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European Society of Cardiology CEO wins PCMA Chairman’s Award
The Chief Executive Officer of the European Society of Cardiology (ESC), Isabel Bardinet, has received the 2015 Professional Convention Management Association (PCMA) Chairman’s Award. It was presented 14 January 2016 at the PCMA Convening Leaders conference in Vancouver, Canada.
The award is the highest honour bestowed by the Chairman of the PCMA.
Isabel Bardinet was acknowledged for her creative involvement of the community in advancing the ESC’s mission at ESC Congress 2015. ESC staff teamed up with local partners to create the London Heart Trail, an interactive walk along London’s iconic South Bank with a specific aim of promoting awareness of heart health to the London public.
ESC Congress, the ESC’s annual event, is the world’s largest and most influential cardiovascular meeting. In 2015 the five-day conference attracted 34,000 delegates to ExCeL London.
Isabel Bardinet said: “Recognition from PCMA, who is a standard setter for our profession, means an awful lot to us.”
“The ESC’s mission is to reduce the burden of cardiovascular disease in Europe. This burden affects nearly one person in four worldwide and kills over four million people in Europe alone every year. Education, sharing and dissemination are our main tools to deal with this pandemic. The most visible of our activities is ESC Congress.”
“The Heart Trail was organised and implemented for the people in London during the congress to get the messages of prevention across to them and indirectly thereby save lives. The success of the Heart Trail was mostly thanks to London & Partners and ExCeL, without whom this would never have been possible.”
“On behalf of the London Team – that is to say London & Partners, ExCeL, ESC staff and volunteers – I would like to thank PCMA for such a wonderful reward which means so much to us all.”
James Rees, Executive Director at ExCeL London, said: “On behalf of ExCeL London, I would like to congratulate Isabel Bardinet on winning the PCMA Chairman’s Award. This is hugely-deserved recognition and we are thrilled for her and the ESC team. Isabel is a thought-leader in our industry who recognises, and champions, the role of events to support the missions of medical associations and leave a legacy of positive change in the destinations they select. It was a pleasure for us to work with ESC and London as a whole during 2015 to host the ESC Congress and raise awareness of the healthy changes that can be made to reduce the burden of cardiovascular disease across London and the UK.”
The Heart Failure Association Declaration
Participants of the 5th National Heart Failure Societies’ Presidents’ Summit.
The 5th National Heart Failure Societies’ Presidents’ Summit, organized by the Heart Failure Association, was held on 24 October, 2015 in Ljubljana, Slovenia. Representatives from 36 countries, the members of the Heart Failure Association Board, and members of the National Heart Failure Societies Committee discussed topics of key relevance for global management and better organization of care in the field of heart failure.
They specifically addressed the continuous education and heart failure sub-specialization curriculum with accreditation process, importance of epidemiological and management information from registries, and the challenges how to put the patient and self-care in the spotlight of comprehensive heart failure management.
The emerging role of young heart failure specialists – the HoT project – was presented to the national representatives, with an initiative to have active representatives from all ESC member countries. Finally, the latest activities of the Global Heart Failure Awareness Program campaign were presented; this project aims to reach out to all stakeholders in the worldwide heart failure community to improve understanding and recognition of the condition and to align intervention strategies.
To foster this campaign, the Heart Failure Association Declaration and A Call for Action was adopted and signed by all participants. This document emphasizes the importance of the campaign and genuine dedication to implementation in the respective countries.
A new heart failure cardiologist is set to conquer Europe
The declaration of war on heart failure (HF) by the iconic Eugene Braunwald MD, marked the spectacular culmination of the first Post Graduate Course on Heart Failure (PCHF) in October 2015.
After 160 hours of intense lectures, 140 hours of self-study and 8 elaborate examinations, Europe witnessed the graduation of the first genuine HF cardiologists trained on its soil. The first group consisted of 59 participants from 32 countries including participants from India, Mexico and the Dominican Republic.
The course was designed and organized by the department cardiology at the University Hospital Zurich, led by the energetic and captivating chairs Prof. Frank Ruschitzka, Prof. Thomas F. Lüscher and Dr. Ruth Amstein. The impressive network of the course directors allowed for lectures given by key opinion leaders from around the world and encouraged interactive discussions with the participants.
The course was also highly dynamic, as the structure was continuously adjusted to allow implementation of paradigm shifting scientific discoveries as they occurred. For instance, the lead author of the PARADIGM study Prof. John McMurray presented unique and detailed insights into the study just weeks after its publication.
In addition to lectures, there were live cases from the catheterization lab, hands on training in various skills including echocardiography, LVAD trouble shooting and ECMO implantation, with clinical rounds and interesting HF cases presented by the participants. The themes were carefully selected to include all relevant aspects of contemporary HF care, including a module with hands on training in device implantation and troubleshooting.
The quality of the course is underscored by the fact that it was categorised as excellent by more than 80% of the candidates. In summary, PCHF is a truly unique initiative that will hopefully allow a swift response to the impending HF epidemic.
B. Daan Westenbrink MD PhD
Department of Cardiology,
University Medical Center Groningen,
Hanzeplein 1, 9700 RB Groningen,
TATORT-NSTEMI trial shows thrombus aspiration does not improve 12-month outcomes
First randomised trial does not support routine thrombectomy in NSTEMI.
Thrombus aspiration before percutaneous coronary intervention (PCI) does not improve 12-month clinical outcomes in patients with NSTEMI, according to results from the TATORT-NSTEMI trial published 19 November in European Heart Journal: Acute Cardiovascular Care. (1)
Professor Holger Thiele, principal investigator, said: “TATORT-NSTEMI (2) was the first randomised trial investigating the impact of thrombectomy prior to PCI, compared to standard PCI, in patients with NSTEMI. All previous trials had been performed in STEMI patients.”
“Patients needed to have a visible thrombus to be included in our study, which was not the case in the STEMI trials,” added Professor Thiele. “There were good reasons to believe that thrombectomy would benefit patients with NSTEMI. Thrombus aspiration in NSTEMI is not included in guidelines because of limited data.”
TATORT-NSTEMI randomised 440 patients from eight sites in Germany in a 1:1 ratio to thrombectomy prior to PCI or standard PCI. The primary study endpoint was microvascular obstruction measured using CMR. As previously reported, thrombus aspiration added to PCI did not reduce microvascular obstruction compared to PCI alone in patients with NSTEMI (3).
The primary endpoint of the current analysis was the occurrence of major adverse cardiac events (MACE) at 12 months. MACE was defined as the composite of all-cause death, myocardial reinfarction, new congestive heart failure, and need for target vessel revascularisation. Secondary endpoints included New York Heart Association (NYHA) class and Canadian Cardiovascular Society (CCS) class, and quality of life using the standardised EuroQol5D (EQ5D) questionnaire.
Thrombectomy did not have any effect on functional class (as assessed by NYHA class and CCS class) or quality of life in patients with NSTEMI.
“Aspiration thrombectomy appears to provide no additional benefit on long-term clinical outcome for patients with NSTEMI who have had PCI,” said Professor Thiele. “This is comparable to data from the TASTE and TOTAL trials in STEMI patients which found no benefit of thrombectomy on all-cause mortality and led to the procedure being downgraded in European and American guidelines.”
ESC spokesperson Professor Steen Kristensen said: “Large trials have shown that thrombus aspiration does not work in STEMI so we no longer use it routinely, but we do use it occasionally. TATORT-NSTEMI confirms that this approach can also be applied in NSTEMI. We should think twice before we use a thrombus aspiration catheter but it might be useful in selected patients.”
1 Meyer-Saraei R, de Waha S, Eitel I, Desch S, Scheller B, Böhm M, Lauer B, Gawaz M, Geisler T, Gunkel O, Bruch L, Klein N, Pfeiffer D, Schuler G, Zeymer U, Thiele H. Thrombus aspiration in non-ST-elevation myocardial infarction – 12-month clinical outcome of the randomised TATORT-NSTEMI trial. Eur Heart J Acute Cardiovasc Care. DOI: 10.1177/2048872615617044
2 TATORT-NSTEMI: Thrombus Aspiration in ThrOmbus containing culprit lesions in Non-ST-Elevation Myocardial Infarction trial
3 Thiele H, de Waha S, Zeymer U, Desch S, Scheller B, Lauer B, Geisler T, Gawaz M, Gunkel O, Bruch L, Klein N, Pfeiffer D, Schuler G, Eitel I. Effect of aspiration thrombectomy on microvascular obstruction in NSTEMI patients: The TATORT-NSTEMI trial. J Am Coll Cardiol. 2014; 64: 1117–1124.
