Interdisciplinary Research—Future of Cardiology

Corresponding author: B Hygriv Rao, KIMS Hospitals, Hyderabad, Telangana 500003, India. E-mail: hygriv@hotmail.com The spectacular innovations in technology in this century have fuelled the exponential growth of cardiovascular medicine in all dimensions eclipsing its conventional boundaries. Optimal diagnosis and management of cardiac patients is currently critically dependent on the interaction with sub-specialties in this field and contribution from other disciplines of medicine and engineering. The large burden of heart failure (HF) population has exposed the challenges in diagnosis, stratification of risk and economic prudence in utilization of healthcare resources. Advances in Radiology in the areas of cardiac MRI and positron emission tomography (PET) have succeeded in meeting some of these challenges. Late gadolinium enhancement (LGE) in cardiac MRI (CMRI ) has proven to be a reliable surrogate of myocardial scar which is the essential substrate for sudden death and worsening HF.1,2 Detailed imaging inputs from CMRI have helped to precisely define the endocardial and epicardial scar, assess accurately the ventricular function, and finely delineate the arrythmogenic channels in the substrate. Further it has aided substantially in prognostication in patients with substrates like hypertrophic cardiomyopathy and nonischemic cardiomyopathy (NICM). Similarly PET has contributed immensely in diagnosing sarcoidosis in patients presenting with new onset of HF, ventricular arrhythmias and conduction blocks. Further sophistication in imaging technology will undoubtedly refine the diagnostic criteria, and ease decision-making algorithms. Imaging has also enabled the clinician to understand and effectively correlate the anatomy in conceptualizing strategies for interventional procedures. This is particularly true in dissections and aneurysms of aorta, and trans-catheter interventions for aortic valves. The increasing safety and better outcomes of the procedures relate as much to the imaging technology as to the increasing operator experience. Ventricular tachycardia (VT) is a fatal arrhythmia conventionally treated with drugs, ablation and implantable defibrillators. Refractory VT and electrical storm is a challenging clinical problem with a high mortality, and radiotherapy has emerged as one of the least expected contender in the rescue of this difficult clinical