Our mission is to become a worldwide reference for education in the field for all professionals involved in the process to disseminate knowledge & skills of Acute Cardiovascular Care.
Our mission is to promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular imaging in Europe.
Our mission is to promote excellence in research, practice, education and policy in cardiovascular health, primary and secondary prevention.
Our mission is to reduce the burden of cardiovascular disease in Europe through percutaneous cardiovascular interventions.
Our mission is to improve the quality of life of the population by reducing the impact of cardiac rhythm disturbances and reduce sudden cardiac death.
Our mission is to improve quality of life and longevity, through better prevention, diagnosis and treatment of heart failure, including the establishment of networks for its management, education and research.
The ESC Working Groups' goal is to stimulate and disseminate scientific knowledge in different fields of cardiology.
The ESC Councils' goal is to share knowledge among medical professionals practising in specific cardiology domains.
OUR MISSION: TO REDUCE THE BURDEN OF CARDIOVASCULAR DISEASE
Dr. Ricardo Fontes Carvalho,
Moderator: R C Vidal Perez (Santiago De Compostela, ES)
This session, organised by the ESC Cardiologists of Tomorrow, was part of a pioneer project of live transmission of some ESC Congress sessions through the internet. Outside Munich, a large and worldwide virtual audience had the opportunity to follow the session and interact with the speakers by submitting questions. It was a fantastic and very futuristic session looking into the management of Heart Failure in the next decades, going from new pharmacological targets and complete cardiac regeneration with stem cell therapy, to the future roles of new devices and mechanical pumps. “There are plenty of new pharmacological agents being tested for chronic heart failure” – Prof McMurray About 100 clinical trials are now registered and under way in chronic heart failure. New pharmacological agents being tested are non-steroidal mineraloreceptor antagonists, new ways of AT1 receptor blockade (TRV120027), PDE-5 inhibitors (eg. sildenafil), ErbB receptor antagonists (recombinant human neuregulin 1-β, used also for breast cancer treatment), and new agents for comorbidities management such as new antidiabetic agents (focus on SLGT-2 inhibitors). Gene therapy can also be the future. Also in acute heart failure (AHF) there are promising new agents being tested but we must be cautious because, in the last several years, AHF has been “the graveyard” of several therapies. Answering a question from the “virtual” audience about the impact of economic restrains in heart failure research, Prof McMurray stated that, for now, HF clinical trials have not been seriously affected. “I am still a believer in the biological heart” - Sir Magdi Yacoub The heart has several functions (pump, endocrine, regulation of the cardiovascular system) and, therefore, hearts will never be totally replaced by machines. However, 60 years ago, heart transplantation was also a “fantasy for the future” and now is in the clinical ground, worldwide. Nevertheless, the long term follow-up of patients after heart transplantation is somewhat disappointing (only 12.5-25% are alive after 20 years) which led Prof Yacoub to cite Winston Churchill that heart transplantation is “at the end of the beginning”, leaving room for an integrated approach between new artificial pumps and the biological heart for the next decades. But, for now, “heart transplantation is here to stay for a long time”. Complete cardiac regeneration from stem cells to create a “bioartificial heart” – the Taylor Heart Stem cell therapy is one of the most promising fields of investigation in Cardiology with about 150 clinical studies now recruiting patients. In her fantastic talk, Prof Doris Taylor showed her results of trying to build a multi-chambered functional heart with contracting and blood-pumping capabilities – a “bioartificial heart”. After decellularizing a pig’s heart (leaving only extracellular matrix protein scaffold) it was possible to recellularize the matrix using stem cells. The future, although still far, is open for an autologous cardiac transplantation. New devices for HF management: new therapeutic targets and improved monitoring technologies – Prof K. Dickstein Several companies have new devices being tested and developed for HF management. The efforts concentrate on two important areas: improved sensing/monitoring capacities and new therapeutic alternatives. To improve monitoring of HF patients, devices that continuously measure left atrium pressure or monitor intracardiac impedance are under development. Regarding new therapeutic devices, the focus goes to autonomic modulation therapies (spinal cord stimulation, baroreflex activation therapy and vagal nerve stimulation), percutaneous ventricular restoration device (Parachute) and new cardiac pumps. One of the most promising therapies, ready to be tested in the short term, seems to be renal denervation therapy also in HF. Conclusion In this session, “science fiction” met reality, and we had a glimpse into the future of heart failure management
Future targets in systolic heart failure management: pharmacological therapy, new artificial hearts, complete cardiac regeneration therapies and upcoming devices
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