EDITOR'S PAGE

AT A GLANCE

This issue of Heart Views is dedicated to the First GCC Cardiovascular Conference held in Doha, Qatar in January 15-17, 2002. 
The conference is important for the region in that it is the first regional and international symposium organized under the auspices of the health ministries of the Arab States of the Gulf Cooperation Council (GCC). 
Dr. Hajar Ahmed Hajar Al BinAli, the Qatar Minister of Public Health opened the three-day conference with a welcome address in Arabic (p.145) and in English (p.147).
 He outlined the objectives of holding this conference. He expressed the hope that through exchange and sharing of scientific ideas, new therapies and new techniques in the diagnosis and treatment of cardiovascular diseases, the rapid increase in the incidence of coronary artery disease in the region might be curbed and prevented.
 He called the holding of such a conference "a dream that became a reality." One of the fruits of the conference was the founding of the Gulf Heart Association (GHA), a landmark development in the area with significant implications (p.148).
 Hopefully, the GHA will foster a spirit of collaboration among the Gulf cardiovascular specialists, stimulate basic and clinical research in the region, and embark on promoting public health education. Heart Views was designated as the official journal of the GHA
 Indeed, it is a distinct honor for the journal to carry the banner of the GHA.
 The editorial board hopes to see many local and regional publications in the journal. The conference focused on comprehensive state-of-the-art approach to the diagnosis, medical, and surgical treatment of cardiovascular diseases. 
Infective endocarditis continues to be a lethal cardiac disease. In the presence of heart failure, mortality is about 75% on medical therapy alone. Dr. Jamil Tajik (Mayo Clinic, USA) discussed the important role of echocardiography, especially transesophageal echocardiography (TEE) in the diagnosis and management of infective endocarditis.
 He emphasized the importance of early diagnosis and the high sensitivity and specificity of TEE (p.149). In real life, clinicians face management dilemmas, especially if the results of clinical trials are contradictory. The question of whether patients with multivessel coronary artery disease should undergo stenting or surgery illustrates this vexing problem. Dr. Ulrich Sigwart (Univ. of Geneva, Switzerland) gave a fresh perspective on the results of the SoS trial (p.149). Another controversial topic is whether surgery should be performed in asymptomatic or mildly symptomatic patients with significant non-ischemic mitral regurgitation. Dr. A. Kalangos (Univ. of Geneva, Switzerland) presented guidelines and data from the literature and his institution favoring early surgery (p.150). Arrhythmias are a common problem in clinical practice. Some arrhythmias cause significant morbidity and mortality. Dr. Edward Rowland (London, UK) gave a concise review of ablation techniques for ventricular and supraventricular arrhythmias. (p.152)
 Although there has been tremendous progress in the surgical correction of complex congenital heart disease, success rate depends on the skill and expertise of the surgeon. Dr. Francois Lacour-Gayet (Eppendorf Univ. Hospital, Germany) presented a novel method developed by the European Congenital Heart Surgeons Foundation for quantifying surgical risks in congenital malformations. Quantification of actual risks is elusive but establishment of a computerized database detailing and grading problems and difficulties of repair encountered by surgeons during operation might provide a more accurate assessment of risks and prognosis (p.153). The pulmonary autograph is a viable tissue valve and its use is an attractive option for patients who need aortic valve replacement. Dr. Zuhair Halees (KFSRC, Saudi Arabia) gave an overview of the Ross procedure and presented results in his institution using this technique (p.153). 
Heart failure is still the leading cause of hospitalizations in patients over 65 years of age and causes considerable loss of quality of life for patients. Dr. John McMurray (Univ. of Glasgow, UK) summarized the results of different heart failure trials evaluating new drugs. He also gave an overview of future management and addressed the use of B-type natriuretic peptide (BNP) as a screening tool for heart failure(p.151). 
The incredible progress in technology in the last decade has made possible the miniaturization of cumbersome medical diagnostic tools. Dr. Jos Roelandt (Thoraxcentre, Netherlands) discussed the small personal hand-held echocardiography machine. This small ultrasound machine, the "ultrasound stethoscope" as he called it, enables us to see the heart during physical examination. 
This will provide diagnostic accuracy as well as quantitative information on site. 
This technology is promising and may revolutionize the way we practice cardiology (p.154) The Abstract sessions were stimulating. Most abstracts came from the GCC States. A few abstracts came from other Arab countries like Syria, Iraq and Tunisia and non- Arab countries such as Iran. Most of the abstracts presented covered risk factors, incidence, and prevalence of cardiovascular diseases in the Arab Gulf States. Some abstracts dealt with clinical and surgical experience.
 (p.162) History of medicine was illuminating and entertaining. Dr. Halees (Saudi Arabia) gave an overview of the history of cardiac surgery. Dr. H.A. Hajar Al BinAli (Qatar) highlighted the ancient roots of modern medicine (p.187).

                                                                                 Rachel Hajar, MD