President's Report, August 2013

 

 

 

 

 

 

Richard N. Mitchell, MD, PhD

To the Members of the Society for Cardiovascular Pathology,

As the leaves begin to turn, and the calendar flips into fall, I hope that this finds you recharged from your summer vacations and ready to tackle the new academic year. Since the USCAP meeting in Baltimore in March, the SCVP has been quite active.

Achievements:

  • SCVP has a total membership of 163 (up from 150 in 2010); there are 140 of us in the US and Canada, with 23 international members scattered across Europe, Asia, Africa, South America, and Australia.
  • Cardiovascular Pathology (the Journal) has smoothly transitioned into the able hands of Max Buja, and continues to post impact factor scores that improve annually: 1.881 for 2010, 2.066 for 2011 (10% increase) and 2.352 for 2012 (14% increase, based on articles published in 2010 and 2011). As noted by Dr. Buja, this represents "a valedictory achievement of our previous editors, Dr. Jagdish Butany and Dr. Avrum Gotlieb, as well as the work of members of our Editorial Board and other reviewers who have worked to elevate the standards of papers published in our journal."
  • The AECVP and SCVP acute cellular rejection tutorial has been translated into Italian, Japanese, French, and most recently Russian (kudos to Marc Halushka, and the other content creators and translators). In the last year, there have been 1622 hits on the English tutorial, 471 on the Japanese version, 292 on the Italian, 58 on the French, and 105 on the Russian).
  • Talking about the SCVP website (scvp.net), the total page views from March 2011-2012 were 5,665, while from August 2012-2013, the numbers are 18,473! That's more than a tripling of hits on our site in just two years. Congratulations to our Web Master Marc Halushka; we're clearly building a following on the web (of course, in comparison, the Grumpy Cat website gets over 1.5 million hits each month).
  • The review summarizing the AECVP/SCVP consensus statement on the "Diagnostic Use of Endomyocardial Biopsy" was published in the July Virchows Archiv (congratulations Drs. Thiene, Bruneval, Veinot, and Leone).
  • Jim Stone and Patrick Bruneval have successfully herded the various SCVP "cats" to generate a superb consensus document on inflammatory diseases of the aorta, which will shortly be heading off for publication. Notably, Elsevier has generously agreed (at the discretion of the Editor) that SCVP can publish this as open access in Cardiovascular Pathology at no charge to the Society.
  • Jim Stone has planned a phenomenal slate of speakers for the Saturday Educational Session ("Role of Viral PCR in Myocarditis") and Sunday SCVP Companion Meeting at USCAP ("Prognostic Cardiac Pathology"):
  • - Diagnostic and Prognostic Value of C4D Staining in Transplant Endomyocardial Biopsies: Gerald Berry

    - Predicting the Development of Cardiac Allograft Vasculopathy: Michael Fishbein

    - Novel Prognostic Tissue Markers in Congestive Heart Failure: James R. Stone

    We will also be feting our 2014 Distinguished Achievement Award recipient, Dr. Jagdish Butany, who will tell us about the "Four Faces of Prosthetic Heart Valves" (Congratulations Jag!).

    Important announcement about dues:

  • Although still financially solvent, the assets of SCVP have seen a consistent downward trend over the past three years; cash assets in 2010 were $81,770, in 2011 were $75,917, and in 2012 were $70,952. Over that time, membership has actually increased (from 150 to 163), but our income flow-mostly from dues-has remained relatively flat at around $28,000 ($21,000 from dues). Royalties from Elsevier are trending slowly up ($2416 in 2012) but remain a fraction of the income total, and gifts from industrial supporters are neither large nor consistent (roughly $5000 in each of 2010 and 2011, but nothing in 2012). The major expense item on the ledger sheet is the cumulative cost of subscriptions to Cardiovascular Pathology, which comes out of the dues; in 2010 this was $15,461, in 2011 it was 16,637, and in 2012 was $18,525. Elsevier's costs have increased roughly 20% in the past two years; indeed, $113 of each membership ($150 US/$160 international) goes to Elsevier for the journal. Notably, SCVP membership dues have NOT increased in over a decade.

  • In recognition of the declining assets, and to insure financial stability, the SCVP Board (Officers, Councilors, and Committee Chairs) voted to increase the membership dues to a $200/year (no cost differential for international members), effective January 1, 2014. Trainee memberships ($65/year) and Emeritus memberships ($113/year) will remain unchanged.

  • . In support of this increase, it is important to note the benefits that SCVP provides to its members. In addition to the Journal and the annual SCVP companion meeting at USCAP, membership in SCVP also provides:

  • - Saturday educational session at USCAP with an SCVP social hour

    - Access to the Members Only SecondSlide site where interesting cases are shown and shared

    - Participation in cardiovascular pathology consensus documents

    - Opportunity to meet and interact with global leaders in cardiovascular pathology

    - Annual awards banquet

    - Medicolegal matchmaking service

  • There is clearly more that we can think about in terms of what SCVP membership can provide. For example, it would be good to have more cardiovascular pathology educational outreach, perhaps through supporting course development at USCAP or Experimental Biology. In addition, supporting research or educational opportunities for young investigators (perhaps a multi-institutional CV fellowship?) has long been on the SCVP wish list. I invite your input about what SCVP can do for you or your colleagues in exchange for your hard-earned dues.