ESC Grants now available
1. EAPCI Training and Research Grants
Gain a one-year specialised training or research grant in Interventional Cardiology!
Deadline: 15 January 2016
25,000 euros to provide an opportunity for specialised research or clinical training in an ESC Member Country in the interventional cardiology field.
The European Association of Percutaneous Cardiovascular Interventions (EAPCI) offers Training and Research Grants of 25,000 Euros to provide an opportunity for specialised research or clinical training in an ESC Member Country in the interventional cardiology field.
- Applicants eligible for the Research or Training Grants Programme are those who meet all the below requirements:
- Are citizens or residents for tax purposes of a country which is a regular ESC Member or Affiliated country (see Appendix I within the Rules and Regulations)
- Are medical graduates providing they have already proved some research potential by publishing in medical journals OR are science graduate holding a PhD or DPhil degree or equivalent or have submitted a thesis before starting the research period relating to the grant
- Are under 36 years of age at the day of application deadline (15 January 2016) or at early stage of training (i.e. internal medicine and cardiology training completed, candidates about to enter interventional cardiology training)
- Are members of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Join us now if you are not a member!
IMPORTANT: Applicants are not asked to identify a centre. A proposal of centre will be made by the EAPCI Training and Research Committee based on applications received from centres.
Final validation of the application will be subject to visa acceptance (when needed) as well as acceptance of the training or research centre.
Applicants who are in doubt about their eligibility are advised to contact the EAPCI prior to submitting an application.
- Percutaneous coronary interventions with focus on metallic and bioresorbable stent technology
- Interventional pharmacology in patients with ACS and structural heart disease
- Transcatheter aortic valve implantation
- Transcatheter mitral valve interventions
- Structural heart disease interventions with focus on left atrial appendage closure, closure of PFO and atrial septal defects, paravalvular leak closure etc.
- Intracoronary imaging (IVUS, OCT, NIRS) and physiologic lesion assessment with FFR
- Carotid and peripheral arterial interventions
2. NEW: ESC early-career Training Grants
25 000 euros for a one-year training for cardiologists under 30.
Deadline: 31 January 2016
The European Society of Cardiology offers grants to help young professionals in the field of cardiology access quality training activities throughout Europe. ESC Early-Career Training Grants award young cardiologists (aged < 30 years) who wish to update their clinical training with modern cardiological methods, especially when it is impossible to learn particular techniques in their own country
Purpose of the Training Grant Programme
To provide an opportunity for clinical training in the field of cardiology in an ESC regular member country other than their own.
The goal of this award is to help young candidates attain clinical competence and acquire experience of high quality cardiological practice which will enable them to contribute to improving academic standards on return to their own country. With this goal in mind preference is given to applicants from countries or regions where modern clinical cardiology is not yet strong, provided that there is enough evidence that the applicant can, after the Training period, contribute to the improvement of clinical cardiology in his home country upon his return.
Any citizen or permanent resident of a country, which is a regular ESC or ESC affiliated member, can apply. Applicants who have not been ordinarily residents in such country throughout the three years preceding the application date are not eligible. Periods of residence mainly for full time education will not be accepted as ordinary residence for this purpose.
Physicians in cardiology with < 2 years in training.
Applicants should be < 30 years of age at the day of application deadline.
Training may be undertaken for any period from six months to one year.
Level of support
Early Career Training grant recipients will receive a sum of Euros 25,000 per annum for their daily subsistence.
Proposals may be submitted for specialized training or further training in the subject relevant to a particular clinical interest. Applicants are advised to seek a centre in another country within Europe which not only offers good training opportunities but is also appropriate for the particular field in which they wish to train.
Application forms, which are in electronic format, may be obtained from the ESC at the following email address:
3. ESC Training Grants
The European Society of Cardiology invites applications for clinical training grants.
25 000 euros for a one-year training in a European country.
Deadline: 31 January 2016
The European Society of Cardiology offers grants to help young professionals in the field of cardiology access quality training activities throughout Europe. ESC Training Grants award young cardiologists (aged < 36 years) who wish to update their clinical training with modern cardiological methods, especially when it is impossible to learn particular techniques in their own country.
For more information: firstname.lastname@example.org
Any citizen or permanent resident of a country, which is a regular ESC or ESC Affiliated member can apply : graduates should have completed the major part of their cardiology training or have an equivalent academic grade.
Regarding the Training programme, proposals may be submitted for specialised training or further training in the subject relevant to a particular clinical interest.
Candidates are advised to seek out a centre in another country within Europe which not only offers good training opportunities but which is also appropriate for the particular field in which they wish to train.
ESC Training Grants may be held for any period from 3 months to 1 year: the recommended training period is 6 months. For invasive/ interventional techniques a 12-month period is encouraged
4. ESC Research Grants
A category of grants awarded to medical graduates at any stage in their career but before obtaining a "permanent", "senior staff" or "consultant" post, or for science graduates with research experience up to Junior Investigator, Lecturer, Assistant Professorship or equivalent level, whose work has been, or is, related to cardiovascular research.
25 000 euros for a one-year specialised research in a European country.
Deadline: 31 January 2016
For more information: email@example.com
Applicants must be under 36 at the day of application deadline.
Any citizen or permanent resident of a country, which is a regular ESC or ESC Affiliated member, can apply. Applicants who have not been ordinarily residents in such country throughout the three years preceding the application date are not eligible. Periods of residence mainly for full time education will not be accepted as ordinary residence for this purpose.
Medical graduates can apply at any stage of their career, provided they have already proved some research potential by publishing in medical journals. Science graduates should hold a PhD or DPhil degree or equivalent or must have submitted a thesis before the grant period commences.
ESC Research Grants are awarded for a period of twelve months
New calls for EU research funding
The European Commission adopted a new work programme for 2016 -2017 on 13 October 2015, foreseeing the investment of €16 billion in research and innovation during the next two years under Horizon 2020.
Funding opportunities for health research are listed in thematic section
8. Health, demographic change and well-being,
which describes the overall objectives, the respective calls for proposals and the topics within each call.
The earliest calls opened on 20 October with a deadline set for 16 February 2016 or 12/13 April 2016.
Of particular interest to medicine:
Through the European Research Council (ERC), the best researchers will be able to investigate the best ideas that could lead to innovative growth-enhancing breakthroughs. Also in 2016, almost 10.000 Fellows will benefit from high -quality training and career development opportunities abroad thanks to Marie Sklodowska-Curie actions. Seven Public-Private Partnerships address strategic technologies that underpin growth and jobs in key European sectors in fields such as innovative medicine. The call on personalised m e d i c in e ( € 6 5 9 million) will boost European industry and the so-called silver economy by investing in strategies for earlier and more effective prevention, diagnosis and treatments, and help Europe address the ageing population and chronic disease burden.
The ESC involvement in EU funded projects is under the following conditions:
1. Only projects related to the ESC mission statement and ESC strategic orientations will be considered.
2. The ESC will not participate in projects for endorsement purposes only.
Timelines and Submission Procedure
- A project proposal synopsis should be submitted at least 12 weeks before the call’s deadline to European Affairs Staff (generic mailbox).
- A complete project proposal should be submitted to the ESC European Affairs Committee Chair at least 6 weeks before the call’s deadline. The document should include a clear description of the expected role of the ESC & budget implications.
- The European Affairs Committee Chair will decide whether the project proposal is complete and worthwhile to be considered by the ESC Leadership for validation.
The final decision will be communicated by the European Affairs Committee Chair.
18th International Congress on Advances in Cardiac Ultrasound
The 18th International Congress on Advances in Cardiac Ultrasound is the third organised by course directors Dr Jeroen J Bax (Leiden, NL) left, and Dr Petros Nihoyannopoulos (London UK) right, and is held biennially to address the use of advanced clinical echocardiography (ECHO).
This unique ECHO course will focus on state of the art technology and developments in echocardiology using all technological advances to apply to daily clinical scenarios.
One of the earliest postgraduate ECHO courses in Europe, it will take place 22-25 February 2016 in Davos, Switzerland, and is a continuation of the course that started some 36 years ago by the legendary Prof Jos RTC Roelandt. It has survived the test of time by being constantly updated to meet the rapid expansion of ECHO.
This traditional course is clinically orientated and directed towards physicians who use ECHO in their daily practice. The course will highlight the new technological developments, such as 3D echocardiography and deformation imaging. There will be a strong focus on echocardiographic solutions for common and rare clinical problems. Specifically, heart valve disease will be discussed, with emphasis on improved quantification of aortic stenosis and mitral regurgitation. Also, the application of 3D ECHO for the assessment of LV function including strain and strain rate. In addition, the pivotal clinical role of the modern echocardiographer, particularly in the emergency room and the cardiac catheterization laboratory, will be addressed.
