What will the future of cardiovascular medicine look like?

A group of scientists, engineers, educators, surgeons, physicians and students explored this question at the Stanford Cardiovascular Institute’s annual retreat earlier this month. More than 100 attendees crowded into Stanford’s Li Ka Shing Center for Learning and Knowledge to learn about the research and advances that will transform cardiovascular care.

“For this year’s retreat we’ve  asked selected members to dig deep into the past and project the future of their specialties,” institute director Joseph Wu, MD, PhD, told the audience.

Talks presented during the day – on topics including sports medicine, stem cells, women’s health and biodesign – reflected the breadth of the institute’s scholarship and the diversity of its members.

Stem cell scientist Hiromitsu Nakuchi, MD, PhD, spoke about recent advances in stem cell biology and regenerative medicine. Only a few years ago, stem cell-based regenerative medicine was widely perceived as the province of science fiction. No more, Nakuchi said. His lab has been working on a new technique to transform human skin cells into induced pluripotent stem cells, or iPS cells, which can then be used to develop organs. The ultimate goal of this research: To create genetically matched human organs in large animals.

Researchers like geneticist Michael Snyder, PhD, envision a day when an “omics” profile will be sequenced before birth, and Snyder took to the stage to discuss the potential of personalized medicine. “I’m a believer in the future,” he said. “Genomics will move medicine from diagnose-and-treat to predict-and-prevent.” After sequencing his own genome and thousands of other biomarkers to create an integrated personal omics profile, Snyder learned that he was at risk for Type 2 diabetes. This knowledge allowed him to transform his diet and ramp up his physical activity, and it provided him a first hand glimpse of the diagnostic power of genomics. Genomic sequencing has the potential to change the way physicians care for patients, Snyder told the audience, resulting in more effective, patient-tailored therapies and a greater focus on disease prevention.

The second half of the retreat focused on women’s health and technological innovation.

Sandra Tsai, MD, MPH, clinical instructor of medicine, outlined her recent work to evaluate the efficacy of a behavioral lifestyle modification program to improve cardiovascular health in pregnant and postpartum women with excessive weight gain. Her program employs text messaging and group classes to encourage women to make healthy changes to their diet and exercise habits. She also shared future directions for similar initiatives, including providing support in Spanish, offering virtual group classes, and encouraging spouse and partner involvement.

In the final talk of the day, Paul Yock, MD, director of the Stanford Biodesign Program, discussed the changing landscape for medical device innovation. Industry globalization and an increased focus on cost-effective health care are forcing people to change the way they innovate, he said: “This is going to turn out to be most interesting time to become a medical technology innovator, because the rules are all profoundly changing.” Yock called for a renewed focus on needs-driven and value-based innovation, and he encouraged attendees to start thinking of the “economic need, not just the clinical need” of a technology. “If we can get infected with an attitude that prioritizes affordable technology innovation, we can learn how to invent differently,” he concluded. “That’s what we need to do for the next 100 years.”