Michel Komajda教授：法国心血管领域杰出教授，ESC前主席。目前任职于巴黎第六大学萨博特慈善医院。主要研究领域为心力衰竭。

　　International Circulation: ESC has maintained close cooperation with China in the field of cardiovascular disease prevention. What key take-home messages will the current ESC & GW-ICC Joint Forum provide the participants?

　　Dr Komajda: Prevention is a key element in the healthcare of a population and the number of people who practice unhealthy lifestyles is significant all over the world. It is true in China. It is true in Europe. It is true in the Americans. I think the best way to avoid a bad lifestyle is through the alliance of associations， organizations， and scientists such as with the Great Wall International Congress of Cardiology meeting and the European Society of Cardiology， because we need to act together in order to fight against cardiovascular disease.

　　《国际循环》：ESC与中国一直进行者心血管疾病防治的合作，本届ESC & GW-ICC联合论坛将为参会者传递哪些ESC2014年会的关键信息？

　　Komajda教授：预防是人口医疗保健的一个关键因素。全世界有不健康生活方式的人口数量巨大，在中国、欧洲、美洲的确如此。我认为，避免不健康生活方式的最好途径是协会、组织和科学家建立联盟，如GWICC和ESC。我们必须共同采取行动，与心血管疾病作斗争。

　　International Circulation: ESC has released its latest guidelines for hypertrophic cardiomyopathy. What is your opinion on the main updates? And what impact will these updates have on the clinical diagnosis and treatment of hypertrophic cardiomyopathy?

　　Dr Komajda: The new guidelines insist on the fact that every patient suspected of having hypertrophic cardiomyopathy should have a thorough clinical examination and should also have an electrocardiogram and echocardiogram at rest and with exercise and other procedures if needed. Our guidelines also insist that because in most instances， hypertrophic cardiomyopathy is a genetic disease， it is not enough to just examine the patient but all the first-degree relatives should be examined because there are a number of asymptomatic relatives who will carry the disease in a single family.

　　《国际循环》：2014年ESC发布了肥厚型心肌病的最新指南，该指南有哪些要点更新？将对肥厚型心肌病的临床诊疗产生哪些深远影响？

　　Komajda教授：新指南坚持每例肥厚型心肌病疑似患者应进行全面的临床检查，并应作静息和运动时心电图和超声心动图以及其他所需操作。我们的指南还坚持，多数情况下肥厚型心肌病是一种遗传性疾病，仅检查患者并不够，还应检查其一级亲属，因为一个家庭中有可能携带这种疾病的无症状患者。

　　International Circulation: On the basis of standard anti-heart failure treatment， heart rate control can significantly improve the therapeutic efficacy in some patients， hence pure heart rate lowering drugs begin to enter the management program. How do you evaluate the role and prospects of heart rate control in the management of heart failure?

　　Dr Komajda: Heart rate is not only a risk marker but also a risk factor in heart failure with low ejection fraction. When you use a pure heart rate-reducing agent such as ivabradine， it has been shown to reduce cardiovascular morbidity and mortality. I think we have probably overlooked the importance of heart rate as a risk factor in heart failure and we need to lower heart rate to around 60 beats/minute in all patients who are in sinus rhythm and with heart failure with low ejection fraction. This is the reason why the ESC guidelines have introduced ivabradine in addition to other medications including ACE-inhibitors or ARBs， beta-blockers and mineralocorticoid receptor antagonists.

　　《国际循环》：在标准抗心衰治疗基础上行心率控制可显著提高部分患者的治疗疗效，单纯降低心率之药物也开始进入心衰管理方案。您如何评价心率控制在心力衰竭管理中地位及前景？

　　Komajda教授：在低射血分数心力衰竭中，心率不仅是风险标志物，还是危险因素。研究显示，当使用单纯的降心率药物如伊伐布雷定时，可降低心血管疾病发病率和死亡率。我认为我们可能忽略了心率作为心力衰竭一种危险因素的重要性。我们需将所有窦性心律和低射血分数心力衰竭患者的心率降至60次/分左右。这就是ESC指南除ACE抑制剂或ARBs、B受体阻滞剂和盐皮质激素受体拮抗剂外，介绍伊伐布雷定的原因。

　　International Circulation: You are the author of a pocketbook which has now been translated into Chinese. You can tell us about this publication?

　　Dr Komajda: The pocket guidelines are a very useful tool for physicians because we have no time to read the full text of long guidelines. The pocket guidelines are a condensed version that allows each cardiologist to quickly review what is most important for the diagnosis and management of cardiovascular disease. It is a very practical tool.

　　《国际循环》：袖珍版指南目前已被译成中文，您是袖珍版指南作者，您能谈谈这本指南吗？

　　Komajda教授：袖珍版指南是医生一个非常有用的工具，因为我们没有时间阅读指南全文。袖珍版指南是指南的浓缩版，每位心脏病可快速回顾心血管疾病诊断和管理的最重要内容。它是一个非常实用的工具。