, myocardial tissue and peripheral vascular resistances were represented by modules each incorporating established physiological and physical principles. The modules were connected to form a network, representing the entire circulation. The simulations of haemodynamics in both the normal and the pathological cardiovascular systems turned out to be very realistic, allowing discussions about the simulated data with clinicians, as if they were measured in a real patient. Because of this realism and the fact that the content of each module is well understood, the model’s application quickly expanded to scientific research. Over the last 10 years, this model has been successfully used for fundamental research in cardiovascular (patho-) physiology,2 – 5 partially funded by the Dutch Heart Foundation.
To extend the application range of the comprehensive CircAdapt model from research to education a project was launched to build a novel, interactive simulation environment that can be used by
medical students with the aim to improve their understanding of cardiovascular haemodynamics and related physiology. This project was greatly facilitated by a generous contribution from the StITPro Foundation, which is gratefully acknowledged. The CircAdapt Simulator is designed as an interactive user-friendly shell around the CircAdapt model. Without much foreknowledge, a novice user can intuitively simulate complex pathophysiological situations by manipulating, e.g. diameter and leakage of heart valves, contractility and stiffness of cardiac walls, stiffness of arteries, and by the creation of shunts. A wide selection of haemodynamic signals (blood flow velocity, cardiac cavity volume, or blood pressure) can be displayed as required to show the resulting effects. For example, after user-initiated mitral insufficiency, the consequences for the pressure–volume relations of the left and right ventricles can be evaluated and discussed (Figure 1). Because of its versatility, the CircAdapt Simulator is an ideal tool for teaching cardiovascular physiology and pathophysiology over a wide range of complexities. Besides being an excellent tool for medical students, it is also suitable for analysing more complex situations to train residents in different clinical disciplines (e.g. cardiology, neonatology, and intensive care medicine). Presently, the CircAdapt Simulator is successfully integrated into the first, second, and third year of the Maastricht University Medical School. From current
Figure 1 Graphical impression of the CircAdapt Simulator. Left: tracings of blood pressures, ventricular cavity volumes, and blood flow velocities under normal, healthy circumstances (reference) and during 10% mitral insufficiency. Right: left and right ventricular pressure–volume relationships corresponding with the reference (dotted lines) and mitral insufficiency (solid lines) simulations.
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Translation from research tool to a user-friendly multi-purpose tool
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experience, it is thought that for best didactic results, the CircAdapt Simulator should be embedded in a well-designed practical setup in which students are challenged, step by step, to predict the outcome of an intervention, and then use the tool to check their predictive thoughts.
From (school) bench to bedside? While CircAdapt has already proved its merit in cardiovascular education and fundamental research, it is currently being investigated whether CircAdapt can be a valuable tool in daily clinical practice. ‘With a grant from the Dutch Heart Foundation, we are investigating whether the CircAdapt environment in combination with cardiovascular imaging techniques can also be used as an integrative support tool for clinical decision making’, says Dr Joost Lumens, member of the ESC Working Group on e-Cardiology and one of the CircAdapt developers (Figure 2). ‘The CircAdapt model describes the general physiological and physical principles underlying many diagnostic measurements on cardiovascular anatomy, structure, and function that are acquired by clinicians on a daily basis. We strongly believe that an integrative patient-specific CircAdapt simulation, in which several of these measurements are brought together, can benefit patient care by improving diagnostic accuracy and by tailoring therapy to the individual patient’.
Meanwhile, the CircAdapt research team will add new useful modules and improve the model where needed. The team’s intention is that more and more students, scientists, and clinical specialists will benefit from CircAdapt.
CircAdapt user community
Joost Lumens PhD Email: [email protected]
University Medical Center (from left to right): Joost Lumens, PhD, Tammo Delhaas, MD, PhD, Koen Reesink, PhD, Theo Arts, PhD, and Willem Dassen, PhD.
