CRY Conference 2019

The CRY Conference was an excellent event yet again, with even more attendees in 2019, as 120 people came to hear experts from around the world present their research

After CRY Chief Executive Dr Steven Cox gave his introduction to the day, former CRY Research Fellow Dr Sabiha Gati presented first.

Dr Gati tackled the subject of exercising with aortic and mitral valve disease, and provided some exercise recommendations and precautions for those with bicuspid aortic valve. Dr Gati also examined matters such as the effects of exercise on those with valvular heart disease, how quickly valves deteriorate with exercise, and factors that could signify increased risk.

Next we were pleased to welcome Dr Maite Tome, a Consultant Cardiologist and Honorary Senior Lecturer at St George’s Hospital, London. Dr Tome’s presentation, “Athletes with dilated aorta; When to worry?”, explored how to assess these athletic individuals, the use of genetic testing in these situations, and how elective surgery can be a life-saving process.

Dr Guido Pieles followed and spoke about new recommendations for those with congenital heart disease participating in competitive sport. Dr Pieles discussed how new recommendations have introduced an approach to provide individual assessment and risk stratification, giving athletes advice that is better tailored to their condition and the physical strain they are undergoing.

Matts Börjesson joined us from Gothenburg, Sweden, to talk about coronary artery anomalies, with his presentation entitled “Exercise and Coronary Artery Anomalies; Two Incompatible Entities?”. “We can clearly say that there is a strong association between coronary artery anomaly and exercise related death,” Professor Börjesson explained early on.

Professor Elijah Behr from St George’s Hospital spoke about “Risk stratification in athletes with Brugada syndrome – Does it matter?” Professor Behr addressed different methods of risk stratification and their different benefits and limitations.

Professor Antonio Pelliccia kindly joined us again from Italy to give a presentation on “Lateral and inferiorlateral T-Wave inversion: search for

cardiac disease.” Professor Pelliccia had several key takehome messages, including the fact that the detection of T-Wave inversion in athletes should lead to a diagnostic search for underlying cardiomyopathies, with family screening and extensive imaging tests.

CRY Research Fellow Dr Aneil Malhotra followed with a talk on “Significance and evaluation of inferior T-Wave inversion”. Dr Malhotra shared some new research which aimed to investigate the prevalence and significance of inferior T-Wave inversions in large groups of healthy individuals and patients with cardiomyopathy.

As always, CRY Consultant Cardiologist Professor Sanjay Sharma attended to offer his support and expertise. With his presentation entitled “Anterior T-Wave inversion in athletes”, Professor Sharma examined various matters, including the prevalence and determinants of anterior T-Wave inversion in athletes, how the prevalence of T-Wave inversion can vary depending on ethnicity, and which methods can be used to differentiate variants from those who might represent cardiac pathology.

To discuss changes in our understanding of arrhythmogenic right ventricular cardiomyopathy (ARVC), Dr Michael Papadakis gave a presentation entitled “Right ventricular remodelling in athletes: When enough is enough!”.

Dr Papadakis discussed the ground-breaking research completed by Dr Chris Miles during Dr Miles’ time as a CRY Research Fellow. This research (“Sudden Death and Left Ventricular Involvement in Arrhythmogenic Cardiomyopathy.” Miles C, et al. Circulation, 2019) revealed that ARVC is in fact a biventricular disease and often affects the left ventricle.

Professor Mary Sheppard from the CRY Centre for Cardiac Pathology (CRY CCP) followed. Professor Sheppard began her talk, entitled “Arrhythmogenic right ventricular cardiomyopathy; A pathologist’s perspective”, by explaining how she got involved with CRY following the misdiagnosis of a case of arrhythmogenic cardiomyopathy. Professor Sheppard went on to discuss ARVC in detail, and how the CRY CCP and new research has had an impact on the practice used to deal with this condition.

When questioned about ARVC at the end of her talk, Professor Sheppard added that the scientific community should stop using the term ARVC – it is not a purely right ventricular disease, and should just be known as arrhythmogenic cardiomyopathy.

The last presentation of the day, “Arrhythmogenic Right Ventricular Cardiomyopathy; Looking into the future”, came from Professor Domenico Corrado. Professor Corrado looked at current diagnostic criteria for ARVC from the 2010 International Task Force (ITF) and some of its significant limitations that need to be improved.

After all of the presentations were finished, the afternoon was made up of case study sessions. These were panelled by Professor Sharma, Professor Corrado, Professor Pelliccia, Professor Börjesson, Professor Behr and Dr Tome. The sessions focused on electrical disease, cardiomyopathies and structural disease, and served as a great way to spark discussions to see how different experts would approach various cases.

Finally, former CRY Research Fellow Dr Joyee Basu hosted a quiz in the style of ‘Who Wants To Be A Millionaire’. This was once again an ideal end to the conference. The quiz was only lighthearted, but reinforced what was discussed through the day.

Many thanks must also go to our sponsor Radcliffe Cardiology, and to our exhibitors GE Healthcare, Sanofi, Schiller, MediBioSense, and Abbott.

To watch videos of all the presentations from the 2019 CRY Conference, you can go to our YouTube channel here: https://www.youtube.com/user/cryvideos/videos

You can register your interest for the 2020 CRY Conference, due to be held on Friday October 16, here: https://www.c-r-y.org.uk/cry-international-conference/