Lectures will be delivered by international opinion leaders with specific keynote lectures on hot topics.
The memorial Jos Roelandt Lecture will be given by Prof Joseph Kislo from Duke University, NC, USA.
Highlights of the course are:
- Strain and deformation imaging
- Percutaneous approach for aortic and mitral valve disease
- Quantification of severity of valve disease
- Evaluating heart failure and preserved EF (HFPEF)
- Echo in aortic disease
- Cardiomyopathies, what is new?
- Echo in emergency room
- Advances in contrast echo
- Stress echo in valve disease
- Assessing complications of percutaneous interventions
- Update on diastology
- Focus on 3D echo
- Focus on clinical use of echo
An important highlight is the interactive discussions between participants and faculty.
Endorsed by: European Association of Cardiovascular Imaging
Accredited by: European Board for Accreditation in Cardiology
The course will be live streamed and broadcast worldwide throughout the web by: www.Livemedia.com
Applications for ESC Training grants are now open
Any citizen or permanent resident of a country, which is a regular ESC or ESC Affiliated member may apply: graduates should have completed the major part of their cardiology training or have an equivalent academic grade.
Regarding the Training programme, proposals may be submitted for specialised training or further training in the subject relevant to a particular clinical interest.
Candidates are advised to seek out a centre in another country within Europe which not only offers good training opportunities but which is also appropriate for the particular field in which they wish to train.
ESC Training Grants may be held for any period from 3 months to 1 year: the recommended training period is 6 months. For invasive/ interventional techniques a 12-month period is encouraged.
Grants are 25 000 euros for a one-year training in a European country.
Application Deadline: 31 January 2016
For more information: firstname.lastname@example.org
The EHJ at the Spanish Society of Cardiology Congress 2015
The EHJ was represented by Prof. Thomas F Lüscher at the Congress of the Spanish Society of Cardiology, 22-24 October, Bilbao, Spain, which attracted 3500 participants.
Prof. Lüscher participated in several sessions at the Congress.
1. Opening ceremony. A very relevant session where Prof. Lüscher played a central role in delivering the opening lecture “From Eisenhower’s Heart Attack to Modern Cardiology”.
2. Hot Topics in Cardiology II “The Environment and Cardiovascular Health”. In this session another lecture was delivered on “Aging and longevity genes in cardiovascular disease”.
3. A Joint session between Revista Española de Cardiología and the European Heart Journal. The session focused on the discussion of the best papers published in Revista along with papers published in the European Heart Journal by Spanish cardiologists. Thomas Lüscher chaired the session and provided the final remarks.
Professor Juan Sanchis Editor-in-Chief of Rev Esp Cardiol commented, “we at the Spanish Society of Cardiology are very pleased with the really active participation of the EHJ editor-in-chief at our Congress”.
Syncope and near drownings should not be ignored
Syncope and near drowning events may signal an increased risk of sudden death, reveals research presented at the South Africa Heart Congress 2015 by Professor Paul Brink, professor of internal medicine at the University of Stellenbosch in Tygerberg, South Africa. Such events point to long QT syndrome (LQTS) that can be undetected or misdiagnosed as epilepsy or a panic attack.
The annual congress of the South African Heart Association was held in Rustenburg 25 - 28 October, 2015.
Numerous patients with LQTS in South Africa share the same causal KCNQ1 A341V mutation which can all be traced to a common founder couple of Dutch descent in the early 18th century. The current study was set up in the early 1990s to document the founder effect and later expanded to study modifiers of severity together with the group of Peter Schwartz in Italy.
Through cascade screening of relatives of 26 LQTS index cases, the researchers identified 203 living patients with the KCNQ1 A341V mutation. Nearly four in five (79%) of the mutation carriers had experienced blackouts. Only 26% of the patients had been diagnosed with LQTS initially and given appropriate treatment, while 40% were incorrectly diagnosed with epilepsy and 34% were given incorrect laymen’s or medical explanations such as drowning or sick sinus syndrome.
Some 23 patients died before the age of 20 years. Half “drowned” despite being able swimmers. A 13 year old girl died on a skating rink while being treated for epilepsy and a five year old boy “choked on water”.
“Our research shows that many patients with LQTS never see a doctor, or when they do, they are misdiagnosed,” said Professor Brink. “The most common misdiagnosis in living patients was epilepsy, while in those who died it was drowning.”
“The most feared consequence of LQTS is death during syncope,” continued Professor Brink. “But a lot of patients do not see a doctor after a first fainting spell, or even subsequent ones. They faint, lie on the ground for a minute or two, wake up and go on with normal life. They may even see alternative medicine practitioners for these seemingly innocuous events.”
Professor Brink concluded: “Sudden deaths can be prevented if people recognise unusual fainting events and take action. Fainting at the sight of blood is harmless but a blackout during activity is cause for further investigation. The same goes for drownings or near drownings. If someone suddenly stops swimming during a competition and floats lifeless this is obviously not a typical drowning.”
11th International Congress on Coronary Artery Disease
The 11th International Congress on Coronary Artery Disease takes place in Italy this year and its theme is “From Prevention to Intervention”.
The 4 day meeting has an extensive programme including topics from angiogenesis and cell therapy, through atheromatous plaque regression, diagnostic methods, interventional cardiology and cardiac surgery.
The 2015 Congress will provide a comprehensive update on all aspects of coronary disease – from prevention to intervention and from bench to bedside. It will also include focused discussions on the new challenges regarding structural heart disease and valve disease now addressed by interventionist and surgeon alike.
There is a large international faculty of speakers from as far afield as Australia to North America.
The venue is Palazzo dei Congress in Florence, Italy and the congress is accredited with 15 EBAC credits.
XXI. World Congress of Echocardiography and Cardiology
The XXI. World Congress of Echocardiography and Cardiology will take place 20-22 November, 2015, in Istanbul, Turkey. The organisers are arranging a high quality scientific program with contributions from world renowned physicians and scientists in the fields of Cardiology, Cardiovascular Surgery and Echocardiography.
The Congress will be held at the Istanbul Lutfi Kirdar Convention and Exhibition Centre (ICEC), located in the heart of congress valley in downtown Istanbul. It is within walking distance of many different category hotels and shopping sites.
Istanbul maintains a distinguished position among the world metropolitan areas, with its unique location between two continents, together with its cultural heritage spanning thousands of years. As one of the most energetic cities in the world, Istanbul continually grows as a center of attraction, representing a contrast in harmony and presenting a breath-taking choice of sights, smells and tastes that everyone must experience at least once in a lifetime. Thus, we believe getting together in such a charming atmosphere with our colleagues is an opportunity nobody should miss.
Hosting this congress in Istanbul -where Asia meets Europe- will not only help us enhance patient care but also build bridges between participants from various countries.
We look forward to welcoming physicians in Istanbul, during November, 2015.
Prof. M. Serdar Küçükoglu
XXI. World Congress of
Echocardiography and Cardiology
Prof. Navin Nanda
XXI. World Congress of
Echocardiography and Cardiology
EU Project unveils obesity & smoking trends across Europe and shows how primary prevention is the key to a healthy future
Results of the EConDA (Economics of Chronic Diseases) EU-funded project were announced in Brussels on 22 September, at a conference bringing together EU policymakers, health professionals, health economists and health stakeholders from the EU arena.
The project, which lasted 2.5 years, showed how ‘upstream’ prevention interventions focusing on reducing people’s exposure to risk factors before a chronic disease has occurred is generally more cost-effective in terms of healthcare savings – including social care, welfare costs and losses in productivity - than treating an individual for a chronic condition.
Chronic diseases are the first cause of mortality in Europe, causing the death of 9 out of 10 citizens. They also represent a major economic burden with a total estimated cost to the EU economy of € 700 billion annually.
According to EConDA, obesity rates will be increasing across Europe and in all social groups, with better educated people projected to be less obese than those with lower education levels. This will have an important impact on health inequalities, with the less educated being subject to a greater burden of obesity-related chronic diseases such as type 2 diabetes.
Portugal represents an interesting exception to this trend, as the social gradient is predicted to reverse by 2050, with the more educated men and women projected to be more obese or overweight than those with lower education levels. A similar pattern in the future is predicted for obesity in the Netherlands.
More encouragingly, by 2050, smoking prevalence is forecast to decrease largely as a result of important policy measures such as tobacco taxation and bans on smoking in public places. Provided that these and other policies are maintained to prevent take up of smoking and help existing smokers to give up, this downward trend is set to continue.
