CardioNerds at THT 2023

The CardioNerds are excited to be covering the CRF Technology and Heart Failure Therapeutics (THT) 2023 conference to be held in Boston, March 20-22. In this interview, CardioNerds correspondents Drs. Nazli Okumus and Sonu Abraham spoke with one of the conference directors, Drs. Daniel Burkhoff, to detail the many things that make THT such an exciting, and innovating meeting to attend. In only its second year, THT 2023 strives to build on the success of last year’s event by featuring the latest and most impactful drug-and device-based therapies for heart failure. See what the CardioNerds and Dr. Burkhoff had to say!

Dr. Nazli Okumus: Hello everyone and thank you so much for tuning in today. My name is Nazli Okumus. I’m a second year general cardiology fellow at Allegheny Health Network in Pittsburgh and I serve as the CardioNerds ambassador for our fellowship. I’m thrilled to be one of the cardio nurse conference scholars for the CRF Technology and Heart Failure Therapeutics conference to be held in Boston, March 20 through 22, THT 23.

Dr. Sonu Abraham: Hi everyone, my name is Sonu Abraham. I’m a cardiology fellow at Lahey Hospital & Medical Center in Massachusetts. I too serve as a CardioNerds ambassador from my institution. I’m excited to join Nazli as a CardioNerds conference scholar for the THT conference here at Boston. Through the CardioNerds Conference Scholars program, the CardioNerds attends conferences and scientific sessions with the goal to distill key takeaways. As the conference scholars, we will be live tweeting during the conference and writing news articles.

Dr. Nazli Okumus: THT 2023 is a conference that focuses on device and technology-based treatments while putting these into the perspective of drug-based therapies, thus filling existing gaps. We are excited to learn about technologies that are in the pipeline and future directions from leading researchers and clinicians in the field.

Dr. Sonu Abraham: We are honored to be joined by Dr. Daniel Burkhoff, one of the directors of this amazing program. A world renowned expert in heart failure and hemodynamics, Dr. Burkhoff is the director of heart failure, hemodynamics and mechanical circulative support research at the Cardiovascular Research Foundation. He directs CRS educational program called TEACH, which is Training and Education in Advanced Cardiovascular Hemodynamics, which I have had the privilege to attend last year. If you need to know anything about PV loops, he’s the master. He’s also the founder of Harvey, an interactive simulation based application for teaching and researching many aspects of ventricular mechanics and hemodynamics. Dr. Burkhoff, welcome. Thank you for taking the time to speak with us.

Dr. Daniel Burkhoff: Thank you so much for having me and for talking about these really interesting topics.

Dr. Sonu Abraham: So I’ll get right to it. Following the incredible success of last year’s inaugural conference, the second annual THT conference is being held with the participation of experts from across the country and will cover a range of updates on the current status of drug and device-based therapies in advanced heart failure. Dr. Burkhoff, could tell us what makes THT a unique experience in itself?

Dr. Daniel Burkhoff: Sure. So why did we generate yet another meeting, THT? We felt that many of us working in the field, especially of device-based therapies, that the meetings that exist like the ACC, AHA, even ISHLT and the HFSA, these are places where mainly drug therapies are featured, where there is some element of also some basic science that is featured. But those of us that are really active in the device field, there’s a little bit of a void where we can all get together, the people that are innovating and developing these new technologies, which span a huge array of devices and aspects of either diagnosing or managing or treating heart failure where we could get together and also the innovators and also the researchers that are doing the work in the field, the clinicians, the key opinion leaders and also a lot of our focus is on the younger stage career and fellows where this is not necessarily a place where you can get a concentrated education in these kinds of aspects. How do you go about developing devices for heart failure? How do you go about researching devices for heart failure?

What are the issues that FDA is concerned about? What are the issues that are of concern to the payers? It’s a very different development and a different mindset, if you will, of developing devices and technologies than it is in developing drugs. So we felt that there was a void and apparently there is because people have given us really good feedback. It’s very, very quick paste, short talks, time for discussion, get right to the point, answer questions with brief answers, get right to the point and then time for discussion and have time to meet afterwards and in between sessions.

