Simple Education Essential Guide: Coronary Physiology Background, Clinical Trials and Future Developments

Overview

Simple Education essential guides Advances in Coronary Physiology is the premiere international course in coronary physiology. This is the 4th year this 5* rated course has been run which has quickly become established as the premier global interventional course in state-of-the-art coronary physiology. The course provides all you need to know to understand coronary physiology from learning the background basics of coronary physiology, to understanding the clinical trial data and implementation of coronary physiology in the catheter laboratory. 

New for 2016 is the addition of an online teaching resource, the Simple Education application which will give access to video content from the days' talks, and a raft of other online educational and learning resources which continue your learning experience and  connect you with the interventional community after the course finishes.

Featuring

Dr. Allen Jeremias Stony Brook University Medical Center, New York

Prof. Javier Escaned Clinico San Carlos, Madrid

Dr. Justin Davies Imperial College, London

Prof. Carlo Di Mario Royal Brompton, London

Agenda: Monday 6th June 2016 Morning 09.00 – 09.10 Welcome and introductions Justin Davies, Course Co-Director 09.10 – 09.20 What’s the role for intra-coronary physiology in 2016? John Davies 09.25 – 09.35 How new techniques are reshaping my clinical practice. Carlo Di Mario 09.40 – 10.20 Live case transmission I Operator: Javier Escaned Clinico San Carlos, Madrid, Spain 10.25 – 10.40 Terminology – iFR, FFR, CFR, HSR what do all the abbreviations mean? Sayan Sen 10.40 – 11.05 Coffee break 11.05 – 11.20 iFR: principals and case examples Sukhjinder Nijjer 11.25 – 11.40 Detecting ischaemia using iFR and FFR in clinical practice Justin Davies 11.45 – 12.00 How to measure FFR and iFR Ricardo Petraco 12.00 – 13.00 Lunch Afternoon 13.00 – 13.15 Tips, tricks, and pitfalls of FFR and iFR assessment - VIDEO CASES Rasha Al-Lamee 13.20 – 13.35 How does right arterial pressure impact physiological assessment? Christopher Cook 13.40 – 14.00 What about ACS, STEMI, bypass grafts and heart failure? Sayan Sen 14.05 – 14.20 How should we interpret borderline physiological lesions? Ricardo Petraco 14.25 – 14.40 Coffee break 14.40 – 14.55 Implementation of physiology into my catheter laboratory Flavio Ribichini 15.00 – 15.15 Management of tandem lesions and diffuse disease Sukhjinder Nijjer 15.20 – 15.35 Case Examples 15.40 – 15.55 Can we use contrast as a substitute for Adenosine? Christopher Cook 16.00 – 16.20 Will the AUC guidelines shape revascularization decision-making worldwide? Allen Jeremias 16.30 Close of the Day 1   19.00 Course Dinner Tuesday 7th June 2016 Morning 09.00 – 09.10 Welcome and introductions Justin Davies, & Javier Escaned, Course Co-Directors 09.10 – 09.25 iFR Outcome data: DEFINE FLAIR and iFR Swedeheart trials Justin Davies 09.30 – 10.10 Live case transmission II Operator: Iqbal Malik and Sayan Sen Hammersmith Hospital, London, UK 10.15 – 10.35 What’s the evidence for coronary flow and outcomes? Fausto Rigo 10.40 – 11.00 Coffee break 11.05 – 11.20 A blue print for coronary physiology in the 21st century Justin Davies 11.25 – 11.40 What did DEFER and FAME tell us? And what have we still got to learn? Javier Escaned 11.45 – 12.00 Can PdPa be used as a substitute for iFR/FFR? Christopher Cook 12.00 – 13.00 Lunch Afternoon 13.10 – 13.25 Big questions in cardiology? PCI or CABG? FAME III & SYNTAX II Iqbal Malik 13.30 – 13.45 Should we need stenting at all? ORBITA study Rasha Al-Lamee 13.50 – 14.05 Using CFD to understand effects of stenting on coronary blood flow Nicolas Foin 14.05 – 14.20 What’s the role for CT-FFR in the catheter laboratory in 2016? Christopher Cook  14.25 – 14.45 Challenging cases 15.20 – 15.35 Summary and Q&A Session Justin Davies & Javier Escaned 15.45 Close of the meeting

Dr Justin Davies is a clinical academic and consultant interventional cardiologist at the National Heart and Lung Institute, Imperial College London. After training at Imperial College, he won a prestigious BHF research fellowship to study in arterial haemodynamics. Since then he has continued to work on the development of mathematical algorithms to aid understanding of large artery physiology and to develop new tools to assess arterial disease. The holder of several patents, he has published widely in the field of hypertension, coronary and large artery physiology and is the winner of many national and international awards. He has several international collaborations, and is the developer of iFR and the co-principal investigator of the ADVISE studies, the DEFINE-FLAIR, and ORBITA studies. Justin has an interest in renal denervation, and has lead the first-in-man studies to evaluate the safety of this technique to patients with chronic systolic heart failure (REACH studies).

