Deans Lecture: The impact of cardiovascular sciences on clinical cardiology Event as iCalendar

07 March 2013

1 - 2pm

Venue: Lecture Theatre 505-007, Ground Floor, Building 505, 85 Park Road, Grafton

Clinical cardiology is riding on waves of discoveries in cardiovascular sciences. These waves rolled in as discoveries of contraction, circulation and bio-electricity, followed by the development of the technology to probe dynamics of the heart and the circulation. The string galvanometer initiated the clinical use of the ECG and preceded detailed organ-imaging studies using ultrasound and MRI s as well steadily improving microscopy of tissue and cell structure and function. Studies of cardiac bio-electricity have shown that the currents the cardiac action potential are generated by a dozen populations of voltage driven membrane proteins which open and close and recover from their actions in a cascade of stochastic steps. Intracellular calcium release, triggered by electrical activation, induces remarkably synchronous contraction of billions of sarcomeres in the cardiac chambers. Their hemodynamic energy output is powered by a rich coronary blood flow and modulated by control systems which tune receptor proteins of the cellular second messengers.

A multitude of these approaches have laid the groundwork for our concepts of the function and malfunction of the heart and circulation and form the direct basis for proven modern medical therapy, which seeks to optimize energy output of the heart and maximize the coronary flow by mechanical or pharmaceutical means.

The recent explosion of the number known proteins and of their function as well as the burgeoning detail of known cellular structure and function has created the need for a new level of ‘comprehension’. This need is reinforced by gene studies that reveal an incredible number of mutations of key proteins, each of which affects specific steps in the cascades of protein function. Modeling of detailed cellular functions in structures embedded in a realistic environment by the use of large computer programs on superb computers is the approach of choice and stimulates the cardiovascular scientist to work in networks of like minded colleagues. This approach will help the clinician to refine treatment, from treatment of the trial –averaged patient, to his patients with their individual medical characteristics.