ESC Vienna 2007

Heart Failure and Hotlines (Prof. Komajda, Paris, France) :

Vienna 2007's highlight is heart failure, a condition with growing importance, due to increasing prevalence in the general population and the complexity of its management ;

• The Hot lines and CTUs of Vienna will present new information : the 3 CPO trial will compare two different non invasive respiratory procedures to standard therapy in the management of acute pulmonary edema.
• The COACH trial will provide results of a nurse led management programme in heart failure compared to standard care.
• The EVEREST trial update will provide new results of this large outcome trial using the Vasopressin antagonist Tolvaptan.

Finally, results of a pilot study with the direct renin inhibitor Aliskiren in heart failure will be presented. Many sessions will also cover the pathophysiology, epidemiology and management of heart failure during our annual meeting.

Hypertension and Peripheral Artery Disease (Prof. Clement, Gent, Belgium) :

 
In 2007, two important new guidelines have been published : those on Hypertension, presented at this meeting, and those on peripheral artery disease, whereon many references are given at this congress.

• The hypertension guidelines, an update of the 2003 document, first highlight that hypertension has to be seen as part of total cardiovascular risk; not as blood pressure elevation only.
• Emphasis is given to BP measurement including ambulatory and home blood pressure and the definitions of "normal" with those techniques;
• Fnally, treatment aims at getting the normal values, whatever the antihypertensive drug. The problem is that the goal pressure often is not obtained.
• Peripheral artery disease is another part of this cardiovascular risk; very often underestimated and not diagnosed because many patients are asymptomatic or atypical symptomatic.
• The best technique for diagnosis is ankle-arm pressure index measurement: easy, simple, cheap and also very informative for long term prognosis.
• As for treatment, the role of antiplatelet drugs is clearly highlighted.

Stroke and Imaging (Prof. Gensini, Florence, Italy) :

Stroke currently represents the major cause of serious long-term disability, accounting for approximately 50% of all patients hospitalised for acute neurological diseases.

• Beside effective prevention, early stroke diagnosis and therapy are crucial to face such a challenging health problem in world population, and imaging is essential to diagnosis and therapy.
• Even if in the past imaging was associated especially with stroke diagnostics, more recently the enormous potential of imaging in acute stroke therapy has been underlined.
• A 2007 evaluation of the safety and efficacy of thrombolysis based on MRI within and beyond 3 hours of acute stroke, compared with standard CT-based thrombolysis, provides interesting clinical findings on stroke imaging which are applicable to real-world health practice (Stroke 2007).
• Evidence-based and really applicable to daily practice imaging interventions are mandatory to improve the health care of acute stroke patients.

You will find, for the above areas of expertise, as well as for Risk stratification and coronary artery disease, Rhythmology and pacing, the complete Take-Home message for Practitioners in the upcoming articles of the e-journal.