Dr Mahmoud Abdellatif from the Medical University of Graz (Austria), interviews Prof. Carolyn Lam, a Senior Consultant at theNationalHeart Centre Singapore (Singapore). Highlight: In this Onlife interview, Professor Carolyn Lam shares her expertise and major scientific findings on the subject of heart failure with preserved ejection fraction

Abdellatif, Mahmoud

Lam, Carolyn S. P.

English

Dr Mahmoud Abdellatif from the Medical University of Graz (Austria), interviews Prof. Carolyn Lam, a Senior Consultant at theNationalHeart Centre Singapore (Singapore).Highlight: In this Onlife interview, Professor Carolyn Lam shares her expertise and major scientific findings on the subject of heart failure with preserved ejection fraction.</p

Proceedings - University of Groningen

   University of GroningenScientists on the SpotAbdellatif, Mahmoud; Lam, Carolyn S. P.Published in:Cardiovascular ResearchDOI:10.1093/cvr/cvab230IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite fromit. Please check the document version below.Document VersionPublisher's PDF, also known as Version of recordPublication date:2021Link to publication in University of Groningen/UMCG research databaseCitation for published version (APA):Abdellatif, M., & Lam, C. S. P. (2021). Scientists on the Spot: A fraction of wisdom on heart failure.Cardiovascular Research, 117(9), E114-E115. https://doi.org/10.1093/cvr/cvab230CopyrightOther than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of theauthor(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons).The publication may also be distributed here under the terms of Article 25fa of the Dutch Copyright Act, indicated by the “Taverne” license.More information can be found on the University of Groningen website: https://www.rug.nl/library/open-access/self-archiving-pure/taverne-amendment.Take-down policyIf you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediatelyand investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons thenumber of authors shown on this cover page is limited to 10 maximum.Download date: 11-09-2023...................................................................................................................Scientists on the Spot: A fraction of wisdom onheart failureMahmoud Abdellatif 1 and Carolyn S. P. Lam2,3,4*1Department of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria; 2Department of Cardiology, National Heart Centre Singapore, Singapore, 169609;3Duke-National University of Singapore, Singapore, 169857; and 4University Medical Centre Groningen, Groningen, Netherlands, 9700 RB GroningenKeywords HFpEF • SGLT2 • Sacubitril/valsartan • Heart failure • Sex differencesDr Mahmoud Abdellatif from the Medical University of Graz(Austria), interviews Prof. Carolyn Lam, a Senior Consultantat the National Heart Centre Singapore (Singapore).Highlight: In this Onlife interview, Professor Carolyn Lam shares herexpertise and major scientific findings on the subject of heart failure withpreserved ejection fraction.Summary of interviewTo kick off the interview, Professor Carolyn Lam reflected on what sheproudly considers her most significant scientific contributions to cardio-vascular medicine. In this regard, two achievements stood out. First, shementioned the Asian Heart Failure Study, which was an investigator-initiated observational study including 11 regions in Asia, thereby pro-ducing one of the very first multinational data on Asian patients withheart failure. The study resulted in multiple successful publications, re-vealing the differences not only between Asian and Western patients butalso within different regions in Asia. Second, she highlighted the recentFDA approval of sacubitril/valsartan as the first evidence-based drug forheart failure with preserved ejection fraction (HFpEF) patients who, asthe name implies, have preserved, but subnormal, ejection fraction. Thisapproval was based on the results of PARAGON-HF, a clinical trial, forwhich Prof. Lam was a steering committee member.On the topic of HFpEF, Prof. Lam discussed that it is a syndrome withmultiple causes and, thus, instead of solely relying on ejection fraction tostratify patients, a more holistic approach considering the diverse aetiol-ogies involved in this syndrome is warranted. Prof. Lam also highlightedthe importance of basic science to improve our understanding of themulti-faceted aspects of HFpEF pathogenesis, and how this might help inthe development of novel and effective therapies, at least in HFpEF pa-tient populations with homogenous phenotypes. Above all, she stressedthe importance of HFpEF prevention and how available drugs, such assodium-glucose transport protein 2 (SGLT2) inhibitors with proven car-diovascular efficacy against common risk factors for HFpEF, such as dia-betes and obesity, might be of clinical value in this respect.Next, Prof. Lam weighed in regarding whether sex plays a biologicalrole in HFpEF development. First, she highlighted the possible confound-ing effects of relying on identical ejection fraction cut-offs for both menand women, despite a relatively higher ejection fraction in women dueto the smaller heart and body size. That said, she then emphasized thatthere might still be biological reasoning behind the higher incidence ofHFpEF in women than men, which could be related to sex differences inthe immune response, as well as ectopic fat accumulation.Towards the end, Prof. Lam shared her advice with young cardiovas-cular researchers, where she stressed the need for continuous learningand following one’s own scientific passions. She mentioned that onlythrough following one’s scientific interests can we be kept driven andeventually achieve success. She also touched on the importance of differ-entiating between good advice, which one should follow and that whichmight be distracting from the path to success. As such, young research-ers should strike a fine balance between listening—and following theirscientific interests.Conflict of interest: C.S.L. is supported by a Clinician Scientist Awardfrom the National Medical Research Council of Singapore; has receivedresearch support from AstraZeneca, Bayer, Boston Scientific and RocheDiagnostics; has served as consultant or on the Advisory Board/SteeringCommittee/Executive Committee for Actelion, Amgen, AppliedTherapeutics, AstraZeneca, Bayer, Boehringer Ingelheim, BostonScientific, Cytokinetics, Darma Inc., Us2.ai, Janssen Research &Development LLC, Medscape, Merck, Novartis, Novo Nordisk, RadcliffeGroup Ltd., Roche Diagnostics, Sanofi and WebMD Global LLC; andserves as co-founder & non-executive director of Us2.ai.* Corresponding author. Tel: +65 6704 8000, E-mail: carolyn.lam@duke-nus.edu.sgPublished on behalf of the European Society of Cardiology. All rights reserved. VC The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.Cardiovascular Research (2021) 117, e114–e115doi:10.1093/cvr/cvab230 SCIENTISTS ON THE SPOTDownloaded from https://academic.oup.com/cardiovascres/article/117/9/e114/6329578 by University of Groningen user on 26 January 2022AuthorsBiography: Dr Mahmoud Abdellatif is a post-doctoral research fellow at the Department of Cardiology, MedicalUniversity of Graz (Austria) and the Kroemer Lab (Institute Gustave Roussy and Centre de Recherche desCordeliers, France). In his research, he studies the molecular mechanisms of cardiovascular aging to exploit themin the development of effective interventions that extend lifespan and delay late-life chronic diseases, includingheart failure. His contributions to the field include discovering the cardioprotective and longevity-promotingeffects of spermidine, as a natural autophagy inducer and caloric restriction mimetic. More recently, he found thatthe NADþ precursor nicotinamide—yet another caloric restriction mimetic—might be effective against a pre-dominant and intractable form of heart failure in the elderly, known as heart failure with preserved ejection frac-tion. Mahmoud received various awards for his work including, the Sanofi Aventis Prize (2017), the Guido Taroneaward of the ESC Heart Failure Association (2020) and the German Society of Cardiology AG23 Heart andDiabetes research prize (2021). As a board member of the European Society of Cardiology committee for youngcardiovascular professionals and the Scientists of Tomorrow nucleus, he is actively involved in supporting and dis-seminating basic science amongst young scientists and clinicians.Biography: Dr Lam is a Senior Consultant at NHCS specializing in heart failure and recognized globally for ex-pertise in heart failure with preserved ejection fraction. She is a recipient of the NMRC Senior InvestigatorClinician Scientist Award, Programme Lead of A*STaR’s Asian neTwork for Translational Research andCardiovascular Trials (ATTRaCT), Principal Investigator of ASIAN-HF (multinational study across 11 Asian coun-tries), and Steering Committee member of multiple global clinical trials. She has published >200 articles in journalsincluding NEJM, JAMA, Lancet, Circulation, and European Heart Journal. She serves as Associate Editor for Circulationand the European Journal of Heart Failure. Dr Lam is heard weekly on the global podcast ‘Circulation On The Run’and seen regularly on television as the Resident Doctor of ‘Body and Soul’ by MediaCorp Singapore.A fraction of wisdom on heart failure e115Downloaded from https://academic.oup.com/cardiovascres/article/117/9/e114/6329578 by University of Groningen user on 26 January 2022

