Waheed Jamal, MD
Published Jul 28, 2021+ Follow
I recently had the pleasure of speaking with Professor Pinto, President of the World Heart Federation as well as Head of Cardiology at the Hospital de Santa Maria in Lisbon, Dean of the Faculty of Medicine of the University of Lisbon, and Past President of the European Society of Cardiology.
As with most conversations of late it is not surprising COVID-19 was the first topic discussed. COVID-19 has affected each of us in different ways and although undisputedly devastating, we agreed that the medical community has come far and that these advances are here to stay. Professor Pinto said rather poignantly, “in difficult times we should try to transform the negative things and find opportunities to deal with some of the issues we have to face.” One such opportunity is presented by the huge technological developments in ‘telemedicine’.
Telemedicine or telehealth refers to the delivery of medical services to patients remotely. In the 21st century, the most common methods are via telephone or more advanced digital platforms with live video.
I agree with Professor Pinto that although these solutions already existed, the pandemicgave us opportunities to rethink some of the models that we are used to. Necessity drove the uptake of digital solutions much more widely and effectively. Continuing to deepen the use of telemedicine will be crucial – we can look to expand its scope to awareness raising and increasing patient access to medical care both during and beyond the pandemic.
We also discussed multidisciplinary care, a topic close to my heart. Professor Pinto commented “the profile of the patient that we see today is different from the one we used to see 10-20 years ago” – the patients are more complex, with more comorbidities and interactions between different organs or systems. Consequently new “subspecialities” are arising to manage the cardio-renal axis, brain-heart axis and metabolic syndrome, all of which put a higher demand on physicians. Despite the recognised connectivity of health conditions, multidisciplinary cooperation is one of the biggest challenges for the medical community today.
Professor Pinto believes that using multidisciplinary teams and the integration of different specialist fields are essential for good clinical practice, and for the improvement of care of highly comorbid conditions. In order to do this effectively, the organisational structure needs to change to allow these communication silos to be broken down, something the World Heart Federation is actively researching.
Regarding the longer-term outlook for cardiovascular medicine, I asked what changes he personally hopes to see for patients. Professor Pinto said that in the last 20 years, “the decline in mortality in all the medical cardiac conditions has been huge, but at the same time the prevalence of disease has been increasing.” He believes that the shift in focus needs to be on improving prevention through addressing disease risk factors.
“80% of CV diseases are preventable, which is amazing…I would love to see in 10 years’ time the reduction in the prevalence of disease.”
The second big shift Professor Pinto foresees in the next 10 years is an increased personalisation of medicine: “When we treat the patient today, we are not 100% sure what’s going to happen…and that’s something we need to improve”. His view is that the better the knowledge about disease mechanisms, the more accurately and effectively we can diagnose, treat, develop new treatments and prevent diseases.
Professor Pinto has fantastic insight and understanding into the whole cardiovascular landscape, working in a global capacity leading the World Heart Federation and in his previous role as President of the European Society of Cardiology, and directly with patients from his hospital in Lisbon. As a physician and scientist in the field of cardiovascular medicine, I was looking forward to this discussion and it has confirmed many of my views on the evolution of cardiovascular care.