In all fields of medicine we are now experiencing an exciting era of advanced technology. Cardiovascular medicine in particular is a rapidly transforming area of medical science that is exhibiting tremendous improvement in all areas from diagnosis to treatment thanks to recent technological developments. These developments were paradigmatically highlighted at the last European Society of Cardiology (ESC) Congress in Munich in the field of non-invasive imaging, with an emphasis on cardiac computed tomography (CT), cardiac magnetic resonance imaging (MRI), 3D echocardiography and nuclear imaging. As President of the European Society for Non-invasive Cardiovascular Dynamics (a society founded in 1960 at the University of Utretch in The Netherlands by Professor HC Burger, the founder of medical physics in his country), I am grateful to European Cardiology for the opportunity to briefly discuss the great advances in the diagnosis and treatment of cardiac diseases that have recently been achieved by these technological improvements in the non-invasive approach to cardiac diseases.
These improvements have several pros and some cons. Among the pros is the fact that cardiovascular imaging is nowadays an established component of the entire diagnostic, prognostic and therapeutic patient work-up. The prevalent non-invasive nature of these techniques has also increased patients’ acceptance of, and confidence with, modern medicine and its greater than ever potential to prevent and cure. The major con is related to the radiation risk associated with cardiac CT and nuclear imaging. Doctors should always consider the increased risk of future cancer associated with cumulative radiation dose, especially when subsequent repeated examinations are thought to be required in relatively young subjects.
Non-invasive and preventative cardiology go hand to hand and their further development and implementation lay the foundations for a better future for human beings. Scientists, physicians and related scientific societies, as well as politicians and national governments, should maintain and possibly increase their own efforts aimed at preparing a future in which disease prevention will be at the centre of national health service plans. Results from clinical trials, including the recent JUPITER study, opened the door to this possible future.
As highlighted in this issue of European Cardiology, technological advances have also had a great impact on invasive and surgical procedures, with more expected in the near future. The articles in this publication deal with the following topics: intravascular ultrasound virtual histology, developments in vascular closure devices, percutaneous heart valve replacement and the continuous improvement in percutaneous coronary interventions and biodegradable stents as a possible new era. Several other high-quality articles are included covering 3D echo, nuclear cardiology and heart failure, maternal and foetal arrhythmias, Wolff-Parkinson-White syndrome in the elderly, use of brain natriuretic peptide in clinical practice, motor development in children with congenital heart disease, circulating endothelial progenitor cells, cardiovascular risk factors, myocardial protection by ranolazine, abortion of acute myocardial infarction by reperfusion therapy, adherence to antihypertensive and lipid-lowering therapy and prognostic relevance of daytime and night-time blood pressure values in hypertension. Future directions in degenerative mitral valve repair are described by Michele De Bonis and Ottavio Alfieri, the inventor of the edge-to-edge intervention for the treatment of mitral regurgitation.
There is a lot to learn for everybody – enjoy your reading.