Compelling Unmet Needs in Treatment of CVD

SAN FRANCISCO, CALIF.—In a session on the most compelling unmet needs in CVD for the next decade, Chaim Lotan, MD, of The Heart Center at Hadassah University Hospital in Israel, summarized six key areas representing the greatest need for innovation: valvular heart disease; sudden cardiac death; hypertension; HF; the development of telemedicine and consumer health care; and diabetes.

“The population is aging and they want to live better and for longer,” Lotan said. “The vision is to bring an idea, but first, the needs should be identified.”

Foremost on the list of unmet needs are patients with valvular heart disease and transcatheter aortic valve replacement (TAVR). The current problems facing these patients are the need to prevent stroke and paravalvular aortic regurgitation, the need for online 3D imaging for best positioning and vascular closure post-procedure.

Lotan said that despite the estimated 300,000 cases of sudden cardiac death in which resuscitation is attempted outside of the hospital annually in the United States, a singular solution has not been identified to treat the condition. Possible options include the development of alarm devices that allow for early defibrillation. Therapeutic hypothermia is also an innovative treatment on the horizon, according to Lotan.

Clinical needs also remain for hypertension, the most common cause of death worldwide. Recent data from a pilot study indicate significant reductions in BP in those with resistant hypertension via a new catheter-based procedure.

Moreover, effective therapies are needed in HF to prevent hospitalizations and to effect myocardial repair and replacement; improvements are also needed in LVADs and total artificial heart technology.

Telemedicine, consumer health care needs and home care information technology will also play a major role in the future development of medicine. “We have to look and see what the needs of our customers are going to be,” Lotan said. “Our medicine is forever changing.”

Lotan ended by discussing issues related to diabetes — in his opinion, the next pandemic. “It seems that most of the population in the next 10 to 15 years will be overweight. [Diabetes] affects the entire body — from the brain, to the heart, to the kidneys — and we have to find a solution,” he said. “We have to find a way to evaluate new therapies, and the [procedure to do so] should be made faster.”