5 Questions with Dr. Bhatt

A Conversation with Christian Hamm, MD

For this issue, Dr. Bhatt asks five questions to Christian Hamm, MD, professor of internal medicine and cardiology at the University of Giessen and director of the Kerckhoff Heart and Thorax Centre, Bad Nauheim, Germany, as well as the current president of the German Cardiac Society and Cardiology Today’s Intervention Editorial Board member.

Dr. Bhatt

Deepak L. Bhatt

Christian Hamm, MD

Christian Hamm

Hamm received his medical degree from the University of Hamburg, Germany, and completed his fellowship at the Ischemic Heart Research Unit at the University of Cape Town, South Africa. To date, he has published more than 400 peer-reviewed papers, 90 editorials and reviews, more than 800 abstracts and three books. Hamm is also on the editorial board of several major cardiology journals, including the European Heart Journal, Journal of the American College of Cardiology and EuroIntervention.

What are your hobbies outside of practicing medicine?

Dr. Hamm: I enjoy swimming, because it is a great way to stay fit and relax. I am also interested in different cultures. Although I travel a lot for business, I enjoy traveling and often do so for holidays. My favorite place to visit is the Mediterranean. Another hobby of mine is reading, particularly biographies and psychology topics.

Who has had the greatest influence on your career?

Dr. Hamm: The first influence would be my father. I’m a third-generation medical doctor, as both my father and grandfather were general practitioners. When I was younger, I decided not to study medicine and pursued German literature instead. My father said I could study whatever I wanted, but on top of that I had to study medicine. So, I took both medicine and German literature and found that I enjoyed medicine more because it is much more interesting. What I like about the job is the combination of intellectual thinking and, in cardiology, being able to use my hands.

Two professors were also very influential in guiding me along the path to becoming the physician I am today: Walter Bleifeld, MD, and Lionel Opie, MD. Prof. Bleifeld was very influential because he taught me everything about cardiology and interventional cardiology and motivated me to pursue cardiology for my career. And for my scientific interests, I was influenced most by Prof. Opie, who is a basic scientist involved with pharmacology. He taught me how to write papers and design and analyze studies.

What was the defining moment that led you to your field?

Dr. Hamm: When I was looking for a doctorate thesis, I initially was interested in gastroenterology, but the gastroenterologists did not want to have me and recommended I pursue cardiology. They thought I wasn’t motivated enough. That is how I ended up in cardiology and I’m very happy about that. Twenty years later I met the professor who said I should go into cardiology. At that time he was retired and I had four papers in the New England Journal of Medicine (NEJM) as first author. I said to him, “I may not have been motivated enough, but at least I was able to publish in the NEJM.”

What area of research in intervention interests you most right now and why?

Dr. Hamm: That would be transcatheter valves, which I believe will be the next wave in cardiology, like stents in PCI. Initially, I was very skeptical about transcatheter aortic valve replacement because I did a lot of valvuloplasties and also had experience in the OR with surgeons and as a result was not entirely convinced it would be a transformative technology. But in 2009 I saw that TAVR works and became really enthusiastic about it. We eventually set up a program and now have quite a busy practice of performing — between the Kerckhoff Clinic and the hospital at the University of Giessen, Germany — close to 400 TAVRs per year. I’ve also helped set up the German Aortic Valve Registry (GARY), which includes follow-up on all TAVRs performed in Germany along with conventional surgery procedures. It is probably the biggest registry of its kind at the moment, with more than 65,000 patients included to date.

Have you ever been fortunate enough to witness or to have been part of medical history in the making?

Dr. Hamm: Early in my career in the 1980s, I was very much interested in what was called unstable angina (now referred to as ACS). At that time, we were looking at biomarkers for thrombus formation, which didn’t really work out. Eventually we began work with a biomarker known as troponin, but in a very small series of patients with elevated troponin; in these patients we did not observe any MI. The manufacturer, Boehringer Mannheim, was ready to stop funding investigation into the biomarker, until we observed that, although these patients did not have MI, they died over the next several weeks, indicating that there was something to it. We continued the research and confirmed the observation that elevated troponin is a very good prognostic marker and it is now used to define non-STEMI and is the gold standard in all emergency units.