Scientists on the Spot:A fraction of wisdom on heart failure

Dissertations of the University of Groningen

   University of GroningenScientists on the SpotAbdellatif, Mahmoud; Lam, Carolyn S. P.Published in:Cardiovascular ResearchDOI:10.1093/cvr/cvab230IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite fromit. Please check the document version below.Document VersionPublisher's PDF, also known as Version of recordPublication date:2021Link to publication in University of Groningen/UMCG research databaseCitation for published version (APA):Abdellatif, M., & Lam, C. S. P. (2021). Scientists on the Spot: A fraction of wisdom on heart failure.Cardiovascular Research, 117(9), E114-E115. https://doi.org/10.1093/cvr/cvab230CopyrightOther than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of theauthor(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons).The publication may also be distributed here under the terms of Article 25fa of the Dutch Copyright Act, indicated by the “Taverne” license.More information can be found on the University of Groningen website: https://www.rug.nl/library/open-access/self-archiving-pure/taverne-amendment.Take-down policyIf you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediatelyand investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons thenumber of authors shown on this cover page is limited to 10 maximum.Download date: 05-06-2022...................................................................................................................Scientists on the Spot: A fraction of wisdom onheart failureMahmoud Abdellatif 1 and Carolyn S. P. Lam2,3,4*1Department of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria; 2Department of Cardiology, National Heart Centre Singapore, Singapore, 169609;3Duke-National University of Singapore, Singapore, 169857; and 4University Medical Centre Groningen, Groningen, Netherlands, 9700 RB GroningenKeywords HFpEF • SGLT2 • Sacubitril/valsartan • Heart failure • Sex differencesDr Mahmoud Abdellatif from the Medical University of Graz(Austria), interviews Prof. Carolyn Lam, a Senior Consultantat the National Heart Centre Singapore (Singapore).Highlight: In this Onlife interview, Professor Carolyn Lam shares herexpertise and major scientific findings on the subject of heart failure withpreserved ejection fraction.Summary of interviewTo kick off the interview, Professor Carolyn Lam reflected on what sheproudly considers her most significant scientific contributions to cardio-vascular medicine. In this regard, two achievements stood out. First, shementioned the Asian Heart Failure Study, which was an investigator-initiated observational study including 11 regions in Asia, thereby pro-ducing one of the very first multinational data on Asian patients withheart failure. The study resulted in multiple successful publications, re-vealing the differences not only between Asian and Western patients butalso within different regions in Asia. Second, she highlighted the recentFDA approval of sacubitril/valsartan as the first evidence-based drug forheart failure with preserved ejection fraction (HFpEF) patients who, asthe name implies, have preserved, but subnormal, ejection fraction. Thisapproval was based on the results of PARAGON-HF, a clinical trial, forwhich Prof. Lam was a steering committee member.On the topic of HFpEF, Prof. Lam discussed that it is a syndrome withmultiple causes and, thus, instead of solely relying on ejection fraction tostratify patients, a more holistic approach considering the diverse aetiol-ogies involved in this syndrome is warranted. Prof. Lam also highlightedthe importance of basic science to improve our understanding of themulti-faceted aspects of HFpEF pathogenesis, and how this might help inthe development of novel and effective therapies, at least in HFpEF pa-tient populations with homogenous phenotypes. Above all, she stressedthe importance of HFpEF prevention and how available drugs, such assodium-glucose transport protein 2 (SGLT2) inhibitors with proven car-diovascular efficacy against common risk factors for HFpEF, such as dia-betes and obesity, might be of clinical value in this respect.Next, Prof. Lam weighed in regarding whether sex plays a biologicalrole in HFpEF development. First, she highlighted the possible confound-ing effects of relying on identical ejection fraction cut-offs for both menand women, despite a relatively higher ejection fraction in women dueto the smaller heart and body size. That said, she then emphasized thatthere might still be biological reasoning behind the higher incidence ofHFpEF in women than men, which could be related to sex differences inthe immune response, as well as ectopic fat accumulation.Towards the end, Prof. Lam shared her advice with young cardiovas-cular researchers, where she stressed the need for continuous learningand following one’s own scientific passions. She mentioned that onlythrough following one’s scientific interests can we be kept driven andeventually achieve success. She also touched on the importance of differ-entiating between good advice, which one should follow and that whichmight be distracting from the path to success. As such, young research-ers should strike a fine balance between listening—and following theirscientific interests.Conflict of interest: C.S.L. is supported by a Clinician Scientist Awardfrom the National Medical Research Council of Singapore; has receivedresearch support from AstraZeneca, Bayer, Boston Scientific and RocheDiagnostics; has served as consultant or on the Advisory Board/SteeringCommittee/Executive Committee for Actelion, Amgen, AppliedTherapeutics, AstraZeneca, Bayer, Boehringer Ingelheim, BostonScientific, Cytokinetics, Darma Inc., Us2.ai, Janssen Research &Development LLC, Medscape, Merck, Novartis, Novo Nordisk, RadcliffeGroup Ltd., Roche Diagnostics, Sanofi and WebMD Global LLC; andserves as co-founder & non-executive director of Us2.ai.* Corresponding author. Tel: +65 6704 8000, E-mail: carolyn.lam@duke-nus.edu.sgPublished on behalf of the European Society of Cardiology. All rights reserved. VC The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.Cardiovascular Research (2021) 117, e114–e115doi:10.1093/cvr/cvab230 SCIENTISTS ON THE SPOTDownloaded from https://academic.oup.com/cardiovascres/article/117/9/e114/6329578 by University of Groningen user on 26 January 2022AuthorsBiography: Dr Mahmoud Abdellatif is a post-doctoral research fellow at the Department of Cardiology, MedicalUniversity of Graz (Austria) and the Kroemer Lab (Institute Gustave Roussy and Centre de Recherche desCordeliers, France). In his research, he studies the molecular mechanisms of cardiovascular aging to exploit themin the development of effective interventions that extend lifespan and delay late-life chronic diseases, includingheart failure. His contributions to the field include discovering the cardioprotective and longevity-promotingeffects of spermidine, as a natural autophagy inducer and caloric restriction mimetic. More recently, he found thatthe NADþ precursor nicotinamide—yet another caloric restriction mimetic—might be effective against a pre-dominant and intractable form of heart failure in the elderly, known as heart failure with preserved ejection frac-tion. Mahmoud received various awards for his work including, the Sanofi Aventis Prize (2017), the Guido Taroneaward of the ESC Heart Failure Association (2020) and the German Society of Cardiology AG23 Heart andDiabetes research prize (2021). As a board member of the European Society of Cardiology committee for youngcardiovascular professionals and the Scientists of Tomorrow nucleus, he is actively involved in supporting and dis-seminating basic science amongst young scientists and clinicians.Biography: Dr Lam is a Senior Consultant at NHCS specializing in heart failure and recognized globally for ex-pertise in heart failure with preserved ejection fraction. She is a recipient of the NMRC Senior InvestigatorClinician Scientist Award, Programme Lead of A*STaR’s Asian neTwork for Translational Research andCardiovascular Trials (ATTRaCT), Principal Investigator of ASIAN-HF (multinational study across 11 Asian coun-tries), and Steering Committee member of multiple global clinical trials. She has published >200 articles in journalsincluding NEJM, JAMA, Lancet, Circulation, and European Heart Journal. She serves as Associate Editor for Circulationand the European Journal of Heart Failure. Dr Lam is heard weekly on the global podcast ‘Circulation On The Run’and seen regularly on television as the Resident Doctor of ‘Body and Soul’ by MediaCorp Singapore.A fraction of wisdom on heart failure e115Downloaded from https://academic.oup.com/cardiovascres/article/117/9/e114/6329578 by University of Groningen user on 26 January 2022

