Top cardiac specialists convene in Missoula for heart-to-heart

During the next two days in Missoula, new scientific thought will be born.

Carlos Duran, who leads the International Heart Institute of Montana, will be the midwife. It’s one of his favorite jobs.

By GINNY MERRIAM of the Missoulian

http://missoulian.com/articles/2004/06/25/news/local/news04.txt

With help from Missoula colleague Stephen Black and London surgeon Sir Magdi Yacoub, Duran chose and invited a dozen of the world’s top thinkers in cardiac science to convene for the Bakken Scientific Encounter. This is the fifth such event since 1997, the second named for heart electronics pioneer Earl Bakken.

The scientists boat out to the University of Montana’s retreat at Salmon Lake, they settle in and they don’t move. They drink coffee, they eat – and they talk, nonstop, about their newest ideas. They argue, and they start cross discussions on related ideas.

Duran, pen in hand, glasses on his nose, prods it along.

"I promote this," he said in an interview on Thursday. "I say, ‘I don’t understand. Start again.’ "

"There’s a particular moment, it clicks," he said. "It goes from a solid into a gas."

Nothing is invented or solved on the spot. But participants go away with a new synthesis of ideas.

"It’s totally and completely unpredictable," he said. "But everybody goes home with several ideas he’d like to test."

Duran likes to think of it as a pot of heating water. Leading up to boiling, individual bubbles pop to the surface. But once it boils, the bubbles connect and the entire surface erupts.

That’s how scientific thought advances, he said.

"Very often, the answer to a problem that a scientist has is already out there," Duran said. "But he doesn’t know. And the guy who has the answer to that problem doesn’t know he has it."

Collaborations between scientists who live thousands of miles apart can come out of the meeting. Black, a molecular physiologist who is director of vascular biology for the Heart Institute and also teaches in the UM School of Pharmacy, met two cardiac surgeons from the University of Pennsylvania in Philadelphia last year. They were working on signaling mechanisms in the cells. Black works on questions of oxidation in cells. The two areas had more in common than they thought and helped Black look at events in the cells right next to the area damaged by the heart attack.

Their model furthered his work, and the other way around, he said.

"I would never have known them," he said. "I didn’t know them until last year. … That sort of back and forth really keeps everybody’s science moving along."

In choosing the 10 scientists to invite from Canada, the United States and the United Kingdom, Black, Duran and Yacoub looked for a mix of people with M.D. and Ph.D. degrees, Black said. That mixes the academic and the theoretical with the clinical and the practical.

The ultimate application, he said, is to help patients.

There is no public at the meeting, so every participant is sometimes teacher, sometimes pupil, Duran said. Scientists from the medical technology company Medtronic Inc., founded by Earl Bakken, who funds the meeting, will observe at the meeting.

The topics they’ll talk about this year are the problems in vascular stenting: Is there a solution at the genetic or cell level to the regrowth of artery clogs even after a patient has a stent implanted to hold the artery open?; heart failure: What happens at the cellular and molecular level?; and inflammation, a big part of heart failure.

For the first time, Duran and the participants had to part with the retreat at Salmon Lake. There were too many people, so the meetings will be held in meeting rooms in town – Duran hopes at no expense to the creative process.

The scientists who will visit Missoula include Yacoub of the Heart and Lung Institute in London, one of the world’s best known cardiac surgeons; Francis G. Spinale, a professor of surgery, physiology and pediatrics at Medical University of South Carolina who works on acute and chronic heart failure; and Susan Krisinski Majka, a cellular and molecular biologist and professor at the University of Colorado Health Sciences Center. Duran himself is a cardiac surgeon known around the world.

"I think that Missoula should become notorious for small encounters among people in all different fields," Duran said. "All they bring is their brain power."

The Heart Institute is a joint project of St. Patrick Hospital and Health Sciences Center and UM.

Reporter Ginny Merriam can be reached at 523-5251 or at [email protected]