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Editorial| Volume 27, ISSUE 11, P1304-1305, November 2021

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Three Takeaways from the HFSA Annual Scientific Meeting

      The HFSA Annual Scientific Meeting (ASM) in Denver, Colorado, was a clear success, despite the complexities created by the COVID-19 pandemic. For those wondering what transpired behind the scenes, the event was possible only due to the heroic efforts of many people, including the ASM Planning Committee chaired by Dr. Larry Allen and the dedicated and talented staff of the HFSA, most notably Jaime Abreu, Vice President, Meetings and Education. The safety of attendees was at the top of the minds of the HFSA leadership and was discussed numerous times at Board meetings and by the Committee when another wave of the pandemic surged in the summer. Ultimately, we implemented several important safety measures such as requiring proof of vaccination for all attendees, a policy of mask wearing during all indoor activities, and deliberate, widespread spacing of seating in the conference rooms to maintain social distancing. More than 1100 attendees participated onsite, with a total attendance of 2302. The feedback I received, and similarly experienced, was that people felt safe at the meeting and were very glad they attended.
      The following are three takeaways from my ASM experience.

      The necessity of in-person, human connection

      A repeated refrain in my conversations with colleagues was how valuable it was to finally see each other in person. While Zoom and Microsoft Teams calls were essential during the height of the pandemic, they were no substitute for seeing our friends and colleagues in person. The energy created by such interactions was palpable. In addition to the banter and laughter heard in hallway conversations, two other moments stood out to me. During the plenary session, Dr. Clyde Yancy delivered an impassioned lecture describing how the COVID-19 pandemic disproportionately affects communities of color and was a bellwether event that exposed the depth of ongoing disparities related to social determinants of health. Further, he posited that the current situation could be tracked back to redlining practices prevalent in the 1930s that contributed to segregation of residential communities. The emotional connection between the speaker and audience was spellbinding, more intense than that achievable over a video connection, and created a memorable moment that touched people. The second example was from Dr. Milton Packer, who told the audience during a Late Breaking Clinical Trials session that one of his goals was to hug as many people as he could at ASM, and then proceeded to do so with the session chair, Dr. Marvin Konstam. In-person, human connection is needed, and the ASM provided such an outlet for the heart failure community to share that amongst colleagues.

      Therapies are emerging to target fundamental defects underlying the cardiomyopathic process

      Guideline-directed medical therapy targeting downstream pathophysiological abnormalities shared among different types of heart failure, e.g., activation of neurohormonal pathways, confers remarkable benefit to large numbers of patients and can lead to remission.
      • Bozkurt B
      • Coats AJ
      • Tsutsui H
      • Abdelhamid M
      • Adamopoulos S
      • Albert N
      • Anker SD
      • Atherton J
      • Bohm M
      • Butler J
      • Drazner MH
      • Felker GM
      • Filippatos G
      • Fonarow GC
      • Fiuzat M
      • Gomez-Mesa JE
      • Heidenreich P
      • Imamura T
      • Januzzi J
      • Jankowska EA
      • Khazanie P
      • Kinugawa K
      • Lam CSP
      • Matsue Y
      • Metra M
      • Ohtani T
      • Francesco Piepoli M
      • Ponikowski P
      • Rosano GMC
      • Sakata Y
      • Seferovi CP
      • Starling RC
      • Teerlink JR
      • Vardeny O
      • Yamamoto K
      • Yancy C
      • Zhang J
      • Zieroth S
      Universal Definition and Classification of Heart Failure: A Report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure.
      Nevertheless, as the genetic underpinnings of cardiomyopathy become elucidated, it seems likely that a more elegant approach that targets the underlying genetic alteration will be feasible and lead to a cure.
      At the ASM, Dr. Barry Greenberg presented the first, in-human clinical trial describing gene therapy delivered by an adeno-associated viral vector for patients with Danon disease.
      • Greenberg B.
      Results From First-In-Human Clinical Trial of RA-A501 (AAV9:LAMP2B) Gene Therapy Treatment for Danon Disease.
      This disease is an X-linked condition leading to a profound hypertrophic cardiomyopathy and premature death in the third decade of life in affected males, resulting from impaired autophagy due to a mutation in LAMP-2. While the presented trial enrolled only three subjects and was a phase 1 experience to assess the safety of this therapy, the investigators were able to document expression of LAMP-2B in the myocardium after gene therapy in each subject, while none was present at baseline. The potential impact of a strategy designed to correct the fundamental defect of a cardiomyopathy, both for this condition and many other monogenic cardiomyopathies, seems immense.

      An opportunity to network with all, regardless of career stage

      The ASM attracts attendees at all stages of career. At the speed mentoring event, where trainees rotate among senior HFSA leaders for seven-minute discussions, I spoke with mentees as they approached major branch points in the career, needing to decide which training path to follow. I also watched with pride as internal medicine residents and cardiology fellows with whom I have worked stepped to the podium and presented their abstracts, some for the first time at a national scientific meeting. I learned from mid-career HFSA faculty as they delivered outstanding lectures on cutting-edge topics. Finally, I had the privilege of seeing Drs. Lynne Stevenson and Inder Anand receive the HFSA Lifetime Achievement Award, both of whom were visibly touched by this capstone recognition of seminal contributions over their impactful, longstanding careers.
      One of the special aspects of ASM is that due to its smaller size, as compared to the meetings of the larger cardiology societies, attendees can easily network with others, regardless of their career stage. I personally remember the excitement when I attended the ASM earlier as a junior attending, yes, at Boca Raton, and getting to meet and talk with HFSA faculty whose names I knew well from their publications in prominent medical journals.
      Planning is already underway for next year's Annual Scientific Meeting to be held in Washington D.C. I hope those of you who were not able to join us this year will do so next year. For those who did engage this year, either in-person or virtually, I would be delighted to hear about your experience and look forward to seeing you back. While the HFSA affords numerous opportunities to its members throughout the year, the ASM remains a focal point: a time when our community comes together to interact with and learn from each other, as well as to enjoy each other's company, all towards the common goal of reducing the burden of heart failure.

      References

        • Bozkurt B
        • Coats AJ
        • Tsutsui H
        • Abdelhamid M
        • Adamopoulos S
        • Albert N
        • Anker SD
        • Atherton J
        • Bohm M
        • Butler J
        • Drazner MH
        • Felker GM
        • Filippatos G
        • Fonarow GC
        • Fiuzat M
        • Gomez-Mesa JE
        • Heidenreich P
        • Imamura T
        • Januzzi J
        • Jankowska EA
        • Khazanie P
        • Kinugawa K
        • Lam CSP
        • Matsue Y
        • Metra M
        • Ohtani T
        • Francesco Piepoli M
        • Ponikowski P
        • Rosano GMC
        • Sakata Y
        • Seferovi CP
        • Starling RC
        • Teerlink JR
        • Vardeny O
        • Yamamoto K
        • Yancy C
        • Zhang J
        • Zieroth S
        Universal Definition and Classification of Heart Failure: A Report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure.
        J Card Fail. 2021 Mar 1; (S1071-9164(21)00050-6)https://doi.org/10.1016/j.cardfail.2021.01.022
        • Greenberg B.
        Results From First-In-Human Clinical Trial of RA-A501 (AAV9:LAMP2B) Gene Therapy Treatment for Danon Disease.
        in: Late Breaking Clinical Trials II at HFSA 2021 Annual Scientific Meeting. 2021