A user-friendly tool has been developed for researchers and policy makers to test the impact of interventions which aim to reduce obesity and smoking on the future burden of chronic diseases. This tool can be downloaded here: http://econdaproject.eu/tools.php
Pacemakers identify atrial fibrillation to start anticoagulation early
Pacemakers identify AF and enable initiation of anticoagulation to prevent strokes, according to research presented in an abstract by Dr Nathan Denham, a cardiologist at Warrington Hospital, UK on 17 October at Acute Cardiovascular Care 2015.
Pacemakers can detect asymptomatic AF but are not routinely monitored for this purpose. The current study investigated whether pacemaker checks could be used to identify patients with asymptomatic AF who could then be given anticoagulation for stroke prevention.
The study retrospectively included 223 patients who received a pacemaker during a 5 year period and had not been diagnosed with AF prior to implantation. During follow up clinics a wand was placed over the pacemaker to collect information on battery life, and so on. The researchers examined the data on how many patents were currently experiencing AF, and how many people had episodes of AF but then converted to sinus rhythm.
In patients with AF, the investigators calculated their stroke risk using the CHA2DS2-VASc score to see how many should be receiving anticoagulation to prevent stroke. ESC guidelines recommend that patients with AF and a score of 2 or more should be given oral anticoagulation to prevent stroke.(1)
During the follow up period, 36 patients had at least one episode of AF detected, of whom 27 had AF identified during a routine pacemaker check (12% of the study population). All but one of the 27 patients needed anticoagulation to prevent stroke based on their CHA2DS2-VASc score.
Dr Denham said: “The proportion of pacemaker patients with undiagnosed AF was higher than expected. Nearly all of them should have been receiving anticoagulation to prevent stroke. Pacemaker checks are simple to perform and our study shows that it is worthwhile using them to identify patients at risk.”
The average time between pacemaker checks and AF diagnosis was 6 months. Just over one-third of patients waited 12 months between checks to discover they had AF. Dr Denham said: “Stable patients have pacemaker checks every 12 months but our results support more frequent monitoring to identify AF.”
Remote telemonitoring would allow pacemaker checks to be done more often without patients having to travel to hospital. “Telemonitoring would identify AF much earlier so that anticoagulation could be started,” said Dr Denham. “The fact that we found such a high proportion of patients with AF who should have been on anticoagulation suggests that telemonitoring is worth pursuing. Although we can’t conclude this from our study, the cost of telemonitoring may be offset by the savings from preventing strokes.”
He concluded: “One-third of people with AF don’t know they have it so we need to use all of the tools available to recognise it. Our study suggests that pacemaker checks are a good way to identify new cases of AF so that anticoagulation can be started to prevent strokes.”
Sources of funding: None.
1. Camm AJ, et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation. European Heart Journal. 2012;33:2719–2747.
Eli Lilly discontinues Evacetrapib development
Eli Lilly and the ACCELERATE study academic leadership announced on 12 October that they will discontinue the development of Evacetrapib for the treatment of high-risk atherosclerotic cardiovascular disease. They accepted the recommendation of the independent data monitoring committee, to terminate the Phase 3 trial of the investigational Evacetrapib due to insufficient efficacy. They will now conclude other studies in the programme.
The independent data monitoring committee based its recommendation on data from periodic reviews, which suggested there was a low probability that the study would achieve its primary endpoint based on results to date. The study will not be discontinued for safety findings. After further analysis results of the study will be presented in scientific forums in the future.
David Ricks Lilly senior vice president and president of Lilly Bio-Medicines stated “we will be working with investigators to appropriately conclude these trials.”
New ESC Grants for Medical Research Innovation
The ESC announced the launch of its new ESC Grants for Medical Research Innovation, at the opening of the ESC Congress 2015 in London. An ambitious programme sponsored exclusively by Böhringer Ingelheim, is aimed at stimulating worldwide research in cardiovascular medicine.
“This grant project is a reflection of the ESC’s commitment to encouraging new and innovative research aimed at improving patient outcomes in thromboembolic disease – a leading cause of mortality worldwide,” said Professor Francesco Cosentino, chair of the programme’s scientific committee. “It is estimated that one in four people die as a result of thromboembolic disease and more research into this disorder is urgently needed,” he said.
The programme, offers four grants, to a maximum of €400,000 each, which will be awarded to independent interventional and observational research projects in the areas of atrial fibrillation, stroke, deep vein thrombosis/pulmonary embolism, percutaneous coronary intervention, coronary artery disease and/or peripheral artery disease.
“We are excited about this initiative because it is a great opportunity to perform important studies aiming for a better understanding of novel therapeutic strategies in this setting,” said Prof. Cosentino. “We are now ready to receive applications from around the world for these prestigious grants - until the November 1st deadline - and look forward to announcing the four winners at European Heart House on December 1st following live presentations by all finalists.”
Eligible research should run no longer than 18 months and have publishable outcomes to be presented at ESC Congress 2017.
Applications may be made via this dedicated webpage: www.escardio.org/innovationgrants
The EHJ at Spanish Society of Cardiology Congress, Bilbao, 22-24 October
The European Heart Journal will be represented at the Congress of the Spanish Society of Cardiology in Bilbao 22-24 October in the following sessions:
1. Opening ceremony. A very relevant session where Thomas Lüscher, EHJ editor-in-chief will play a central role delivering the opening lecture entitled “From Eisenhower’s Heart Attack to Modern Cardiology”.
2. Hot Topics in Cardiology II. “Environment and Cardiovascular Health”. In this session Thomas Lüscher will speak about “Aging and longevity genes in cardiovascular disease”.
3. A Joint session between Revista Española de Cardiología and the European Heart Journal. The session will focus on the discussion of the best papers published in Revista along with some papers published in the European Heart Journal by Spanish cardiologists. Thomas Lüscher will chair the session and provide the closing statements.
Acute Cardiovascular Care conference will highlight innovations and controversies
Acute Cardiovascular Care 2015 will be held 17 - 19 October 2015 in Vienna, Austria at the HOFBURG Vienna Congress Centre. It is the annual meeting of the Acute Cardiovascular Care Association (ACCA), a registered branch of the European Society of Cardiology (ESC).
Prof Kurt Huber, Chairperson of the Scientific Programme Committee stated “The main theme this year is innovations in acute cardiovascular care. Novelties will be presented and discussed through the abstracts and symposia. E.g. in a session on innovations in acute heart failure, experts will present the latest data on new treatments such as vasodilator therapy, ventricular-arterial coupling, an interatrial decompression device, and mechanical support.”
Controversies in clinical practice that are heavily discussed among physicians will include:
- pre-hospital treatment of patients with ACS,
- the use of bivalirudin versus heparin during primary PCI,
- thrombus aspiration in patients with STEMI,
- the early management after, out of hospital cardiac arrest.
Antiplatelet therapy in ACS patients is a hot topic and research will be revealed on the duration of dual antiplatelet therapy. Biomarkers are a rapidly evolving area and new rule-in and rule-out strategies in MI using high sensitive troponin assays and the new marker copeptin will be debated.
Treatment of pulmonary embolism and DVT with non-vitamin K antagonist oral anticoagulants (NOACs), will be included in the programme for the first time this year.
Other crucial topics have been added to the scientific programme such as antithrombotic therapy, atrial fibrillation, treatment of bleeding, interventional cardiology, pacemakers and ICDs, external heart pumps, and stroke systems of care.
A novel ESC position paper on the pre-hospital management of chest pain and dyspnoea will be distributed during the meeting. (1)
First author Professor Farzin Beygui said: “The position paper is the first symptom based paper ever published on the subject covering the wide spectrum of acute cardiovascular conditions that may cause chest pain or dyspnoea.”
“Its aim is to provide guidance which may be applicable in all European countries despite the variety of emergency medical services (EMS), for pre-hospital management, based on evidence where available or expert opinion and consensus.”
The paper may provoke controversy over its recommendation for physician based EMS. Unlike most EMS worldwide, the majority of EMS in Europe are physician-based. Because a high level of pre-hospital care may require emergency physicians on scene, the paper recommends a physician-based EMS organisation with the availability of emergency physicians in the case of chest pain or acute dyspnoea of suspected cardiac origin.
“This point is based on expert consensus and not striking evidence,” said Professor Beygui. “The presence of a physician may improve pre-hospital diagnosis (ultrasound), allow higher rates of reperfusion therapy especially by pre-hospital fibrinolysis, provide higher levels of competence for treating life threatening conditions and more accurate identification of the destination for patient transfer.”