References 1. Arts T, Delhaas T, Bovendeerd P, Verbeek X, Prinzen FW. Adaptation to mechanical load determines shape and properties of heart and circulation: the circadapt model. Am J Physiol Heart Circ Physiol 2005;288:H1943 – H1954. 2. Lumens J, Arts T, Marcus JT, Vonk-Noordegraaf A, Delhaas T. Early-diastolic left ventricular lengthening implies pulmonary hypertension-induced right ventricular decompensation. Cardiovasc Res 2012;96:286 –295. 3. Lumens J, Delhaas T. Cardiovascular modeling in pulmonary arterial hypertension: focus on mechanisms and treatment of right heart failure using the circadapt model. Am J Cardiol 2012;110:39S –48S. 4. Lumens J, Leenders GE, Cramer MJ, De Boeck BW, Doevendans PA, Prinzen FW, Delhaas T. Mechanistic evaluation of echocardiographic dyssynchrony indices: patient data combined with multiscale computer simulations. Circ Cardiovasc Imaging 2012;5:491–499. 5. Lumens J, Ploux S, Strik M, Gorcsan J 3rd, Cochet H, Derval N, Strom M, Ramanathan C, Ritter P, Haissaguerre M, Jais P, Arts T, Delhaas T, Prinzen FW, Bordachar P. Comparative electromechanical and hemodynamic effects of left ventricular and biventricular pacing in dyssynchronous heart failure: electrical resynchronization versus left-right ventricular interaction. J Am Coll Cardiol 2013 Aug 23 (E-pub ahead of print), doi:10.1016/j.jacc.2013.08.715
CardioPulse contact: Andros Tofield, Managing Editor. Email: [email protected]
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The researchers behind this project attach great importance to the spread of CircAdapt Simulator throughout the medical community. ‘By making CircAdapt Simulator available as freeware we hope that the program will be incorporated in medical curricula elsewhere’, says Prof. Tammo Delhaas, chair of the Department of Biomedical Engineering (Cardiovascular Research Institute Maastricht, Maastricht University Medical Center), where the CircAdapt control centre is based. ‘All requirements for incorporating CircAdapt Simulator in medical schools elsewhere will soon be available as freeware on the website www.circadapt.org, including the CircAdapt Simulator itself, an extensive manual and some course material examples for teaching cardiovascular physiology’. The website is envisioned to become an open platform where users of both the CircAdapt Simulator and the core model can discuss and exchange topics related to CircAdapt. New users are encouraged to share ideas and materials related to CircAdapt, for application in education, research, and clinical care of patients with cardiovascular disease.
Figure 2 Members of the CircAdapt research team at Maastricht
‘Where everything comes together!’ European Society of Cardiology Congress 2014 Barcelona, Spain, 30 August – 3 September 2014, for all cardiologists
Innovation and the heart: spotlight of the Congress in 2014 This spotlight captures innovations in scientific discovery, in clinical practice, in discovery, in technology, in education, and, importantly, in applications to clinical care. Cardiology is evolving rapidly and it is critically important for us to keep up-to-date, not only in the areas of our special interests but also in what is happening elsewhere across the spectrum of cardiovascular disease. The ESC Congress in Barcelona will also highlight innovations in the scientific programme and in how it will be delivered. Based on the feedback from Congress participants in 2013, the interactive sessions and case-based formats were rated very highly, and in 2014 we will develop and expand these themes. The ‘Hub’ of the Congress provided a novel and innovative way of engaging with the audience, and this year we will have four circular and open-sided venues and these will be the setting for ‘Rapid Fire’ abstract sessions, as well as special tracks and other interactive sessions. The scientific exhibition provides an important opportunity for delegates to engage with participants from industry and to learn about the latest developments in diagnostic and therapeutic products and technology. In addition, we have a new development—Global Focus Sessions. These are interactive, built around case presentations or live cases, and with active audience participation. They are designed for clinical cardiologists across the spectrum of specialty interests. To complement Global Focus, we will have a new format of specialist-cased-based sessions, embedded in the Topic Villages, and designed for those with a specialist interest. A ‘Day with the Legends’ includes not only the named lectures but also the opportunity to interact with true legends, individuals who have changed the landscape of modern cardiology. There is much the clinical cardiologist, the trainee, and the researcher can learn. What made them do it, what lessons have they learned, and what may inspire leaders of tomorrow? You ask the Legend . . .!
Looking to the future The average age of ESC Congress participants is getting younger and in 2013 there were .3300 participants 35 years of age or less. Cardiologists of Tomorrow tracks have been a great success; purpose designed by ESC Cardiologists of Tomorrow, for cardiologists of tomorrow (even a session on how to survive your first night, as a trainee, on the Intensive Care Unit!). For the first time Cardiovascular Scientists of Tomorrow will have their own track in 2014. Sessions include key tips on the first successful grant application, the first paper published and, importantly, opportunities to develop the next career step.