For this issue, Dr. Bhatt asks five questions to Christian Hamm, MD, professor of internal medicine and cardiology at the University of Giessen and director of the Kerckhoff Heart and Thorax Centre, Bad Nauheim, Germany, as well as the current president of the German Cardiac Society and Cardiology Today’s Intervention Editorial Board member.

Dr. Bhatt

Deepak L. Bhatt

Christian Hamm, MD

Christian Hamm

Hamm received his medical degree from the University of Hamburg, Germany, and completed his fellowship at the Ischemic Heart Research Unit at the University of Cape Town, South Africa. To date, he has published more than 400 peer-reviewed papers, 90 editorials and reviews, more than 800 abstracts and three books. Hamm is also on the editorial board of several major cardiology journals, including the European Heart Journal, Journal of the American College of Cardiology and EuroIntervention.

What are your hobbies outside of practicing medicine?

Dr. Hamm: I enjoy swimming, because it is a great way to stay fit and relax. I am also interested in different cultures. Although I travel a lot for business, I enjoy traveling and often do so for holidays. My favorite place to visit is the Mediterranean. Another hobby of mine is reading, particularly biographies and psychology topics.

Who has had the greatest influence on your career?

Dr. Hamm: The first influence would be my father. I’m a third-generation medical doctor, as both my father and grandfather were general practitioners. When I was younger, I decided not to study medicine and pursued German literature instead. My father said I could study whatever I wanted, but on top of that I had to study medicine. So, I took both medicine and German literature and found that I enjoyed medicine more because it is much more interesting. What I like about the job is the combination of intellectual thinking and, in cardiology, being able to use my hands.

Two professors were also very influential in guiding me along the path to becoming the physician I am today: Walter Bleifeld, MD, and Lionel Opie, MD. Prof. Bleifeld was very influential because he taught me everything about cardiology and interventional cardiology and motivated me to pursue cardiology for my career. And for my scientific interests, I was influenced most by Prof. Opie, who is a basic scientist involved with pharmacology. He taught me how to write papers and design and analyze studies.

What was the defining moment that led you to your field?

Dr. Hamm: When I was looking for a doctorate thesis, I initially was interested in gastroenterology, but the gastroenterologists did not want to have me and recommended I pursue cardiology. They thought I wasn’t motivated enough. That is how I ended up in cardiology and I’m very happy about that. Twenty years later I met the professor who said I should go into cardiology. At that time he was retired and I had four papers in the New England Journal of Medicine (NEJM) as first author. I said to him, “I may not have been motivated enough, but at least I was able to publish in the NEJM.”

What area of research in intervention interests you most right now and why?

Dr. Hamm: That would be transcatheter valves, which I believe will be the next wave in cardiology, like stents in PCI. Initially, I was very skeptical about transcatheter aortic valve replacement because I did a lot of valvuloplasties and also had experience in the OR with surgeons and as a result was not entirely convinced it would be a transformative technology. But in 2009 I saw that TAVR works and became really enthusiastic about it. We eventually set up a program and now have quite a busy practice of performing — between the Kerckhoff Clinic and the hospital at the University of Giessen, Germany — close to 400 TAVRs per year. I’ve also helped set up the German Aortic Valve Registry (GARY), which includes follow-up on all TAVRs performed in Germany along with conventional surgery procedures. It is probably the biggest registry of its kind at the moment, with more than 65,000 patients included to date.

Have you ever been fortunate enough to witness or to have been part of medical history in the making?

Dr. Hamm: Early in my career in the 1980s, I was very much interested in what was called unstable angina (now referred to as ACS). At that time, we were looking at biomarkers for thrombus formation, which didn’t really work out. Eventually we began work with a biomarker known as troponin, but in a very small series of patients with elevated troponin; in these patients we did not observe any MI. The manufacturer, Boehringer Mannheim, was ready to stop funding investigation into the biomarker, until we observed that, although these patients did not have MI, they died over the next several weeks, indicating that there was something to it. We continued the research and confirmed the observation that elevated troponin is a very good prognostic marker and it is now used to define non-STEMI and is the gold standard in all emergency units.