The three day event features over 45 sessions with lectures from global leaders and breaking results in the abstract-based programme. More than 1 000 cardiologists, emergency physicians, intensive care physicians, internists, surgeons, imaging specialists, interventionists, nurses, paramedics and students from nearly 80 countries are expected.
State-of-the-art advances in emergency cardiac care are set to be unveiled, making it an event not to be missed.
The scientific programme is available here
(1)Beygui F, Castren M, Brunetti ND, Rosell-Ortiz F, Christ M, Zeymer U, Huber K, Folke F, Svensson L, Bueno H, Van't Hof A, Nikolaou N, Nibbe L, Charpentier S, Swahn E, Tubaro M, Goldstein P. Pre-hospital management of patients with chest pain and/or dyspnoea of cardiac origin. A position paper of the Acute Cardiovascular Care Association (ACCA) of the ESC. Eur Heart J Acute Cardiovasc Care. 2015 Aug 27. http://acc.sagepub.com/content/early/2015/08/27/2048872615604119.full
Two sets of “Ten Commandments” are presented with some overlap for this very serious condition, Infective Endocarditis, which has a grave prognosis and mortality even in the 21st century.
“Ten Commandments” presented by ESC Task Force member Barbara JM Mulder MD
- Antibiotic prophylaxis should be restricted to highest-risk patients, but preventive measures should be maintained or extended, to all patients with cardiac disease.
- Echocardiography (TTE and TOE), positive blood cultures and clinical features remain the cornerstone for the diagnosis of IE and new imaging modalities (MRI, CT, PET/CT) may allow the diagnosis of embolic events and of cardiac involvement when TTE/TOE are negative or doubtful.
- Prognostic assessment at admission, using simple clinical, microbiological, and echocardiographic parameters, should be used to select the best initial approach; patients with persistently positive blood cultures after 48–72 h of starting antibiotics have a worse prognosis.
- Heart failure is the most frequent and among the most severe complication of IE and is an indication for early surgery in native and prosthetic valve endocarditis, even in patients with cardiogenic shock.
- Uncontrolled infection is most frequently related to peri-valvular extension or ‘difficult-to-treat’ organisms and is an indication for early surgery.
- The risk of embolism is highest during the first 2 weeks of antibiotic therapy and the decision to operate early to prevent embolism should depend on size and mobility of the vegetation, previous embolism, type of microorganism, and duration of antibiotic therapy.
- After a first neurological event, cardiac surgery, if indicated, is generally not contraindicated, except when extensive brain damage or intracranial haemorrhage is present.
- Recurrences are rare following IE, and may be associated with inadequate initial antibiotic therapy, resistant microorganisms, a persistent focus of infection, intravenous drug abuse, and chronic dialysis.
- Complicated and staphylococcal prosthetic valve endocarditis are associated with a worse prognosis and must be managed aggressively; patients with non-complicated, non-staphylococcal late prosthetic valve endocarditis can be managed conservatively with close follow-up.
- Cardiac device-related IE must be suspected in the presence of frequently misleading symptoms: prognosis is poor, probably because of its frequent occurrence in elderly patients with associated comorbidities and must be treated by prolonged antibiotic therapy and device removal.
Barbara JM Mulder MD
ESC Task Force member
“Ten Commandments” presented by ESC Task Force member, co-chair and chair.
- Creation of an “Endocarditis Team”. A multidisciplinary approach is mandatory, to include cardiologists, cardiac surgeons and specialists of infectious diseases.
- The creation of referral Endocarditis Centres is recommended due to the severity of the disease. Centres with experience in complex surgery are the best place to treat such patients.
- While echocardiography plays a key role in diagnostic algorithms, the need for a multimodality imaging approach for diagnosing endocarditis is highlighted. The new guidelines show the important diagnostic role of other imaging techniques, such as PET-CT that may be helpful in diagnosis and management decisions.
- The Early strategy in endocarditis is crucial:
- Early diagnosis,
- Early antibiotic therapy,
- Early surgery.
- Repeat TTE and /or TOE examination is recommended within 5–7 days in case of initially negative examination when clinical suspicion of IE remains high, or as soon as a new complication of IE is suspected (new murmur, embolism, persisting fever, heart failure, abscess, atrioventricular block).
- Prophylaxis is still controversial. Antibiotic prophylaxis should be considered for patients at highest risk for IE with a IIa recommendation. It should be considered in:
i) Patients with any prosthetic valve, including transcatheter valve, or those in whom any prosthetic material was used for cardiac valve repair.
ii) Patients with previous episode of IE.
iii) Patients with congenital heart disease:
a) Any type of cyanotic congenital heart disease or
b) Any type of congenital heart disease repaired with a prosthetic material.
- New antibiotic strategies were proposed in staphylococcal endocarditis. A consensus was difficult to obtain in the subgroup of patients with the most severe form of IE. Ongoing studies on this topic will be useful.
- Urgent surgery in specialised Centres is recommended in cases with aortic or mitral native valve endocarditis (NVE) or prosthetic valve endocarditis (PVE) with severe regurgitation or obstruction causing symptoms of heart failure or echocardiographic signs of poor haemodynamic tolerance, must by treated by urgent surgery. It is also recommended in patients with locally uncontrolled infection (abscess, false aneurysm, fistula, enlarging vegetation) or in infections caused by fungi or multiresistant organisms. Patients with aortic or mitral NVE or PVE with persistent vegetations >10 mm after ≥1 embolic episode despite appropriate antibiotic therapy must also be treated by urgent surgery.
- Special mention is made related to endocarditis in patients with cardiac devices (CDRIE). Prolonged (i.e. before and after extraction) antibiotic therapy and complete hardware (device and leads) removal are recommended. Percutaneous extraction is recommended in most patients with CDRIE, even those with vegetations >10 mm. In these patients routine antibiotic prophylaxis is recommended before device implantation.
- Related to patients with neurological complications. After a silent embolism or transient ischaemic attack, cardiac surgery, if indicated, is recommended without delay.
José Luis Zamorano MD
ESC Task Force member
Gilbert Habib MD
ESC Task Force Chairperson
Patrizio Lanzelloti MD
ESC Task Force co-Chairperson
“Ten Commandments” of 2015 ESC Guidelines for the Management of Acute Coronary Syndromes in patients presenting without Persistent ST-Segment Elevation (NSTE-ACS)
- "Similar to the 0 h and 3 h protocol”, a rapid rule-out and rule-in protocol for myocardial infarction (MI) at 0 h and 1 h is recommended if a high-sensitivity troponin test with a validated 0 h/1 h algorithm is available.
- Echocardiography is recommended to evaluate regional and global left ventricular (LV) function and to rule in or rule out differential diagnoses.
- A P2Y12 inhibitor is recommended in addition to aspirin for 12 months, unless there are contraindications such as excessive risk of bleeds.
- Ticagrelor is recommended for all patients at moderate to high risk of ischaemic events (e.g. elevated cardiac troponins), regardless of initial treatment strategy.
- Prasugrel is recommended in patients who are proceeding to percutaneous coronary intervention (PCI).
- Clopidogrel is recommended for patients who cannot receive ticagrelor or prasugrel or who require oral anticoagulation.
- Antithrombotic strategies for patients requiring oral anticoagulation should be personalized, and the different combinations of oral anticoagulants with single or dual antiplatelet therapy and their variable duration be tailored on the basis of the patient's bleeding risk and management strategy.
- An immediate invasive strategy (<2 h) is recommended in patients with at least one of the following very-high-risk criteria:
Haemodynamic instability or cardiogenic shock,
Recurrent or ongoing chest pain,
Refractory to medical treatment,
Life-threatening arrhythmias or cardiac arrest,
Mechanical complications of MI,
Acute heart failure with refractory angina or ST deviation,
Recurrent dynamic ST- or T-wave changes, particularly with intermittent ST elevation.
- An early invasive strategy (<24 h) is recommended in patients with at least one of the following high-risk criteria:
Rise or fall in troponin compatible with MI,
Dynamic ST- or T-wave changes (symptomatic or silent),
Registry of Acute Coronary Events (GRACE) score >140.
- An invasive strategy (<72 h) is recommended in patients with at least one of the following intermediate risk criteria:
Diabetes mellitus renal insufficiency (eGFR <60 mL/min/1.73 m2),
LV ejection fraction <40% or congestive heart failure,
Early post-infarction angina,
Prior coronary artery bypass grafting (CABG),
Global GRACE risk score >109 and <140,
Or, in the presence of recurrent symptoms or ischaemia on non-invasive testing.
- In centres experienced with radial access, a radial approach is recommended for coronary angiography and PCI. It is recommended that centres treating ACS patients implement a transition from transfemoral to transradial access.