Published on behalf of the European Society of Cardiology. All rights reserved. & The Author 2014 . For permissions please email: [email protected]
Downloaded from http://eurheartj.oxfordjournals.org/ by guest on November 14, 2015
Barcelona has proved to be an excellent venue for the ESC Congress and we will return in 2014. It is a city ‘Where Everything Comes Together’—a state of the art congress venue, a vibrant culture, an elegant lifestyle and a unique Catalan ambiance. Just what we will all need after a full day at the scientific congress!
332
Global focus session The Multinational Congress of Cardiology
‘Villages’ of key cardiology themes How can the clinician keep up-to-date in his or her field and still know about the important developments across the spectrum of cardiovascular disease? The Topic Villages will provide the latest developments in your specialty of interest and in Central Village you will find the central themes and Global Focus sessions. Together these will ensure that we can keep our professional development at the forefront of clinical practice; 2014 ESC Clinical Practice Guidelines will be presented in Central Village; in addition, you have the chance to question the Guideline panels in Meet the Guideline Taskforce sessions. What do the new guidelines really mean and how do you implement them in clinical practice? New sessions called ‘Guidelines in Daily Practice’ have been designed and will be presented in each village; Meet the Expert sessions will be held as well. Another new type of session called Cases in Crossfire will be conducted, where challenging cases will be debated between an expert panel and the audience. In addition to the Basic Science Village, we are building on the ‘Science in Practice’ developed last year to give clinicians insights into developments in the future and to give scientists insights on where their innovations may be leading; these tracks will be hosted in the topic-related villages. By attending the Congress, we will earn 21 continuing medical education credits and, importantly, we have opportunities to interact
directly with experts and thought leaders through many interactive sessions. Why come to the Congress rather than read accounts of the sessions that appear online? The ESC Congress is a key opportunity for participants to engage with peers from other countries and to build networks and collaborations around the world—we have much to learn from each other! A second hand account of the Congress is never the same as being there and discussing what is’ new, directly questioning the presenters, and mulling it over with your friends! Although various summaries of Hotlines will appear online, you really need to be there to understand the significance of the new research and decide where it will really change clinical practice, or not! Remember Valentine’s Day! The 14th of February is the deadline for abstract submissions and this is a key opportunity to have your research discussed and to get feedback from international experts. The ESC Congress is the largest Cardiovascular International Congress and its true international nature provides exciting and innovative opportunities to be part of the multinational cardiology ‘family’. You have the choice: be part of the action and the breaking innovations or just sit on the sidelines!
Downloaded from http://eurheartj.oxfordjournals.org/ by guest on November 14, 2015
There is huge international enthusiasm for participation in the ESC Congress and the Congress Programme Committee has had to select 400 sessions from the very large number of submissions for the planned symposia. We will also have over 30 joint sessions with other major cardiovascular organizations from around the world. Cardiology is an international community and we have much to learn from each other. Although the clinical settings differ around the world, we face similar challenges and similar cardiovascular disease processes. None of our healthcare systems has all the answers, but perhaps we each can share innovations that improve our understanding of the underlying science, innovations in therapies and how they are applied, and innovations in how we balance risks vs. benefits of new developments. We will have experts and key opinion leaders from 60 nations and healthcare professionals from all the continents in symposia and in original research presentations. The ESC is a truly global community.
