Q & A with Speakers

Q & A with Speakers

Some of our Key speakers reveal more interesting information about the Heart and Brain Symposium 2018.

Natan Bornstein
Director of the Brain Division at the Shaare-Zedek Medical Center
Vice President of the World Stroke Organization (WSO)
Member of the Executive Committee of the European Stroke Organization (ESO)

Why is the interdisciplinary team important?


 


Professor Wolfram Doehner,Wolfram.jpg

Vice Chair of the ESC Council on Stroke and Professor at the Stroke Research Center, Charité Universitätsmedizin Berlin

We spoke with Professor Doehner about the 2017 ESC position paper on the role of cardiologists in stroke prevention and treatment, collaboration, and his vision for the future of the field. 
Professor Doehner will be delivering a Keynote lecture on The Heart Failure Patient with Stroke - What is Important, What is Different? and also be participating in a panel discussion on Collaborative Medicine.

What is the ideal collaborative approach? 

There should always be collaboration and mutual feedback between both specialties .This should start as early as the initial diagnostic work-up when the stroke patient arrives in the emergency department. For example, vital aspects such as heartbeat, heart rhythm and functions of the myocardium must be taken care of immediately.
Once initial stroke treatment by the neurologist has commenced in the stroke unit, there should be further collaboration with cardiologists to manage the many complications originating from the cardiovascular system. Specifically, this would address the interaction between brain injury and myocardial function. While cardiac function may be responsible for cerebral injury, there are also neuro-endocrine signaling pathways through which acute stroke may have a detrimental effect on cardiac function.

Read Prof. Doehner’s full interview here >
 
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Costantino Iadecola
Feil Family Brain and Mind Research Institute, USA

What are the learning objectives of your session "The Neurovascular Unit and Cognitive Impairment"?

- To learn about recent advances in the regulation of the cerebral circulation in the normal state and in diseases associated with cognitive impairment

- To learn the mechanistic bases by which alterations of the cerebral circulation lead to the neuronal dysfunction and damage underlying cognitive impairment

Why is the lecture important?

There has been a dramatic change in the landscape of cognitive impairment in that cerebrovascular dysfunction has emerged as a key contributor both in vascular cognitive impairment and in dementia on neurodegenerative bases, e.g., Alzheimer’s disease. This lecture explores the mechanistic bases of the fundamental contribution of cerebrovascular dysfunction to cognitive impairment of such diverse etiology.


james reiffel.jpgJames Reiffel
Columbia University, USA

Please describe a case of yours which shows how knowing how to work inter-departmentally improve patient care and outcome?

A case that comes to mind in response to your questions is a 74-year-old female with a background of hypertension who presented to our neurology service with a seizure. Upon full examination and laboratory testing, after her post-ictal state resolved, it was clear that she had a mild left hemiparesis, that cleared almost completely over the next 72 hours, and an embolic-mediated defect on her MRI. Her ECG on admission was unremarkable but on day 2 of her hospitalization, while on a monitor, a 4-hour episode of atrial fibrillation was detected. 

She was started on an antiarrhythmic regimen (dronedarone) and on a DOAC (apixaban). Her neurologist felt that she was not at risk for recurrent seizures, having attributed it to the acute lesion, and she was not started on an antiseizure regimen.


philip gorelick.jpg Philip Gorelick
Mercy Health Hauenstein Neuroscience Center, USA 

Tell us more about your session "Defining Optimal Brain Health in Adults"?

In relation to optimal brain health, learners will be able to discuss:
1. Background information regarding world brain health and the American Heart Association/American Stroke Association’s Presidential Advisory on optimal brain health; and 

2. How to define optimal brain health and what are the prospects for maintenance of cognitive vitality during one’s lifetime

Why is the lecture important?

About 1 in 3 persons will experience a stroke, Alzheimer’s disease (AD) or both during their lifetime.

More recently it has been recognized that the same cardiovascular risks for stroke are shared by AD. Thus, it may be possible to prevent or slow major cognitively impairing disorders as we age by cardiovascular risk factor control. 

In this lecture, I will review prospects for healthy brain ageing and the role of cardiovascular risk factor control as a means to avoid dementia or cognitive decline.  


View the full program of HBS 2018>