- In patients with multivessel coronary artery disease, it is recommended to base the revascularisation strategy (e.g. ad hoc culprit-lesion PCI, multivessel PCI, CABG) on the clinical status and comorbidities as well as the disease severity (including distribution, angiographic lesion characteristics, SYNTAX score) according to the local Heart Team protocol.
- It is recommended to start high-intensity statin therapy as early as possible unless contraindicated, and maintain it long-term.
Marco Roffi MD FESC
Carlo Patrono MD
The “Ten Commandments” of the ESC Guidelines 2015 for Diagnosis and Management of Pericardial Diseases
1. Hospital admission is recommended for high risk patients with acute pericarditis, defined by a risk factor of either predictor of a specific cause (non-viral or non-idiopathic) or of increased risk of complications.
At least one risk factor among: high fever (>38ºC), subacute course, large pericardial effusion, cardiac tamponade, failure to respond to non-steroidal anti-inflammatory drug (NSAID) therapy; myopericarditis, immunosuppression, trauma or oral anticoagulant therapy.
2. Colchicine is recommended as a first line therapy for acute pericarditis as an adjunct to aspirin/NSAID therapy.
3. Pericardiocentesis, or surgical drainage, is indicated for cardiac tamponade, or for symptomatic moderate to large pericardial effusions which do not respond to medical therapy and for suspicion of bacterial or neoplastic aetiology.
4. The mainstay of treatment for chronic permanent constriction is pericardiectomy.
5. A general diagnostic work-up should be performed to identify causes that require targeted therapies. A modern approach for the management of pericardial diseases should include the integration of biological markers, as well as different imaging modalities.
6. Routine viral serology is not recommended in acute pericarditis, with the possible exception of HIV and HCV. For the definite diagnosis of viral pericarditis, a comprehensive work-up of histological, cytological, immunohistological and molecular investigations in pericardial fluid should be considered. In the absence of such argument the term “presumed viral pericarditis” should be used.
7. In patients living in non-endemic areas, empiric anti-tuberculosis treatment is not recommended when systematic investigation fails to yield a diagnosis of tuberculous pericarditis. By contrast, in patients living in endemic areas empiric antituberculosis chemotherapy is recommended for exudative pericardial effusion, after excluding other causes.
8. Effective pericardial drainage is recommended for purulent pericarditis as well as administration of intravenous antibiotics.
9. Cytological analyses of pericardial fluid are recommended for the confirmation of malignant pericardial disease. Pericardial or epicardial biopsy should be considered for the confirmation of malignant pericardial disease.
10. Aspirin is not recommended for therapy of acute pericarditis in children but NSAIDs at high doses are recommended as first line therapy.
For more information see: http://www.escardio.org/guidelines-surveys/esc-guidelines/Pages/essential-message-slideset.aspx
Philippe Charron MD PhD
Yehuda Adler MD MHA
The “Ten Commandments” of the 2015 ESC-ERS Guidelines on Pulmonary Hypertension
- Right heart catheterization is recommended to confirm the diagnosis of pulmonary arterial hypertension (PAH - Group 1) and to support treatment decisions
- Vasoreactivity testing performed during right heart catheterization is recommended in patients with idiopathic PAH, inherited PAH and PAH induced by drugs or toxin use, to detect patients who can be treated with high doses of a calcium channel blocker
- It is recommended to evaluate the severity of PAH patients with a panel of data derived from clinical assessment, exercise tests, biochemical markers, and echocardiographic and haemodynamic evaluation and to perform regular follow-up assessments every 3-6 months in stable patients.
- It is recommended to avoid pregnancy in patients with PAH
- It is recommended for referral centres to provide care by a multi-professional team (cardiology and respiratory medicine physicians, clinical nurse specialist, radiologists, psychological and social work support, with appropriate on-call expertise)
- Initial drug monotherapy or initial oral drug combination therapy is recommended in treatment naïve, low or intermediate risk patients with PAH
- Sequential drug combination therapy is recommended in PAH patients with inadequate treatment response to initial monotherapy or to initial oral drug combination therapy.
- Initial combination therapy including an intravenous prostacyclin analogue is recommended in high risk PAH patients
- The use of PAH approved therapies is not recommended in patients with pulmonary hypertension due to left heart disease or lung diseases
- Surgical pulmonary endarterectomy in deep hypothermia circulatory arrest is recommended for patients with chronic thrombo-embolic pulmonary hypertension [CTEPH] and it is recommended that the assessment of operability and decisions regarding other treatment strategies (drugs therapy or balloon pulmonary angioplasty) be made by a multidisciplinary team of experts
Nazzareno Galiè MD
Marc Humbert MD PhD
“Ten Commandments” of the 2015 ESC Guidelines for the Management of Patients with Ventricular Arrhythmias and Prevention of Sudden Cardiac Death
- Investigate individuals with known or suspected ventricular arrhythmias completely, applying both non-invasive and invasive techniques: a good etiological diagnosis is the first step towards efficient management of patients and the prevention of sudden cardiac death.
- Perform a complete autopsy in victims of sudden unexplained death, especially when they are young: the identification of an inheritable disease as the cause of death may prevent other tragedies within their family.
- Consider the use of an implantable cardioverter defibrillator (ICD) in all survivors of an episode of ventricular fibrillation or ventricular tachycardia accompanied by haemodynamic instability that occurs without apparent reversible causes or outside of the acute phase of myocardial infarction. These patients have a high incidence of recurrent life-threatening arrhythmias.
- Ensure that patients with STEMI acute coronary syndromes and unstable angina are urgently sent to reperfusion, especially when recurrent ventricular tachycardia and ventricular fibrillation are present: reducing delays from first medical contact to reperfusion helps prevent sudden cardiac death.
- Evaluate left ventricular ejection fraction both before discharge and 6–12 weeks after myocardial infarction: post-MI patients may benefit from ICD implantation for the primary prevention of sudden cardiac death.
- Implement optimal therapy including pharmacological agents (ACE inhibitors, beta-blockers, and mineralocorticoid receptor antagonists) and, if appropriate, ICDs in patients with heart failure with severe systolic dysfunction (left ventricular ejection fraction ≤35%).
- Consider the addition of cardiac resynchronization therapy for patients with the previous characteristics, when they also have intraventricular conduction delays with left bundle branch block appearance and QRS duration of >120 ms.
- Updated diagnostic criteria for inherited arrhythmogenic syndromes, including Long QT Syndrome and Brugada Syndrome, have been proposed by the new guidelines. Please refer to them in your clinical practice.
- Consider catheter ablation in experienced centres as a valuable tool to treat patients presenting scar-related ventricular tachycardias, bundle branch re-entrant tachycardia or electrical storms.
- Discuss with your patients the issues related to the impact that ICDs may have on their quality of life, before the implant and during their disease progression. Consider the possibility of deactivating the ICD when their clinical conditions deteriorate. Always respect your patients’ autonomy.
Andrea Mazzanti MD
A Day with the Legends at ESC Congress 2015
Sunday 30 August in The Hub at Regents Park
08:30 to 09:10 - ESC Andreas Grüntzig Lecture on Interventional Cardiology
Interventional cardiology, where real life and science do not necessarily meet
Bernard Meier (Bern, CH)
Chairman and Professor of Cardiology, Swiss Cardiovascular Center Bern, University Hospital, Bern, Switzerland.
Swiss native. Trained at the medical school of the University of Zurich, Switzerland, graduated 1975 (best of 180). Board certified in internal medicine 1980 and cardiology 1983. Cardiology training at Emory University, Atlanta, Georgia, USA, with Andreas Grüntzig
1983 - 1992 Head of invasive cardiology, University Hospital, Geneva, Switzerland.
1992 - Chairman and Professor of Cardiology, University Hospital, Bern, Switzerland.
2001 - Rotating Chairman, Swiss Cardiovascular Center, University Hospital, Bern, Switzerland.
Specialized in interventional cardiology. Involved in coronary angioplasty since the first case performed by Andreas Grüntzig on September 16, 1977 in Zurich, Switzerland. Author and co-author of numerous books, reviews, and original articles on cardiology, in particular interventional cardiology. Organizer and active participant of countless educational meetings on interventional cardiology. Fellow of the American College of Cardiology and of the European Society of Cardiology. Past president of the Swiss Society of Cardiology. Recipient of several awards.
09:20 to 10:00 - ESC William Harvey Lecture on Basic Science
Microcircular networks: the business end of the circulation
Axel Radlach Pries (Berlin, DE)
Axel Radlach Pries studied medicine at the University of Cologne and defended his doctoral thesis in 1980 with ‘summa cum laude’.