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New European Heart Journal International Editorial Board members 2014 The European Heart Journal welcomes two new Board Members from Portugal and one from Korea
Prof. Lino Manuel Martins Gonc¸alves, MD, PhD, FESC
Adelino Leite-Moreira is full professor of Physiology, Pathophysiology and Cardiothoracic Surgery at the Faculty of Medicine of the University of Porto (FMUP), Portugal, and is also Head of the Department of Physiology and Cardiothoracic Surgery and the Coordinator of the Cardiovascular R&D Center of the same institution. He also has an appointment as senior cardiothoracic surgeon at the affiliated University Hospital Sa˜o Joa˜o in Porto, Portugal. Besides these positions, he has accumulated different management duties at the University. He graduated as a physician in 1989 at FMUP and trained as a research fellow from 1991 to 1994, at the Department of Physiology, the University of Antwerp in Belgium, where he developed his interest in the field of diastolic function and heart failure with preserved ejection fraction. It was in this field that he defended his PhD thesis in 1997. In 2003 he completed his clinical training as cardiothoracic surgeon at Hospital Sa˜o Joa˜o. Since then he has been concentrating his clinical activities in adult cardiac surgery. He has a special interest in surgical and technical innovation and holds particular expertise in the fields of reconstructive mitral and aortic valve’ surgery, aorta and aortic root surgery, as well as in total arterial off-pump coronary artery bypass graft surgery. Besides cardiac surgery, diastolic function, and heart failure, his research interests also include right ventricular function and pulmonary hypertension. His double appointment in the fields of Physiology and Cardiothoracic Surgery has been crucial for the translational nature of his research, clearly facilitating the bench-to-bedside and back approach. Over the years, he has authored or co-authored almost 200 full papers in well-recognized international journals and was granted with .3 million Euros on competitive calls for research. He has also been awarded several major scientific prizes. His future endeavours are mainly focused on increasing the level of scientific and technological innovation and excellence in Portugal, with a special emphasis in the promotion of translational and clinical research. His scarce free time is spent with his family and friends, particularly with his wife and three children with whom he enjoys long walks in the countryside, and in mountain climbing.
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Lino Manuel Martins Gonc¸alves is a Chief of Clinic at Coimbra University Hospital, Portugal, where he works as a senior invasive cardiologist. A native of Portugal, he obtained his MD in 1984 and in the same year received a Master’s in Cellular Biology. His postgraduate training was also in Portugal, after which he worked as a visiting associate at the National Institutes of Health’s Cardiology Branch, Bethesda, USA, from 1997 to 1998. The Portuguese Medical Association certified him as a Cardiologist in 1992 and in 2001 he became a fellow of the European Society of Cardiology. Lino Gonc¸alves is associate professor of Cardiology with full responsibility for the teaching of cardiology. Additionally, he is a member of the Scientific Council of the University of Coimbra Medical School. He has held several positions in the Portuguese Society of Cardiology; first as assistant secretary, then as vice-president (three terms of 2 years). He was also Board Member of the PCI Working Group of the Portuguese Society of Cardiology and President of the 33rd Portuguese Congress of Cardiology (2012). Finally, he was Director of the National Center for Data Collection in Cardiology for 5 years. Besides these activities for the Portuguese Society of Cardiology, he is a member of the Portuguese National Ethics Committee for Clinical Research, and is co-director of the Harvard Medical School CSRT Programme in Portugal. In European Affairs, Prof. Gonc¸alves has been on several committees in institutions related to education, accreditation, and certification, such as Secretary of the UEMS—Cardiology Section, EBAC chairman, ESC Board member, Education Committee member, Web Committee member, Chair of the ESCeL platform Task Force, Chair of the ESC Search Engine Task Force, Editor-in-Chief of the ESC Congress Reports, ESC Spokesperson on CME/Accreditation/Certification, EAPCI Board Member, and Chair of the EAPCI Education and Training Committee. He acts as reviewer for 10 journals including the European Heart Journal, has received 21 scientific awards, and has published 58 papers in international peer-reviewed journals and 85 papers in Portuguese journals. Prof. Gonc¸alves’ main research interests are coronary artery disease, interventional cardiology, angiogenesis, and stem cells.
