Cardiologist Nazzareno Galiè: A Guiding Light for Worldwide Consensus on Pulmonary Hypertension

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If anyone is keeping track of the number of scientific publications on pulmonary arterial hypertension (PAH), pulmonary embolism, chronic heart failure, and heart transplantation authored or coauthored by Nazzareno Galiè, MD, the total has reached more than 280. But that impressive figure is only one measure of the stature of Dr Galiè as a world-class investigator in this field. Dr Galiè's influence extends far beyond the borders of his native Italy where he is Head of the Pulmonary Hypertension Center at the University of Bologna.

Evidence of his influence on state-of-the art knowledge in PAH is apparent in this issue as he analyzed highlights from the Third World Symposium on Pulmonary Hypertension held in Venice from June 23 to 25. As one of the organizers of this symposium, Dr Galiè helped bring together cardiologists and pulmonologists from leading research centers around the world to address topics of central importance to clinicians involved with the disease.

Aside from postdoctoral training in London and at the University of Arkansas, Dr Galiè has spent his entire career at the Institute of Cardiology, University of Bologna, where he is looked to as one of the guiding lights for European research in PAH. This is the program that kindled his interest in PAH soon after he wrote his doctoral thesis on the topic. As his interest in this field grew, he became more interested in PAH because it lacked a cure and other clinicians began sending more patients with PAH to Bologna for treatment. The University of Bologna's program earned a reputation as one of the centers of excellence for the treatment of PAH.

By the late 1990s, his center became one of the pivotal locations in Europe for investigations on new drugs being developed for PAH, including treprostinil, bosentan, beraprost, and iloprost. More recently, Dr Galiè's group has been involved in an international study on the effects of sildenafil in PAH, results of which are expected early in 2004. Working with colleagues in Europe and the United States, Dr Galiè has served on numerous committees to evaluate the effects of the new agents, and in particular he has led the first double-blind, placebo-controlled study on the effect of the endothelin receptor antagonist bosentan on the echocardiographic and Doppler parameters in PAH patients.

Academically, he earned appointments as Associate Professor of Cardiology on the Medical Faculty at the University of Bologna and Professor at the Postgraduate Medical Schools of Pulmonary Diseases and of Cardiology at the same University. He has served as past chairman of the Working Group on Pulmonary Circulation and Right Ventricular Function of the European Society of Cardiology, and he is also a member of the Scientific Council of this Society.

Much of his time in recent years has been consumed with organizing the sessions of the World Symposium on Pulmonary Hypertension, including the Evian conference in 1998 when he served on the Task Force on Medical Treatment. The excitement generated by this year's Third World Symposium on Pulmonary Arterial Hypertension in Venice—which produced a consensus on many key issues affecting diagnosis and treatment—will continue as new options in therapy are explored and delineated in the reports emerging from this meeting. Many of the consensus statements will serve as the basis for revising the guidelines for treating PAH.

Looking ahead to these developments, Dr Galiè predicted many advances in basic science and therapy during the next 5 to 10 years. “We need to identify the precise link between the mutation of the gene responsible for familial idiopathic PAH. We have the disease on one side and the mutation on the other—what lies between is still unknown, yet critical to understanding the disease. New treatments have been focused on correcting the changes in different pathways, including the endothelin pathway, the prostacyclin pathway, the nitric oxide pathway, and in the future perhaps the serotonin pathway. In addition the appropriate strategy for the combination of these therapies represents an important challenge for the coming years.”