He worked as postdoctoral fellow in Cologne and Berlin University and 1997-1998 at the Institute of Anaesthesiology of the German Heart Center Berlin. 1998 he became full professor at the Department of Physiology, Free University Berlin and 2001 head of the Charité Institute for Physiology.
His scientific interests include microcirculation, tumour vasculature, blood rheology, vascular adaptation, angiogenesis, and the endothelial surface layer. He was general secretary of the ESM (European Society for Microcirculation) and is chair of the International Liaison Committee for Microcirculation.
In the ESC, he was chair of the Working Group for Coronary Pathophysiology and Microcirculation and the Council for Basic Cardiovascular Science (CBCS). Since 2015, he is Dean of the Charité University Medicine Berlin.
Meet the Legends
10:10 - 10:50 - Keith Fox (Edinburgh, UK)
He was a founding Fellow of the European Society of Cardiology and Chair of the Programme of the European Society of Cardiology 2012-2014. In addition, he was President of the British Cardiovascular Society from 2009 to 2012.
His awards include the Silver Medal of the European Society of Cardiology in 2010 and again in 2014 and the Mackenzie medal of the British Cardiovascular Society (2013). Professor Fox’s major research interest lies in the mechanisms and manifestations of acute coronary arterial disease; his work extends from underlying biological mechanisms to in vitro and in vivo studies and clinical trials.
He is an International Associate Editor of the European Heart Journal and Deputy Editor of the Journal of the American College of Cardiology JACC (Europe). His ongoing research interests include the mechanisms of inflammation and plaque rupture in acute coronary syndromes and antithrombotic therapies.
A Journey to Stockholm
11:00 - 12:30 - Ageing and cardiovascular disease: role of cellular senescence
Elisabeth Blackburn (San Francisco, US)
Professor Elizabeth H. Blackburn is a Nobel Laureate and Morris Herzstein Professor of Biology and Physiology, in the Department of Biochemistry and Biophysics at the University of California San Francisco (UCSF).
She is a leader in the area of telomere and telomerase research. Elizabeth Blackburn discovered the molecular nature of telomeres - the ends of eukaryotic chromosomes that serve as protective caps essential for preserving the genetic information - and co-discovered the ribonucleoprotein enzyme, telomerase. Professor Blackburn and her research team at UCSF are working with various cells including human cells, with the goal of understanding telomerase and telomere biology. They also collaborate in investigating the roles of telomere biology in human health and diseases, in clinical and other human studies.
Throughout her career, Professor Blackburn has won many prestigious awards. She was elected Fellow of the American Academy of Arts and Sciences (1991) and the Royal Society of London (1992). She was elected Foreign Associate of the National Academy of Sciences (1993) and Member of the Institute of Medicine (2000). She served on the President’s Council on Bioethics from 2002 to 2004, and has been awarded honorary degrees by 11 Universities. She received the Albert Lasker Medical Research Award for Basic Medical Research in 2006, and in 2007 was named one of TIME Magazine’s 100 Most Influential People. In 2008 she was the North American Laureate for L’Oreal-UNESCO For Women in Science.
In 2009, Professor Blackburn was awarded the Nobel Prize in Physiology or Medicine.
Meet the Legends
14:00 - 14:40 - Richard Popp (Palo Alto, US)
Dr. Richard Popp is Emeritus Professor of Medicine at Stanford University. Dr. Popp is a clinical cardiologist and teacher who focused his research on the development of all forms of ultrasound in cardiology with more than 300 scientific publications. He has trained over 150 cardiologists through his clinical laboratory program.
Dr. Popp was Senior Associate Dean for Academic Affairs at Stanford from 1995-2000. He continues to teach in the Stanford Biodesign Innovation Program where he heads the Ethics and Policy group. He has been Chair, the Conflict of Interest Committee at the Medical School since 2000.
Dr. Popp was President of the American College of Cardiology, the American Society of Echocardiography and the Association of University Cardiologists. He is the previous Chairman of the American Board of Internal Medicine’s Cardiovascular Diseases Sub-specialty Board. He is a Master of the American College of Cardiology and a Fellow of the American Heart Association, the American Society of Echocardiography, and the European Society of Cardiology. He has been given Honorary Fellowship in the Cardiology Society of several countries.
14:50 -15:30 Michel Haissaguerre (Pessac, FR)
16:30 - 17:10 - ESC Rene Laennec Lecture on Clinical Cardiology
The interaction of acute blood pressure change, pericardial restraint and acute outflow tract stretch - A new paradigm underlying sudden cardiac death
George Sutherland (London, UK)
17:20 -18:00 - ESC Geoffrey Rose Lecture on Population Sciences
Optimising cardiovascular health: old and new challenges
Kay-Tee Khaw (Cambridge, UK)
Kay Tee Khaw is Professor of Clinical Gerontology, University of Cambridge.
She trained in medicine at Girton College, University of Cambridge and St. Mary's Hospital, University of London (now Imperial College). She worked under Geoffrey Rose in clinical medicine at St. Mary’s Hospital and subsequently in epidemiology at the London School of Hygiene and Tropical Medicine, with later clinical and academic posts in the University of London and University of California San Diego.
Her research interests are the maintenance of health in later life and the causes and prevention of chronic diseases including cardiovascular disease, cancer and osteoporosis with a focus on nutrition, physical activity, and hormones. The research is based on longitudinal population studies and clinical trials.
She is a principal investigator in the European Prospective Investigation in Cancer in Norfolk, part of a ten country half million participant research collaboration over two decades. She is a Fellow of the Academy of Medical Sciences, UK and has a National Institutes of Health Research Senior Investigator award.
Continuing Excellence at the Heart of Cardiology – ESC publishing in 2015
The 2015 European Society of Cardiology Congress in London is in many ways the true highlight of the year for publishing in cardiology. Oxford University Press is delighted to be working with ESC again on what appears to be a bigger conference than ever before. Alongside the flagship European Heart Journal (now officially #2 in the world of cardiovascular medicine), we are showcasing some exciting new publications that are part of the ever-growing international ESC portfolio.
There are two new journals (EHJ-Cardiovascular Pharmacotherapy and EHJ-Quality of Care & Clinical Outcomes), as well as 4 major new ESC textbooks in, Intensive and Acute Cardiovascular Care; Cardiovascular Imaging; Preventive Cardiology; and a beautiful, accessible case-based learning book with MCQs: The EHRA Book of Pacemaker, ICD, and CRT Troubleshooting. All are new for 2015 and available alongside the well-established ESC Textbook of Cardiovascular Medicine (Second Edition), The EAE Textbook of Echocardiography and the journal family, including Cardiovascular Research, European Heart Journal Supplements, EP-Europace and EHJ-Cardiovascular Imaging.
To give participants a taste of what’s new this year, don’t miss our series of Lightning Talks at the Oxford University Press stand (#B801) during lunch and coffee breaks. Every day during the Congress, ESC editors, authors, and advisors – all experts in their field – will give short talks about their work and experience.
- Professor Thomas Lüscher kicks-off the Lightning Talks at 16:00 on Saturday.
- On Sunday Professor Jolanda van der Velden will speak, followed by Professor Marco Tubaro on STEMI systems of care and therapeutic strategies.
On Monday our line-up includes:
- Professor Haran Burri who will present cases and brain teasers from his new book on device trouble shooting,
- Professor Stefan Agewall who will introduce the new journal EHJ-Cardiovascular Pharmacotherapy,
- Professor Pascal Vranckx and Professor Adam Timmis, who will share his experiences as a journal editor on low-level research misconduct. And for insights into the world of publishing in clinical medicine,
- Ms. Rachel Fenwick from OUP will showcase our digital publishing platform Oxford Medicine Online, and
- Mr Andy Sandland reveals all about Open Access Publishing during the breaks on Tuesday.
So don’t miss out – drop by the Oxford University Press stand to hear the speakers and discover everything that is on offer this year in cardiology, from definitive new textbooks with exclusive discounts, to free copies of all the ESC journals published by Oxford University Press.
The Russian National Congress of Cardiology 2015
The 2015 Congress will be held in Moscow, capital of the Russian Federation 22-25 September reports Prof Evgeny Shlyakhto
The Russian National Congress of Cardiology is a key annual event of the Russian Society of Cardiology, which gives an opportunity to discuss crucial issues of cardiovascular research and clinical practice on the multidisciplinary and international basis.
Today, the Russian Society of Cardiology is an all-Russian organization with more than 5,500 members and representations in about 60 regions of Russia. At the moment, 30 sections and 3 working groups are included in the Russian Society of Cardiology.