University of Groningen

   University of GroningenScientists on the SpotAbdellatif, Mahmoud; Lam, Carolyn S. P.Published in:Cardiovascular ResearchDOI:10.1093/cvr/cvab230IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite fromit. Please check the document version below.Document VersionPublisher's PDF, also known as Version of recordPublication date:2021Link to publication in University of Groningen/UMCG research databaseCitation for published version (APA):Abdellatif, M., & Lam, C. S. P. (2021). Scientists on the Spot: A fraction of wisdom on heart failure.Cardiovascular Research, 117(9), E114-E115. https://doi.org/10.1093/cvr/cvab230CopyrightOther than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of theauthor(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons).The publication may also be distributed here under the terms of Article 25fa of the Dutch Copyright Act, indicated by the “Taverne” license.More information can be found on the University of Groningen website: https://www.rug.nl/library/open-access/self-archiving-pure/taverne-amendment.Take-down policyIf you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediatelyand investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons thenumber of authors shown on this cover page is limited to 10 maximum.Download date: 29-04-2023...................................................................................................................Scientists on the Spot: A fraction of wisdom onheart failureMahmoud Abdellatif 1 and Carolyn S. P. Lam2,3,4*1Department of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria; 2Department of Cardiology, National Heart Centre Singapore, Singapore, 169609;3Duke-National University of Singapore, Singapore, 169857; and 4University Medical Centre Groningen, Groningen, Netherlands, 9700 RB GroningenKeywords HFpEF • SGLT2 • Sacubitril/valsartan • Heart failure • Sex differencesDr Mahmoud Abdellatif from the Medical University of Graz(Austria), interviews Prof. Carolyn Lam, a Senior Consultantat the National Heart Centre Singapore (Singapore).Highlight: In this Onlife interview, Professor Carolyn Lam shares herexpertise and major scientific findings on the subject of heart failure withpreserved ejection fraction.Summary of interviewTo kick off the interview, Professor Carolyn Lam reflected on what sheproudly considers her most significant scientific contributions to cardio-vascular medicine. In this regard, two achievements stood out. First, shementioned the Asian Heart Failure Study, which was an investigator-initiated observational study including 11 regions in Asia, thereby pro-ducing one of the very first multinational data on Asian patients withheart failure. The study resulted in multiple successful publications, re-vealing the differences not only between Asian and Western patients butalso within different regions in Asia. Second, she highlighted the recentFDA approval of sacubitril/valsartan as the first evidence-based drug forheart failure with preserved ejection fraction (HFpEF) patients who, asthe name implies, have preserved, but subnormal, ejection fraction. Thisapproval was based on the results of PARAGON-HF, a clinical trial, forwhich Prof. Lam was a steering committee member.On the topic of HFpEF, Prof. Lam discussed that it is a syndrome withmultiple causes and, thus, instead of solely relying on ejection fraction tostratify patients, a more holistic approach considering the diverse aetiol-ogies involved in this syndrome is warranted. Prof. Lam also highlightedthe importance of basic science to improve our understanding of themulti-faceted aspects of HFpEF pathogenesis, and how this might help inthe development of novel and effective therapies, at least in HFpEF pa-tient populations with homogenous phenotypes. Above all, she stressedthe importance of HFpEF prevention and how available drugs, such assodium-glucose transport protein 2 (SGLT2) inhibitors with proven car-diovascular efficacy against common risk factors for HFpEF, such as dia-betes and obesity, might be of clinical value in this respect.Next, Prof. Lam weighed in regarding whether sex plays a biologicalrole in HFpEF development. First, she highlighted the possible confound-ing effects of relying on identical ejection fraction cut-offs for both menand women, despite a relatively higher ejection fraction in women dueto the smaller heart and body size. That said, she then emphasized thatthere might still be biological reasoning behind the higher incidence ofHFpEF in women than men, which could be related to sex differences inthe immune response, as well as ectopic fat accumulation.Towards the end, Prof. Lam shared her advice with young cardiovas-cular researchers, where she stressed the need for continuous learningand following one’s own scientific passions. She mentioned that onlythrough following one’s scientific interests can we be kept driven andeventually achieve success. She also touched on the importance of differ-entiating between good advice, which one should follow and that whichmight be distracting from the path to success. As such, young research-ers should strike a fine balance between listening—and following theirscientific interests.Conflict of interest: C.S.L. is supported by a Clinician Scientist Awardfrom the National Medical Research Council of Singapore; has receivedresearch support from AstraZeneca, Bayer, Boston Scientific and RocheDiagnostics; has served as consultant or on the Advisory Board/SteeringCommittee/Executive Committee for Actelion, Amgen, AppliedTherapeutics, AstraZeneca, Bayer, Boehringer Ingelheim, BostonScientific, Cytokinetics, Darma Inc., Us2.ai, Janssen Research &Development LLC, Medscape, Merck, Novartis, Novo Nordisk, RadcliffeGroup Ltd., Roche Diagnostics, Sanofi and WebMD Global LLC; andserves as co-founder & non-executive director of Us2.ai.* Corresponding author. Tel: +65 6704 8000, E-mail: carolyn.lam@duke-nus.edu.sgPublished on behalf of the European Society of Cardiology. All rights reserved. VC The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.Cardiovascular Research (2021) 117, e114–e115doi:10.1093/cvr/cvab230 SCIENTISTS ON THE SPOTDownloaded from https://academic.oup.com/cardiovascres/article/117/9/e114/6329578 by University of Groningen user on 26 January 2022AuthorsBiography: Dr Mahmoud Abdellatif is a post-doctoral research fellow at the Department of Cardiology, MedicalUniversity of Graz (Austria) and the Kroemer Lab (Institute Gustave Roussy and Centre de Recherche desCordeliers, France). In his research, he studies the molecular mechanisms of cardiovascular aging to exploit themin the development of effective interventions that extend lifespan and delay late-life chronic diseases, includingheart failure. His contributions to the field include discovering the cardioprotective and longevity-promotingeffects of spermidine, as a natural autophagy inducer and caloric restriction mimetic. More recently, he found thatthe NADþ precursor nicotinamide—yet another caloric restriction mimetic—might be effective against a pre-dominant and intractable form of heart failure in the elderly, known as heart failure with preserved ejection frac-tion. Mahmoud received various awards for his work including, the Sanofi Aventis Prize (2017), the Guido Taroneaward of the ESC Heart Failure Association (2020) and the German Society of Cardiology AG23 Heart andDiabetes research prize (2021). As a board member of the European Society of Cardiology committee for youngcardiovascular professionals and the Scientists of Tomorrow nucleus, he is actively involved in supporting and dis-seminating basic science amongst young scientists and clinicians.Biography: Dr Lam is a Senior Consultant at NHCS specializing in heart failure and recognized globally for ex-pertise in heart failure with preserved ejection fraction. She is a recipient of the NMRC Senior InvestigatorClinician Scientist Award, Programme Lead of A*STaR’s Asian neTwork for Translational Research andCardiovascular Trials (ATTRaCT), Principal Investigator of ASIAN-HF (multinational study across 11 Asian coun-tries), and Steering Committee member of multiple global clinical trials. She has published >200 articles in journalsincluding NEJM, JAMA, Lancet, Circulation, and European Heart Journal. She serves as Associate Editor for Circulationand the European Journal of Heart Failure. Dr Lam is heard weekly on the global podcast ‘Circulation On The Run’and seen regularly on television as the Resident Doctor of ‘Body and Soul’ by MediaCorp Singapore.A fraction of wisdom on heart failure e115Downloaded from https://academic.oup.com/cardiovascres/article/117/9/e114/6329578 by University of Groningen user on 26 January 2022

