Cardiovascular Diseases Faculty of Medicine Second Annual Retreat December 11th, 2017 Nadia Giannetti MD Chief, Division of Cardiology MUHC Ariane Marelli MD, MPH Director of Cardiovascular Research MUHC

Background In spring 2017, a grid developed to categorize tertiary and quaternary clinical activities across the McGill RUIS Now moving forward to enhance collaboration in clinical activities as well as academic/research across the sites

McGill Collaborations in CV Sciences Working groups being created across McGill with leaders from both MUHC and JGH identified to advance collaborations the following programs: Congenital Heart Disease Heart Failure Cardio-oncology Cardiac imaging Interventional/structural cardiology Cardiac intensive care Arrhythmia Prevention Fundamental research Outcomes research

Timeline Face-to-face meeting in the early new year Review current status Identify goals Identify strategies Benchmarks Mini-Summit in early spring

McGill Cardiovascular Research Day Dedicated to students in CV Research Across McGill Started in 2005 CME accredited since 2010 80 number of abstracts presented by students in 2017 (up from 29 in 2005) 100-138 attendees in the last 5 years

MUHC Precision Medicine Initiative in Cardiovascular Disease Where transformative cardiovascular research meets innovation in clinical care

What is Precision Medicine? Prevention and treatment that take individual variability into account leveraging technology for rapid analysis and knowledge translation NEJM 2015; 372:9

Why now? Dawn of the 21st Century we can harness Genetics (inc. epigenetics) and ’omics’ (proteomics, metabolomics) Big Data Electronic health records and Digital Health Antman Nature Card 2016;13:591

Cardiovascular Health MUHC infrastructure Cardiovascular Health Across the Lifespan (CHAL) Research and Clinical Care aligned Cardiovascular Health Clinical Pod (CHCP)

CHAL research program at the MUHC-RI Brings together CV researchers from Cardiology, IM, Epidemiology, Cardiac Surgery Span from genetics to population

Cardiovascular Health MUHC infrastructure Cardiovascular Health Clinical Pod (CHCP) >20 thousand visits per year in Cardiology, Cardiac Surgery, Vascular Surgery, and Cardiovascular Prevention

Vision: Harnessing existing infrastructure To decrease the burden of cardiovascular disease by implementing personalized prediction and prevention of cardiovascular events

What does this mean? PREDICTING DISEASE

Mission: research In patients across the lifespan To develop ‘Cardiovascular Health Signatures’* for prevention and treatment Each individual’s Health Signature will be derived from morphology, biologics and lifestyle variables Using cross-cutting platforms at the MUHC including imaging (phenotype), biologicals (genotype and omics), digital health data and artificial intelligence *Mathias Friedrich

Precision Medicine Initiative in Cardiovascular Disease Start locally and expand Imaging Genetics and biomarkers Artificial intelligence Digital Health Platform

How? CTB MRI (CIM) Personalized Outcomes (CORE) Health Data CHCP Adapted from Antman Nature Card 2016;13:591

Mission: clinical Personalized patient-centered health care delivery platform “Providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions (IOM 2015) Patient Centered Cloud Platform for Mobile-Health Enabled Clinical health delivery: patient custodians; patient navigators; health coachs; medication management; access management

Resources MUHC-R.I. funding: 22 million dollars (2012-16) in CV research through the CHAL program MUHC/RVH/MGH foundations: 33 million dollars Dedicated CV research MRI and “Health Signature” Dedicated Family Heart Center and Prevention Centre Dedicated Digital Health in Heart Failure Dedicated Innovation in Valvular Heart Disease Excludes large collaborative grants including 25 million SPOR with CHILD BRIGHT that Dr. Marelli is a PI on.

Precision Medicine Initiative in Cardiovascular Disease Conclusions We propose to deliver a Cardiovascular Precision Medicine Initiative Intersection between biology, digital health, imaging to collect highly specific data and use AI to implement predictive analytics We can build on a cardiovascular research program and clinical pod to transform the way we deliver care

Thank you