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[ACC2013]大会特色及心血管领域新进展——ACC 2013大会主席William A. Zoghbi博士专访
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作者:W.A.Zoghbi 编辑:国际循环网 时间:2013/3/10 11:26:32    加入收藏

 标签:  关键字:PCI MRI 心房纤颤 二尖瓣反流 

  William A. Zoghbi博士  ACC 2013大会主席

  <International Circulation>:As chair of the ACC13, could you please comment on some of your hopes from this years conference? What are you most excited about?

  《国际循环》:作为ACC 13的主席,您对今年会议有哪些希望?会议的哪些内容最令您激动?

  Dr. Zoghbi: We are very excited to be in SF. The ACC has not been held there for over 40 years and it will be exciting. For one, it is closer to our friends in Asian and the Pacific Rim. It will also be a wonderful venue. We will have more than 2000 abstracts to share on new discovery and research as well as 22 late-breaking trials. One of them, PREVAIL, will be looking at outcomes for patients with AF who undergo an occluder device. There will also be trials from prevention to trials on intervention. Also, there will be very prominent people who will be giving their view on the art in various areas. The Simon Dack Lecture will be given by Dr. Valentin Fuster, who will talk from atherosclerosis to health. Dr. Helen Hobbs will talk about the latest research in genetics and applications in CV disease. Alain Cribier, a pioneer in interventional cardiology and valve replacement with catheters, will be addressing the audience as the featured international lecturer. We will be very excited about having more than 22,000 people converging in SF to enjoy the Scientific Sessions as well as this wonderful city.

  Zoghbi博士:ACC已经有40年没有在旧金山举办,我们对在这里举行会议非常激动。原因之一是旧金山离我们在亚太地区的朋友们更近。这是一个非常好的会议举办地点。我们会有超过2000个论文摘要来分享新的研究和发现以及22个最新临床试验。其中,PREVAIL研究是关于接受封堵器治疗的房颤患者的结局。还会有关于预防和干预的试验。会有许多知名专家会介绍他们在不同领域的观点。Valentin Fuster博士将会做有关动脉粥样硬化与健康的Simon Dack报告。Helen Hobbs博士会介绍遗传学及其在心血管疾病方面应用的最新研究。介入心脏病学和经导管瓣膜置换术的开拓者Alain Cribier会作为特邀国际专家做报告。会有超过22000名与会者来到旧金山享受本次学术会议和这个美丽的城市,我们对此非常激动。

  <International Circulation>:What separates this year’s conference from those of previous years? What structures or events have you introduced?

  《国际循环》:和往届会议相比,今年的会议有哪些特色?您会引入哪些项目?

  Dr. Zoghbi: There is a lot of collaboration with other societies. Some of them, like the multi-modality full-day imaging course. This session is collaboration with all the subspeciality societies on imaging, be it echocardiography or nuclear MRI and CT, and will give a global and integrated view on useing imaging in CV disease. Secondly, there will be a continuous course by Dr. Fuster regarding all areas of CV disease and will be addressed to those attendees early in their careers. There will also be CME certification. Believe it or not, this is as popular with our US colleagues as well as with individuals from international destinations. The ACC13 is a great immersion of all areas of CV disease. I am looking forward to three days of excitement.

  Zoghbi博士:首先,今年的会议会和其他学会有大量合作。一些议程,如多模式立体成像,是与和其相关的所有影像学会合作进行,包括超声心动图、MRI以及CT,这会为在心血管疾病中影像技术的应用提供一个全面和完整的观点。其次,Fuster博士将举办一个连续课程,内容包括心血管疾病的所有领域,主要面向低年资医生。此外还会有关于医学继续教育的证书。这个证书在我们的美国同行和国外同行之间都同样受欢迎。ACC 13是所有心血管疾病的一次大融合。我非常期待这令人激动的3天。

  《国际循环》:您刚才提到了影像学。那么作为影像学和超声心动图方面的领军人物,您能介绍一些本次会议上将公布的进展吗?

  <International Circulation>:You mentioned imaging and as a leader in imaging and echocardiography, could you please talk about some of the developments to be introduced at this meeting?

  《国际循环》:您刚才提到了影像学。那么作为影像学和超声心动图方面的领军人物,您能介绍一些本次会议上将公布的进展吗?