Prof. Adelino Leite-Moreira, MD, PhD, FETCS
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Prof. Seung-Jung Park, MD, PhD, FACC
has been the principal investigator of many international multi-centre trials conducted in the Asan Medical Center, Seoul, Korea and has authored or co-authored over 360 original, peer-reviewed research articles published in numerous journals including EHJ, Circulation, NEJM, JACC, and the American Journal of Cardiology. He has also contributed as an editorial board member to several international journals with a high impact factor, including JACC, Cardiovascular Interventions, and the American Journal of Cardiology, Catheterization and Cardiovascular Interventions. Dr Park has been dedicated and passionate in educating the young generation of cardiologists. As part of the education process, he has been organizing the Asan Medical Center Interventional Cardiology Training Program since 2009 and helping young interventional cardiologists especially in the Asia Pacific region to develop their clinical knowledge and skills. Dr Park received the Ethica Award at EuroPCR in 2005, the highest honour of the European cardiovascular intervention academies and, in 2008, received the Career Achievement Award for his contribution to coronary intervention at TCT, USA. In 2011, he was awarded the Best Impression of Science and Technology presented by Ministry of Education, Science and Technology, Republic of Korea. Andros Tofield
Changing times in Cardiology II
Interview with Prof. Panos Vardas, President of the European Society of Cardiology Cardiology is one of the fastest paced specialties in medicine. In this second of two articles, Dr Shouvik Haldar interviews Prof. Panos Vardas, to ascertain his view on the ever changing landscape of Cardiology from a personal and societal perspective. Change is the only constant (from ‘all entities move and nothing remains still’ Heraclitus, 401 BC)
(1) Modern cardiology owes much of its success to important technological advances alongside evolving procedural Panos Vardas (credit Sam C. Rogers) techniques. What do you see as important advances that are on the horizon for cardiology? It is true that some of the most significant developments in cardiovascular medicine in the last 30 years are strongly connected with the evolution of interventional techniques. Interventional cardiologists perform angioplasty, stenting and, recently, transcutaneous aortic valve implantation, and cardiac electrophysiology using a wide spectrum of ablation techniques. On the other hand, we should acknowledge that, in the last few years, we have reached a plateau, with no exceptional achievements in our field. What I expect as a radical advance, not only in cardiovascular medicine, but also in medicine as a whole is the development of tissue engineering. Regretfully, despite the spectacular progress in tissue engineering and three-dimensional tissue printing, these are not expected to be clinically available very soon. We should, nevertheless, acknowledge that they are an impressive advance to be gradually developed in the next two decades. (2) In the recent adverse economic climate, there has been declining industry funding and sponsorship for cardiologists and cardiology trainees to attend conferences. How has the European Society of Cardiology (ESC) acknowledged this and what measures have been taken to support cardiologists to attend important conferences such as the ESC Annual Congress?
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Dr Seung-Jung Park is Chairman of the Heart Institute of Asan Medical Center and a Professor of Medicine at the University of Ulsan College of Medicine, Republic of Korea. He has also been serving as Chairman of the CardioVascular Research Foundation since 2002, and as a course director, he has been organizing the annual conference, CardioVascular Summit-TCTAP, which has been one of the leading interventional cardiology meetings in the Asia Pacific region for about two decades. Dr Park has been a pioneer in the field of left main intervention and an expert in the use of stents. He was the first doctor in Korea to perform a stenting intervention for angina pectoris. Additional areas of expertise are complex PCIs (long lesions, bifurcation and tandem lesions PCI functional approach). His current research interests focus on ‘Integrated Use of FFR and IVUS’ Functional Approach for Current PCI. Through a variety of clinical activities and researches, Dr Park has devoted himself to the development of interventional cardiology. He
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Creating your own virtual patient with CircAdapt Simulator Dutch researchers have produced software for simulating cardiovascular dynamics for teaching and improving patient care Researchers from Maastricht University Medical Center have launched the first release of the CircAdapt Simulator. This freeware application enables you to simulate cardiovascular system dynamics in a wide variety of physiological and pathophysiological circumstances. The CircAdapt Simulator can be downloaded free of charge from www. circadapt.org and is compatible with both Windows and Mac OS X.
shunts, if present, are displayed graphically (Figure 1). The application makes the complex dynamic behaviour of the cardiovascular system accessible to a wide audience in a user-friendly fashion. In addition to use in education and research, the simulator may also be a promising tool for the cardiologist analysing real clinical cases.
What is CircAdapt Simulator?