NARCIS 

Scientists on the Spot: A fraction of wisdom on heart failure

ARTS repository - University of Groningen

   University of GroningenScientists on the SpotAbdellatif, Mahmoud; Lam, Carolyn S. P.Published in:Cardiovascular ResearchDOI:10.1093/cvr/cvab230IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite fromit. Please check the document version below.Document VersionPublisher's PDF, also known as Version of recordPublication date:2021Link to publication in University of Groningen/UMCG research databaseCitation for published version (APA):Abdellatif, M., & Lam, C. S. P. (2021). Scientists on the Spot: A fraction of wisdom on heart failure.Cardiovascular Research, 117(9), E114-E115. https://doi.org/10.1093/cvr/cvab230CopyrightOther than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of theauthor(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons).The publication may also be distributed here under the terms of Article 25fa of the Dutch Copyright Act, indicated by the “Taverne” license.More information can be found on the University of Groningen website: https://www.rug.nl/library/open-access/self-archiving-pure/taverne-amendment.Take-down policyIf you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediatelyand investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons thenumber of authors shown on this cover page is limited to 10 maximum.Download date: 01-11-2023...................................................................................................................Scientists on the Spot: A fraction of wisdom onheart failureMahmoud Abdellatif 1 and Carolyn S. P. Lam2,3,4*1Department of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria; 2Department of Cardiology, National Heart Centre Singapore, Singapore, 169609;3Duke-National University of Singapore, Singapore, 169857; and 4University Medical Centre Groningen, Groningen, Netherlands, 9700 RB GroningenKeywords HFpEF • SGLT2 • Sacubitril/valsartan • Heart failure • Sex differencesDr Mahmoud Abdellatif from the Medical University of Graz(Austria), interviews Prof. Carolyn Lam, a Senior Consultantat the National Heart Centre Singapore (Singapore).Highlight: In this Onlife interview, Professor Carolyn Lam shares herexpertise and major scientific findings on the subject of heart failure withpreserved ejection fraction.Summary of interviewTo kick off the interview, Professor Carolyn Lam reflected on what sheproudly considers her most significant scientific contributions to cardio-vascular medicine. In this regard, two achievements stood out. First, shementioned the Asian Heart Failure Study, which was an investigator-initiated observational study including 11 regions in Asia, thereby pro-ducing one of the very first multinational data on Asian patients withheart failure. The study resulted in multiple successful publications, re-vealing the differences not only between Asian and Western patients butalso within different regions in Asia. Second, she highlighted the recentFDA approval of sacubitril/valsartan as the first evidence-based drug forheart failure with preserved ejection fraction (HFpEF) patients who, asthe name implies, have preserved, but subnormal, ejection fraction. Thisapproval was based on the results of PARAGON-HF, a clinical trial, forwhich Prof. Lam was a steering committee member.On the topic of HFpEF, Prof. Lam discussed that it is a syndrome withmultiple causes and, thus, instead of solely relying on ejection fraction tostratify patients, a more holistic approach considering the diverse aetiol-ogies involved in this syndrome is warranted. Prof. Lam also highlightedthe importance of basic science to improve our understanding of themulti-faceted aspects of HFpEF pathogenesis, and how this might help inthe development of novel and effective therapies, at least in HFpEF pa-tient populations with homogenous phenotypes. Above all, she stressedthe importance of HFpEF prevention and how available drugs, such assodium-glucose transport protein 2 (SGLT2) inhibitors with proven car-diovascular efficacy against common risk factors for HFpEF, such as dia-betes and obesity, might be of clinical value in this respect.Next, Prof. Lam weighed in regarding whether sex plays a biologicalrole in HFpEF development. First, she highlighted the possible confound-ing effects of relying on identical ejection fraction cut-offs for both menand women, despite a relatively higher ejection fraction in women dueto the smaller heart and body size. That said, she then emphasized thatthere might still be biological reasoning behind the higher incidence ofHFpEF in women than men, which could be related to sex differences inthe immune response, as well as ectopic fat accumulation.Towards the end, Prof. Lam shared her advice with young cardiovas-cular researchers, where she stressed the need for continuous learningand following one’s own scientific passions. She mentioned that onlythrough following one’s scientific interests can we be kept driven andeventually achieve success. She also touched on the importance of differ-entiating between good advice, which one should follow and that whichmight be distracting from the path to success. As such, young research-ers should strike a fine balance between listening—and following theirscientific interests.Conflict of interest: C.S.L. is supported by a Clinician Scientist Awardfrom the National Medical Research Council of Singapore; has receivedresearch support from AstraZeneca, Bayer, Boston Scientific and RocheDiagnostics; has served as consultant or on the Advisory Board/SteeringCommittee/Executive Committee for Actelion, Amgen, AppliedTherapeutics, AstraZeneca, Bayer, Boehringer Ingelheim, BostonScientific, Cytokinetics, Darma Inc., Us2.ai, Janssen Research &Development LLC, Medscape, Merck, Novartis, Novo Nordisk, RadcliffeGroup Ltd., Roche Diagnostics, Sanofi and WebMD Global LLC; andserves as co-founder & non-executive director of Us2.ai.* Corresponding author. Tel: +65 6704 8000, E-mail: carolyn.lam@duke-nus.edu.sgPublished on behalf of the European Society of Cardiology. All rights reserved. VC The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.Cardiovascular Research (2021) 117, e114–e115doi:10.1093/cvr/cvab230 SCIENTISTS ON THE SPOTDownloaded from https://academic.oup.com/cardiovascres/article/117/9/e114/6329578 by University of Groningen user on 26 January 2022AuthorsBiography: Dr Mahmoud Abdellatif is a post-doctoral research fellow at the Department of Cardiology, MedicalUniversity of Graz (Austria) and the Kroemer Lab (Institute Gustave Roussy and Centre de Recherche desCordeliers, France). In his research, he studies the molecular mechanisms of cardiovascular aging to exploit themin the development of effective interventions that extend lifespan and delay late-life chronic diseases, includingheart failure. His contributions to the field include discovering the cardioprotective and longevity-promotingeffects of spermidine, as a natural autophagy inducer and caloric restriction mimetic. More recently, he found thatthe NADþ precursor nicotinamide—yet another caloric restriction mimetic—might be effective against a pre-dominant and intractable form of heart failure in the elderly, known as heart failure with preserved ejection frac-tion. Mahmoud received various awards for his work including, the Sanofi Aventis Prize (2017), the Guido Taroneaward of the ESC Heart Failure Association (2020) and the German Society of Cardiology AG23 Heart andDiabetes research prize (2021). As a board member of the European Society of Cardiology committee for youngcardiovascular professionals and the Scientists of Tomorrow nucleus, he is actively involved in supporting and dis-seminating basic science amongst young scientists and clinicians.Biography: Dr Lam is a Senior Consultant at NHCS specializing in heart failure and recognized globally for ex-pertise in heart failure with preserved ejection fraction. She is a recipient of the NMRC Senior InvestigatorClinician Scientist Award, Programme Lead of A*STaR’s Asian neTwork for Translational Research andCardiovascular Trials (ATTRaCT), Principal Investigator of ASIAN-HF (multinational study across 11 Asian coun-tries), and Steering Committee member of multiple global clinical trials. She has published >200 articles in journalsincluding NEJM, JAMA, Lancet, Circulation, and European Heart Journal. She serves as Associate Editor for Circulationand the European Journal of Heart Failure. Dr Lam is heard weekly on the global podcast ‘Circulation On The Run’and seen regularly on television as the Resident Doctor of ‘Body and Soul’ by MediaCorp Singapore.A fraction of wisdom on heart failure e115Downloaded from https://academic.oup.com/cardiovascres/article/117/9/e114/6329578 by University of Groningen user on 26 January 2022

