Prof. Dr. med Hugo A. Katus
Interview of September 28, 2007 with Dr. Birgit Teichmann
Prof. Katus, cardiovascular disease is the most common cause for death and disease in western industrialized countries. Genetic factors play an important role with cardiovascular diseases. Your team finds more and more gene defects. Does that mean that man is helpless against these defects?
Indeed, some genetic defects lead inevitably to the disease and the person affected is more or less helpless. These monogenic diseases with high penetrance are rather seldom. More common, diseases are caused by interaction of several genes or through genes with small penetrance. These genetic disorders provide the basis on which an unhealthy life style or other impairment may lead to the disease (genes load the gun, environment pulls the trigger). For instance, I may have a disposition for heart attack, but I might never have one, if I lead a healthy life. Therefore we are not totally helpless based on our genetic defects because through a healthy life style and physical activity we can influence other factors which are very important with cardiovascular diseases.
According to literature, the number of heart attacks increases drastically with age. Do we have the same problem as with Alzheimer disease: You only have to get old enough and you get heart problems?
Unfortunately this is true. It is not only the heart attack but even more so the heart insufficiency, meaning the myocardial insufficiency, which increases enormously with age. This insufficiency is the most common reason for hospitalization and there seems to be no end in sight for this increasing trend. It is not quite clear why the heart becomes weak with age, but of course the sum of circulatory disorders, high blood pressure and a genetic predisposition are important factors.
The stem cell therapy is mentioned more frequently in connection with cardiovascular diseases. Will pace makers and artificial heart become obsolete in the future?
Interesting question. The idea is tempting, we place our heart in a fountain of youth and all is well. In truth, it is not that simple and whether stem cells can be used as a therapy is questionable. Certainly we can manipulate stem cells in the laboratory. We can insert genes and then these stem cells become pace maker cells, setting the pace of the heart. In theory this would prevent the necessity of an artificial heart pace maker. The research perspective is there, but the clinical factor still has a long way to go.
What kind of academic training must one have to apply for a research position at your clinic?
One has to be motivated, open minded and naturally have the necessary qualifications and credentials. After that we are interested in the individuals training. Personality is a high factor, we need individuals who are ambitious, motivated and take on a task. Our choice is also based on the molecular or clinical experience and if he or she has engaged in scientific questions beyond his academic qualifications.
What is the inheritance factor for children? Is it already decided in the womb if the child will have a strong or weak heart?
We believe so and we can prove it with test results that the genetic equipment is decisive for heart insufficiency. Also how thick a heart muscle grows or if there will be deposits on the vessels is determined genetically. As I mentioned at the beginning, genes are not everything. It is a complex interaction, also with the environment and other diseases, which contribute their part and are determining if these genes are important for a clinically apparent disease. It cannot be argued, heart attacks and insufficiency are heredity diseases. It is therefore important that doctors, when they see patients with heart attacks, also ask questions concerning the siblings, children and point out that this family has an increased risk and that precautionary tests should be considered.
Which preventive measures are part of your daily routine? Do you watch your diet or do sports?
Yes I do and I hope it is enough. I use my bike daily to go to work, even though I have a car, and I am doing this because I do not have enough time to do sports. At the clinic, I walk the stairs instead of taking the elevator, even to the last floor. I try to integrate physical activity in my daily work and since I like the Mediterranean diet, I have no problem leaving out animal fats as much as possible.
How do you envision your aging?
That is a good question. A question you should not ask, because I am so busy with my daily work that I do not think about aging. Somehow everything I do is aimed for improving things in the future and one forgets that in the process we still continue to age. I have to admit that I have not thought about aging in detail. This ignorance I share with a lot of others who are so involved in their daily work process.
The Network Aging Research combines scientists of different Departments in order to explore aging in all aspects. What do you hope to gain from the NAR with regard to your work?
I find the idea of creating a network excellent because the aging process of the heart, in many aspects, does not differ from the aging process of the brain or other organs. It is very important, that scientists with certain viewpoints exchange their ideas and realize common approaches, which are important for different organs. I am convinced that scientifically we can profit from each other. On top of that I hope that there will be a network which offers the opportunity to carry clinical problems to basic research and that the basic researcher develops an interest and motivation on clinical questions and that his or her experimental work is also oriented on disease pictures. I am looking forward to this network and hope we can celebrate many successes. In particular through bridge building between the various working groups.
Hugo Katus was born 1951 in Steinfeld (Rheinland/Pfalz). He studied medicine in Heidelberg. He completed his studies in Heidelberg and at Harvard Medical School. As a result of these studies he developed the Troponin assays, today state of the art for clinical chemical heart attack diagnostic.
Hugo Katus is the speaker for cardiovascular diseases in the National Genom Research Network, President of the Academy of the German Society for Cardiology and editor of the scientific magazine for the German Society for Cardiology. Professor Katus left his full professorship in Lübeck after his nomination for a chair in Heidelberg. He is now the Clinical Director of the Department of Cardiology, Angiology and Pneumology, as well as Managing Director of the Medical Clinic, Heidelberg.