When did you first decide you wanted a career in medicine?

Since I was a child I always used to say I would like to become a doctor to be able to treat sick people. Despite the fact that there are not many doctors in my immediate family, that was a wish I used to express since early childhood. Later on, in high school, there was no other field I would like to follow professionally, although I was very attracted by history but only as a hobby. When already in medical school I became very attracted by clinical work, although in the first years I also enjoyed basic research.

Why did you decide to enter cardiology?

I was very much influenced by someone I worked with in my medical school, Frederico Silveira Machado, who was a doctor of the old school of Internist/Cardiologist. I also enjoyed very much the fact that in cardiology you could do several procedures that could not only help the patients but improve the way you understand pathophysiology and link basic knowledge with actual impact on patient outcome.

Who were your greatest influences?

In Portugal my greatest reference was my mentor Professor Fernando de Pádua, who was the Head of Department in my hospital and who influenced me very much in my career. He himself trained in the US, where he worked with Paul White. He was a great enthusiast and supporter of my career and helped me immensely not only when I started my fellowship in Lisbon University Hospital, but also in the decision to go the US and then when I decided to return to Portugal.

In 1989 I went to Stanford University where I stayed until 1993. There I had the chance to work with a great group of people, but I have to mention my immediate mentor, Richard Popp, who influenced me immensely and to whom I owe a lot of what I am today. He was the Head of the Echo lab at Stanford and then Vice Dean. He is not only a tremendous cardiologist, researcher and scientist but truly what you imagine a mentor should be: inspiring, supporting, hard when he had to be, always knowing what to tell you and how to tell you.

Then I have been fortunate enough to have met a number of outstanding people that have shaped my life. I will not enumerate them since I may be able to forget some, but would also like to say that one of my greatest influences have been my students. The time I spent teaching was as one of my main achievements. It is truly a unique experience, and also a great lesson of humility.

You were one of the pioneers in the introduction of intravascular ultrasound in the clinical arena. How did this come about?

I was a fellow at Stanford University when intravascular ultrasound started so I got very interested in doing it. The project at the time was looking at graft atherosclerosis since Stanford is a well-known centre for cardiac transplantation. Graft atherosclerosis is a major cause of death after the first year after cardiac transplantation and the annual coronary angiography done to these patients was not enough to detect early changes. Therefore the use of IVUS looked very promising as a new tool to detect intimal thickening at the earliest stage of development. The idea was nurtured by my mentor, Richard Popp, the team leaders of the transplant programme, John Schroeder, Sharon Hunt and Hanna Valantine, and together with another fellow and very good friend, Frederick St. Goar, and some other colleagues, we started an innovative programme on the use of IVUS in early detection of graft atherosclerosis. I was so interested that also decided to do a formal interventional cardiology fellowship so I could not only interpret the studies but performed them myself. With the support of Edwin Alderman and Stephen Oesterle, I actually did a formal interventional cardiology fellowship at Stanford (1992–93). It was a great period for me (very busy as well), since I was an interventional fellow in the cath lab and attended the echo lab.

On a professional level what have been your proudest moments?

It is difficult to choose since I have been very fortunate in being involved in several projects which have been quite successful. I have to mention, however, the pioneering work I did at Stanford on the study of graft atherosclerosis; the creation of the Lisbon Cardiovascular Institute in 1999, together with my colleague Jose Fernandes e Fernandes, who is the current Dean at my Medical School; and the creation of the European Association of Echocardiography, of which I was the first president.

Are you currently involved in research? What specific areas are you most interested in and why?

My main current research interests are in the use of ultrasound/imaging in different settings. I am a clinical researcher, therefore my work is done always with a focus on clinical grounds. I have also responsibilities with the pre and post graduate students which are always a great resource of new ideas. My main research projects at the moment are: study of left and right ventricular function parameters by echocardiography in hypertension, looking at new ways of detecting early changes in myocardial function; development of a new model to assess quality control in interventional cardiology; pulmonary hypertension; role of OCT (optical coherence tomography) in interventional cardiology.

You were president and founder of the European Association of Echocardiography. Why have you become involved in medical societies?

I became more deeply involved in medical societies after returning from the US to Europe in the 1990s. First, I became involved with my own national society where I was the chairman of the Working Group on Echocardiography from 1995–97 and, at the same time, started to get involved with the European Society of Cardiology, namely the Working Group on Echocardiography. I became responsible for one of the subgroups at the time (IVUS and vascular) and then in 2000 I was elected as chairman elect and became chairman in 2002. This was a very exciting period in Europe and it coincides with the decision of the European Society of Cardiology to create associations. I worked hard with the ESC leadership at the time to have echocardiography as one of the first ESC associations. In fact, in 2003, in Vienna, the first two associations were created, the EHRA (European Heart Rhythm Association) and EAE (European Association of Echocardiography) and I became the first president of EAE. I believe it was a major decision and very important for the future not only of the subspecialities but mostly for the future of Cardiology in Europe. I am very proud and honoured of having been the first president of EAE.

I continued to serve ESC, first on the Board as Councillor (2004–06), then as representative of ESC on EBSC (European Board for the Speciality of Cardiology), and now I was nominated chairman of the Congress Program Committee (CPC) of ESC for 2009–10, which is certainly one of the biggest challenges I have ever faced in my professional life.

In your opinion, what are the main trends in echocardiography at the moment and what kind of developments can we expect to see in the near future?

