Many thanks to Ed Horn and Amresh Raina for coordinating the content for this month's issue.

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This month's 2014 September ISHLT Links Newsletter provides a spotlight on 36 Hours in Nice. As we anticipate the Mediterranean breeze of next year, Jim Coons from the University of Pittsburgh Medical Center gives us a breath of fresh air summarizing the pharmacotherapeutic advances in treating pulmonary arterial hypertension and their correlation with reduced morbidity and mortality in the sufferers of pulmonary hypertension. Also, Christina Doligalski of Tampa General Hospital enlightens us on the link between PDE5-Inhibitors and melanoma and how to risk assess such a complex population who would rather not be kept in the dark. Amresh Raina from Allegheny General Hospital further moves us into the digital age with the promise of implantable hemodynamic monitoring to manage patients with pulmonary arterial hypertension while Veronica Franco updates us on what's new in pulmonary hypertension.

Also included are several ISHLT announcements: the ISHLT's newest grant award winners, the Transplant Registry Early Career Award, and the ISHLT's encouragement to persuade, coerce, or compel all of you to GO! Write! Win! with the Links Travel Awards.

And to conclude this issue, check out a taste of contention between Rousseau and Voltaire with thoughts worth thinking, and my more in-depth analysis in the Editor's Corner. By the way, your Editor really knows nothing, therefore he writes too much.

Vincent Valentine, MD
Links Editor-in-Chief


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36 Hours in Nice

from the New York Times

On the southeast coast of France, Nice welcomes travelers with alluring restaurants, a broad beach, sherbet-hued buildings and gay-friendly night life. Packing year-round sun, the Mediterranean Sea, belle époque and Art Deco architecture, Nice attracts visitors with the bonuses of an atmospheric old quarter, an evolving restaurant scene, the Riviera's best museums and some high-profile public works. A city for all budgets, Nice buzzes with an energy and diversity that often surpasses its coastal rivals.

"It is often said that in Nice, we are always on vacation. Which indeed, isn't wrong."

"You should be thinking to come to Nice one time in your life because it's probably one of the most beautiful cities in the world. Honestly, you cannot find a place like Nice elsewhere."

See more in 36 Hours in Nice →


Breath of Fresh Air for PAH and CTEPH: Pharmacotherapy Update

by Jim Coons

links imagePharmacotherapeutic advances in the treatment of pulmonary arterial hypertension (PAH) have coincided with reductions in overall morbidity and mortality for this progressive, fatal disease [1,2]. Despite these improvements, PAH, in the modern management era, is still associated with a significant clinical burden for patients in the form of advanced symptoms, poor quality of life, and suboptimal outcomes [3]. The mainstays of treatment encompass prostacyclins, endothelin receptor antagonists (ERA) and phosphodiesterase-type 5 (PDE-5) inhibitors. The year 2013, however, was particularly notable in the PAH field as three new medications gained regulatory approval: riociguat (Adempas®), macitentan (Opsumit®), and oral treprostinil (Orenitram®) [4-6]. Read more →

Shining a Light on the Link between PDE5-Inhibitors and Melanoma

by Christina Doligalski

links imageThe first correlation between PDE5A and melanoma was reported in 20082, following several years of groundbreaking research in which the cellular pathways of melanoma were being elucidated. This research identified two key regulatory melanoma pathways, both of which are effected by PDE5A expression. The most significant pre-clinical finding came in 2011, when Arozarena and colleagues investigated the physiologic relevance of PDE5A to melanoma, and were able to find that PDE5A inhibition produced increased melanoma invasion, while PDE5A stimulation produced stable or decreased invasive potential. These findings led to the question: Is there a clinically-significant link between melanoma and sildenafil use? Read more →