From educational to fundamental research tool
The interactive CircAdapt Simulator simulates cardiovascular haemodynamics in real-time. Dynamic tracings of blood pressures, volumes, and blood flow velocities in the heart, blood vessels, valves, and
The CircAdapt model of the human heart and blood vessels forms the core of the Simulator.1 Initially, this model was designed for teaching purposes, to show the importance of the physical laws of mechanics
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The ESC has not acknowledged this declining industry funding as a significant problem, particularly when taking into consideration that attendance at our recent 2013 Congress in Amsterdam reached record numbers. No doubt, traditional European participation remains relatively stagnant or has a slight decline in contrast to the increasing international participation. In parallel, industry sponsors a greater number of satellite symposia and other educational activities. Not only have the ESC central and ESC Associations been offering a significant number of fellowships to support younger cardiologists, they have also offered free registration to their congresses. Following our central decision, each National Society now has the right to provide 25 free registrations for cardiologists under the age of 35. This decision was enthusiastically received. (3) Owing to changes in industry rulings, there is a changing relationship between industry and cardiology. How do we as cardiologists better engage with industry and what plans does the ESC have to do so? Industry has always been a major contributor to continuous medical education despite some concerns occasionally raised. Unfortunately, in ESC member countries with huge deficits in their economies CME cannot be supported by National Healthcare systems or doctors themselves. Both industry and the cardiovascular communities of the ESC have generally been making enormous efforts to comply with the new rules while co-existing in educational and research projects. Nowadays, this collaboration is more transparent and innovative and effective ideas are always financially supported by the Industry. (4) The ESC has made significant progress in its educational agenda in recent years, and now has an impressive annual programme of events. You have been instrumental in this development. What are the key factors necessary to ensure that both individual educational events and the programme as a whole are a success? The Brussels project, or the European Heart Agency as it is now called, aims to cover a number of traditional or evolving needs and develop ideas. We are working close to the EU strategy and policy centres to prevent and treat cardiovascular and cerebrovascular diseases. In cooperation with other disciplines, we set up the Biomedical Research Alliance, which focuses on systematically promoting biomedical research in Europe. In parallel, the European Heart Agency has developed the European Heart Health Institute with different units as well as the European Heart Academy. In the first, among the others, a Heart Health policy observatory will be created, monitoring realities in cardiovascular medicine in our 56 member countries. As for the European Heart Academy, it will promote postgraduate medical education in collaboration with selected Universities.
336 and fluid dynamics in understanding cardiovascular physiology. From the beginning the founding father of the CircAdapt, Prof. Theo Arts chose a modular design for the model. Valves, blood vessels, cardiac cavities, myocardial tissue and peripheral vascular resistances were represented by modules each incorporating established physiological and physical principles. The modules were connected to form a network, representing the entire circulation. The simulations of haemodynamics in both the normal and the pathological cardiovascular systems turned out to be very realistic, allowing discussions about the simulated data with clinicians, as if they were measured in a real patient. Because of this realism and the fact that the content of each module is well understood, the model’s application quickly expanded to scientific research. Over the last 10 years, this model has been successfully used for fundamental research in cardiovascular (patho-) physiology,2 – 5 partially funded by the Dutch Heart Foundation.
To extend the application range of the comprehensive CircAdapt model from research to education a project was launched to build a novel, interactive simulation environment that can be used by
medical students with the aim to improve their understanding of cardiovascular haemodynamics and related physiology. This project was greatly facilitated by a generous contribution from the StITPro Foundation, which is gratefully acknowledged. The CircAdapt Simulator is designed as an interactive user-friendly shell around the CircAdapt model. Without much foreknowledge, a novice user can intuitively simulate complex pathophysiological situations by manipulating, e.g. diameter and leakage of heart valves, contractility and stiffness of cardiac walls, stiffness of arteries, and by the creation of shunts. A wide selection of haemodynamic signals (blood flow velocity, cardiac cavity volume, or blood pressure) can be displayed as required to show the resulting effects. For example, after user-initiated mitral insufficiency, the consequences for the pressure–volume relations of the left and right ventricles can be evaluated and discussed (Figure 1). Because of its versatility, the CircAdapt Simulator is an ideal tool for teaching cardiovascular physiology and pathophysiology over a wide range of complexities. Besides being an excellent tool for medical students, it is also suitable for analysing more complex situations to train residents in different clinical disciplines (e.g. cardiology, neonatology, and intensive care medicine). Presently, the CircAdapt Simulator is successfully integrated into the first, second, and third year of the Maastricht University Medical School. From current
Figure 1 Graphical impression of the CircAdapt Simulator. Left: tracings of blood pressures, ventricular cavity volumes, and blood flow velocities under normal, healthy circumstances (reference) and during 10% mitral insufficiency. Right: left and right ventricular pressure–volume relationships corresponding with the reference (dotted lines) and mitral insufficiency (solid lines) simulations.