  Dr. Zoghbi: We have had so much progress in imaging to diagnosis disease and not only to diagnosis and management, but also in early detection. Looking at echocardiography specifically, there have been new applications and refinement in 3D, as well as strain and strain rate imaging. These refinements have given us a better visualization of structure in 3D. Gradually gaining more and more automation of ventricular or atrial function would hopefully be possible with strain and strain rate imaging. You are going to see more and more refinement of this and hopefully variability among industries, because that has been an issue we have been dealing with as of late. The new areas in CT were gradually we have come down significantly on radiation dose and more applications that will be more patient friendly. MRI, I think is coming on very strong as the only methodology that can image scare as opposed to inferior scare in someone who had an MI. We are going to see quite a few application of MRI. Having said all this, ultimately, what we need, more and more in research, is to try and help the physician navigate the system, because you have too many choices and we want to make sure that we are cost conscience in target the highest yield to answer the question or how to management patients. I think that is going to be the challenge in going forward.

  Zoghbi博士:我们在影像学检查方面取得了很大的进展,不仅在诊断疾病和治疗疾病方面,而且在早期检测方面也取得了很大进展。尤其是超声心动图,目前有了新的软件以及3D技术的改进,以及应变率成像技术。这些技术进步使我们能够获得视觉效果更好的3D结构图像。对于心室和心房功能的自动化检测的不断进步也有希望在应变率成像中应用。你将会看到不同厂家之间对这项技术的不断改进,因为这是我们一直在处理的问题。CT方面的新进展是辐射剂量的显著降低以及方便患者使用的更多应用。我认为MRI的发展速度很快,MRI是唯一一种能对发生过心肌梗死的患者进行瘢痕显像的方法。我们会看到很多关于MRI的应用。最终,我们所需要的,也是目前研究越来越多的,是帮助医生来操作这个系统,因为现在有太多的选择,而我们希望能够使医疗开销取得最高利用率,以明确诊断或如何治疗患者。我认为这将是未来的挑战。

  <International Circulation>:You will discussing mitral valve disease and specifically mitral regurgitation (MR). Do you have any comments on your research or understanding of mitral regurgitation imaging characteristics and calculation modules?

  《国际循环》:您会就二尖瓣疾病尤其是二尖瓣反流(mitral regurgitation, MR)进行讨论。您对您的研究或者对二尖瓣反流的影像学特征和计算模块有何评论?

  Dr. Zoghbi: Whenever we address mitral valve disease we have to realize it is complex, but also capable of being repaired. We have to address two things. One, what is the mechanism of MR, and with that imaging has been really phenomenal. Is it functional? Is it organic? Is there a problem with the leaflet? Where is the problem in the ventricle? Echo has been the basis but can be refined further with MRI. Number one is the mechanism of regurgitation. Number two is assessing the severity. We still have some issues here. We will be addressing classification of severity and part of the reason is the difficulty in quantification. It is highly variability, even with more robust technology such as MRI. It is very technology driven. Although it is a “gold standard” we want to make sure that individuals know that there are some difficulties and technical issues that we want to make sure we address and that patients are informed. Ultimately, we look at adaptation of the heart and hopefully we can intervene earlier on those values that can be repaired. This may be truer for the organic ones, rather than functional ones, but we do hope that further refinement of repair techniques, we will be able to repair the functional regurgitation.

  Zoghbi博士:无论什么时候,我们说到二尖瓣疾病的时候,要认识到它很复杂,但同时应当认识到它是可以修复的。我们需要强调两件事。第一,MR的机制是什么,对此影像学检查提供了现象。疾病是功能性的还是器质性的?是瓣叶的问题吗?心室的问题在哪里?超声检查确实是诊断的基础,但是MRI可以进一步改进对疾病的评估。首先是反流的机制,其次是严重程度评估。我们还有其他一些问题。我们会讨论严重程度的分类,部分的原因是定量评估存在困难。即使是更先进的检查如MRI,检查结果仍然存在很大变异性。疾病的诊断和分类很大程度上是由技术所驱动。尽管存在困难和技术问题,我们希望能够建立一个“金标准”来为医生和患者提供信息。最终,我们着眼于心脏的适应性,并且希望能够对于能够修补的瓣膜进行早期干预。和功能性病变相比,器质性病变更应当这样处理。但是我们希望随着修复技术的改善,将来能够修复功能性反流。



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