Cristina Basso specializes in cardiology and pathology and is a professor of pathology at the University of Padua, Italy—home to the world’s oldest anatomical theatre. Her main interests include sudden death, cardiomyopathies and myocarditis, pathology of arrhythmias and conduction tissue, heart tumours, and valve diseases (Figure 1).
Cristina Basso, a professor of pathology at the University of Padua, Italy
Prof. Basso’s career was shaped by her upbringing as the daughter of a family doctor in a small Italian village. She says: ‘The doctor was everything—not just a physician, but also a confidant, counsellor and much more.’ Inspired by her father’s multifaceted role and a desire to follow in his footsteps as a general practitioner, she opted to study medicine at the University of Padua. During her medical studies, she explored cardiology and pathological anatomy but had no real career plans until, by chance, she entered a lecture on the physiopathology of coronary artery disease delivered by the hugely influential Professor Sergio Dalla Volta, then Chair of the Cardiology Clinic at Padua. She says: ‘I was captivated and decided to request an internship in the cardiology department where they offered me a thesis on cardiac tumours with clinical-pathologic correlations.
This brought her closer to pathological anatomy and another hugely influential figure at Padua, Gaetano Thiene, who served as Professor in the Cardiovascular Pathology Unit. During training, she attended clinicopathological conferences and had the opportunity to see the structural substrates of cardiovascular diseases in both biopsy and autopsy specimens. She says: ‘I was increasingly fascinated by the mystery of sudden death. The investigation of its causes, with clinicopathological correlations particularly in the field of cardiomyopathy, soon became my major interest, both in clinical and experimental settings.’ With her career path in motion, she undertook specialist training abroad at the Royal Brompton Hospital in the UK and later in the USA at the Minneapolis Heart Institute and Mayo Clinic.
At the European Society of Cardiology Congress 2024, Prof. Basso delivered the William Harvey Lecture, titled ‘Sudden Cardiac Death and Autopsy in the Era of Molecular Medicine’. The lecture emphasized the enduring significance of autopsy in exploring the causes of sudden cardiac death, particularly in young people.
The challenging role of the cardiovascular pathologist
The role of a cardiovascular pathologist is challenging due to its hybrid nature, she says: ‘Pathologists usually focus on diagnosing neoplastic diseases, while cardiologists treat patients with cardiovascular conditions and although sometimes, you feel like “nobody's child,” the passion for healthcare, research, and teaching keeps you going.’ Prof. Basso describes her typical day as ‘half spent in the autopsy room and/or at the microscope and the other half spent on administration’. She observes however that each day is unique with new cases and stimulating questions from students and trainees that trigger curiosity.
Maintaining a healthy workflow is challenging and requires a highly motivated, well-organized team. She says: ‘My role has become more demanding since I was appointed Vice Rector for International Relations at the University of Padua, and I have had to balance this with my clinical and teaching responsibilities.’ She remains committed to her teaching role and values the interaction with trainees and students. Similarly, staying involved in research is crucial to understanding and treating conditions and diseases, which present themselves daily in the clinic.
To succeed in the challenging role of the cardiovascular pathologist, it requires curiosity, perseverance, and commitment to teamwork, as well as the ability to admit to making mistakes. ‘I always tell my students that medicine is not a perfect science, and every diagnosis is a search for confirmation. I motivate my team by reminding them that our goal is to save lives, even though we often deal with the deceased. Finding a mentor who prioritizes helping young professionals to grow, or even surpass them, is essential. Reading widely and generating ideas that can lead to meaningful studies is important as one original paper is worth more than a hundred reviews or task force documents. Ultimately, you need to enjoy what you do, although there's always the risk of not knowing when to stop.’ Patience and determination are personal qualities that will help you make progress, she says, and a supportive family is an essential ingredient to sustain you, particularly during the early stages of your career.
Looking to the future, she recognizes the transformational impact of digitization and artificial intelligence on both imaging and pathology for the pre-analytical management of tissues and traceability of specimens. The benefits of digital transformation are obvious, including the ability to share digital slides through telepathology and analyse them with software for both quantitative and qualitative measurements. Image analysis algorithms, already available or in development, will assist in standardizing pathologist reporting and documenting parameters with high inter-observer variability.
The role of the pathologist in accurate diagnosis of cardiovascular diseases
Proteomic studies offer insights into cardiovascular diseases, although using human cardiac tissue is challenging due to factors such as tissue heterogeneity, comorbidities, disease state, and treatments. Techniques like laser capture microdissection, animal models, and induced pluripotent stem cells can help address these challenges. ‘With the rise of precision medicine, biomarker-driven clinical trials are increasingly led by academic institutions and drug companies with the aim of identifying new treatments. Pathologists play a key role in this by providing accurate diagnoses of cardiovascular diseases, similar to their work in neoplastic diseases. Ancillary tests to detect tissue biomarkers can offer valuable prognostic information for example in the case of rare cardiovascular diseases such as storage or infiltrative diseases, and also of inflammatory myocardial diseases with the potential of immunosuppressive therapies.’
Areas of growth and development also include pathologic expertise in the interpretation of tissue changes after drug administration. These are also crucial factors in pre-clinical studies with animal models to evaluate treatment efficacy, where pathology also offers structured, quality-assured histological analysis of research animal tissues for clinical trials, she says.
Researchers wishing to stay on track with the latest trends and advances in the field should spend time reading widely and be prepared to engage directly with colleagues at meetings and congresses. Those in the earlier stages of their career are advised to look for smaller, niche, sub-speciality meetings that can provide greater opportunities to engage and share ideas.
Declarations
Disclosure of Interest
All authors declare no disclosure of interest for this contribution.
Author notes
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