    Long-range planning:

    Since the March annual meeting, a handful of the SCVP leadership has developed a SWOT analysis (Strengths, Weaknesses, Opportunities, and Threats) for our Society. This is attached as a Word document. The bottom line is that SCVP has a large number of strengths and opportunities; indeed, ours is a pathology specialty with extremely high clinical relevance, and we have robust long-standing affiliations with industry groups, device and therapeutics innovators, and forensic medicine. However, SCVP is also hampered by a perception that there's not much "new" in CV pathology, and its a specialty that can only rarely support a full-time FTE; most of us do something else in parallel with our CV pathology job. Consequently, it's increasingly difficult to attract younger pathologists and investigators lured by the siren song of neoplasia or other areas of pathology.

    I think that we can help change that perception. There are three areas in particular that I think can become the equivalent of the "endomyocardial biopsy" in driving new enthusiasm (and recruits) for cardiovascular pathology.

  • molecular biology of cardiovascular disease
  • regenerative technologies in heart disease
  • cardiovascular imaging
  • On the first bullet point alone, we should be increasingly incorporating genetic analyses of entities that currently get only rather broad diagnoses. Thus, polymorphisms in dilated cardiomyopathy or mitral valve myxomatous degeneration; cytokine and inflammatory marker profiles in rejection or atherosclerotic plaque; and ion channel sequencing in patients with arrhythmias or sudden cardiac death should be routinely included along with the morphologic diagnosis. One might argue that such information currently has no therapeutic implication. However, this is where we take a page from the neoplasia playbook; pathologists performed immunohistochemical and genetic analyses years before there were targeted therapies, and it was probably that information that ultimately drove the ability to develop and target drugs. It is not unreasonable to suggest that knowing the genetic underpinnings of a dilated cardiomyopathy or even an atherosclerotic plaque may well make a difference in the subsequent medical management. To quote SCVP Councilor Mike Seidman:

    "The role of autopsy in these contexts also becomes more clear, as we are well into the era of identifying germ line genetic predictors of phenotypes, even the most complex of them, and thus can contribute to informing surviving family members of their risk not just for Mendelian traits, but very soon also (admittedly more vaguely) for complex traits. The appeal of cardiovascular pathology to younger folk then becomes more clear...it is a field in its infancy with respect to translational research, and it specifically ALLOWS people to pursue a second subspecialty or area of interest, be that formal research, epidemiology, molecular genetic pathology, etc. Speaking as a trained cardiovascular and molecular genetic pathologist, I can say that interpretation of genetic variants pertaining even to Mendelian cardiac disease (cardiomyopathy, arrhythmia, etc.) is easier when the phenotype is better understood, and I think this will only become more true."

    It is imperative that we find a way to compete with all the bells and whistles that make neoplasia pathology so attractive for trainees; it will be the best way to recruit new blood and bring new energy into our Society. Cardiovascular Pathology really does have the potential to be a specialty with wide-open opportunities for junior investigators and pathology trainees with interests in molecular biology, myocardial regeneration, and imaging. SCVP should help lead the way by educating ourselves in these areas, reaching out to the geneticists, radiologists, stem cell biologists, and engineers for collaborations, and encouraging up-and-coming residents and fellows to get additional training in these areas.

    Going forward:

    Each year at our annual meeting, there is a flurry of activity, enthusiasm, and best intentions as we focus (at least for a week-end) on the Society, and the opportunities that we have through the combined efforts and critical mass of such a dedicated group of talented pathologists. Much of this energy carries forward throughout the year with the consensus documents and CV tutorials that SCVP members help to generate; these bring rigor, uniformity, and reproducibility to cardiovascular diagnoses, and also provide the Society with national and international visibility and relevance. The Journal is also developing an expanding readership, with high quality manuscripts from leaders in the cardiovascular community increasingly being sent to Cardiovascular Pathology as a first stop, and not the "fall-back" option.

    But.As the annual meeting recedes into the past, and as we all get back to our regular jobs and activities, SCVP matters often get put on a back burner. Grants, teaching, research, administration, writing---all the other things in our academic lives-vie for our attentions. This is not to advocate that SCVP should top our daily to-do lists, but difficult issues such as member recruitment, strategic partnerships with other Societies, and garnering stable industrial support for our academic mission require ongoing attention.

    So.I invite you to participate in the discussion; this is a dialogue that's important to have for the health of our specialty. Specifically, please take a moment to send me an e-mail about:

  • what you see are the objectives of SCVP
  • what one thing should we (SCVP) be doing
  • With very best wishes, and I look forward to working with you.

     

     

     

     

    Richard N. Mitchell, MD, PhD

    President, Society for Cardiovascular Pathology

     

    August,  2013