Prof Javier Escaned is Consultant Interventional Cardiologist / Associate Professor and Head of Section, Cardiology Department, Hospital Clinico San Carlos (Madrid, Spain). He trained as a cardiologist the United Kingdom (Queen Elizabeth University Hospital, Birmingham and Walsgrave Hospital, Coventry) before moving to the Thoraxcenter / Rotterdam (The Netherlands), where he obtained his PhD degree in 1994. Author of more than 200 scientific articles, books and book chapters on different aspects of interventional cardiology, imaging and physiology, his latest contribution is the textbook “Coronary Stenosis. Imaging, Structure and Physiology”, co-edited with Patrick W Serruys. He is currently co-director or EuroPCR. Some of his additional interests are philosophy, education and music.

Dr Sayan Sen is a Cardiologist and NIHR Clinical Lecturer at Imperial College London. His research interests are dedicated to improving patient care. As such, they include the development and validation of new diagnostic tools, determining how the design of comparative efficacy studies can affect clinical use of competing therapies and the development and application of tools that permit a more patient centered approach to therapy. He studied Medicine at University College London (UCL), achieving a First Class (Honours) Bachelor of Science degree in Medical Sciences & Neuroscience in 2000 and graduated with distinction (Surgery) in his final MBBS Examinations in 2003. He trained as a junior doctor on the Hammersmith and UCL medical rotations prior to being appointed as a Cardiology Specialist Registrar in the North West London region in April 2006 and a NIHR clinical Lecturer in 2013. One of the themes of his research is to determine the need for potent vasodilators when assessing coronary stenosis severity. Working with Dr Justin Davies, Dr Sen’s PhD introduced and developed a new technique of stenosis evaluation (the instantaneous wave-free ratio, iFR). He is the first author of ADVISE and CLARIFY - two investigator lead studies that demonstrate the potential of iFR and challenge current concepts of coronary physiology. Currently, in addition to being the Principal Investigator of several first in man physiological studies, he is also the Medical Director of the FLAIR trial – a global multi-centre randomized study comparing iFR to existing techniques.

Dr Rasha Al-Lamee is an Interventional Cardiologist at Imperial College Healthcare NHS Trust. Her sub-speciality interests are complex coronary intervention, coronary physiology and invasive intra-vascular assessment. She has 8 years of Cardiology experience, including an Interventional Fellowship with Professor Antonio Colombo in Milan. She completed her speciality training at Hammersmith Hospital, London, and is currently working as both an Interventional Cardiologist and Clinical Researcher at Imperial College. She is currently leading the ORBITA trial as part of a PhD programme under Dr Justin Davies and Professor Darrel Francis.

Dr Christopher Cook is a MRC Clinical Research Fellow at the National Heart and Lung Institute, Imperial College London. His research interests include coronary haemodynamic parameters to quantify the role of the collateral circulation in multi-vessel coronary artery disease. He was the winner of the inaugural PCR’s Got Talent award at EuroPCR2015 for the best oral abstract.

He studied Medicine at UCL, graduating with Distinction and a total of 17 prizes including the prestigious Proxime Accessit Gold Medal Medicine 2009. He also achieved a First Class (Honours) Bachelor of Science degree in Physiology undertaking a period of research at The Hatter Cardiovascular Institute.

Dr John Davies qualified from Guy’s Hospital Medical School in 1997 and trained in Cardiology at St Bartholomew’s and The London Chest from 2000 to 2008. He spent 3 years at Jesus College, Cambridge from 2002 to 2005 carrying out research into identification and quantification of inflammation in atherosclerotic plaques. He was awarded a PhD in 2007. He completed his training in coronary intervention at The Essex Cardiothoracic Centre and was appointed as a consultant in 2009. He has been appointed as the cardiology research lead for The Essex Cardiothoracic Centre concentrating on three main areas, coronary physiology (including the DEFINE-FLAIR, ORBITA and IMPACT-CTO studies), chronic total coronary occlusion, and cardiac arrest.

