November 6th, 2012

Breadth vs. Depth at AHA

Several Cardiology Fellows who are attending AHA.12 in LA this week are blogging together for CardioExchange. The Fellows include Tariq AhmadReva Balakrishnan, Megan Coylewright, Eiman Jahangir, Amit Shah, and John Ryan (moderator). Read the previous post here. Find the next one here. For related CardioExchange content, go to our AHA 2012 Headquarters page.

This year’s AHA seems to have everything for every kind of cardiologist. My colleagues, ranging from purely clinical interventionists to basic scientists, seem giddy all day with excitement. What I notice, however, is that most have kept to their area of interest.

At last year’s AHA, I was still at an early stage of differentiation into a heart failure fellow, and attended a wide variety of talks, ranging from the benefits of GWAS, to choosing patients for TAVI. I learnt quite a bit, but it seemed that I had sacrificed gaining meaningful insights into a few questions for knowing a little about many.

This year I decided to go for depth rather than breadth.

So far, this seems to have been a good decision. I have spent many hours looking at the posters focused on the use of biomarkers in heart failure and the management of advanced heart failure. The posters don’t seem to get as much attention as the oral sessions, but I found them to be incredibly interesting, especially in terms of giving me new ideas for research.

An especially interesting session I attended last night was on acute decompensated heart failure. It was titled “Why Have We Failed?” It included discussions by some of the most prominent cardiologists of our day, including Drs. Milton Packer, Adrian Hernandez, and Lynne Stevenson. Dr. Eugene Braunwald chaired the session. Each discussant gave their perspective on why the majority of our trials in ADHF have failed. They approached it from the perspective of not choosing the right patient, using the wrong endpoints, giving patients the wrong medications, and having wrong strategies and execution. The room was packed, and the attendees appeared spellbound by the discussion.

In many ways, this session epitomized, for me, the best of AHA. I left it with questions on my mind and many ideas for research: it “recharged” my inner investigator.

Today is especially exciting for those interested in heart failure. The results of RELAX-AHF (Relaxin in Acute Heart Failure) and CARRESS-HF (UF vs. usual care in Acute Heart Failure) are being presented. Initial reports released by Novartis suggest that Relaxin may have a benefit, and I’m quite excited to hear about the actual findings, as it may represent a novel treatment for acute heart failure.

Have others employed a specific strategy for getting the most out of these meetings? I’m especially curious to get input from those who do not have a specific subspecialty interest. How do you approach a meeting of this size?

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