Jean Rouleau, MD FRCPC

Named Dean of the Faculty of Medicine of the University of Montréal in June 2003, Dr. Rouleau first obtained his MD (cum laude) from the University of Ottawa in 1974 and his FRCPC in Internal Medicine and in Cardiology following his training at McGill University.

He won the McLaughlin Research Fellowship to the Cardiovascular Research Institute at the University of California at San Francisco and returned to Canada.

He has since held a number of key positions in Medicine, Cardiology, Physiology and Pharmacology at McGill University, Montréal General Hospital, University of Montréal, University of Sherbrooke and the Montréal Heart Institute.

Dr. Rouleau is an accomplished clinical cardiologist, having served as Director of the Coronary Care Unit at the Montréal General Hospital, the Hôpital du Sacré Coeur in Montréal, and most recently at the University Health Network in Toronto. He has also been Director of the Medical Intensive Care Unit of the Montréal General Hospital.

He has served as Professor of Medicine and Director of Cardiology at the University of Sherbrooke as well as Associate Director of Research and Director of the Medical ICU at the Montréal Heart Institute. He received the Exceptional Merit Award of the FRSQ, and has been Governor for Quebec at the American College of Cardiology. He received the Confederation Commemorative Medal of Canada in 1992.

In addition, he is an excellent teacher who has influenced a generation of students in both Cardiology and Medicine. In 1996-97 he won the Best Teacher of the Department of Medicine at the Montréal Heart Institute. He has also been a mentor to over 20 graduate and postgraduate research students who have come to study with him.

However, it is for his research accomplishments that Dr. Rouleau has been best recognized in Canada and throughout the academic world. His research interests include: heart failure, post-infarction, ventricular remodelling, neurohormones, therapeutic interventions, ventricular function, and the development of heart failure post-infarction. His work has explored myocardial pathophysiology, pharmacology, and molecular biology in animal models and human subjects, and has contributed greatly to our fundamental understanding of myocardial and endothelial function in human disease. He also chaired the MRC Cardiovascular B Committee.

He has made major contributions in clinical research, examining multiple aspects of investigation and intervention in human heart disease. His studies have resulted in 300 peer-reviewed publications in high impact journals, 6 book chapters and 271 published abstracts. For these research accomplishments, Dr. Rouleau was awarded the Career Research Achievement Award of the Canadian Cardiovascular Society in 1997.

He has served on several editorial committees, including his present post on the prestigious editorial board of Circulation (Journal of the American Heart Association), and the Editorial Board of the Canadian Medical Association Journal. He is also Member of the Governing Council, Canadian Institutes for Health Research (CIHR) since 2005.

Studies that Impact Medical Therapy of CHF from Now to 2010

Monday, March 17, 2008
8:30 AM

Download Dr. Rouleau’s complete slide set [8.48 MB PPT].
Download Dr. Rouleau’s featured preconference slides [233.44 KB PDF].

The medications that have most influenced the therapy of CHF are those that attenuate neurohumoral over-activation. Most recently, devices such as implantable defibrillators and those that resynchronize the ventricle have proven to be particularly effective as well. Other therapies have either proven disappointing, or are still being developed or assessed.

Although secondary prevention remains an important part of the therapy of patients with CHF, in patients with a very poor prognosis, it does not appear to have the same impact as in patients with a better prognosis. At least this appears to be the case with cholesterol lowering with statins. Attenuation of the downstream effects of over-activated neurohormones has not as of yet had the desired beneficial effects. This includes attenuation of the inflammatory response that accompanies CHF, and certain approaches that modify ventricular remodelling.

The therapy of patients with acute volume overload has become the focus of multiple therapies. Unfortunately, many of these new approaches have been attempted with little success. These include the use of natriuretic peptides, calcium sensitizers and inotropes. Better approaches to the use of diuretics are presently being evaluated, as are newer forms of diuretics. Finally, hemofiltration to remove fluid is being assessed in patients that develop the cardio-renal syndrome when being treated for acute CHF.

Other emerging therapies that will eventually be much superior to what they are at this point in their development include individualized therapy of patients via pharmaco-genomics, cell therapy with stem cells, and implantable cardiac assist devices.

Fundamental questions still remain to be answered with regards to the use of cardiac surgical therapies for CHF. This includes the use of CABG in a large number of patients in with its indications remain to be proven, the use of mitral valve surgery to reduce mitral regurgitation in patients with non-ischemic significant mitral regurgitation, and the use of surgical ventricular restoration (SVR) in patients with dilated ischemic CHF amenable to this therapy.