Christian Eugen Mueller
Date of Birth:
April 24th, 1968
Married, two childen
Swiss & German
Director Cardiovascular Research Institute Basel
Department of Cardiology, University Hospital Basel
Petersgraben 4, 4031 Basel, Tel: 0041 61328 65 49
Summary: most important research achievements
I would like to divide my research achievements in three parts: first content, second training,
motivation, and mentoring of physician scientists, and third strategy.
Content: my research aims to contribute to improving the early diagnosis and management of cardiovascular
disorders, particularly the most common causes of death and disability in Switzerland: acute myocardial
infarction (AMI) and acute heart failure (AHF). I consider seven novel insights of most importance, as all of them
had major impact on clinical practice in Switzerland and worldwide, and four of them already resulted in class I
recommendations in current clinical practice guidelines of the European Society of Cardiology and widespread
First, systemic plasma concentrations of B-type natriuretic peptide (BNP) and NT-proBNP are quantitative
markers of hemodynamic cardiac stress and heart failure and provide incremental value in the early
diagnosis and management of patients with suspected AHF (e.g. Mueller C, et al. N Engl J Med 2004,
Mueller C, et al. EJHF 2020)
Second, high-sensitivity cardiac troponin T and I concentrations as quantitative markers of cardiomyocyte
injury provide substantially higher diagnostic accuracy for the early diagnosis of AMI as compared to conventional
cardiac troponin assays, or other markers of cardiomyocyte injury (e.g. Reichlin T, et al. N Engl J Med 2009; Kaier
T, et al. Circulation 2019).
Third, using short-term absolute changes in high-sensitivity cardiac troponin T and I concentrations
provides incremental value to their concentrations at presentation to the emergency department and allows an
earlier diagnosis of AMI (e.g. Reichlin T, etal. Circulation 2011, Haaf P, et al. Circulation 2012; Neumann J, et al.
N Engl J Med 2019).
Forth, assay-specific early triage algorithms combining 1h (or 2h) absolute changes in high-sensitivity
cardiac troponin T and I concentrations with their concentrations at presentation to the emergency department
achieve very high safety and high efficacy both for the early rule-out as well as the early rule-in of AMI. (e.g.
Reichlin T, et al. Arch Intern Med 2012, and Boeddinghaus J, et al. Eur Heart J 2018, Boeddinghaus J, et al. Clin
Chem 2019, Collet JP, et al. Eur Heart J 2021, Ayala Lopez P, et al. Circulation 2021).
Fifth, given the central role that high-sensitivity cardiac troponin T and I concentrations have obtained in the
early diagnosis of AMI, non-cardiac sources for cardiac troponin T and I are of major concern. Acute injury
and systemic release of skeletal muscle proteins as in acute rhabdomyolysis does not seem to be a non-cardiac
cause. In contrast, chronic skeletal muscle disorders, particularly non-inflammatory myopathy and myositis seem
to be non-cardiac causes of systemic cardiac troponin T concentrations.
Sixth, early intensive and sustained vasodilation using universally available and inexpensive drugs (e.g.
nitrates), is relatively well tolerated, but does not improve outcomes in patients with AHF who are stable
enough to not require ICU-admission initially (Breidthardt T, et al. JIM 2012, Kozhuharov N, et al. JAMA 2019).
Seventh, perioperative myocardial infarction/ injury (PMI) following non-cardiac surgery is a silent
and neglected killer (Puelacher C, et al. Circulation 2018). Due to intense anaesthesia and analgesia, it is
asymptomatic in 85% of patients and therefore missed in the absence of systematic screening. PMI occurs in
about 15% of patients at high CV risk and is associated with a very high risk of death within 30-days (about
10%). Strategies for improved phenotyping and possible therapy are evolving (Puelacher C, et al. JACC 2020;
Gualandro DM, et al. Clin Research Cardiol 2021).
Training, motivation, and mentoring of physician scientists: Likely my most important and for sure the
most rewarding achievement is that with my training, motivation, and mentoring I have been able to contribute
to the academic career of several outstanding physician scientists. More than 60 physician scientists have
achieved at least one first authorship on a peer-reviewed publication under my supervision. Many of these
physician scientists currently pursue an academic career and continue to combine clinical work with research. Six
of them have already been appointed professors themselves.
Strategy: With the help of the Swiss National Science Foundation, I was able to continuously and sustainably
follow a specific strategy when increasing the size and the professionalism of my research team. This strategy
has over the years found support and recognition by many stake-holders at the University Hospital Basel and the
University of Basel. It also has allowed me to co-found and lead the Cardiovascular Research Institute Basel
A) Focus on young physicians and be very inclusive. Attracting young physicians already shortly after
graduation into clinical research is mandatory for the identification, training, motivation, and mentoring of the
most talented and most capable physician scientists. This allows safe-guarding the academic leaders of the future
to our University, but also builds a positive and appreciating attitude towards research in those physicians, who
after their research period with me (e.g. during their medical thesis, n=110) will never again have an active role
as researchers. This is of key importance as the update and implementation of research findings by practicing
physicians is a prerequisite for all research findings to ultimate benefit patients.
B) Focus on outcome research with immediate impact on patient care. In order achieve and maintain
acceptance and support for clinical research at times of continuously increasing economic pressure in University
Hospitals, the immediate benefit of research findings for patient care must be highlighted widely within the
hospital, but also to the public.
C) Focus on interdisciplinary diagnostic research (precision medicine). This area of clinical medicine has
major unmet clinical needs, but also provides unique opportunities for academic-lead research. Thanks to
intensive and successful networking over decades, I have been able to create, maintain, and expand an
international interdisciplinary consortium, which allows me to conduct cutting-edge research protocols such as
e.g. Heart & Muscle.