Attended by more than 1400 doctors and health professionals, the annual congress of the European Association of Preventive Cardiology (EAPC), EuroPrevent, took place, for the first time in Ljubljana, Slovenia, last April (2018). The main theme of this year’s congress was ‘Evidence based cardiovascular prevention: A lifelong endeavour’, which was delivered through an intense programme including invited lectures and symposia, young-investigators awards sessions, abstract presentations and moderated poster sessions, alongside with a series of social and networking events. The most recent updates on cardiac rehabilitation, prevention and epidemiology, sports cardiology and exercise, and basic and translational research were presented. Highlights and new exciting areas included the scientific evidence supporting the adoption of relaxation techniques to reduce cardiovascular risk and the cardiovascular protective effects of food. In more detail, regular sauna was shown to have positive effects on vascular physiology, morbidity and mortality in patients with cardiac disease.1–3 However, alternating between heat exposure and cold water immersion should be avoided as it may trigger acute coronary syndromes and arrhythmias.4 Yoga was shown to improve left ventricular ejection fraction and inflammatory markers in cardiovascular diseases and heart failure patients;5–7 whilst, in addition to pharmacological therapy, it has also shown beneficial effects in atrial fibrillation treatment.8 Red rice yeast (RYR), soy and combined nutraceuticals have shown low-density lipoprotein cholesterol lowering effects. However, RYR is chemically identical to lovastatin and therefore some side effects typical of this molecule may appear. Moreover, the presence in these products of citrinin and non-purified monocolin K are raising some safety concerns.9–12
The latest news regarding the most important trials on e-health in cardiac rehabilitation were presented, including the EU-Care Project, implemented with EU Horizon 2020 funds. The project, dedicated to elderly cardiac patients undergoing rehabilitation, aims to compare conventional cardiac rehabilitation programmes with innovative mobile tele-monitoring protocols.13
The SmartCare-CAD trial has the objective of investigating the efficacy of cardiac tele-rehabilitation versus centre-based cardiac rehabilitation.14 eEduHeart I aims to study the efficacy of combined conventional cardiac care with e-learning in cardiac rehabilitation.15 The REMOTE-CR trial aims to assess the effects and non-inferiority of mobile health technologies for the remote delivery of rehabilitation exercise programmes.16 Novelties in the management of cardiomyopathy and implantable cardioverter-defibrillators (ICDs) in athletes were also presented. That there is not enough evidence to support the assumption that exercise increases the risk of life-threatening arrhythmias in patients with hypertrophic cardiomyopathy was admitted. Therefore, the sudden cardiac death risk during exercise may be low, especially compared with that of patients affected by arrhythmogenic cardiomyopathy.17 ICD indications in athletes, their management and advantages of subcutaneous devices were extensively discussed during a dedicated session, which highlighted the most innovative practices implemented worldwide.18–21
The first results from the EUROASPIRE V survey, currently involving 27 countries, were presented and compared with the previous studies. The most up-to-date approaches on the management of patients with coronary heart disease (CHD) were presented. Results showed that the European Society of Cardiology (ESC) guidelines regarding lifestyle changes could be implemented more effectively, in particular when it comes to promoting smoking cessation, physical activity participation, nutrition management, hypertension and lipid control. This partial result, despite the considerable evidence available on the benefit of lifestyle changes (e.g. the preventive effect of physical activity)22 and international resolutions continuously adopted.23 Therefore, prevention of CHD is possible but a stronger effort with a multidisciplinary approach is needed.
Editor-in-Chief Massimo Piepoli and Social Media Editor Silvia Castelletti meeting with an author.
Great novelty for this year’s conference was represented by the special focus given to gender differences in heart diseases management and in exercise prescription, a topic where each gender has its specific needs.
Educational and interactive sessions, including EAPC quizzes (cardiopulmonary exercise testing, exercise prescription, risk assessment and sport cardiology), two sport cardiology master classes, how-to-sessions and case-based sessions, were extremely engaging and had a high attendance rate. Another highlighted session of the congress was ‘How can I get my research published and recognized?’; this was very well attended by participants of all ages. Massimo Piepoli, the Editor-in-Chief of the European Journal of Preventive Cardiology, the association’s official journal, which boasts an impact factor of 3.606, together with other members of the Editorial Board, gave useful tips on how to draft a manuscript and have it accepted for publication. A meeting with the Editor-in-Chief and the Social Media Editors of the journal was held also in the SAGE Press stand for a more unconventional and personalized encounter.
Great visibility was given to the youngest participants through several dedicated sessions and young investigator awards, rewarding the best oral abstract for each section of the Association. This year, the winners are: Dr Miles for the sport cardiology section, showing the results from a case series of 98 arrhythmogenic cardiomyopathy cases diagnosed at post-mortem, including 35 young competitive athletes; Dr Maessen for the cardiac rehabilitation section, illustrating the results of outpatient cardiac rehabilitation participation impact on all-cause mortality in a heterogeneous group of more than 78,000 cardiac patients; Dr Witvrouwen for the exercise basic and translational research and prevention section, illustrating the SAINTEX-CAD24 sub-analysis results, suggesting that better baseline cardiopulmonary exercise testing characteristics may result in reduced training improvement; Dr Willemsen for the epidemiology and population science section, showing that CD14 and cystatin C in extracellular vesicles are associated with both renal dysfunction and heart failure in patients presenting with dyspnoea at the emergency department. Best posters were awarded to Dr Hansen, Dr Leonova, Dr Brambilla, Dr Hamazaki and Dr Galson.
Another successfully replicated event was the ‘Career-Cafe’, a ‘speed dating’ format session, where the youngest participants had the opportunity to meet experts in the field for a face-to-face interview: Ana Abreu, Paul Dendale, Rick Grobbee, Marco Guazzi, Martin Halle, Arno Hoes, Paul Leeson and Antonio Pelliccia met young participants for a 15-minute interview.
One of the key sessions of the congress was the General Assembly, during which Professor Grobbee, President of the Association, illustrated the EAPC structure revision, implemented to improve and strengthen the Association’s internal organization. In the same session, Dr D’Ascenzi, the representative of the Young Community of the Association, introduced the EAPC Young Community Ambassadors initiative, created with the objective of expanding the community of young researchers in the field.25 The opening of the call for applications was officially announced and will last until the end of June.
Furthermore, the congress wasn’t only meetings and lectures. Besides the scientific sessions, informal meetings took place in order to facilitate networking in a more relaxed and friendly setting.
People participated in the congress not only on-site. This year, for the first time, the contents of the event were also shared and commented on Twitter, through the official ESC Twitter channel and the Twitter ambassadors present in Ljubljana. High expectations were already evident before the Congress from the online discussion concerning several important topics. During the Congress, key messages were shared through the official hashtag #EuroPrevent, which was tweeted more than 2.4 K times and re-tweeted more than 1.8 K times by doctors, health professionals, patients and people from all over the world. The most popular tweet was about the increasing need to move away from a glucocentric focus in diabetes management, since intensive glucose therapy neither reduces the mortality rate nor prevents cardiovascular events.26,27
Next year the Congress will be in Lisbon from the 11th to the 13th of April. We are expecting more and more participants, on-site and through Twitter, so stay tuned!
Declaration of conflicting interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
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