Dr. Sonu Abraham: Perfect. That’s incredible. It looks like there’s no shortage for learning opportunities at THT. From what I understand, it looks like we are going to be learning about device related technologies from diagnosis all the way to management, also maybe learn about how the research works in the background, which we don’t usually hear about or even talk about during our clinical training. So that’ll be pretty interesting.

Dr. Nazli Okumus: So Dr. Burkhoff, in addition to advanced heart failure, the agenda of THT combines various subspecialties such as critical care and interventional cardiology. What are the goals and target audience fort THT?

Dr. Daniel Burkhoff: So really as we outlined on the website, the audience is extremely broad. Really in our view, anyone who’s really interested in learning about anything about heart failure diagnosis, treatment is a target here. Our main goal is to bring together heart failure people and interventional cardiologists. So this is really another unique aspect. As the devices are getting more and more important in the research realm, many of them are put in by interventional cardiologists. But the heart failure people are the ones who have to refer the patients and like we saw in TAVR and structural heart where there was a development of the heart team with cardiologists and interventionalists, general cardiologists and interventionalists we’re seeing now the development of teams that are interventional cardiologists and heart failure cardiologists. So those are clearly targets. But as you pointed out, the intensivists, we’re going to be dealing with shock. We’re going to be dealing with acute decompensated heart failure, patients who get admitted to the intensive care unit. So there it brings in the intensivists.

Nurses, APNs, technologists, perfusionists are the ones that are actually on the front line managing these patients and I believe that they also want to learn about these aspects that we’re going to be dealing with, so all of them. We have a session for nurses and pharmacists that are dealing with advanced heart failure patients. We’ve got a session on transplant of course and of course on LVESD. But now as you probably know, the whole space of transplant is even being transformed by devices, by devices that are prolonging organ preservation and these are having a very large effect on organ donation and allocation and increasing the pool. So those are all technologies that we’re going to be talking about. Percutaneous VADs, of course, a lot of innovation going on there and Impella is really just the start and ECMO with the rise of ECMO, these are just the start. It’s going to continue to evolve. So here again, interventionalists put it in. Heart failure and intensivists refer the patient. The interventional cardiologist put it in. So really if you can think of anyone who touches a heart failure patient that is the target audience.

Dr. Nazli Okumus: This is such an incredible way of emphasizing the teamwork that we need at both inpatient and outpatient setting. Thank you, Dr. Burkhoff. Here’s another question. As fellows, we are training in an era of ample progress with a plethora of evidence-based therapies. I’m looking forward to the sessions featuring the ongoing clinical trials, such [inaudible 00:09:17] and also learning about futuristic concepts of AI and machine learning in the care of heart failure patients. Could you tell us about the sessions geared towards trainees and how fellows can get more involved?

Dr. Daniel Burkhoff: Well, it would be, I think, wrong of me to say one or another session is appropriate for fellows because they’re all appropriate. One thing I would say, first of all, I think that attending … So we have three late breaking clinical science sessions, two that are basically by, let’s say, established clinicians and the list of presenters in the late breaking clinical science is really among the who’s who of heart failure. So I mean the whole meeting is a chance for fellows to meet key opinion leaders. There is a special session on fellows abstract competition. We had over 30 submissions. We accepted most of them either as a talk or as a poster presentation. We selected what we thought were the top seven that will be presented on Tuesday afternoon and it’s going to be presented as a competition and the panelists are going to choose a winner and a runner up. Everyone is a winner in a way by just being selected and for presentation.