   University of GroningenScientists on the SpotAbdellatif, Mahmoud; Lam, Carolyn S. P.Published in:Cardiovascular ResearchDOI:10.1093/cvr/cvab230IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite fromit. Please check the document version below.Document VersionPublisher's PDF, also known as Version of recordPublication date:2021Link to publication in University of Groningen/UMCG research databaseCitation for published version (APA):Abdellatif, M., & Lam, C. S. P. (2021). Scientists on the Spot: A fraction of wisdom on heart failure.Cardiovascular Research, 117(9), E114-E115. https://doi.org/10.1093/cvr/cvab230CopyrightOther than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of theauthor(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons).The publication may also be distributed here under the terms of Article 25fa of the Dutch Copyright Act, indicated by the “Taverne” license.More information can be found on the University of Groningen website: https://www.rug.nl/library/open-access/self-archiving-pure/taverne-amendment.Take-down policyIf you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediatelyand investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons thenumber of authors shown on this cover page is limited to 10 maximum.Download date: 07-06-2022...................................................................................................................Scientists on the Spot: A fraction of wisdom onheart failureMahmoud Abdellatif 1 and Carolyn S. P. Lam2,3,4*1Department of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria; 2Department of Cardiology, National Heart Centre Singapore, Singapore, 169609;3Duke-National University of Singapore, Singapore, 169857; and 4University Medical Centre Groningen, Groningen, Netherlands, 9700 RB GroningenKeywords HFpEF • SGLT2 • Sacubitril/valsartan • Heart failure • Sex differencesDr Mahmoud Abdellatif from the Medical University of Graz(Austria), interviews Prof. Carolyn Lam, a Senior Consultantat the National Heart Centre Singapore (Singapore).Highlight: In this Onlife interview, Professor Carolyn Lam shares herexpertise and major scientific findings on the subject of heart failure withpreserved ejection fraction.Summary of interviewTo kick off the interview, Professor Carolyn Lam reflected on what sheproudly considers her most significant scientific contributions to cardio-vascular medicine. In this regard, two achievements stood out. First, shementioned the Asian Heart Failure Study, which was an investigator-initiated observational study including 11 regions in Asia, thereby pro-ducing one of the very first multinational data on Asian patients withheart failure. The study resulted in multiple successful publications, re-vealing the differences not only between Asian and Western patients butalso within different regions in Asia. Second, she highlighted the recentFDA approval of sacubitril/valsartan as the first evidence-based drug forheart failure with preserved ejection fraction (HFpEF) patients who, asthe name implies, have preserved, but subnormal, ejection fraction. Thisapproval was based on the results of PARAGON-HF, a clinical trial, forwhich Prof. Lam was a steering committee member.On the topic of HFpEF, Prof. Lam discussed that it is a syndrome withmultiple causes and, thus, instead of solely relying on ejection fraction tostratify patients, a more holistic approach considering the diverse aetiol-ogies involved in this syndrome is warranted. Prof. Lam also highlightedthe importance of basic science to improve our understanding of themulti-faceted aspects of HFpEF pathogenesis, and how this might help inthe development of novel and effective therapies, at least in HFpEF pa-tient populations with homogenous phenotypes. Above all, she stressedthe importance of HFpEF prevention and how available drugs, such assodium-glucose transport protein 2 (SGLT2) inhibitors with proven car-diovascular efficacy against common risk factors for HFpEF, such as dia-betes and obesity, might be of clinical value in this respect.Next, Prof. Lam weighed in regarding whether sex plays a biologicalrole in HFpEF development. First, she highlighted the possible confound-ing effects of relying on identical ejection fraction cut-offs for both menand women, despite a relatively higher ejection fraction in women dueto the smaller heart and body size. That said, she then emphasized thatthere might still be biological reasoning behind the higher incidence ofHFpEF in women than men, which could be related to sex differences inthe immune response, as well as ectopic fat accumulation.Towards the end, Prof. Lam shared her advice with young cardiovas-cular researchers, where she stressed the need for continuous learningand following one’s own scientific passions. She mentioned that onlythrough following one’s scientific interests can we be kept driven andeventually achieve success. She also touched on the importance of differ-entiating between good advice, which one should follow and that whichmight be distracting from the path to success. As such, young research-ers should strike a fine balance between listening—and following theirscientific interests.Conflict of interest: C.S.L. is supported by a Clinician Scientist Awardfrom the National Medical Research Council of Singapore; has receivedresearch support from AstraZeneca, Bayer, Boston Scientific and RocheDiagnostics; has served as consultant or on the Advisory Board/SteeringCommittee/Executive Committee for Actelion, Amgen, AppliedTherapeutics, AstraZeneca, Bayer, Boehringer Ingelheim, BostonScientific, Cytokinetics, Darma Inc., Us2.ai, Janssen Research &Development LLC, Medscape, Merck, Novartis, Novo Nordisk, RadcliffeGroup Ltd., Roche Diagnostics, Sanofi and WebMD Global LLC; andserves as co-founder & non-executive director of Us2.ai.* Corresponding author. Tel: +65 6704 8000, E-mail: carolyn.lam@duke-nus.edu.sgPublished on behalf of the European Society of Cardiology. All rights reserved. VC The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.Cardiovascular Research (2021) 117, e114–e115doi:10.1093/cvr/cvab230 SCIENTISTS ON THE SPOTDownloaded from https://academic.oup.com/cardiovascres/article/117/9/e114/6329578 by University of Groningen user on 26 January 2022AuthorsBiography: Dr Mahmoud Abdellatif is a post-doctoral research fellow at the Department of Cardiology, MedicalUniversity of Graz (Austria) and the Kroemer Lab (Institute Gustave Roussy and Centre de Recherche desCordeliers, France). In his research, he studies the molecular mechanisms of cardiovascular aging to exploit themin the development of effective interventions that extend lifespan and delay late-life chronic diseases, includingheart failure. His contributions to the field include discovering the cardioprotective and longevity-promotingeffects of spermidine, as a natural autophagy inducer and caloric restriction mimetic. More recently, he found thatthe NADþ precursor nicotinamide—yet another caloric restriction mimetic—might be effective against a pre-dominant and intractable form of heart failure in the elderly, known as heart failure with preserved ejection frac-tion. Mahmoud received various awards for his work including, the Sanofi Aventis Prize (2017), the Guido Taroneaward of the ESC Heart Failure Association (2020) and the German Society of Cardiology AG23 Heart andDiabetes research prize (2021). As a board member of the European Society of Cardiology committee for youngcardiovascular professionals and the Scientists of Tomorrow nucleus, he is actively involved in supporting and dis-seminating basic science amongst young scientists and clinicians.Biography: Dr Lam is a Senior Consultant at NHCS specializing in heart failure and recognized globally for ex-pertise in heart failure with preserved ejection fraction. She is a recipient of the NMRC Senior InvestigatorClinician Scientist Award, Programme Lead of A*STaR’s Asian neTwork for Translational Research andCardiovascular Trials (ATTRaCT), Principal Investigator of ASIAN-HF (multinational study across 11 Asian coun-tries), and Steering Committee member of multiple global clinical trials. She has published >200 articles in journalsincluding NEJM, JAMA, Lancet, Circulation, and European Heart Journal. She serves as Associate Editor for Circulationand the European Journal of Heart Failure. Dr Lam is heard weekly on the global podcast ‘Circulation On The Run’and seen regularly on television as the Resident Doctor of ‘Body and Soul’ by MediaCorp Singapore.A fraction of wisdom on heart failure e115Downloaded from https://academic.oup.com/cardiovascres/article/117/9/e114/6329578 by University of Groningen user on 26 January 2022

