Sunday 2 September 2007
This year's ESC gold medallists
Honours reward 'remarkable contributions'
At the Opening Ceremony held on 1 September, ESC Gold Medals were awarded to Valentin Fuster of Mount Sinai Heart Hospital in New York, and to Karl Swedberg from Göteborg University. Our ESC Congress News correspondent spoke to both of them about their careers.
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An ability to prioritise and organise lies behind the dynamic career of Valentin Fuster, to whom the ESC is awarding its Gold medal for his contributions to cardiovascular science.
Many achievements...
He was one of the first to recognise the importance of the vulnerable atheromatous plaque, he refined imaging techniques to detect vulnerable plaques, and demonstrated that rapamycin works as an inhibitor of post-injury smooth muscle cell migration.
Other achievements include past presidencyof the New York Heart Association, the American Heart Association and the World Heart Federation, and editor-in-chief of Nature Cardiovascular Medicine. |
“It’s been fascinating to go from working in the community to working nationally and then internationally,” says Fuster. “But I’ve come to the conclusion that in the field of prevention, the community approach works best. You can’t just give people blanket advice, it needs to be tailored to their individual circumstances.”
Aged 64, he still devotes half his time to seeing patients. “I couldn’t carry on my research without seeing patients because all my science is based on observations in people.”
Almost a different career path
Born in Barcelona after the end of the Spanish Civil War, Fuster showed an early aptitude for tennis, competing at national level. He wanted to study agriculture but could not find a convenient course, so turned to medicine instead.
Through tennis he met Pedro Farreras – the author of the standard textbook of medicine for Spanish-speaking countries – who became his mentor. When Farreras had a heart attack at 45, he persuaded Fuster to specialise in cardiology. Fuster graduated first in his year at the University of Barcelona.
Tennis also brought Fuster to the attention of Harold Sheehan, head of pathology at Liverpool University, who introduced him to the coronary care unit in Edinburgh where he worked with Desmond Julian and Michael Oliver. He completed his PhD thesis on the role of platelets in myocardial infarction at Edinburgh.
He moved to the Mayo Clinic in Minnesota in 1971, became a professor of medicine at 39, worked at Harvard Medical School, Massachusetts General Hospital, and is now medical director at Mount Sinai Heart, where he is developing an autonomous centre with strong basic and clinical research.
Fostering young talent
Grateful for his early support, Fuster recognises the importance of fostering young talent. In Madrid he is spearheading a new centre for cardiovascular investigation – the Centro Nacional de Investigaciones Cardiovasculares (CNIC) – where he wants to discover the young investigators of the future from school students, those starting careers in biology or medicine, and cardiologists in training, and translate laboratory findings into clinical applications.
| Fuster finds time for many other activities, including amateur film-making, writing poetry, reading contemporary history and sport. Cycling is a major passion; each summer he cycles through the Pyrenees or the Alps, averaging around 50 to 70 kms a day. He says that doing something different to cardiology offers him the opportunity for real mental relaxation, and being physical activity keeps his brain healthy. |
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Although he needs only four hours sleep a day, he puts his productivity down to prioritisation. “What you see is the product of many years of an organised approach.”
A career in heart failure research
With heart failure (HF) the theme of this Congress, it seems fitting that Karl Swedberg – whose career has been devoted to conducting HF clinical trials and writing HF guidelines – was honoured with the Gold Medal at the Opening Ceremony of the ESC Congress 2007.
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Over the past 30 years Swedberg, now a professor of medicine at the Göteborg University, Sweden, has played a pivotal role in many of the big studies influencing the treatment of HF. CONSENSUS, COMET and CHARM have all benefited from his diplomacy, organisational ability and skills as a team player. Swedberg has been president of the Swedish Society of Cardiology and chairman of the ESC Working Group on HF; sin5ce January 2005, he has been editor-in-chief of the European Journal of Heart Failure.
Swedberg enrolled at Göteborg University in 1963 and continued at Umeå University, graduating in 1970. Even as a medical student he found himself inexplicably drawn to the mechanics of the heart and spent much free time reading electrocardiograms. |
Landmark papers and breakthroughs
Based on initial observations by Finn Waagstein, his PhD thesis studied the effects of beta-blockers in dilated cardiomyopathy and resulted in the publication of a landmark paper (Lancet 1979;1:1374-1376). “We had an idea and decided to run with it,” remembers Swedberg. “It was a really exciting time. We saw patients making dramatic improvements, but no one was prepared to believe us. It wasn’t until 1999 that this breakthrough became widely accepted.”
The 1987 CONSENSUS study was the first report of ACE inhibitors improving survival in congestive HF (N Engl J Med 1987;316:1429-1435) and firmly established Swedberg’s international profile. The CHARM programme was a major career highlight. It was designed to ascertain whether the angiotensin receptor blocker candesartan could reduce the incidence of cardiovascular death or need for hospitalisation in a range of HF patients, and resulted in new advances in the management of those HF patients with reduced ejection fractions.
Swedberg was chairman of the Task Force on the Diagnosis and Treatment of Chronic HF that updated the ESC Guidelines in 2005, and says writing guidelines was intellectually challenging and rewarding. “The truth of the matter is that unless studies are incorporated into guidelines they won’t ever have any tangible effects,” he says.
Nowhere to hide...
He is passionate about fighting fraud in science. Recently, Swedberg has been involved in forming the HEART network, a new initiative where editors from cardiovascular journals exchange information on any instances of scientific fraud, data falsification or plagiarism. “We’re developing a system where journals can collaborate, telling each other if we have a strong suspicion that someone has falsified data. The idea is to name and shame. Otherwise there’s a danger they could slip through the net and destroy the credibility of the scientific community.”
| Swedberg enjoys golf and downhill skiing. He and his wife Ingela have six grandchildren whose visits leave him little spare time but plenty of opportunity to use his negotiation skills, honed on guideline committees and journal boards. |
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