But I think to see your co-fellows in a pressure cooker under the pressure of having to present and also answer questions from the panel of experts, these are the program directors top programs around the country. So to see your co-fellows, what it’s like, if you haven’t done it already, to present and answer questions and also to be there to support your co-fellows is I think something that should be very appealing. Having said that, there’s ample opportunity and a very, very diverse array of topics. Pick the topics that you’re really interested in and in between sessions, go to the presenters. Go to the panelists and get them to answer your questions and also don’t be shy to ask questions during the discussion sessions. Please get up and ask questions.

This is a meeting that is geared towards people that are emerging in the field of heart failure because a lot of what we’re going to be talking about is what’s going to be coming not this year, not next year, but in 2, 4, 5, 10 years from now and we want you to be inspired to be a part of the innovation process, including those that are interested in clinical medicine to get involved with clinical research. This is also the arena for understanding what is involved in developing. A lot of the presentations are going to be presentations. There’s a whole session on first in man. These are devices that have only been used in 1 to 20 patients. So will all of these make it? No, but you get to see how people start from the very, very beginning of introducing devices in clinical trials. You’ll also see late breaking clinical trials. We do have a few studies that are going to be presented where there have been 3 or 400 patients presented, new data from some of these studies.

So it’s an opportunity for you, for fellows to get involved at whatever appeals to them the most, innovation, of course. We also have the shark tank. These are devices that are still in the development and may only have a few patients that they have treated. But there’s an opportunity to see, at the very, very beginning. Then there’s the first in man session. Then there’s the late breaking clinical science and then we have results of more mature studies. So jump in at any level that you want and please, we encourage you to actually come all two and a half days and be there. There’s nowhere else I think that you can get the education if you attend these sessions.

Dr. Nazli Okumus: This is really exciting and as a fellow, I’m also presenting at the competition and I can’t wait to engage with other fellows.

Dr. Daniel Burkhoff: I did not remember that. I was not involved with the selection because being on a selection committee, you don’t make friends. You make enemies. So I’m very happy to hear that you’ll be presenting and I’ll look forward to the presentation.

Dr. Sonu Abraham: Dr. Burkhoff, I’m going to ask the last question. What would you say is the one thing that you’re really excited about in this conference, if you could choose this one thing?

Dr. Daniel Burkhoff: I can’t choose one thing. It’s like trying to ask who’s your favorite child. I just have to say there are over 40 sessions in two and a half days. It’s extremely packed and, as I said, very, very fast pace and that’s one thing I think people like about it. Fast pace, get in out about an idea. We spent 12 months carefully crafting the program and hours sequencing on every session. What should the sequence be? Who should be the speakers? We spent a lot of time, myself and our co-directors, a huge amount of time. Every session is a session that I want to attend. So maybe it’s something I crafted in a way that I would want to attend a meeting and because of that, I want to attend every single session. So it’s not possible because there are three rooms running in parallel. So some people like vanilla. Some type people like chocolate. Some people like strawberry ice cream. That’s why they make different flavors is that different people are really more attracted to different things.

Dr. Sonu Abraham: And are these sessions available virtually?

Dr. Daniel Burkhoff: There’s no virtual component. I think people that are running meetings found that having a virtual component disrupts and discourages people from attending in person and now that we’re past the COVID era, people have really realized the importance of in-person contact. You cannot replace the interpersonal contacts and interpersonal interactions, the benefits of that, especially for young people. You cannot have the interactions like you have on a Zoom that you have in person and that’s another important thing. The ACC I think is another great example this last week. There were, as I understand it, almost 17,000 people in person and only 2,000 people online and it’s a lot of effort to make an online a meeting that’s hybrid, both and it doesn’t seem that it’s really worthwhile. I think people now are yearning for that contact, the personal contact. Having said all that, all of the sessions I believe are being recorded and they will be available to view offline after the meeting on the TCT MD website.

Dr. Sonu Abraham: Thank you, Dr. Burkhoff. This all sounds really amazing. As you know, both Nazli and I are really looking forward to a great time in Boston at THT. We’re so grateful to have the opportunity to speak with you and are looking forward to you there. Thank you everyone for joining us today and thank you for inviting us to THT 23.