The Russian Society of Cardiology (RSC) is developing interdisciplinary approaches and aims to cooperate with other medical specialties. Among its members, there are internists, cardiovascular specialists, endocrinologists and other specialists interested in cardiovascular diseases.
The Russian National Congress of Cardiology has been held annually since 2000. Since 2012, one of the priorities for the RSC became its integration into the world cardiovascular community. Since that time there has been growing international participation, including leaders from the top world professional associations such as European Society of Cardiology and American College of Cardiology, which has become a new feature of the national event. This ensures an important contribution to its success as well as, to its scientific and educational value.
Today, the Russian National Congress of Cardiology is the key annual event of the most influential professional medical association in the country. The Congress scientific programme discusses the most significant modern achievements in prevention, diagnostics and treatment of cardiovascular diseases. The main topics include:
- most demanding issues of emergency and elective cardiovascular care;
- key problems in development and introduction of modern medical technologies into the primary and secondary prevention, diagnostics and treatment;
- development of basic research: introducing the concept of translational medicine into cardiology;
- improvement of pharmacotherapy following the latest evidence-based medical achievements;
- modern imaging techniques in cardiology;
- development of modern diagnostic methods (including prenatal methods) and technologies for the treatment of congenital cardiovascular defects and cardiology issues in perinatology and paediatrics;
- development and introduction of new surgical interventions and hybrid technologies, problems of heart transplantation and innovations in the treatment of cardiac arrhythmias;
- co-morbidities in cardiology, geriatric aspects in cardiovascular diagnostics and treatment;
- rehabilitation issues of cardiovascular patients and sports cardiology;
- development of continuous medical education (CME) system in cardiology;
- organization of nursery for cardiovascular patients.
The scientific programme traditionally consists of keynote lectures, plenary sessions, scientific symposia, workshops, poster sessions, a Young Cardiologist Award session, as well as training sessions with the possibility of receiving CME credits.
The 2014 Congress held in Kazan became the most significant event for the professional community: 170 scientific sessions and symposia, among them 12 plenary sessions, 11 educational seminars, 3 master classes, 3 discussion clubs and 3 round tables. In all about 4,500 delegates from 191 Russian cities and 29 foreign countries participated.
In 2015, the Russian National Congress of Cardiology will be held in Moscow, the capital of the Russian Federation, which hosts numerous of the most important events every year and well known for its traditional hospitality. The Congress guests will have an opportunity to get in touch with thousand years of Russian history and see the outstanding sights of one of the most beautiful cities in the world.
Evgeny Shlyakhto MD FESC
President of the Russian Society of Cardiology
Adolfo J de Bold’s 1981 pioneering discovery results in first ARNi drug approval for heart failure
The first drug in the class ARNi, a combination of an Angiotensin Receptor Blocker (valsartan) and a Neprilysin inhibitor (sacubitril) was approved by the U.S. Federal Drug Administration on 7 July 2015, after it had been demonstrated to reduce rehospitalisation rates and prolong life in patients with heart failure and reduced ejection fraction.
Adolfo J. de Bold discovered atrial natriuretic protein (ANP) in 1981 which he originally called atrial natriuretic factor whilst at Queen’s University, Kingston, Ontario, Canada. He found that an extract from the atrial muscle of rat hearts caused a rapid and profound increase in sodium and chloride excretion. This led to the PARADIGM-HF (Prospective comparison of ARNi with ACEi to Determine Impact on Global Mortality and Morbidity in Heart Failure) trial which was closed early based on the strength of interim results.
Dr Eugene Braunwald, TIMI Study Group, Boston, USA, has stated, “the unambiguous superiority of clinical outcomes in patients with HFrEF by the first ARNi over enalapril in the PARADIGM HF trial represents a significant achievement with important clinical implications. Adolfo J. de Bold’s discovery places him among the most important cardiovascular scientists of the last 100 years”.
Policy statement from AHA, ESC, EACPR and ACPM
Experts call for ‘all hands on deck’ to tackle global burden of non-communicable disease. A policy statement from the American Heart Association, the European Society of Cardiology, the European Association for Cardiovascular Prevention and Rehabilitation and the American College of Preventive Medicine on the action needed to tackle non-communicable diseases (NCDs) on a global basis, has just been published, simultaneously in EHJ and Mayo Clinic Proceedings .
The authors propose that organisations at every level of society, from the family unit, to companies, to industry, to government and non-governmental organisations worldwide should collaborate to create, implement and sustain healthy lifestyle initiatives that will reverse the current upward trajectory of NCDs.
They say that identifying the enormous burden caused by NCDs is not enough and it is time to pursue strategies both within and outside traditional healthcare systems that will succeed in promoting healthier lifestyles in order to prevent or delay health conditions that cause the deaths of over 36 million people worldwide each year at a cost of at least US $6.3 trillion – that is projected to rise to $13 trillion by 2030.
Professor Ross Arena, of the University of Illinois at Chicago (USA), who was chair of the policy statement authors stated “The challenge is how to initiate global change, not towards continuing documentation of the scale of the problem, but towards true action that will result in positive and measurable improvements in people’s lifestyles.”
The experts call for a paradigm shift in the prevention and treatment of NCDs. “The importance of promoting and leading a healthy lifestyle must take a significantly more prominent role, from the individual/family to global population level, capitalising on all forms of preventive strategies. They propose that the treatment of NCDs should move outside of the traditional, often reactionary, healthcare model. Prevention is the key and preventive strategies at earlier stages in the community are best, for instance at the very beginning of life.
The paper identifies a number of barriers or challenges to implementing healthy lifestyles, and it suggests possible solutions. The authors conclude that they hope their paper will motivate organisations at all levels of society to: “1) Embrace their defined roles with respect to HL [healthy lifestyles] promotion and take action that will result in meaningful and positive change; 2) officially designate one or more healthy lifestyle ambassadors that have the organisational support needed to develop and implement HL initiatives; and 3) commit to ongoing communication amongst stakeholders that will result in collaborative HL initiatives.”
 “Healthy lifestyle interventions to combat non-communicable disease: a novel non-hierarchical connectivity model for key stakeholders. A policy statement from the AHA, ESC, EACPR and ACPM”, by Ross Arena et al.
Published simultaneously in:
Mayo Clinic Proceedings, doi: 10.1016/j.mayocp.2015.05.001
European Heart Journal. doi:10.1093/eurheartj/ehv207
Endurance athletes should have cardiac testing while exercising rather than at rest
New evidence published in the European Heart Journal  3 June, has shown that important signs of right ventricular dysfunction which are potentially fatal can only be detected during exercise.
In this new study, Prof André La Gerche and his colleagues in Australia and Belgium have found that problems in the way the right ventricle works become apparent only during exercise and cannot be detected when an athlete is resting. La Gerche said: “You do not test a racing car while it is sitting in the garage. Similarly, you can’t assess an athlete’s heart until you assess it under the stress of exercise.”
The researchers tested cardiac performance in 17 athletes with right ventricular arrhythmias, 8 of whom had an ICD in place, 10 healthy endurance athletes and 7 non-athletes, using invasive procedures such as cardiac MRI with intravascular catheters, and non-invasive methods e.g. echocardiography. They found that cardiac function at rest was similar in all three groups, as was left ventricular function during exercise. However, measurements during exercise showed changes in right ventricular function in the athletes who were known to have arrhythmias compared to the other two groups.
La Gerche said: “These results should stimulate cardiologists who manage athletes to pay greater attention to the right side of the heart. The tests that we describe are ready for clinical use now and are not too challenging. It is simply a case of ‘you will not find unless you look’.”
In an accompanying editorial , Prof Sanjay Sharma, of St George’s University of London (UK), who is medical director of the London Marathon and chair of the European Society of Cardiology’s sports cardiology nucleus, and Dr Abbas Zaidi, a research fellow at St George’s University of London, and a marathon runner, describe the study as “novel and important in several regards”. They write: “Importantly, assessment of the right ventricle should form an integral component of risk assessment in athletes presenting with potentially lethal rhythm disturbances. Until only recently considered to be a Pandora’s Box of spurious and detrimental public messages, the right ventricle and its potential for adverse remodelling is increasingly acknowledged to represent the true Achilles’ heel of the endurance athlete.”
 “Exercise-induced right ventricular dysfunction is associated with ventricular arrhythmias in endurance athletes”, by André La Gerche et al. European Heart Journal. doi:10.1093/eurheartj/ehv202
 “Arrhythmogenic right ventricular remodelling in endurance athletes: Pandora’s Box or Achilles’ heel?” by Abbas Zaidi and Sanjay Sharma. European Heart Journal. doi:10.1093/eurheartj/ehv199