The importance of basic science in clinical cardiology.

But, some clinicians may ask, how long does it take for a basic science advance to make a practical difference in the clinic? ‘Basic science discoveries have the potential of being translated into practice much more quickly than they used to be’, says Prof. Barbara Casadei (Oxford, UK), chairperson of the European Society of Cardiology (ESC) Council on Basic Cardiovascular Science. ‘If one looks at fields like microRNA, they have only been recently discovered and there are already clinical trials ongoing. So one can see how important it is to maintain a pipeline of discoveries’. Drug-eluting stents are another good example of basic science influencing clinical practice in cardiology. The idea started in basic science when a researcher observed that the cancer drug paclitaxel could inhibit the proliferation of vascular smooth muscle cells. Shah says: ‘Someone then had the idea of putting it onto a stent, it was trialled and look where we are now’. Exciting advances are also being made in molecular imaging, with new probes that can image biological processes in the whole animal or the whole patient. Shah says: ‘None of us would be surprised if in a few years’ time we are sending our patients to have a particular scan to identify a vulnerable plaque.Noneof that couldhappen without basic science’. While basic science is vital, equally important is that it be well connected to clinical questions and to patients. Cardiology needs people who are comfortable with a foot in both camps and can do translational studies. Good career paths are needed for bright young clinical academics. ‘It’s easy to lose those people [given] the way the current system is configured in many countries’, says Shah.