   University of GroningenScientists on the SpotAbdellatif, Mahmoud; Lam, Carolyn S. P.Published in:Cardiovascular ResearchDOI:10.1093/cvr/cvab230IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite fromit. Please check the document version below.Document VersionPublisher's PDF, also known as Version of recordPublication date:2021Link to publication in University of Groningen/UMCG research databaseCitation for published version (APA):Abdellatif, M., & Lam, C. S. P. (2021). Scientists on the Spot: A fraction of wisdom on heart failure.Cardiovascular Research, 117(9), E114-E115. https://doi.org/10.1093/cvr/cvab230CopyrightOther than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of theauthor(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons).The publication may also be distributed here under the terms of Article 25fa of the Dutch Copyright Act, indicated by the “Taverne” license.More information can be found on the University of Groningen website: https://www.rug.nl/library/open-access/self-archiving-pure/taverne-amendment.Take-down policyIf you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediatelyand investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons thenumber of authors shown on this cover page is limited to 10 maximum.Download date: 20-11-2022...................................................................................................................Scientists on the Spot: A fraction of wisdom onheart failureMahmoud Abdellatif 1 and Carolyn S. P. Lam2,3,4*1Department of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria; 2Department of Cardiology, National Heart Centre Singapore, Singapore, 169609;3Duke-National University of Singapore, Singapore, 169857; and 4University Medical Centre Groningen, Groningen, Netherlands, 9700 RB GroningenKeywords HFpEF • SGLT2 • Sacubitril/valsartan • Heart failure • Sex differencesDr Mahmoud Abdellatif from the Medical University of Graz(Austria), interviews Prof. Carolyn Lam, a Senior Consultantat the National Heart Centre Singapore (Singapore).Highlight: In this Onlife interview, Professor Carolyn Lam shares herexpertise and major scientific findings on the subject of heart failure withpreserved ejection fraction.Summary of interviewTo kick off the interview, Professor Carolyn Lam reflected on what sheproudly considers her most significant scientific contributions to cardio-vascular medicine. In this regard, two achievements stood out. First, shementioned the Asian Heart Failure Study, which was an investigator-initiated observational study including 11 regions in Asia, thereby pro-ducing one of the very first multinational data on Asian patients withheart failure. The study resulted in multiple successful publications, re-vealing the differences not only between Asian and Western patients butalso within different regions in Asia. Second, she highlighted the recentFDA approval of sacubitril/valsartan as the first evidence-based drug forheart failure with preserved ejection fraction (HFpEF) patients who, asthe name implies, have preserved, but subnormal, ejection fraction. Thisapproval was based on the results of PARAGON-HF, a clinical trial, forwhich Prof. Lam was a steering committee member.On the topic of HFpEF, Prof. Lam discussed that it is a syndrome withmultiple causes and, thus, instead of solely relying on ejection fraction tostratify patients, a more holistic approach considering the diverse aetiol-ogies involved in this syndrome is warranted. Prof. Lam also highlightedthe importance of basic science to improve our understanding of themulti-faceted aspects of HFpEF pathogenesis, and how this might help inthe development of novel and effective therapies, at least in HFpEF pa-tient populations with homogenous phenotypes. Above all, she stressedthe importance of HFpEF prevention and how available drugs, such assodium-glucose transport protein 2 (SGLT2) inhibitors with proven car-diovascular efficacy against common risk factors for HFpEF, such as dia-betes and obesity, might be of clinical value in this respect.Next, Prof. Lam weighed in regarding whether sex plays a biologicalrole in HFpEF development. First, she highlighted the possible confound-ing effects of relying on identical ejection fraction cut-offs for both menand women, despite a relatively higher ejection fraction in women dueto the smaller heart and body size. That said, she then emphasized thatthere might still be biological reasoning behind the higher incidence ofHFpEF in women than men, which could be related to sex differences inthe immune response, as well as ectopic fat accumulation.Towards the end, Prof. Lam shared her advice with young cardiovas-cular researchers, where she stressed the need for continuous learningand following one’s own scientific passions. She mentioned that onlythrough following one’s scientific interests can we be kept driven andeventually achieve success. She also touched on the importance of differ-entiating between good advice, which one should follow and that whichmight be distracting from the path to success. As such, young research-ers should strike a fine balance between listening—and following theirscientific interests.Conflict of interest: C.S.L. is supported by a Clinician Scientist Awardfrom the National Medical Research Council of Singapore; has receivedresearch support from AstraZeneca, Bayer, Boston Scientific and RocheDiagnostics; has served as consultant or on the Advisory Board/SteeringCommittee/Executive Committee for Actelion, Amgen, AppliedTherapeutics, AstraZeneca, Bayer, Boehringer Ingelheim, BostonScientific, Cytokinetics, Darma Inc., Us2.ai, Janssen Research &Development LLC, Medscape, Merck, Novartis, Novo Nordisk, RadcliffeGroup Ltd., Roche Diagnostics, Sanofi and WebMD Global LLC; andserves as co-founder & non-executive director of Us2.ai.* Corresponding author. Tel: +65 6704 8000, E-mail: carolyn.lam@duke-nus.edu.sgPublished on behalf of the European Society of Cardiology. All rights reserved. VC The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.Cardiovascular Research (2021) 117, e114–e115doi:10.1093/cvr/cvab230 SCIENTISTS ON THE SPOTDownloaded from https://academic.oup.com/cardiovascres/article/117/9/e114/6329578 by University of Groningen user on 26 January 2022AuthorsBiography: Dr Mahmoud Abdellatif is a post-doctoral research fellow at the Department of Cardiology, MedicalUniversity of Graz (Austria) and the Kroemer Lab (Institute Gustave Roussy and Centre de Recherche desCordeliers, France). In his research, he studies the molecular mechanisms of cardiovascular aging to exploit themin the development of effective interventions that extend lifespan and delay late-life chronic diseases, includingheart failure. His contributions to the field include discovering the cardioprotective and longevity-promotingeffects of spermidine, as a natural autophagy inducer and caloric restriction mimetic. More recently, he found thatthe NADþ precursor nicotinamide—yet another caloric restriction mimetic—might be effective against a pre-dominant and intractable form of heart failure in the elderly, known as heart failure with preserved ejection frac-tion. Mahmoud received various awards for his work including, the Sanofi Aventis Prize (2017), the Guido Taroneaward of the ESC Heart Failure Association (2020) and the German Society of Cardiology AG23 Heart andDiabetes research prize (2021). As a board member of the European Society of Cardiology committee for youngcardiovascular professionals and the Scientists of Tomorrow nucleus, he is actively involved in supporting and dis-seminating basic science amongst young scientists and clinicians.Biography: Dr Lam is a Senior Consultant at NHCS specializing in heart failure and recognized globally for ex-pertise in heart failure with preserved ejection fraction. She is a recipient of the NMRC Senior InvestigatorClinician Scientist Award, Programme Lead of A*STaR’s Asian neTwork for Translational Research andCardiovascular Trials (ATTRaCT), Principal Investigator of ASIAN-HF (multinational study across 11 Asian coun-tries), and Steering Committee member of multiple global clinical trials. She has published >200 articles in journalsincluding NEJM, JAMA, Lancet, Circulation, and European Heart Journal. She serves as Associate Editor for Circulationand the European Journal of Heart Failure. Dr Lam is heard weekly on the global podcast ‘Circulation On The Run’and seen regularly on television as the Resident Doctor of ‘Body and Soul’ by MediaCorp Singapore.A fraction of wisdom on heart failure e115Downloaded from https://academic.oup.com/cardiovascres/article/117/9/e114/6329578 by University of Groningen user on 26 January 2022

