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well good morning it is a humbling introduction and I am really touched by the generosity of dr. Barrons words Im also thrilled to be here and beyond the faculty with friends and colleagues that Ive known for quite a period of time Im amused by the introductions if dr. Nishimura is a plain old cardiologist and if dr. burden is a country surgeon from Texas what do you see about a guy from Chicago found just not sure so Ill leave that up to your own devices I am really going to focus on what I think is the most precious part of this conversation I say precious because it really has great bearing on outcomes it really has great bearing on patient management and it really forces us to think beyond the valve and think about the ventricle and specifically to think about heart failure in these discussions I do have the privilege of serving as deputy editor for JAMA cardiology and working very closely with Bob bono and I thought this presentation in our Journal a year ago was incredibly p