16 Jan Interview Francisco Fernández-Avilés – Professor of Cardiovascular Medicine at the UCM and Co-Founder of Corify Care

Francisco Fernández-Avilés: “the development of imaging techniques in cardiology helps significantly in decision-making and in the planning of surgical or catheter-based interventions. The incorporation of artificial intelligence (AI) is undoubtedly a new revolution in this field, facilitating high-precision early diagnoses and more appropriate decisions for each risk profile”.
Dr. Fernández Avilés is Professor of Cardiovascular Medicine at the Complutense University (UCM), Director of the Department of Cardiology at the University Hospital San Rafael in Madrid (Orden Hospitalaria de San Juan de Dios). As Scientific Director of the CIBERCV, he has coordinated the activity of the best basic and clinical cardiovascular research groups in Spain. For more than 18 years he has also been head of the Cardiology Service at the Gregorio Marañón University Hospital in Madrid. His research focuses on the protection and regeneration of damaged myocardium. He has received several awards and has published more than 700 articles in scientific journals, abstracts and book chapters, with a total impact factor of 1,703.02, a cumulative citation index of 13,727 and an H-index of 42. He actively participates in various national and international public and private organisations as an expert in the planning and evaluation of healthcare activity, teaching and research. He is a member of the American College of Cardiology, the American Heart Association and the European Society of Cardiology and is a member of the Editorial Board of the main international cardiovascular journals.
What do you consider to have been the most significant achievement of your career and what impact has it had on the field of cardiology?
Perhaps I am not the best person to answer this question. In any case, I believe that the only relevant achievement that can be attributed to me is that I have managed to accompany myself well, which in turn has derived from a real mentality of service to the citizens, trying to contribute something to preserve their health.
When you really want to solve problems, you need to work in a team with the best people. If you can do that, everything else follows. See Medline or Pubmed for details.
With the current technological developments in diagnostics and therapy, what role do new medical imaging techniques, supported by AI, and new regenerative therapies for the heart play? Are there any other significant advances you would like to mention?
The truth is that in the last two decades the development of imaging techniques in cardiology has been spectacular and has consolidated the isolated and combined use of the different cardiac imaging modalities (echocardiography, computed tomography, MRI and invasive angiography) as essential in daily practice, not only for the precision diagnosis of this pathology, but also, and very importantly, for decision making and for the planning of surgical or catheter-based interventions.
The incorporation of artificial intelligence (AI) is undoubtedly a new revolution in this field, for several reasons. Firstly, AI helps to detect patterns and anomalies with a precision and speed that surpasses traditional techniques. It also allows for the cross-analysis in seconds of large volumes of different types of data (demographic, socioeconomic, genetic, associated pathologies, etc.), facilitating high-precision early diagnoses and more appropriate decisions for each risk profile; helping doctors to identify cardiovascular diseases at an early stage. For example, techniques such as optical coherence tomography (OCT), histological and myocardial perfusion characterisation with cardiac resonance, or the evaluation of different cardiovascular structures with CT, are used to accurately diagnose the presence and severity of pathologies, to make decisions as important as implanting a defibrillator, or to plan complex interventions such as catheter implantation of artificial valves. In addition, with the help of deep learning algorithms, AI can detect small variations in images that may go unnoticed by the human eye, increasing diagnostic accuracy and enabling earlier and more targeted treatment.
Regenerative therapies, such as stem cell therapy, cell fragments (vesicles) or molecules capable of activating the heart’s regenerative capacity, are opening up new possibilities for the treatment of heart disease, especially in cases of irreversible damage to heart tissue, such as after a heart attack.
What we have learned from several decades of research is that the biological mechanisms of cardiac regeneration need to be further elucidated before these therapies can be considered for routine use in humans. To this end, basic research and translational studies using experimental and in silico models need to be strengthened.
Specifically, with AI support and through computational modelling, in silico research in cardiac regeneration will be a fundamental tool to simulate, analyse and predict the effects of different regenerative therapeutic interventions on the heart. This is of enormous significance because such studies will reduce the need for early-stage animal and human experimentation, allowing rapid assessment of the results of regenerative therapies. They will also allow optimisation of treatment parameters and prediction of tissue response in a controlled environment, thus accelerating the development of safe and effective interventions.