There are several developments in echocardiography that are particularly important and that will receive continued attention in the future, but the main advantages of echocardiography that makes it so attractive and so popular are its portability, user friendliness and amount of clinically relevant and reliable information it can provide immediately at the bedside, translating into relevant clinical implications. Besides that, the use of tissue velocities, myocardial deformation parameters, myocardial contrast perfusion assessment, real time 3-dimensional echocardiography, portable echo devices, etc., will certainly continue to make echocardiography as one of the main used imaging modalities in medicine.

But I would also like to say that I believe that cardiovascular imaging will evolve very fast in the future. Right now, we have different imaging technologies, not only echocardiography, but we have multislice computerised tomography, cardiac magnetic resonance imaging and nuclear imaging, all of them with a huge potential for development. What I would like to see in the future is the complementary use of these different technologies in the assessment of different clinical problems. In addition, the development of molecular imaging will also be very important for the future. Some developments already have occurred in fusion imaging: the ability to use some of the advantages of different imaging technologies and put them together (such as ultrasound with cardiac magnetic resonance imaging or with computerised tomography). Continued refinement of the various technologies will result in new developments that will help overcome some of the difficulties researchers have come across in recent years. The focus should be on the clinical problems, and the technology should be a tool to help solving these problems. Technology should be used to understand the mechanisms of disease, as well as to define diagnostic and treatment strategies; at the same time we are facing new challenges and new limitations.

Outside of medicine what other interests do you have?

I love travelling, reading, classical music and art. Travelling gives me the opportunity to meet new people, new sounds, new tastes, i.e. insights into human kind, and at the same time it provides me with new chances to meet nature at different levels. It is this mix of nature and humanity that keeps challenging me in my travels. Reading has been a long passion, since young age, from the classics to modern writers. I actually “worked” as a librarian in a local library when I was 13 years old and already enjoyed books (even the smell of them) and reading. I enjoy very much to become familiar with different authors, particularly from places that I am not so familiar with. I also like history very much; therefore, reading history books is one of my pleasures. Music has also been part of my life since I was born. My father was an amateur musician, who played in a band in his spare time and was (is) also a great connoisseur of classical music. I guess I received that in my genes, since listening to music (particularly classical and jazz) is also one of my favourite things to do, even when I am working. Finally, art as a whole is one of the finest expressions of human feelings and emotions, and it certainly moves me as well. I like particularly paintings – the impressionist and post-impressionist periods are my favourites.

What was the most memorable of your travels?

I have been fortunate enough to have great trips in my life, so it is also difficult to pick the single best. I select two: one was in 2003 to the French Polynesia, in particular to Bora Bora, which is one of the most paradisiacal places I have ever been to. The other one was last year, a safari in Tanzania that was absolutely adorable.

What places are on your list for future visits?

I am planning to go to New Zealand in August and would like to visit Sri Lanka in the near future.

 

FACT FILE

Professor Fausto J Pinto
Born: 3 November, 1960

Qualifications

1997 - “Agregação” in Medicine (Cardiology), Faculty of Medicine of Lisbon, Lisbon University, Portugal.
1993 - PhD, University of Lisbon, Portugal
1984 - MD, University of Lisbon, Portugal

Positions held

2004 - Professor of Cardiology, Lisbon University Medical School
1999 - Director, Lisbon Cardiovascular Institute
1999 - Consultant Cardiologist, University Hospital of Santa Maria, Lisbon
1997–2004 - Associate Professor of Cardiology, Faculty of Medicine of Lisbon, Lisbon University
1994–1997 - Assistant Professor of Medicine (Cardiology), Faculty of Medicine of Lisbon, Lisbon University
1993–1999 - Attending Cardiologist, University Hospital of Santa Maria, Lisbon
1991–1993 - Clinical Attending in the Echocardiography,             Laboratory Stanford University (USA)
1990–1991 - Post-Doctoral Fellow, Div Cardiovascular Medicine, Stanford University (USA)
1987–1990 - Cardiology Fellow, University Hospital of Santa Maria (Portugal)
1985–1987 - Resident, University Hospital of Santa Maria (Portugal)

Selected ESC positions

• President and founder of the European Association of Echocardiography (2003–04)
• Representative of the ESC on ACC Committee to Develop an Expert Consensus Document on Standards for Acquisition, Measurement and Reporting of Intravascular Ultrasound Studies (IVUS) (1998).
• Representative of ESC in the ACC Echo Committee (2002/05)
• Science Council member (2004–06)
• Member of Task Force 1 of CRT (2005–06)
• Board Member of ESC, Councillor (2004–06)
• EBSC Board member (European Board for the Specialty of Cardiology) (2006–10)
• Nominated Chairman of the Congress Program Committee (CPC) of ESC (2009–2010)

Academic activities

• 122 Papers
• 520 Presentations at national and international meetings
• 170 Scientific original presentation at international meetings

Journal activities

• Editor-in-chief of the Portuguese Journal of Cardiology (1999–   )
• Editorial Board of (among others): European Heart Journal (1996-2002), European Journal of Echocardiography, The Journal of Heart Disease (2001– ), International Journal of Cardiovascular and Science (2003– ), Hellenic Journal of Cardiology (2004– ), Turkish Journal of Cardiology (2004– ), Romanian Heart Journal (2005– ), Archives of Medical Science (2005– )
• Reviewer of the following journals (among others): American Journal of Cardiology, Biomedical Imaging and Interventional Journal, Circulation, Clinical Cardiology, Echocardiography, European Heart Journal, European Journal of Echocardiography, Heart, International Journal of Cardiology, Journal of the American College of Cardiology (JACC), Journal of the American Society of Echocardiography