Groundbreaking Studies in the Practice of Cardiovascular Medicine from the AHA 2018 Circulation Symposium

By Joseph A. Hill, M.D., Ph.D.
Chief of Cardiology

UT Southwestern Cardiology was a powerful presence at the 2018 American Heart Association Scientific Sessions in Chicago. A storm of tweets from many of our meeting participants highlighted exciting events during the congress. Through our leadership of Circulation, we published 21 papers simultaneous with their presentation at the meeting.

On Sunday, Nov. 11, we held the third Circulation Symposium orchestrated by our UT Southwestern-based team of editors, and it was a huge success! We highlighted some of the most impactful papers published in our journal this past year, hosted a robust discussion of cutting-edge science, and featured “household name” luminaries from around the world who publish in Circulation. One happy side benefit is that we showcased the incredible talent, dedication, and “sweat equity” commitment of our editorial team and its outstanding diversity across subspecialty focus and science platform, gender, career stage, and geography.

A wide spectrum of science was presented, reflective of the broad swath of cardiovascular content published in Circulation. Dr. Mandeep Mehra (Brigham and Women’s Hospital) discussed his work analyzing the cost-effectiveness of the newest LVAD, the HeartMate 3 device; we’re getting close to levels of cost-effectiveness deemed acceptable across medicine. Dr. Nicholas Mills (University of Edinburgh) discussed his study focusing on the utility of high-sensitivity cardiac troponin measurements, which now arguably supersede numerous risk-estimating algorithms in the evaluation of patients presenting to the Emergency Department with chest discomfort. Dr. Rahul Deo (Brigham and Women’s Hospital) discussed the rapidly emerging role of artificial intelligence and machine learning in cardiovascular medicine, focusing specifically on echocardiography. Dr. Filippo Crea (Universitá Cattolica del Sacro Cuore, Rome) discussed an impactful review article he wrote with other international thought leaders on the role of microvascular dysfunction in numerous types of cardiovascular disease; his paper was the most “tweeted” item in the journal this past year!

Dr. Brahmajee Nallamothu (University of Michigan) discussed a very creative study in which he and his team interviewed in-hospital cardiac arrest teams across a range of hospitals – some with outstanding outcomes and some with quite poor outcomes – and gleaned a number of insights, many of which are innovative, insightful, and even surprising. Dr. Barry Borlaug (Mayo Clinic) discussed his pathbreaking work to identify patients presenting with breathlessness in whom the underlying pathophysiology is heart failure with preserved ejection fraction (HFpEF). Recognizing that this syndrome is substantially underdiagnosed, Dr. Borlaug developed and validated the “H2FpEF score,” a quick and easy way to estimate the likelihood of underlying HFpEF based on readily available clinical markers; this novel and simple algorithm might well emerge as a significant advance in the battle against this expanding, perplexing, and mortal syndrome. Dr. Marc Sabatine (Brigham and Women’s Hospital) discussed his work in FOURIER to evaluate the relative benefit of PCSK9 inhibition in patients across a spectrum of disease risk. Finally, to cap off a fabulous three-hour symposium, Dr. Eugene Braunwald discussed his paper titled “Aortic Stenosis: Then and Now,” in which he summarized the enormous changes that have occurred in the pathology, presentation, and therapy for aortic stenosis since the publication of his landmark paper in Circulation – 50 years ago! – which rapidly emerged as the platform for our understanding of the natural history of this disease. That this giant of medicine published these two important papers in Circulation, and discussed each at our symposium, is a rare treat and a special honor.

At UT Southwestern, we are privileged to lead the flagship international cardiovascular journal Circulation, and it’s my honor to serve as Editor-in-Chief. Our overarching objective is to inform and direct the field, drive global science, and sculpt the future of cardiovascular science and medicine for the benefit of all. The 2018 Circulation Symposium at the AHA was another exciting step in this direction.