The most promising therapies are those based on pluripotent stem cells, allogeneic cells, cell vesicles, and tissue engineering. New 3D bioprinting techniques are also emerging to create structures similar to cardiac tissue, which could, in the future, allow the creation of personalised heart patches or even artificial hearts from the patient’s own cells. Finally, gene therapy to modify specific genes associated with inherited heart disease and gene editing using CRISPR are areas of research that could change the landscape of heart disease prevention and treatment in the future. In the world of cardiology, the advances derived from technological modernisation, mainly in the field of imaging and biomaterials, have been many and very significant. Among others, the following should be highlighted the enormous progress in minimally invasive mechanical or electrical intervention techniques, such as catheter implantation of heart valves or ablation of arrhythmogenic foci; the development of advanced medical devices such as smart pacemakers and implantable cardioverter-defibrillators (ICDs), which can be connected to cloud systems and monitored remotely; improvements in telemedicine, which allows remote monitoring of patients; or the use of wearable devices, such as smartwatches, to monitor heart rate, rhythm and other parameters in real time. Finally, advances in genetic sequencing and clinical interpretation of DNA mutations, previously far removed from our speciality, have been fully incorporated into the approach to heart disease and have become essential in decision-making in many cases.
One of the most successful spin-offs in Spain today is Corify, a company you co-founded, which has a very relevant role in personalised medicine for the treatment of heart disease. To what extent do you think its implementation will improve health outcomes for patients?
I believe that Corify is one of the most innovative initiatives in the field of anticipatory and precision medicine in cardiology, and that its technology has the potential to significantly transform health outcomes in patients with heart disease, specifically in such prevalent and malignant arrhythmias as atrial fibrillation and ventricular arrhythmias. It is a paradigmatic example of personalised medicine, as it has developed a system capable of adapting treatments to the specific characteristics of each patient, identifying those who can respond to ablation techniques, and consequently improving the efficacy of interventions and reducing the risk of side effects. Indeed, the technology developed by Corify includes advanced cardiac electrical signal mapping and analysis systems, which are applied in a non-invasive and simple way, and allow a much more accurate and detailed view of the state of each patient’s cardiac muscle. By identifying arrhythmogenic muscle areas with certain characteristics using Corify, the likelihood of success of certain treatments, such as ablation or targeted drug therapy, can be precisely elucidated.
The implementation of this technology in the clinical setting has the potential to significantly improve health outcomes for patients. By more precisely identifying the substrate of arrhythmias in each individual case, interventions are personalised; and as a result, the recurrence rate of arrhythmias and other cardiac events can be reduced, patients’ quality of life improved, and the number of hospital admissions reduced. In addition, by optimising the use of healthcare resources, Corify contributes to a more efficient system of care, minimising the costs associated with unnecessary treatments.
In the future, the adoption of technologies such as Corify could set a new standard in the personalised treatment of heart disease, both in Spain and globally. This represents a unique opportunity to move towards more accurate and effective cardiology, with a positive impact on both patient health and the sustainability of the healthcare system.
From your point of view, what is the importance of technology transfer and collaboration with industry in bringing scientific advances to clinical practice? What role do you think biomedical consulting companies, such as GENESIS Biomed, play in this transfer?
Technology transfer and collaboration with industry are essential to bring scientific advances into clinical practice, as they allow research to be converted into concrete solutions with direct benefit. These processes facilitate innovation and accelerate the implementation of new treatments, diagnostics and medical technologies, making scientific work have a real impact on society.
Biomedical consulting firms, such as GENESIS Biomed, are central to this ecosystem, providing a bridge between researchers and industry, facilitating the development of business strategies, the search for funding and regulatory compliance. They also help identify market opportunities and design plans for the commercialisation of new technologies, maximising the likelihood of success and bringing advances to the patient faster.
For us, the role of GENESIS Biomed has been key because of their support in the transfer of Corify’s technology from the laboratory to the market. In addition to the enormous importance of their advice, we have received their help in guiding us on the path that scientific developments must follow to become solutions applicable to clinical practice, previously assessing their viability. His help in financial management has been crucial, effectively guiding us in raising capital through grants, investment rounds or agreements with large pharmaceutical and medical device companies. Their role in the regulatory process has also been key, ensuring compliance of our technology with the necessary standards and regulations for approval in different markets. This is crucial in the healthcare sector, where regulatory compliance is complex but essential to ensure the safety and efficacy of new treatments and technologies.
We sincerely believe that GENESIS Biomed unreservedly fulfils the role of facilitating and streamlining the technology transfer process.