CLINICAL INNOVATORS
Interview by
KATLYN NEMANI, MD
Promoting Cardiovascular
Health Worldwide:
An interview with Valentin
Fuster, MD, PhD
Dr. Valentin Fuster, MD, PhD, serves The Mount
Sinai Medical Hospital as Physician-in-Chief, as
well as director of Mount Sinai Heart, the Zena and
Michael A. Wiener Cardiovascular Institute and the
Marie-Josée and Henry R. Kravis Center for Cardiovascular Health. He is also the Richard Gorlin, MD/
Heart Research Foundation Professor at the Icahn
School of Medicine at Mount Sinai and the editorin-chief of the Journal of the American College of
Cardiology. The innumerable positions he has held
include serving as president of both the American
Heart Association and the World Heart Federation.
Dr. Fuster is the only cardiologist to have received
the highest awards for research from the four leading cardiovascular organizations: the American
Heart Association, the ACC, the European Society
of Cardiology, and the Interamerican Society of Cardiology. Dr. Fuster, in addition to his dedication to
research, is strongly committed to his responsibility
to communicate to the public. This commitment
has in the last 4 years produced six top-selling
books and led to Dr. Fuster launching the Science,
Health and Education Foundation (SHE), which is
directed at improving public health, especially in
the young.
As a young man you were a talented tennis
player competing at a national level. How did
you decide to pursue a career in medicine?
I love tennis. I spent so many years playing 2 to
3 hours each day, but I reached a point one day
where I decided that I would not make it, and that
day I decided to do something else. I wanted to
pursue agriculture, because I like biology. The way
plants talk to each other is interesting. I thought the
biology of agriculture was similar to human biology,
but I couldn’t do it because, at that time, you used to
stay home where your parents were from, and there
was no university for agriculture in Barcelona. I was
very lucky, because someone I knew from the same
tennis club I played at in Barcelona told me something I couldn’t believe—he told me I would make a
great physician.
I thought that if someone of such caliber tells you
to do medicine, you do it. You give credit to someone you respect. Throughout my career I have been
guided by people who inspire me, and now I am
obsessive about mentoring others. I think it’s critical.
And how did you segue from basic science into
public health?
I have always been driven to get to the root of problems. My research on blood clots lead me to ask the
question, “What causes a blood clot?” Most clots are
related to atherosclerotic disease. What causes atherosclerosis? The world of consumption we live in—obesity, tobacco, lack of exercise. So from there I segued
into the world of health promotion and prevention.
However, I never left basic investigation. I’ve been
surrounded by talented people who do in vivo imaging, and I’m still working in this field today. From
imaging the heart I’ve moved into imaging the brain,
because when you look at our world of consumption,
it is our brain that decides whether we take care of
ourselves or we don’t. The roots of cardiovascular
disease are behavioral.
Early in your career you were involved in basic
research investigating the role of platelets in
atherothrombotic disease. Was it a mentor of
yours who lead you to this field of study?
It was. I went to Liverpool for a few months where I
had a fantastic mentor in Harold Sheehan, MD. He
was one of the best pathologists in the UK, and he
told me I had to research blood clots. I went to the
University of Edinburgh to start my research career,
and my thesis was about whether blood clots are the
cause or consequence of a heart attack. From there I
became interested in platelets, one of the ingredients
of blood clots.
What kind of brain research are you doing?
My research in the brain has three main objectives.
The first is to determine the role of risk factors that
impact the micovasculature of the brain, leading to
lacunar lesions, cognitive dysfunction, and the acceleration of Alzheimer’s disease. The second objective
is to determine how we can motivate the individuals
who are developing atherosclerotic disease to change
their behavior. The third objective is to determine
how best to engage children. Age 3 to 6 is critical
time. Lessons that children learn at this time could
last for a lifetime.
Throughout my career I have been guided
by people who inspire me, and now I am
obsessive about mentoring others.
50 CardioSource WorldNews
How can you motivate people to take care
of themselves when they are developing
atherosclerotic disease that has not manifested
itself yet clinically?
We have a group therapy model which is similar to
Alcoholics Anonymous. People meet every 2 weeks
in groups of 10 to discuss smoking cessation, exercising, and eating healthier. We piloted it in five communities and we found it to be extremely helpful.
Sometimes it is a cultural shift that you have to
May 2016