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Translation from research tool to a user-friendly multi-purpose tool
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experience, it is thought that for best didactic results, the CircAdapt Simulator should be embedded in a well-designed practical setup in which students are challenged, step by step, to predict the outcome of an intervention, and then use the tool to check their predictive thoughts.
From (school) bench to bedside? While CircAdapt has already proved its merit in cardiovascular education and fundamental research, it is currently being investigated whether CircAdapt can be a valuable tool in daily clinical practice. ‘With a grant from the Dutch Heart Foundation, we are investigating whether the CircAdapt environment in combination with cardiovascular imaging techniques can also be used as an integrative support tool for clinical decision making’, says Dr Joost Lumens, member of the ESC Working Group on e-Cardiology and one of the CircAdapt developers (Figure 2). ‘The CircAdapt model describes the general physiological and physical principles underlying many diagnostic measurements on cardiovascular anatomy, structure, and function that are acquired by clinicians on a daily basis. We strongly believe that an integrative patient-specific CircAdapt simulation, in which several of these measurements are brought together, can benefit patient care by improving diagnostic accuracy and by tailoring therapy to the individual patient’.
Meanwhile, the CircAdapt research team will add new useful modules and improve the model where needed. The team’s intention is that more and more students, scientists, and clinical specialists will benefit from CircAdapt.
CircAdapt user community
Joost Lumens PhD Email: [email protected]
University Medical Center (from left to right): Joost Lumens, PhD, Tammo Delhaas, MD, PhD, Koen Reesink, PhD, Theo Arts, PhD, and Willem Dassen, PhD.
References 1. Arts T, Delhaas T, Bovendeerd P, Verbeek X, Prinzen FW. Adaptation to mechanical load determines shape and properties of heart and circulation: the circadapt model. Am J Physiol Heart Circ Physiol 2005;288:H1943 – H1954. 2. Lumens J, Arts T, Marcus JT, Vonk-Noordegraaf A, Delhaas T. Early-diastolic left ventricular lengthening implies pulmonary hypertension-induced right ventricular decompensation. Cardiovasc Res 2012;96:286 –295. 3. Lumens J, Delhaas T. Cardiovascular modeling in pulmonary arterial hypertension: focus on mechanisms and treatment of right heart failure using the circadapt model. Am J Cardiol 2012;110:39S –48S. 4. Lumens J, Leenders GE, Cramer MJ, De Boeck BW, Doevendans PA, Prinzen FW, Delhaas T. Mechanistic evaluation of echocardiographic dyssynchrony indices: patient data combined with multiscale computer simulations. Circ Cardiovasc Imaging 2012;5:491–499. 5. Lumens J, Ploux S, Strik M, Gorcsan J 3rd, Cochet H, Derval N, Strom M, Ramanathan C, Ritter P, Haissaguerre M, Jais P, Arts T, Delhaas T, Prinzen FW, Bordachar P. Comparative electromechanical and hemodynamic effects of left ventricular and biventricular pacing in dyssynchronous heart failure: electrical resynchronization versus left-right ventricular interaction. J Am Coll Cardiol 2013 Aug 23 (E-pub ahead of print), doi:10.1016/j.jacc.2013.08.715
CardioPulse contact: Andros Tofield, Managing Editor. Email: [email protected]
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The researchers behind this project attach great importance to the spread of CircAdapt Simulator throughout the medical community. ‘By making CircAdapt Simulator available as freeware we hope that the program will be incorporated in medical curricula elsewhere’, says Prof. Tammo Delhaas, chair of the Department of Biomedical Engineering (Cardiovascular Research Institute Maastricht, Maastricht University Medical Center), where the CircAdapt control centre is based. ‘All requirements for incorporating CircAdapt Simulator in medical schools elsewhere will soon be available as freeware on the website www.circadapt.org, including the CircAdapt Simulator itself, an extensive manual and some course material examples for teaching cardiovascular physiology’. The website is envisioned to become an open platform where users of both the CircAdapt Simulator and the core model can discuss and exchange topics related to CircAdapt. New users are encouraged to share ideas and materials related to CircAdapt, for application in education, research, and clinical care of patients with cardiovascular disease.
Figure 2 Members of the CircAdapt research team at Maastricht