   University of GroningenScientists on the SpotAbdellatif, Mahmoud; Lam, Carolyn S. P.Published in:Cardiovascular ResearchDOI:10.1093/cvr/cvab230IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite fromit. Please check the document version below.Document VersionPublisher's PDF, also known as Version of recordPublication date:2021Link to publication in University of Groningen/UMCG research databaseCitation for published version (APA):Abdellatif, M., & Lam, C. S. P. (2021). Scientists on the Spot: A fraction of wisdom on heart failure.Cardiovascular Research, 117(9), E114-E115. https://doi.org/10.1093/cvr/cvab230CopyrightOther than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of theauthor(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons).The publication may also be distributed here under the terms of Article 25fa of the Dutch Copyright Act, indicated by the “Taverne” license.More information can be found on the University of Groningen website: https://www.rug.nl/library/open-access/self-archiving-pure/taverne-amendment.Take-down policyIf you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediatelyand investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons thenumber of authors shown on this cover page is limited to 10 maximum.Download date: 04-06-2022...................................................................................................................Scientists on the Spot: A fraction of wisdom onheart failureMahmoud Abdellatif 1 and Carolyn S. P. Lam2,3,4*1Department of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria; 2Department of Cardiology, National Heart Centre Singapore, Singapore, 169609;3Duke-National University of Singapore, Singapore, 169857; and 4University Medical Centre Groningen, Groningen, Netherlands, 9700 RB GroningenKeywords HFpEF • SGLT2 • Sacubitril/valsartan • Heart failure • Sex differencesDr Mahmoud Abdellatif from the Medical University of Graz(Austria), interviews Prof. Carolyn Lam, a Senior Consultantat the National Heart Centre Singapore (Singapore).Highlight: In this Onlife interview, Professor Carolyn Lam shares herexpertise and major scientific findings on the subject of heart failure withpreserved ejection fraction.Summary of interviewTo kick off the interview, Professor Carolyn Lam reflected on what sheproudly considers her most significant scientific contributions to cardio-vascular medicine. In this regard, two achievements stood out. First, shementioned the Asian Heart Failure Study, which was an investigator-initiated observational study including 11 regions in Asia, thereby pro-ducing one of the very first multinational data on Asian patients withheart failure. The study resulted in multiple successful publications, re-vealing the differences not only between Asian and Western patients butalso within different regions in Asia. Second, she highlighted the recentFDA approval of sacubitril/valsartan as the first evidence-based drug forheart failure with preserved ejection fraction (HFpEF) patients who, asthe name implies, have preserved, but subnormal, ejection fraction. Thisapproval was based on the results of PARAGON-HF, a clinical trial, forwhich Prof. Lam was a steering committee member.On the topic of HFpEF, Prof. Lam discussed that it is a syndrome withmultiple causes and, thus, instead of solely relying on ejection fraction tostratify patients, a more holistic approach considering the diverse aetiol-ogies involved in this syndrome is warranted. Prof. Lam also highlightedthe importance of basic science to improve our understanding of themulti-faceted aspects of HFpEF pathogenesis, and how this might help inthe development of novel and effective therapies, at least in HFpEF pa-tient populations with homogenous phenotypes. Above all, she stressedthe importance of HFpEF prevention and how available drugs, such assodium-glucose transport protein 2 (SGLT2) inhibitors with proven car-diovascular efficacy against common risk factors for HFpEF, such as dia-betes and obesity, might be of clinical value in this respect.Next, Prof. Lam weighed in regarding whether sex plays a biologicalrole in HFpEF development. First, she highlighted the possible confound-ing effects of relying on identical ejection fraction cut-offs for both menand women, despite a relatively higher ejection fraction in women dueto the smaller heart and body size. That said, she then emphasized thatthere might still be biological reasoning behind the higher incidence ofHFpEF in women than men, which could be related to sex differences inthe immune response, as well as ectopic fat accumulation.Towards the end, Prof. Lam shared her advice with young cardiovas-cular researchers, where she stressed the need for continuous learningand following one’s own scientific passions. She mentioned that onlythrough following one’s scientific interests can we be kept driven andeventually achieve success. She also touched on the importance of differ-entiating between good advice, which one should follow and that whichmight be distracting from the path to success. As such, young research-ers should strike a fine balance between listening—and following theirscientific interests.Conflict of interest: C.S.L. is supported by a Clinician Scientist Awardfrom the National Medical Research Council of Singapore; has receivedresearch support from AstraZeneca, Bayer, Boston Scientific and RocheDiagnostics; has served as consultant or on the Advisory Board/SteeringCommittee/Executive Committee for Actelion, Amgen, AppliedTherapeutics, AstraZeneca, Bayer, Boehringer Ingelheim, BostonScientific, Cytokinetics, Darma Inc., Us2.ai, Janssen Research &Development LLC, Medscape, Merck, Novartis, Novo Nordisk, RadcliffeGroup Ltd., Roche Diagnostics, Sanofi and WebMD Global LLC; andserves as co-founder & non-executive director of Us2.ai.* Corresponding author. Tel: +65 6704 8000, E-mail: carolyn.lam@duke-nus.edu.sgPublished on behalf of the European Society of Cardiology. All rights reserved. VC The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.Cardiovascular Research (2021) 117, e114–e115doi:10.1093/cvr/cvab230 SCIENTISTS ON THE SPOTDownloaded from https://academic.oup.com/cardiovascres/article/117/9/e114/6329578 by University of Groningen user on 26 January 2022AuthorsBiography: Dr Mahmoud Abdellatif is a post-doctoral research fellow at the Department of Cardiology, MedicalUniversity of Graz (Austria) and the Kroemer Lab (Institute Gustave Roussy and Centre de Recherche desCordeliers, France). In his research, he studies the molecular mechanisms of cardiovascular aging to exploit themin the development of effective interventions that extend lifespan and delay late-life chronic diseases, includingheart failure. His contributions to the field include discovering the cardioprotective and longevity-promotingeffects of spermidine, as a natural autophagy inducer and caloric restriction mimetic. More recently, he found thatthe NADþ precursor nicotinamide—yet another caloric restriction mimetic—might be effective against a pre-dominant and intractable form of heart failure in the elderly, known as heart failure with preserved ejection frac-tion. Mahmoud received various awards for his work including, the Sanofi Aventis Prize (2017), the Guido Taroneaward of the ESC Heart Failure Association (2020) and the German Society of Cardiology AG23 Heart andDiabetes research prize (2021). As a board member of the European Society of Cardiology committee for youngcardiovascular professionals and the Scientists of Tomorrow nucleus, he is actively involved in supporting and dis-seminating basic science amongst young scientists and clinicians.Biography: Dr Lam is a Senior Consultant at NHCS specializing in heart failure and recognized globally for ex-pertise in heart failure with preserved ejection fraction. She is a recipient of the NMRC Senior InvestigatorClinician Scientist Award, Programme Lead of A*STaR’s Asian neTwork for Translational Research andCardiovascular Trials (ATTRaCT), Principal Investigator of ASIAN-HF (multinational study across 11 Asian coun-tries), and Steering Committee member of multiple global clinical trials. She has published >200 articles in journalsincluding NEJM, JAMA, Lancet, Circulation, and European Heart Journal. She serves as Associate Editor for Circulationand the European Journal of Heart Failure. Dr Lam is heard weekly on the global podcast ‘Circulation On The Run’and seen regularly on television as the Resident Doctor of ‘Body and Soul’ by MediaCorp Singapore.A fraction of wisdom on heart failure e115Downloaded from https://academic.oup.com/cardiovascres/article/117/9/e114/6329578 by University of Groningen user on 26 January 2022

