Dr Teresa Castiello is a consultant cardiologist at Homerton Hospital NHS Foundation Trust; CEO and founder of MIAL Healthcare, Cardiology president at the Royal Society of Medicine, UK and Ordinary Nucleus Member in the Cardiomyopathy working group at the European Society of Cardiology.
The potential to make a tangible difference in the lives of those affected by heart failure has always been a powerful motivator. And the multifaceted nature of the condition – being a syndrome with diverse etiologies – presents a compelling diagnostic challenge that fuels my scientific curiosity.
My career has been a dynamic blend of long ward rounds, bustling clinics, mountains of paperwork, urgent emails, academic writing, teaching, lecturing and attending conferences. Recently I’ve also embarked on an entrepreneurial journey, adding another layer of unpredictability to my routine. Remote consultations from my home office, sometimes with patients in different countries, are becoming increasingly common. Digital health is breaking down geographical barriers, allowing specialised care to reach underserved areas. It’s a privilege to be working in such a transformative and innovative phase of medicine.
A real strength lies in the presence of specialised heart failure nurses and dedicated pathways. These resources provide invaluable support and guidance to those living with heart failure, contributing to improved management and outcomes. However, there’s room for improvement. Diagnosis of heart failure often faces delays, and there’s an underemphasis on prevention and holistic care. Lifestyle factors are frequently overlooked or underestimated by healthcare teams and patients. Furthermore, greater attention should be given to patient wellbeing, with more robust psychological support integrated into the care model.
I first came across the HFPN last year when I was honoured to attend the launch of the Heart Failure Mission Statement at the European Parliament. It quickly became evident to me that effective heart failure care across Europe necessitates the collaboration of multiple stakeholders. Focusing solely on local efforts, without considering the broader picture, is no longer viable. I felt that by joining the HFPN, I could play a more central role in driving the necessary changes to achieve these objectives.
With the prevalence of heart failure steadily increasing, I believe the only way to achieve a real shift is through prevention and early diagnosis, facilitated by the widespread application of digital technologies throughout the entire patient pathway.
Equitable access to care, widespread digitalisation and government-led prevention strategies. A delicate balance must be struck between established and new, digitalised pathways alongside the integration of personalised medicine. Policymakers and healthcare specialists should prioritise lifestyle interventions, early diagnosis and home-based care models supported by digital health technologies.
Ten years ago, the PARADIGM-HF trial results introduced a crucial medication for heart failure. More recently, the proven benefit of SGLT2 inhibitors in heart failure has further expanded our therapeutic capacity. However, in my opinion, the most exciting therapeutic promise lies in the realms of genetic therapy and precision medicine. This brings us to a key point: heart failure is a syndrome, and the true path to effective treatment lies in elucidating the underlying etiology and targeting the root cause. By understanding the genetic and molecular mechanisms driving heart failure, we can tailor therapies for optimal outcomes.
My two wonderful daughters are my greatest joy outside of my work. I’m a strong advocate for a healthy lifestyle, and I’m passionate about running and exercise – regardless of the weather or my busy schedule. I also have a deep appreciation for art in all its forms, and I love exploring galleries and museums. I enjoy a good social life and cherish the time I spend with friends and my broader network. Travel has always been an enriching part of my life and, like any true Italian, I love coffee.
The Heart Failure Policy Network brings together experts who are united in their passion: to improve outcomes for people living with heart failure.
We share profiles of our members to showcase what led them to work in heart failure, and find out about changes they would like to see in prevention and care.