Professor Carlo Do Mario is currently Professor of Clinical Cardiology, NHLI, Imperial College of Sciences, Medicine & Technology, London. He is theme leader of the area Complex Coronary Artery Disease of the Cardiovascular Biomedical Research Unit of the Royal Brompton & Harefield Foundation Trust. He was appointed in 2010 Senior Investigator of the National Institute of Health Research. He maintains an active clinical involvement having performed more than 200 PCI per year in the last 10 years in London with special interest in treatment of chronic total occlusions, bifurcations, calcified lesions and diffuse disease. He is a regular TAVI operator and certified implanter for the Medtronic CoreValve and Edwards Sapien transcatheter aortic valves. In 2014 he successfully led a bid for the commissioning of MitraClip in his hospital (40/year for 3 years, worth 3.6 million £ only for the devices). He holds an NHS Bronze National Award. Professor Di Mario pioneered the use of intracoronary Doppler, pressure measurement, ultrasound and optical coherence tomography. These techniques have become the gold standard for physiological assessment of lesion severity and have revolutionised the technique of stent implantation with the use of high pressure dilatation which led to the universal application of this method in interventional cardiology. Professor Di Mario is now applying these intravascular techniques for guidance of implantation of fully bioabsorbable stents and optimal stent apposition across bifurcations and in complex lesions. He has led or participated in studies and trials to improve technical success of recanalisation of chronic total occlusion and demonstrate its clinical usefulness. He cooperated with Dr J. Davies to the development of the concept of iFR to facilitate assessment of lesion severity and discriminate the contribution of individual lesions, and with Dr A Lyon to the intracoronary delivery of SERCA-2 genes via adenoviral vectors in the CUPID2 trial. Prof di Mario was Principal Investigator of the CARESS in AMI trial, a large multicentre trial showing that patients who receive fibrinolytic therapy for ST-elevation myocardial infarction benefit from early angioplasty. This trial and a subsequent meta-analysis have led to a change in the European Society of Cardiology and AHA/ACC Guidelines of treatment of STEMI patients.

Dr Nicolas Foin is Scientific Lead for Medtech research at the National Heart Centre Singapore and Adjunct Associate Professor at Duke-National University of Singapore Graduate Medical School. His research expertise focuses on treatment of coronary heart diseases using minimally invasive approach, as well as arterial diseases models and intravascular imaging.  Regular speaker in international cardiac interventional congresses, he has to date published over 60 publications and book chapters in the field of cardiovascular interventions and intravascular OCT imaging. He has also collaborated with several large medical device companies and start-ups on new product developments and he authored 5 patents.

Dr Allen Jeremias, M.D., M.Sc. is the Director of the Cardiac Catheterization Laboratory and an Associate Professor of Medicine at Stony Brook University Medical Center. He also is the Director of the Physiology Core Laboratory at the Cardiovascular Research Foundation, New York, NY.
Dr Jeremias received his medical degree from Heinrich-Heine University School of Medicine in Düsseldorf, Germany. He completed his residency at the Cleveland Clinical Foundation in Cleveland, Ohio, and cardiology, interventional cardiology, and peripheral vascular fellowships at Beth Israel Deaconess Medical Center and Harvard Medical School in Boston.
Dr Jeremias is board certified in cardiovascular medicine, interventional cardiology, and vascular medicine. He is a member of several professional societies and a Fellow of the American College of Cardiology and the Society for Cardiovascular Angiography and Interventions.
Dr. Jeremias has numerous publications in the area of interventional cardiology and is the editor of 'Cardiac Intensive Care', the only major textbook on that topic. He is the author of "Your Personal Guide to Angioplasty", a patient centered book focusing on coronary artery disease and various treatment options. He also is the recipient of numerous awards, including Castle Connolly's Top Doctors: New York Metro Area, 2009 - 2015.

Dr Iqbal Malik is an Honorary Senior lecturer at Imperial College London, and Consultant Interventional Cardiologist at Hammersmith and St Mary’s Hospitals. His research interests are in complex coronary disease and structural heart disease. He qualified from Cambridge University with a 1st Class degree, and then moved to Guys Hospital, London, winning the Golding Bird Medal as an undergraduate. He trained in Medicine and then Cardiology, before completing a PhD at Imperial College London, looking at the role of Inflammation in Coronary Artery Disease. He was awarded a BHF junior research fellowship for 3 years. He was appointed as a Consultant in 2003, having completed sabbaticals in Italy and Germany to hone his skills in Structural Heart Disease. He is clinical lead for the care of acute coronary syndromes and Structural Heart Disease at Imperial College Healthcare NHS trust, including the Transcatheter Valve (TAVI) and Septal Defect Closure programs. He has been involved with Simplephysiology since the inception of the concept of iFR as a way to simplify the use of coronary physiological assessment. His meticulous verification of data with the more complex technique of coronary flow measurement, has allowed validation of the science behind iFR. Starting from normal arteries, simple and complex native coronary lesions, and bypass grafts, the group has now studied the effects of hemodynamic support device such as balloon pumps and Impella devices on coronary physiology. Next is the unique opportunity to assess the effect of immediate removal of aortic stenosis using TAVI!

