Greetings from the President

I have been appointed as the 7th President of the Japanese Heart Failure Society. Heart failure has been recognized as a disease status for a long time, but it was almost incurable (and still is, in some ways). However, in the 1990s, drug evidence was gradually accumulated from large-scale clinical trials, and progress was made in elucidating the onset and exacerbation mechanisms of heart failure based on the theory of neurohumoral factors. Such growing interest in heart failure both in Japan and overseas urged the establishment of Heart Failure Society of America (HFSA) and Heart Failure Association (HFA) of the European Society of Cardiology (ESC), and the establishment of 2 societies stimulated the foundation of the Japanese Heart Failure Society under the leadership of the 1st president, Prof. Sasayama. The first scientific meeting was held in October 1997 in Kyoto. At the beginning, the number of members was 900, but since then, it has increased as the society's activities have spread and become more active, and exceeded 4,500 recently after the introduction of the type B membership (especially for medical staff) in 2006. Under these circumstances, the Society has promoted a wide range of research activities and supported the development of heart failure treatment in Japan through social contribution activities. In Japan, a super-aged society unlike any other in the world, the importance of heart failure in the cardiovascular field is increasing, and we recognize that the role of this society has never been more important. Looking back, all of the past presidents have truly been representatives of our country. Despite my lack of knowledge, I have been elected as a representative of this society, and I will do my best to further develop the society.

The vision of this society is to provide patients and their families with a high quality of life through elucidation of the pathogenesis of heart failure, accurate diagnosis, effective prevention, and development of effective and safe treatments.

Former President Prof. Tsutsui has set 3 goals for the society: (1) promotion of team medical care, (2) education and training of medical professionals and enlightenment of patients, and (3) enhancement of the network that serves as the foundation for clinical research. He led the society for six long years, developing a wide range of activities. The promotion of team medical care, the education and training of medical professionals and the enlightenment of patients, are two sides of the same coin. These activities have fructified the system of Certified Heart Failure Educator (in cooperation with the Japanese Circulation Society), the publication of Heart Failure Pocketbook (now 3rd edition), and many other achievements. In order to enhance the network that serves as the foundation for clinical research, the construction of registries for new drugs and devices is progressing. In addition, the recognition of heart failure as an important disease that requires countermeasures under the Act on Measures against Stroke and Cardiovascular Diseases enacted in 2018 based on the five-year plan of the Japanese Circulation Society has become a tailwind for this society. We also continue to aim for these previously-set goals, but I would like to raise the following 3 other points as new goals in anticipation of further development.

1. Play a role in the Japan Cardiovascular Alliance and strengthen horizontal connections
   At present, 8 societies, including us, have formed the Japan Cardiovascular Alliance and are searching for a mutual cooperation system. I feel that this effort is very meaningful. It is feared that there may be a wall between the sub-specialties of cardiology, which could hinder each other. In promoting multidisciplinary team medical care, there must be no wavering in the cooperative system among doctors who deal with cardiovascular diseases. I think it is important to promote exchanges between academic societies at various levels. In-person exchanges, which were in danger of being lost due to the COVID-19 pandemic, are gradually recovering. Now is the time to strengthen horizontal ties.
2. Eliminate regional disparities and promote home medical care
   Since Japan is not a large country and has a well-developed transportation network, it was thought that it would not be so difficult to travel for a short period of time and receive the necessary medical treatment as needed. However, the significant aging trend in rural areas and the mismatch with local medical systems are obvious facts. For elderly advanced heart failure patients, it is not always physically possible to move to the city to receive treatment, or they or their family members have significant QOL impairments to do so. Therefore, it is crucial to establish self-contained community-based medicine. This includes the facilitation of a guideline-directed medical treatment, the development of remote monitoring, the establishment of at least 1 hospital in each prefecture that can provide state-of-the-art medical care, the design of a home care system, and the standardization of palliative care including end-of-life care. I think it is also important to work closely with council bodies in each prefecture, which have begun preparations under the countermeasures law.
3. Diversity and Inclusion
   Diversity is a buzzword these days, and I feel that in our society, we can achieve a great deal by promoting multidisciplinary team medical care. I would like to continue to promote heart failure treatment along with the co-medical staff. Recently, however, it has been pointed out that young doctors are moving away from the cardiovascular system, although I think it is not only due to the effects of work style reforms. There are concerns that the online presentation during the COVID-19 pandemic is not all about the positive aspects, and that it may be reducing the motivation of young people to make presentations. There is also a need to diversify the age composition of doctors, and I would like to explore ways to create an academic society that appeals to young doctors.

None of this would be possible without the cooperation of our members, and I ask for your guidance and support. Thank you for your continued support.

October 27, 2022
The President of the Japanese Heart Failure Society President
Koichiro Kinugawa