“We don’t only want to intervene, but also slow down and even prevent”

What is the core message of your inaugural lecture, and why did you choose this focus?

“We have made enormous progress in the treatment of heart valve diseases. Nowadays, we can repair or replace valves with procedures that are less and less invasive. But we still do not fully understand why these diseases develop or why their course can differ so much between patients. This requires collaboration between cardiologists, geneticists, biologists, engineers and other specialists. If we better understand the underlying mechanisms, we can recognise disease earlier, determine more accurately who will benefit from an intervention, and hopefully in the future also develop medications that slow disease progression.”

What are some of the main research lines that you and your team focus on?

“My team and I study heart valve diseases from different perspectives. Using advanced imaging, we aim to detect valve disease earlier, assess its severity more accurately, and better predict which patient needs which treatment. We don’t only want to intervene when disease is severe, but also understand how we can slow deterioration or perhaps even prevent it.”

“In addition, we investigate why valve diseases arise, for example through genetic predisposition, inflammation, calcification or changes in the heart muscle. We also study patients whose disease course differs from what we would expect. These exceptions can teach us a great deal. Our goal is to better predict individual risk and make treatments more personalised.”

What role do education and patient care play in your vision of this field?

“For me, patient care, education and research are closely connected. In clinical care you see which questions really matter to patients. In research you try to find answers to those questions. And through education you pass this knowledge on to the next generation of doctors and researchers. Valve disease requires collaboration between different specialists. That is why I find it important to teach young colleagues not only knowledge and technical skills, but also how to make good decisions, how to guide patients carefully, and how to work together to arrive at the best treatment plan.”

What has really stayed with you from recent years?

“What has stayed with me most is how quickly the field has changed. When I started, many patients with severe valve disease were too frail for surgery. Now, we can replace or repair a heart valve in many of these patients using a catheter, often via a small incision in the groin. That is remarkable. Imaging cardiology also plays an increasingly important role, both in diagnosis and in planning and guiding treatment. At the same time, I have realised that technical progress alone is not enough, and how important it is to better understand the disease mechanisms themselves.”

Looking ahead, where do you hope the field will be in 10 to 15 years?

“I hope that by then we will not only be able to repair valve diseases, but also better prevent or slow them. I also hope that we will understand more clearly, for each individual patient, why the disease develops and how quickly it will progress. My ambition is to move from general treatments to truly personalised care.”

“In addition, I hope that all involved specialists continue to work together to advance the field of heart valve disease. And that we pass on this culture of collaboration, curiosity and careful decision making to the next generation.”

The inaugural lecture of Nina Ajmone Marsan,“Klepziekten van het hart: heden, vooruitgang en toekomst”, will take place on 3 July from 14:00 to 15:00. You can follow it live via the Leiden University livestream.