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Professor Mariell Jessup, Chief Science and Medical Officer of the American Heart Association and an Emeritus Professor of Medicine at the University of Pennsylvania School of Medicine, PA, USA, is a leader in heart failure (HF) research, prevention and treatment, who has played an enormous part in putting HF on the cardiology subspecialty map in the US. A widely published author, she has for many years also been an integral member of the writing team for the American College of Cardiology/American Heart Association clinical practice guidelines.
As a medical student, Prof. Jessup was drawn to cardiology because she saw it was an area in which patients could be made to feel better very quickly. “A lot of changes were happening at the time,” she adds. “Scientists were identifying risk factors and understanding that by influencing these factors, a real impact could be made on decreasing morbidity and mortality. The dynamism of the field and the new therapies emerging made it a very exciting time to be a young cardiologist.”
Prof. Jessup pinpoints the proudest moment of her career as being in 2004, when, after she and others had campaigned for many years, the American Board of Internal Medicine recognised advanced HF and transplant as a certified subspecialty of cardiology. “What it means is that there are now a set of mandatory training experiences and a knowledge base that have to be achieved before a cardiologist can take care of these desperately ill patients,” she says. “As a result, patients are getting much better treatment.” Prof. Jessup is also very proud of her work writing for clinical practice guidelines but thinks that more needs to be done to make sure that messages are translated into clinical practice. “I think that we have to get better at implementing the guidelines in our hospitals and clinics. All too often, the guidelines live a sanitised life within a journal. We need to push for wider integration into clinical practice so that we can deliver the best care to the widest number of people.” She thinks that the ESC’s efforts to quantify guideline use is a move in the right direction—“You can’t change what you can’t measure”—and one that is to be applauded.
One of the biggest challenges is the lack of proven therapies for HF with preserved ejection fraction (HFpEF).
“We still don’t have proven effective therapies for HFpEF and the community received another blow with the results from the PARAGON-HF trial, which, as we heard during ESC Congress 2019, delivered neutral results with sacubitril/valsartan,” observes Prof. Jessup. Her hope is that future research will develop more specific therapies for this condition. And she takes comfort from the fact that promising treatments are emerging for other forms of HF, such as hypertrophic cardiomyopathy and cardiac amyloidosis. “However,” she says, “in HF, we are nowhere near the precise, personalised medicine everyone talks about as being the goal of management. This is where we need to go.” She has great faith in the future and in scientists’ determination to understand HF. “I have the great advantage of being able to look back over my career and see what we’ve achieved in this relatively short time. And that gives me hope to think that we’ll see even better therapies in the upcoming decades.”
Prof. Jessup is also keen to help address the gender imbalance in cardiology. “We need more women in cardiology. We know that patients feel more comfortable if there’s somebody they can relate to and there’s some suggestion that women feel more comfortable with—and are actually listened to in a more optimal way by—women cardiologists. And if half the population is female it isn’t hard to see why we need to recruit more women into this field.”
Expressing her honour at receiving the award from the ESC, Prof. Jessup concludes, “I’m extremely grateful that I’ve had the profound experience of witnessing what’s happened in HF over the last 30 to 40 years and I look forward to seeing the next chapter unfold.”
Mee the gold medalist: Mariell Jessup
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