Into The Digital Age: The Promise of Implantable Hemodynamic Monitoring in the Management of Pulmonary Arterial Hypertension

by Amresh Raina

links imageIn May 2014, the United States Food and Drug Administration (FDA) approved the first implantable hemodynamic monitor (IHM) for the treatment and monitoring of New York Heart Association (NYHA) functional class III heart failure (HF) [1]. The CARDIOMEMs device (St. Jude Medical, St. Paul, MN), is a wireless sensor placed in a distal branch of the pulmonary artery during right heart catheterization (RHC), and transmits measured pulmonary artery (PA) systolic, diastolic and mean pressures via an external console to a secure website, accessed by a patient's physician. This sensor also has the potential for measurement of cardiac output, but this algorithm remains to be validated. Read more →

What's New in Pulmonary Hypertension?

by Veronica Franco

links imagePreparations for the 2015 ISHLT meeting are underway and it promises to be a great collection of symposia in the beautiful city of Nice. The world of pulmonary hypertension is also full of exciting news. Today, PH specialists have many more treatment options than they did a decade ago and three new medications have been approved as of 2013. Additional studies on these newer medications were presented at the American Thoracic Society (ATS) meeting in May 2014. Read more →


ISHLT Newest Grant Award Winners Announced

by Daniel R. Goldstein and Andrew J. Fisher

On behalf of the ISHLT Grants & Awards Committee, we are pleased to announce the winners of the ISHLT/Bayer Pulmonary Hypertension Research Grant Award and the ISHLT/HeartWare Award for Translational Research in Mechanical Circulatory Support. From 20 applications for the ISHLT/Bayer award and 22 applications for the ISHLT/HeartWare award, one winner was selected for each award: Read more →

Transplant Registry Early Career Award

from Evan Kransdorf, JFTC Registries & Databases Workforce Leader

Summer greetings from the Junior Faculty and Trainee Council of the ISHLT! As you return from summer holiday/vacation, we wanted to alert you to an exciting opportunity that is available from ISHLT for fellows and junior faculty. The Transplant Registry Early Career Award is given annually to a fellow or junior faculty member to fund a clinical research project that utilizes the ISHLT registry. The deadline for submission will be January 15, 2015, and up to three awards will be funded. Read more →

Links Travel Awards: Go! Write! Win!

With the support of W.O. and Joan Leach (Gadsden, Alabama, USA), Mrs. Sue Abramson (Birmingham, Alabama, USA) and Mr. Larry Imhoff (La Place, Louisiana, USA), ISHLT has been able to offer the Leach-Abramson-Imhoff Links Travel Awards to support the growth and development of our future leaders from within our society. From physicians to nurses to other health care professionals, anyone motivated enough by investigation, communication, and dissemination of new ideas for the betterment of patients with failing lungs and/or a failing heart should be rewarded for their efforts. Whether writing about conditions such as pulmonary fibrosis, cystic fibrosis, emphysema, pulmonary hypertension, and from ischemic, nonischemic to congenital heart diseases, those who work tirelessly to educate themselves, their patients and their field should not go unnoticed or unmentioned. Read more →


Voltaire and The Man Who Knew Too Much, Que Sera, Sera

by Vincent Valentine

links imageAlfred Hitchcock's suspense thriller, The Man Who Knew Too Much, was released and included the Oscar Award winning, "Whatever Will Be, Will Be" (Que Sera, Sera) sung by Doris Day, who starred with James Stewart in 1956, precisely 200 years after Jean-Jacques Rousseau wrote a furious response to Voltaire's Poem on the Lisbon Disaster published in 1756. The Lisbon earthquake shook Europe on November 1, 1755 and left Lisbon in ruins and seared Voltaire's and Europe's consciousness at a time when 18th Century Europe was enlightened; seeing through nature to the God of nature, and through the laws of nature to the wisdom and beneficence of God. In his poem, Voltaire reassessed his Leibnizian optimistic philosophy and theology, seeing evil and suffering as inexplicable given that God is infinitely good, and asserting that suffering humanity requires his love more than God does. The furious response from Jean-Jacques Rousseau accused Voltaire of attacking the Divinity. Read more →


Vincent G Valentine, MD

Editorial Staff

"People who know little are usually great talkers, while men who know much say little."
— Jean-Jacques Rousseau

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Disclaimer: Any opinion, conclusion or recommendation published by the Links is the sole expression of the writer(s) and does not necessarily reflect the views of the ISHLT.