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Cardiovascular Genetics Will Herald New Age of Cardiology
Simon Dack Lecture
March 21, 2002

ATLANTA, Georgia (ACC) -- Cardiology has not seen much success in gene therapy yet, but just you wait. When the breakthroughs come—and they will come soon—they will surpass all of the achievements in the discipline of the past 50 years and the 2,000 years before that, said Robert Roberts, MD, who delivered the annual Simon Dack Lecture on Monday, March 18, 2002.

“Cardiology is clearly on the verge of its most golden era,” Dr. Roberts said.

Dr. Roberts, chief of Cardiology at the Baylor College of Medicine, Houston, spoke on “Cardiovascular Genetics and the 21st Century.”

The past 50 years, with its multitude of advances, has already been dubbed the “golden age of cardiology.” None of the therapies common today were available 60 years ago, Dr. Roberts noted, from open-heart surgery and cardiac catheterization to ablation and antibiotics.

Cardiology advanced more in the past 50 years than in the previous 2,000, he said, and the next 50 years will surpass even that.

The completion of the Human Genome Project—the $3 billion effort to map the human genome—Dr. Roberts believes, “will usher in the next marvelous era of cardiovascular medicine.”

Personalized medicine

Mastery of the human genome will present physicians with a new perspective on medicine, Dr. Roberts said, that of using multiple etiologies—genes—to look for a disease in a specific individual.

“This will be a totally different picture,” he said. “Within 10 years we will have sequenced 30,000 to 40,000 genes related to human disease. A single blood sample will contain 40,000 etiologies.”

The Human Genome Project is about 88 percent complete, Dr. Roberts noted, and should be completed within a year. So far, only about 1,000 genes in the gene bank have been associated with disease, and 18 percent of those are related to cardiovascular disease.

But daily advances in computational biology and bioinformatics point to a time in the next five to 10 years when an individual will have his or her entire genome available for risk assessment, treatment selection, and prognosis.

The average lifespan more than doubled over the past century, from 36 years in 1900 to 80 years in 2000. Personalized medicine based on gene therapy, Dr. Roberts predicted, will play an essential role in doubling that again by the year 2100.

“Embrace the techniques and be patient,” he said. There will be failures along the way, he concluded, “but the next things that happen for all of us will be beyond our imagination at this time.”

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