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Renate B. Schnabel, MD, MSc, is an accomplished interventional cardiologist and Professor of Cardiology at the University Heart and Vascular Center in Hamburg, Germany. Her dedication to advancing science and patient care has made her a leader in the field and a sought-after expert speaker. She delivered the Geoffrey Rose Lecture in Population Sciences at the European Society of Cardiology (ESC) 2023 Congress (Figure 1).
Renate B. Schnabel, MD, MSc
Prof. Schnabel graduated from the medical school of Johannes Gutenberg University, Mainz, in Germany, and later undertook a research fellowship at the Framingham Heart Study at Boston University in the USA, where she received her master’s degree. Her expertise encompasses both epidemiological and clinical trials, and her research interests are in coronary artery disease/acute coronary syndrome, atrial fibrillation, risk assessment, and prevention. She is funded by the German Research Foundation, the Federal Ministry of Education and Research (BMBF), and the European Research Council (ERC).
Prof. Schnabel’s motivation to study medicine grew from a desire to help sick people. Her interest in the cardiovascular system goes back to her early years as a medical student. She says, ‘I was fascinated by the mechanics and fine-tuned action of the cardiovascular system very early on, so, cardiology was the sub speciality of choice. Interventional cardiology appeared to be a rapidly evolving discipline with dramatic therapeutic results that offered a chance to make a huge difference to patient outcomes’. This early interest and curiosity took her to the USA, where she investigated epidemiology and prevention at the Framingham Heart Study in Boston. It was a pivotal experience: ‘I learned that the majority of cardiovascular diseases in the population could be prevented by small changes in lifestyle and that the first contact with clinicians should not necessarily be in the cath lab’. Armed with this understanding, after 2 years in Boston, she returned to Germany, where she established her own research group. This marked the achievement of a personal goal—serving science and treating patients.
Prof. Schnabel enjoys the role of the physician–scientist with its ‘three pillars’ comprised of patient care, research, and teaching. ‘This is such a multi-faceted job that it never gets boring. You encounter new situations every day in the clinic and with students and fellows who ask questions about areas you have never thought about. This fires your curiosity and drives your motivation’. She emphasizes the pivotal role mentors and sponsors played in shaping her career trajectory and highlights Emelia J. Benjamin of Boston University and her current head of department, Stefan Blankenberg, for their guidance and encouragement. She is also grateful for her supportive family, who understand the demands of a busy clinical academic career. Although Prof. Schnabel characterizes her professional progress as ‘smooth’, she acknowledges the challenges she faced, particularly as a woman in the male-dominated field of interventional cardiology in Germany. Despite encountering disparities, she believes the landscape has changed since then, especially in research circles. She values the ESC environment, where innovative ideas are objectively discussed on a level playing field, and individuals are valued irrespective of gender or ethnicity.
Cardiology, she says, offers an unparalleled sense of fulfilment from the impact on patient outcomes to the exhilaration of advancing scientific frontiers. Aspiring cardiologists should cultivate a deep-rooted interest, seek diverse experiences, and, above all, find mentors who will champion their growth. ‘If you want to succeed, you need to be fascinated by what you are doing, and you need to like it. And beyond that, sound training and background knowledge is the basis for a career. It also helps to have a pioneering spirit and the ability to think out-of-the-box’. Her advice to anyone seeking a career in interventional cardiology is to simply make a start. She says, ‘If you’re truly interested in cardiology, the future is bright. I don’t think you can take a wrong step because it’s very broad-based and is such a fast-advancing field that you’ll find your place. Try to get experience in diverse areas of modern cardiology, from prevention to imaging, to coronary structural procedures, and then later on, it will be easier to find a sub-speciality’.
As a cardiologist whose career now spans several decades, she notes how the field is ever-evolving. ‘Cardiology has been able to reinvent cardiovascular medicine again and again through blockbuster interventions, new drugs, devices, and new treatment strategies and now digitalization will significantly advance prevention and treatment making maximum use of big data resources’. Machine learning or artificial intelligence (AI) will advance remote monitoring and treatment, with patients taking more personal responsibility for their health in response to growing demands on the health care system. All of which future cardiologists will need to weigh up and implement into clinical practice.
Her own work reflects her long-standing experience in coronary and structural interventions, and she has pushed to advance the field of risk prediction, prevention, and screening. In epidemiology, she has demonstrated and raised stakeholder awareness of the huge burden of arrhythmias and atrial fibrillation at the population level. In genetics, multi-omics, and multi-scale imaging approaches, her team endeavour to understand mechanisms of disease for primary and secondary prevention.
Prof. Schnabel’s overarching goal remains to leverage technology and expertise for the betterment of patient care. The AFFECT-EU project for atrial fibrillation, which focuses on digitalization and screening, is an example of this. She says, ‘We are trying to understand what the best screening strategy is, how to use digital devices best, and which type of devices to use. We are looking at what type and intensity of monitoring we should use in order to identify AF that needs treatment in terms of anticoagulation to prevent strokes and also in terms of heart failure or dementia’. This international project involves 26 partners, many beyond Europe, and will deliver an understanding of disease mechanisms, risk stratification, and earlier disease detection in order to reduce the burden of cardiovascular diseases.
Keeping yourself updated on developments in the field is time consuming but essential, and she advises emerging professionals to form their own networks and attend organized cardiology meetings such as those of the ESC, as well as those of the main subspecialities. National cardiac societies are a useful source of information; emerging knowledge, good journals, and dedicated resources play a part; and the opportunity to attend in-person events and engage directly with the researcher and other colleagues is an invaluable way to stay up to date. For those thinking about entering the field, she has the following advice: ‘The future of cardiology is bright, and for those truly interested, the opportunities are endless’.
Declarations
Disclosure of Interest
All authors declare no disclosure of interest for this contribution.