Dr Sukhjinder Nijjer is an Interventional Cardiology Registrar at the Hammersmith Hospital. He completed his PhD in invasive coronary physiology with the support of the highly prestigious Medical Research Council Clinical Research Fellowship at Imperial College. He is the author of many peer-reviewed publications and text books and has presented at major international conferences, including prizes at TCT-AP 2015, BCS 2015 and he has been runner-up for Young Investigator of the Year competitions held by the Academy of Medical Sciences, Royal Society of Medicine and the British Cardiovascular Intervention Society.

Sukhjinder’s work has focused on the impact of coronary intervention on invasive physiology, specifically how the changes can be predicted using iFR-Pullback and virtual-PCI. His work has demonstrated these technologies have the capacity to transform physiologically-guided intervention from vessel-level decision-making to a lesion-specific approach.

Dr Ricardo Petraco  is a Cardiology Specialist Registrar and a Research Fellow at the International Centre for Circulatory Health and National Heart and Lung Institute at Imperial College London. Dr Petraco graduated from The Federal Faculty of Medical Sciences (FFFCMPA) and undertook his junior General Medical Training at the Santa Casa University Hospital in Porto Alegre, Brazil. He came to the UK in 2006 to start his higher specialist training in Cardiology. Throughout his career, Dr Petraco has been a high achiever on clinical and academic grounds. As an undergraduate, he was awarded two Scientific Initiation Scholarships by the National Research and Technology Council (CNPq, Brazil). In the UK, he worked as a junior Research Fellow at the Royal Brompton Hospital, in the Adult Congenital Heart Unit under Professor Gatzoulis. He helped to identify markers of poor prognosis in adult patients with congenital heart disease. After passing his membership examination (MRCP UK), he started clinical work as a Specialist Registrar in Cardiology at the Royal Brompton and St Mary’s Hospitals. He has completed his PhD in the pathophysiology of coronary artery disease, coronary haemodynamics and myocardial ischaemia.

Prof Flavio Ribichini is an Associate Professor of Cardiovascular Medicine at the University of Verona, and obtained the degree of “Full Professor of Cardiovascular Medicine” according to the resolution of the National Ministry of Education in December 2013. He teaches at the School of Medicine of the Univeristy of Verona at different courses, medical students, nurses, physiotherapists, residents of the School of Cardiology and PhD students.Director of the PhD School of Life and Health Sciences of the University of Verona. Member of the Task Force for Guidelines in Myocardial revascularization of the European Society of Cardiology. Member of the Task Force for Acute Ischemic Stroke of the European Society of Cardiology. Member of the Editorial Board of the European Heart Journal since 2010. Member of the European Rotablator Club, the European Bifurcation Club and the European Expert group on Impella circulatory assistance. Coordinator, Principal Investigator or member of the steering committees of several clinical trials. Author of over 180 full publications on clinical and basic cardiovascular research in peer reviewed scientific journals available on PubMed.

Dr Fausto Rigo graduated in Medicine in 1982 (110/110 cum laude) and specialized in Cardiovascular Diseases and in Sports Medicine at the University of Padua. From 1985 to 2011 Dr Rigo was consultant Cardiologist at the Division of Cardiology of Umberto I Hospital of Metre-Venice and since 2011 he is Head of Division of Cardiology of dell’Angelo Hospital in Mestre-Venice, Italy. 

Dr Rigo is the author of over 250 scientific publications, many of which are published in international scientific journals with a high impact factor. He is a peer reviewer for many Journals (JACC,EHJ,etc) and the author of numerous chapters of books on Imaging in Cardiology (15). Since 2010 he has been Fellow of European Society of Cardiology, Member and Councillor and Secretary of National Society of Echocardiography, (2010-2014), Chairperson of Cardioimaging Area of ANMCO ( 2014-2016), Councillor of EACVI ( 2011-2015). Dr Rigo’s field of interest includes: Coronary artery disease, Cardiomyopathy, Heart failure Expert in Echocardiography/Stress Echocardiography, Magnetic Resonance and CT-Scan. and pioneer in the implementation of coronary flow and reserve assessment with ultrasound.