Christos G. Mihos1, Rory Lee2
1Echocardiography Laboratory, Columbia University Division of Cardiology, Mount Sinai Heart Institute, 4300 Alton Road, Suite 2070, Miami Beach, FL 33140, USA; 2JTD Editorial Office, AME Publishing Company
Correspondence to: Rory Lee. JTD Editorial Office, AME Publishing Company. Email: jtd@amepc.org.
Editor’s note
Journal of Thoracic Disease (JTD) has published a number of special series in recent years, receiving overwhelming responses from academic readers around the world. Our success cannot be achieved without the contribution of our distinguished guest editors. This year JTD launched a new column, “Interviews with Guest Editors”, to better present our guest editors and to further promote the special series. We also hope to express our heartfelt gratitude for their tremendous effort and to further uncover the stories behind the special series.
The special series “Novel Concepts in Cardiopulmonary and Structural Heart Disease” (1) led by Dr. Christos G. Mihos (Figure 1) from the Columbia University Division of Cardiology has attracted many readers since its publication. This special series aimed to provide treatment strategies of complex structural heart and obstructive epicardial coronary artery disease (CAD). At this moment, we are honored to have an interview with Dr. Mihos to share his scientific career experience and insights on this special series.
Figure 1 Dr. Christos G. Mihos.
Expert introduction
Dr. Christos G. Mihos is a non-invasive cardiologist and echocardiographer with board certification in cardiovascular disease and level III board-certification in Adult Comprehensive Echocardiography. Dr. Mihos serves as the Director of the Echocardiography Laboratory at the Columbia University Division of Cardiology at Mount Sinai Medical Center. Dr. Mihos has vast experience in clinical cardiovascular research and presents at national and international conferences. His academic focus includes valvular heart disease, inherited and acquired cardiomyopathy, and the use of strain echocardiography to study cardiac mechanics in health and disease. He is the principal investigator of the grant-funded prospective “Effects of Exercise and FITness on Left Ventricular Remodeling, Torsion and Wall MechanIcs Study (FIT-TWIST)”, which is studying the effects of recreational exercise and cardiac rehabilitation on the structure and function of the left ventricle in health and after a myocardial infarction, as well as the grant-funded “Secondary Tricuspid Regurgitation, Right Heart Remodeling, and Mechanics Following Mitral Valve Surgery or Transcatheter Edge-to-Edge Repair (STEER)” study on structural and valvular heart disease. He is a research mentor to medical students, residents, and fellows, and helps to maintain the academic excellence of Mount Sinai Medical Center.
Interview
JTD: What motivated you to specialize in the field of echocardiography?
Dr. Mihos: From basic science courses in medical school, to medical student clerkships, residency, fellowships, and beyond, the cardiovascular system has always challenged me to grow, teach, and contribute scientifically. Echocardiography exposes the intricacies of the cardiovascular system in beautiful detail, and provides us with tools to diagnose and treat our patients and advance the field.
JTD: Over the years, there have been many advancements in cardiac surgery, from new surgical techniques to improved surgical tools and equipment. What advancements have you seen in cardiac surgery during your career? Are there any particular challenges or obstacles that need to be overcome in this direction?
Dr. Mihos: Cardiac surgery and percutaneous structural heart interventions are under the umbrella of structural heart disease, and we have seen a rapid expansion of technologies in both fields in recent years. I would consider the most novel improvements have been within the realm of percutaneous transcatheter therapies, such as TAVR, TEER (edge-to-edge mitral valve repair), and tricuspid valve edge-to-edge repair. In the coming years we hope to develop approved transcatheter prosthetic valves for the mitral and tricuspid positions, which would revolutionize the field. The most benefit from these advances are to the patients, and in particular higher-risk populations who would otherwise not have a therapeutic option.
JTD: The evolution of echocardiography has been dramatic over the years. Could you share with us the latest techniques of echocardiography? How does early detection through these advanced imaging techniques impact the prognosis and treatment options for patients with structural heart disease?
Dr. Mihos: As it pertains to the field of structural heart disease, it is safe to say that the exponential growth in 4D and interventional echocardiography have been the most pivotal development. This has been across vendors and is becoming fairly standardized, with important guideline documents by the American Society of Echocardiography and the European Association of Cardiovascular Imaging providing the framework. 4D echocardiography improves diagnosis and treatment planning for patients, and gives the interventional echocardiographer, interventional cardiologist and cardiac surgeons a greater degree of procedural confidence.
JTD: Which part of the special series has impressed you the most? What do you think is the unique strength of this special series?
Dr. Mihos: The series of studies and articles were forward-thinking and tackled the subjects from unique perspectives, with teams of authors from multiple specialties and backgrounds. This enhances the educational benefit to our readers at the journal.
JTD: Have you recently conducted any research projects related to the topic of this series? If so, could you share some of your key findings?
Dr. Mihos: At our institution we are currently conducting a prospective study entitled: “Secondary Tricuspid Regurgitation, Right Heart Remodeling, and Mechanics Following Mitral Valve Surgery or Percutaneous Edge-to-Edge Repair (STEER)”. We hypothesize that the severity of functional tricuspid regurgitation following mitral valve surgery or percutaneous edge-to-edge repair is directly related to patterns of valvular or ventricular remodeling, which we are assessing pre- and post-intervention using advanced imaging techniques such as strain and 4D echocardiography. We hope to have preliminary results from an interim analysis later this year.
JTD: If given an opportunity to update this special series, what would you like to moderate, add or emphasize to provide a more comprehensive series?
Dr. Mihos: There have been many advances in cardiovascular imaging as it pertains to structural heart pathology and procedures. An updated issue focusing on strain echocardiography, 4D reconstruction, and guidance of transcatheter procedures would be of special interest.
Reference
- Novel Concepts in Cardiopulmonary and Structural Heart Disease. Available online: https://jtd.amegroups.com/post/view/novel-concepts-in-cardiopulmonary-and-structural-heart-disease