MEET RICARDO SEABRA GOMES
Born in Lisbon in 1944. Married with 5 daughters. Retired in 2005. Qualified by the University of Lisbon Medical School in 1968. Cardiologist by the Portuguese Medical Association in 1971. Resident Medical Officer to the Surgical Unit at the National Heart Hospital under Sir Donald Ross and Research Fellow to the Cardiothoracic Institute (University of London) under Prof. Peter Harris from 1971 to 1978. At the Cardiothoracic Institute studied mainly the effects of hypoxia and anoxia on isolated hearts (rats, guinea-pigs, etc), using the Langendorff technique and electron microscopy. The studies were mainly done with Winifred Nayler and Charles Ganote. The main publications were "Irreversible myocardial injury in anoxic perfused rat hearts"(Am J Pathol 1975), "Species variation in anoxic-induced damage of heart muscle" (J Mol and Cell Cardiology, 1975) and "Excitation-contraction coupling in cardiac muscle" (Progress in Cardiovascular Diseases, 1975). At the National Heart Hospital worked with many distinguish cardiologists (Aubrey Leatham, R. Emanuel, Edgar Sowton, Raphael Balcon, Derek Gibson, Jane Somerville, etc.) and surgeons (Donald Ross, Magdi Yacoub, Keith Ross, John Parker, etc.) and mainly with Anthony Rickards in the cardiac catheterization laboratory. From this close work with A. Rickards, resulted the development of a new method of wall motion analysis from left ventricular angiograms (Eur J Cardiol 1977). Returning to Portugal helped the opening of the Hospital de Santa Cruz where became director of the Department of Cardiology in 1984. Apart from clinical work, he has participated in many clinical trials both as local investigator or member of the Steering Committee. Very active in the implementation of thrombolysis for acute myocardial infarction. In the Hospital of Santa Cruz and with a small number of patients, he did the first trial comparing streptokinase with anisoylated plasminogen streptokinase activator complex (APSAC)(Drugs 1987). But the first Trial with definitive influence for this activity was the mega trial ISIS IV with Peter Sleight, Rory Collins and Richard Peto (was member of the Steering Committee) (Amer J Cardiol 1991 and Lancet, 1995). Investigator in a study who had as chair and principal investigator Salim Yusuf (The CORE Trial)(Circulation 1997) with RheothRx and in many thrombolysis trials including prehospital thrombolysis with anistreplase (EMIP Experience)(National Coordinator)(Eur Heart J 1996). Part of the European Secondary Prevention Study Group that presented the "Translation of Clinical trials into practice: a European population-based study of the use of thrombolysis for acute myocardial infarction" (Lancet 1996) and as part of The European Netwok for acute myocardial infarction (ENACT) - a pan-European study of the management and outcomes of acute coronary syndromes" he was member of the investigators (Eur Heart J 2000). Involved practically in all trials with all new thrombolytic agents (tenecteplase, alteplase (continuous infusion and double bolus), reteplase, saruplase, pro-urokinase, and antiplatelet therapy (sibrafiban - oral glycoprotein IIb/IIIa antagonists, and intravenous abciximab). Another study was a comparison of 6 days and 14 days treatment of low molecular weight heparin with 6 days unfractioned heparin in unstable and non-Q wave myocardial infarction (FRAXIS, Eur Heart J 1999). In a collaborative overview of early mortality and major morbidity the Fibrinolytic Trialists´(FTT) Collaborative Group review the results from all randomised trials of more than 1000 patients (Lancet 1994). It should be stressed the special liaison with Eric Topol for the GUSTO Group and with Frans van de Werf for the ASSENT trials.
Also in 1984 started coronary angioplasty in Portugal. This pioneering work at the Hospital of Santa Cruz was continue over the years with the introduction of all forms of coronary interventions: atherectomies (directional, rotational), intracoronary laser, intracoronary brachytherapy and stents. The firs stent were implanted in 1990 and the first drug eluting stents (Cypher) in 2002. Participation in clinical trials mainly evaluating new stents. It is important to stress the liaison with Patrick Serruys of Rotterdam. The list of stents and trials studied included the multi-Link (TRENDS study ) (Am J Cardiol 2006 and EuroInterv 2007), phosphorylcholine-coated biodivYsio stent (SOPHOS study, Int J Cardiovasc Intervent 2000), beStent (ROSE trial, Int J Cardiovasc Intervent 2000), etc, and the first trials comparing stenting and surgery like the CABRI trial (Lancet 1995), the Stent or Surgery trial (SOS)(Semin Intervent Cardiol 1999) and the ARTS study ( Int J Cardiovasc Interventions 1999). Later, with the drug eluting stents, entered in the Benestent, e-Sirius and Taxus trial. The experience of the first 500 patients with balloon angioplasty and up to 5 years follow-up served the basis for the PhD Thesis at the University of Oporto in 1994. In Portugal, implemented a multicenter registry with stent Multi-Link 2.5 to small coronary arteries (published in Portuguese) and together with brazilian coleagues developed the PORTO trial with sirolimus eluting stent for small arteries of diabetics and non-diabetic patients with 6 month angiographic follow-up. This study was presented in Paris in the EuroIntervention Congress.
In relation to other areas of interest the highlight was for heart failure. The first trial was the PICO (Pimobendan in congestive heart failure, Circulation, 1992), but others were the DEFIANT-II study - doppler flow and echocardiography in functional cardiac insuficiency: assessment of nisoldipine therapy) (Eur Heart J 1997), the ATLAS study (comparative effects of low and high doses of the angiotensin-converting enzyme inhibitor, Lisinopril on mobidity, and mortality in chronic heart failure (Circulation 1999); the ATLAS trial (acute coronary findings at autopsy in heart failure patients with sudden death)(Circulation 2000); the ATLAS trial (efficay and safety of high-dose lisinopril in chronic heart failure patients at high cardiovascular risk, including those with diabetes mellitus (Eur Heart J 2000). ). Other important area was the use of beta-blockers. With the European Secondary Prevention Study Group beta-blockers and antithrombotic treatment for secondary prevention after acute myocardial infarction (Eur Heart J 1998). With carvedilol there was the Prospective randomized cumulative survival study group evaluating the effect on survival in severe chronic heart failure (N Eng J Med 2001). Also the CIBIS II study (trial of beta blckade with bisoprolol in heart failure, Circulation. In more severe patients, there was the COPERNICUS study with carvedilol (JAMA 2003). The most recent participation in trials was in the BEAUTIFUL in stable coronary artery disease (Lancet 2008) and the SHIFT trials in patients with heart failure (Lancet 2010) with ivabradine.
Honours and Awards
Comendador "Ordem of Merit of the Nation"
Honour of "Grau de Comendador da Ordem do Infante D. Henrique"
Gold Medal of the Ministry of Health
Prize Nunes Correia Verdades de Faria, of the Santa Casa da Misericórdia de Lisboa (Charitable Institution)
27 scientific prizes from the Portuguese Society of Cardiology