   University of GroningenScientists on the SpotAbdellatif, Mahmoud; Lam, Carolyn S. P.Published in:Cardiovascular ResearchDOI:10.1093/cvr/cvab230IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite fromit. Please check the document version below.Document VersionPublisher's PDF, also known as Version of recordPublication date:2021Link to publication in University of Groningen/UMCG research databaseCitation for published version (APA):Abdellatif, M., & Lam, C. S. P. (2021). Scientists on the Spot: A fraction of wisdom on heart failure.Cardiovascular Research, 117(9), E114-E115. https://doi.org/10.1093/cvr/cvab230CopyrightOther than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of theauthor(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons).The publication may also be distributed here under the terms of Article 25fa of the Dutch Copyright Act, indicated by the “Taverne” license.More information can be found on the University of Groningen website: https://www.rug.nl/library/open-access/self-archiving-pure/taverne-amendment.Take-down policyIf you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediatelyand investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons thenumber of authors shown on this cover page is limited to 10 maximum.Download date: 01-02-2024...................................................................................................................Scientists on the Spot: A fraction of wisdom onheart failureMahmoud Abdellatif 1 and Carolyn S. P. Lam2,3,4*1Department of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria; 2Department of Cardiology, National Heart Centre Singapore, Singapore, 169609;3Duke-National University of Singapore, Singapore, 169857; and 4University Medical Centre Groningen, Groningen, Netherlands, 9700 RB GroningenKeywords HFpEF • SGLT2 • Sacubitril/valsartan • Heart failure • Sex differencesDr Mahmoud Abdellatif from the Medical University of Graz(Austria), interviews Prof. Carolyn Lam, a Senior Consultantat the National Heart Centre Singapore (Singapore).Highlight: In this Onlife interview, Professor Carolyn Lam shares herexpertise and major scientific findings on the subject of heart failure withpreserved ejection fraction.Summary of interviewTo kick off the interview, Professor Carolyn Lam reflected on what sheproudly considers her most significant scientific contributions to cardio-vascular medicine. In this regard, two achievements stood out. First, shementioned the Asian Heart Failure Study, which was an investigator-initiated observational study including 11 regions in Asia, thereby pro-ducing one of the very first multinational data on Asian patients withheart failure. The study resulted in multiple successful publications, re-vealing the differences not only between Asian and Western patients butalso within different regions in Asia. Second, she highlighted the recentFDA approval of sacubitril/valsartan as the first evidence-based drug forheart failure with preserved ejection fraction (HFpEF) patients who, asthe name implies, have preserved, but subnormal, ejection fraction. Thisapproval was based on the results of PARAGON-HF, a clinical trial, forwhich Prof. Lam was a steering committee member.On the topic of HFpEF, Prof. Lam discussed that it is a syndrome withmultiple causes and, thus, instead of solely relying on ejection fraction tostratify patients, a more holistic approach considering the diverse aetiol-ogies involved in this syndrome is warranted. Prof. Lam also highlightedthe importance of basic science to improve our understanding of themulti-faceted aspects of HFpEF pathogenesis, and how this might help inthe development of novel and effective therapies, at least in HFpEF pa-tient populations with homogenous phenotypes. Above all, she stressedthe importance of HFpEF prevention and how available drugs, such assodium-glucose transport protein 2 (SGLT2) inhibitors with proven car-diovascular efficacy against common risk factors for HFpEF, such as dia-betes and obesity, might be of clinical value in this respect.Next, Prof. Lam weighed in regarding whether sex plays a biologicalrole in HFpEF development. First, she highlighted the possible confound-ing effects of relying on identical ejection fraction cut-offs for both menand women, despite a relatively higher ejection fraction in women dueto the smaller heart and body size. That said, she then emphasized thatthere might still be biological reasoning behind the higher incidence ofHFpEF in women than men, which could be related to sex differences inthe immune response, as well as ectopic fat accumulation.Towards the end, Prof. Lam shared her advice with young cardiovas-cular researchers, where she stressed the need for continuous learningand following one’s own scientific passions. She mentioned that onlythrough following one’s scientific interests can we be kept driven andeventually achieve success. She also touched on the importance of differ-entiating between good advice, which one should follow and that whichmight be distracting from the path to success. As such, young research-ers should strike a fine balance between listening—and following theirscientific interests.Conflict of interest: C.S.L. is supported by a Clinician Scientist Awardfrom the National Medical Research Council of Singapore; has receivedresearch support from AstraZeneca, Bayer, Boston Scientific and RocheDiagnostics; has served as consultant or on the Advisory Board/SteeringCommittee/Executive Committee for Actelion, Amgen, AppliedTherapeutics, AstraZeneca, Bayer, Boehringer Ingelheim, BostonScientific, Cytokinetics, Darma Inc., Us2.ai, Janssen Research &Development LLC, Medscape, Merck, Novartis, Novo Nordisk, RadcliffeGroup Ltd., Roche Diagnostics, Sanofi and WebMD Global LLC; andserves as co-founder & non-executive director of Us2.ai.* Corresponding author. Tel: +65 6704 8000, E-mail: carolyn.lam@duke-nus.edu.sgPublished on behalf of the European Society of Cardiology. All rights reserved. VC The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.Cardiovascular Research (2021) 117, e114–e115doi:10.1093/cvr/cvab230 SCIENTISTS ON THE SPOTDownloaded from https://academic.oup.com/cardiovascres/article/117/9/e114/6329578 by University of Groningen user on 26 January 2022AuthorsBiography: Dr Mahmoud Abdellatif is a post-doctoral research fellow at the Department of Cardiology, MedicalUniversity of Graz (Austria) and the Kroemer Lab (Institute Gustave Roussy and Centre de Recherche desCordeliers, France). In his research, he studies the molecular mechanisms of cardiovascular aging to exploit themin the development of effective interventions that extend lifespan and delay late-life chronic diseases, includingheart failure. His contributions to the field include discovering the cardioprotective and longevity-promotingeffects of spermidine, as a natural autophagy inducer and caloric restriction mimetic. More recently, he found thatthe NADþ precursor nicotinamide—yet another caloric restriction mimetic—might be effective against a pre-dominant and intractable form of heart failure in the elderly, known as heart failure with preserved ejection frac-tion. Mahmoud received various awards for his work including, the Sanofi Aventis Prize (2017), the Guido Taroneaward of the ESC Heart Failure Association (2020) and the German Society of Cardiology AG23 Heart andDiabetes research prize (2021). As a board member of the European Society of Cardiology committee for youngcardiovascular professionals and the Scientists of Tomorrow nucleus, he is actively involved in supporting and dis-seminating basic science amongst young scientists and clinicians.Biography: Dr Lam is a Senior Consultant at NHCS specializing in heart failure and recognized globally for ex-pertise in heart failure with preserved ejection fraction. She is a recipient of the NMRC Senior InvestigatorClinician Scientist Award, Programme Lead of A*STaR’s Asian neTwork for Translational Research andCardiovascular Trials (ATTRaCT), Principal Investigator of ASIAN-HF (multinational study across 11 Asian coun-tries), and Steering Committee member of multiple global clinical trials. She has published >200 articles in journalsincluding NEJM, JAMA, Lancet, Circulation, and European Heart Journal. She serves as Associate Editor for Circulationand the European Journal of Heart Failure. Dr Lam is heard weekly on the global podcast ‘Circulation On The Run’and seen regularly on television as the Resident Doctor of ‘Body and Soul’ by MediaCorp Singapore.A fraction of wisdom on heart failure e115Downloaded from https://academic.oup.com/cardiovascres/article/117/9/e114/6329578 by University of Groningen user on 26 January 2022

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Scientists on the Spot:A fraction of wisdom on heart failure

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