In the second webinar of our PVRI2021 series, Prof Martin Cowie (Imperial College London, UK) gave a keynote lecture on “mHealth and wearables: Is this the dawn of a new age for cardiovascular medicine?”, a timely topic of utmost importance for all of us. Prof Cowie is a worldwide renowned speaker on this topic, serves as Chair of Cardiology at the National Heart & Lung Institute, and as a Non-Executive Director of the National Institute for Health and Care Excellence (NICE). Wearable and implanted sensors connected to telematic infrastructure or smartphones, point-of-need diagnostic devices and medical imaging powered by real-time data streams and supported by automated tools to aid clinical decision-making potentially enable care and improve our understanding of physiological variability. However, the path to incorporation of mHealth into clinical care remains still fraught with challenges. Prof Cowie provided us a “state-of-the-art” update on where we stand in 2021, and what we may expect in the near future. He is convinced that the “new normal” in cardiovascular medicine will base on patient data and that a rethinking in responsible administrations has already commenced towards an integration of mHealth into the health care system.
This presentation was followed by a second keynote lecture, the “Professor Sheila Glennis Haworth Memorial Lecture” given by Prof Jason Yuan (University of California San Diego, USA) on “Translational Research on Pulmonary Arterial Hypertension: TRPC6, a Therapeutic Target for Treatment of PAH”. Prof Yuan focused on novel mechanistic insights of TRPC6 (Transient Receptor Potential Canonical 6) - related Ca²⁺signaling which is involved in many pathways of the cell cycle and represents a potential trigger for pulmonary vasoconstriction and vascular remodeling in animal models. In a mouse model, TRPC6 was upregulated, and receptor-/store-operated Ca²⁺entry was enhanced in IPAH-PASMC compared to normal PASMC. Blockade of TRPC6 resulted in an inhibition of hypoxic pulmonary vasoconstriction and partially reversed pulmonary vascular remodeling. Finally, oral administration of the TRPC6 blocker Bl-749327 could partially reverse established PH.
Hereinafter, Prof Marc Humbert (Professor of Respiratory Medicine at the South Paris University, France) gave a talk about a biomarker analysis of the PULSAR study: an ongoing phase 2, double-blind, placebo-controlled, randomised study to compare the efficacy and safety of sotatercept versus placebo when sotatercept was added to standard of care for the treatment of PAH with promising results, which make sotatercept a candidate for a potential broader pharmaceutical use in the treatment of PAH, regardless of BMPR2 status.
Referring to the REPLACE study results, Professor Raymond Benza (Professor of Medicine at Temple University School of Medicine, Philadelphia, PA, USA) highlighted the potential benefits of switching from PDE5i to riociguat in patients with PAH, which appeared to be safe and resulted in beneficial clinical effects when compared to PDE5i maintenance. This makes the approach a promising strategic option for treatment escalation, especially for PAH patients at intermediate risk.
Finally, Ms Niamh Errington (PhD student at the University of Sheffield), the winner of the Rupert Swift Award 2021, explained the diagnostic usage of miRNA signature for PAH using a consensus machine learning approach.
Summary by Tilmann Kramer, University of Cologne
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