Figures of the Heart Failure Association (HFA): Prof. Dr. Jelena ČElutkienė, HFA Board Member (2016–2020) and Co-Coordinator of the Imaging Study Group of the HFA Diagnosis Committee

Prof. Dr. Jelena Čelutkienė is a member of the Board of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) and the first woman to be elected President of the Lithuanian Society of Cardiology. Recently she was awarded the ESC grant to attend the Women Transforming Leadership programme at Oxford University. She also is proud to be the initiator of the new nurse-led service of heart failure (HF) care which has been established in Lithuania along with specialist nursing education, and to be awarded the title of the Cardiologist of the Year 2017 in Lithuania. The professional career of Jelena Čelutkienė is tightly linked to Vilnius University, Lithuania, where she studied medicine and now works as a Professor of Cardiology, and as a HF cardiologist in Vilnius University hospital, Santaros Klinikos. One of the oldest universities in Central and Eastern Europe (founded in 1579), Vilnius University is listed year after year by QS World University Rankings among the top 4% of the best universities in the world. Jelena's research interests have focused on cardiovascular imaging; due to the project supported by European structural funds she could improve her echocardiography skills at King's College Hospital, London, under the supervision of Professor Mark Monaghan. In the early 2000s, Jelena was excited by the idea of improving the accuracy of stress testing using velocity or deformation imaging. Her thesis was dedicated to a study of the indices of myocardial ischaemia derived from pulsed-wave Doppler myocardial imaging during dobutamine stress echocardiography.1 She implemented the use of post-systolic motion, then speckle-tracking technology and the method of contrast echocardiography in the everyday practice of the stress echo laboratory. Jelena has successfully led a number of research projects supported by the Lithuanian Research Council. The results of ‘Ultrasound myocardial deformation imaging for predicting of significant coronary stenoses during dobutamine stress echocardiography’ were very well accepted and appreciated as a ‘missing piece of data’ in speckle tracking technology.2, 3 Good quality data were obtained in the sham-procedure controlled multicentre study of cardiac shock wave therapy for refractory angina.4, 5 Recently the LEDA study, which recruited a large national cohort of patients with acute dyspnoea, became an excellent opportunity for two Lithuanian medical universities to join the international GREAT network, collaborating with Prof. Alexandre Mebazaa (data will be published soon). In the partnership with Prof. Anna Stromberg and Prof. Tiny Jaarsma, Prof. Čelutkienė was proud to win a solid NordForsk grant for Nordic-Baltic study in user-driven innovations investigating telemonitoring of lung impedance after HF hospitalization.6, 7 Throughout her career, Dr. Čelutkienė has been significantly contributing to the efficiency of both diagnosing and managing HF; she started widespread use of BNP/NT-proBNP, launched cardiopulmonary stress testing; and pushed stepped-up employment of cardiac resynchronization therapy. Jelena has made an important contribution to the creation of the national heart transplantation programme. Her latest initiative is the creation of joint national guidelines on how to use HF biomarkers spreading the utilization of this important tool to the emergency, specialized and primary care settings. While serving as a chair of the HF Working Group of the Lithuanian Society of Cardiology (after the predecessor Prof. Aušra Kavoliūnienė), Jelena saw the Group win the HF Awareness Day programme 3 years in a row for exemplary educative work involving public and social media activities,8 and ultimately receive a Golden Award. Q1. What does a commitment to the HFA agenda mean to you? J: I am honoured to contribute to disruptive HFA healthcare projects such as online education, European HF certification exam, Patient Care workshop, HFA ATLAS and the HF-III registry. The HFA Summit of National HF Societies, which I hosted in Vilnius in 2018, was called by numerous participants a grand success for unforgettable experience, hospitality and friendship. I had a great privilege to participate in writing several position statements on behalf of the HFA: on acute right ventricular failure,9 right heart dysfunction in HF with preserved ejection fraction,10 in-hospital monitoring of acute HF,11 mostly being responsible for echocardiographic evaluation. I took part in the workshop and subsequent paper on heart and brain interaction in HF aiming to address unmet needs in this scientific area,12 as well as in the recent position paper on cardiomyopathies.13 Q2. How do you deliver expertise in the imaging area of HFA activities? J: Being a co-coordinator of the HFA Imaging Study Group of the Diagnosis Committee, I share the responsibility to promote the position of the HFA on the role of multi-modality imaging in several fields: acute HF, comprehensive monitoring, cardio-oncology surveillance (manuscripts are in progress). My very special experience was to compose a statement on innovative imaging methods for HF.14 It was an exciting piece of work with a reputable team of experts to reflect on shifting paradigms of structural and functional evaluation, and at the same time considering the concepts of myocardial performance, pathology detection, and of defining the scope of technologies to be clinically developed from an ocean of innovations. Q3. What is your key to success in lobbying for changes in healthcare policy? J: We have to become more political and pro-active in advocacy of the European ideas on efficacious management of cardiovascular issues. One of my most pertinent initiatives to date has been the arrangement of a visit of the Lithuanian Minister of Health to Linkoping, Sweden, for exchange of best practice in nurse-led HF clinics. This would not have been possible without the distinguished reputation and support of my chief, head of the Clinic of Cardiac and Vascular Diseases Prof. Aleksandras Laucevičius. I am delighted that, as a result of subsequent attempts on the part of HF Working Group, the advanced HF management service has been established by the Ministry of Health, with the first launch of specialization for HF nurses in Lithuania.15 This HF patient care system providing abundant attention to patients in the vulnerable phase of their journey is unique and represents the actualization of the recommendations of the HFA,16, 17 making Lithuania a leader in the Baltic States and the broader region of Central and Eastern Europe. Presently, I coordinate the training course for nurses and cardiologists for this new HF care programme taking place in two Lithuanian Medical Universities. Q4. What are your impressions of completing the Women Transforming Leadership programme? J: It was a highly emancipating experience encouraging me to seriously think about myself as a leader, my personal journey, ups and downs in life and career, to reflect on my future goals and long-term strategic plan, and to analyse my strengths and limitations. A special advantage of the course is a personalized approach with psychometric evaluation and an individual coaching session. Psychometric testing defines a profile in the ‘big five’ personality domains of neuroticism, extraversion, openness to experience, agreeableness, conscientiousness, allowing one to assess, for example, the level of anxiety, impulsiveness, vulnerability, warmth, or openness to ideas or aesthetics. The coaching session boosted my self-confidence and empowered me to improve my pattern of communication with a boss regarding my future career perspectives, ideas previously strongly restricted by old cultural constraints. It is such an inspiration to find yourself in a room full of women leaders sharing thoughts on different leadership styles, barriers and achievements.