Roberto Ferrari, professor of Cardiology at the University of Ferrara, Italy, has recently concluded his term as president of the European Society of Cardiology. In this interview, Ferrari, who is also director of Cardiology at S Anna University Hospital of Ferrara, spoke to Cardiovascular News about his current areas of research and his achievements as ESC president.
When did you decide you wanted a career in medicine?
It was after high school, but I was not very convinced. I had always wanted to be an architect, but my father did not like the idea. I then chose to study law at the University of Bologna. It was a cousin of mine who directed me to medicine.
Why did you decide to specialise in cardiology?
A good friend of mine was a cardiologist and he influenced me in a decision which, again, was taken without much conviction. After completing a medical degree at the University of Bologna in 1974, I studied at the University of Parma’s Postgraduate School of Cardiology for two years, before returning to Bologna to study radiology. I then went to London and completed a PhD in cardiac metabolism at the UK’s National Heart Hospital. As part of my studies, I was sent to work with rabbits to investigate how to protect against myocardial infarction. This was a key turning point in my career, and gave me an enduring love for research.
Who have been your greatest influences?
During my career as a cardiologist the people who have influenced me most are the late Prof Peter Harris, from the University of London, who taught me not to necessarily follow in others’ footsteps; Prof Shahbudin Rahimtoola, who taught me the importance of putting the patient as the most important target of our actions; the late Alan Fletcher, a world famous designer who taught me how to communicate by drawings and in a simple way; and Prof Luigi Tavazzi, who taught me the importance of working together as a team.
What have been your proudest moments?
One of my proudest moments was when we concluded a series of research in India showing that neuroendocrine response to heart failure is dangerous and therefore a therapeutic target. This finding has changed the way we treat this disease. And, of course, another proud moment was when I was elected president of the ESC.
How has interventional cardiology evolved since you began your career?
Tremendously. Interventional cardiology has completely changed the way we treat myocardial infarction. All the drugs which I was taught to use in heart failure are nowadays forbidden and we use those drugs that we were taught not to use. I am also a believer in prevention, a concept that did not exist when I graduated.
You have concluded your term as president of the European Society of Cardiology. What have your biggest achievements been?
The establishment of European Heart for Children, the restructure of the surveys and registries programme and the creation of a friendlier atmosphere at the European Heart House.
One of your aims as president of the ESC was to increase ties especially with Eastern European countries. Were you successful in implementing these plans?
I believe so, although it is difficult to measure success. I attended many of the national meetings of all 52 cardiology associations. I asked to be given 15 minutes to speak at each event, and for a closed meeting with the leadership of each society to determine how best to work together. I also gave a brief talk on my work to show members that I am one of them, a cardiologist, not just a diplomat. The results are that now each national society has its own joint ESC-National Society symposium, and each society is working more closely with the ESC to provide better European cardiology registries and surveys. They are cooperating in many projects and increasing their presence at the annual congress. Maybe this can be considered as success.
What makes the ESC Congress so successful every year?
It is the biggest cardiovascular congress in the world and I believe this is due to two things: the programme is identified by our members, and it is fair, we consider everything they are telling us and we provide what they think is important for them in a very transparent way. The second thing is the organisation. We care about the delegates. When you arrive at the venue, you know that you are at the ESC Congress, you know that you will meet with your people, you know that we care and that we want delegates to participate.
What is the role of prevention in cardiology?
I believe that the future is in prevention. In cardiology we have almost reached the top in terms of treatment. We are extremely good at treating patients. In fact, we prolong life expectancy by at least seven years. Prevention is awareness; it is something that cardiologists cannot do by themselves. The ESC Congress is an arena to discuss how to really implement prevention in Europe.
You have been involved in several studies mainly in basic research. Can you tell us what investigation surprised you the most?
The mechanism of action of several classes of drugs such as calcium inhibitors, ACE-inhibitors and If-channel as well as the understanding of the metabolics of the molecular and cellular changes in ischaemia and heart failure.
Transcatheter valve implantation has emerged as an alternative to surgery and has grown considerably in the last few years in Europe. How do you see this field in the future?
I believe it is very important and will progress thanks to advancing technology and to the skills of cardiologists.
Tell us about one of your most memorable clinical cases.
It was a patient with hibernating myocardium, very poor LV function and unsuitable for operation. After a lively discussion I convinced the surgeon to operate on him even though it was obvious that he had no chances of survival. The patient did well and recovered some, not all, ventricular function. When I went to discharge him he asked me if he could stay a night longer at the hospital as he wanted to watch the football match with his roommates. He came back to my office after one year to thank me and he brought a Campari Soda, a very common aperitif in Italy, which we shared. For me it was an important gift and the normal patients are the ones who find the best ways of thanking you from the heart.
What are your current areas of research?
Stem cells application in cardiology, mechanism of remodelling and the life and death cycle.
Outside of medicine, what other interests do you have?
I like food, design and printing. Basically, I like everything even though I am not good at anything.
Professor of Cardiology, University of Ferrara, Ferrara, Italy
Director of Cardiology at S Anna University Hospital of Ferrara, Ferrara, Italy
Director of the Centre of Cardiovascular Research S Maugeri, Ferrara, Italy
1969–1974 Bologna School of Medicine
1974–1976 Postgraduate School of Cardiology, University of Parma
1977–1980 Postgraduate School of Radiology, University of Bologna
1980–1982 PhD in Cardiac Metabolism at the University of London
2008–2010 President, European Society of Cardiology
2006–2008 President Elect, European Society of Cardiology
2004–2007 President of the World Section, International Society for Heart Research
2004–2006 Vice President and Chairman of the Associations, Councils and Working Groups
2002–2004 Executive Board Member and Chairman of the Education Committee
1996–2002 Member of the Scientific Committee, Italian Society of Cardiology
1996–2000 Councillor of the Board, Italian Society of Cardiology, Italian Society of Cardiology
1996–1999 Councillor of the Board, Italian Federation of Cardiology
1994–2002 Treasurer, International Society for Heart Research
1994–1996 Chairman of the Working Group on Cellular Biology
1996–Present Editor, Dialogues in Cardiovascular Medicine
1996–2004 Editor, European Heart Journal Supplement