Circulation and the fields of noninvasive and nuclear cardiology lost an esteemed colleague with the passing of Mario S. Verani on October 30, 2001. A creative clinician-scientist, an ardent patron of the arts, and an ebullient lover of life, Mario died after a brave battle with pancreatic cancer at The Methodist Hospital in Houston, Texas, where he practiced Cardiology.
Director of the Nuclear Cardiology laboratory at The DeBakey Heart Center since 1982, one of the first nuclear laboratories in the world dedicated solely to Cardiology, Verani was also one of the founding members of the American Society of Nuclear Cardiology and served as its president in 1996–1997. Mario made many seminal contributions to the field of nuclear cardiology. He optimized radionuclide angiography for the assessment of ventricular function and pioneered the use of the multiwire gamma camera in combination with tantalum-178. His work propelled the quantitative approach to myocardial perfusion tomography along with evaluation of new myocardial perfusion and blood tracers. More recently, Verani and his team studied and validated techniques such as gated-SPECT scintigraphy and photon attenuation correction.
Among his most important contributions to the field of noninvasive imaging was his use of intravenous adenosine as a pharmacological test for diagnosing the presence of coronary artery disease. His initial studies laid the foundation for two multicenter clinical trials in the United States comparing adenosine scintigraphy to exercise scintigraphy, which led to the approval of adenosine as a new stress modality. Since his first study, millions of patients around the world have been evaluated with this technique and multiple aspects of adenosine scintigraphy have come into wide use, such as in the risk stratification of patients after myocardial infarction. This is the subject of a large prospective randomized multicenter (INSPIRE) trial led by Dr John Mahmarian, his former trainee and long-time colleague and friend. Adenosine vasodilator stress is also now used for perfusion imaging with contrast echocardiography.
Mario also had a significant impact on the field of echocardiography and ischemic heart disease. Back in 1985, stress echocardiography was still viewed skeptically by some, but he enthusiastically launched into a collaboration with our echocardiography laboratory to compare the accuracy of simultaneous perfusion and wall motion studies during exercise. He was a model collaborator, valued for his openness, drive, and integrity. The collaboration between the two laboratories grew over the years, advancing our understanding of myocardial function and perfusion under various physiological and stress conditions and improving the application of these techniques in evaluating myocardial ischemia and risk stratification. Mario’s collaboration was pivotal in our research efforts aimed at detecting and unraveling the pathophysiology of myocardial hibernation.
Born in Brazil, Mario entered medical school there after a brief flirtation with legal studies. Mario had always been more drawn to literature than to science, but it was much more difficult to gain admission to medical school than law school in Brazil at that time, and it was probably the challenge that initially drew him to medicine more than the subject matter. Nevertheless—or perhaps because of his humanist leanings—Mario proved to be a caring physician and a creative scientist who was beloved by his patients, trainees, and colleagues alike.
Mario received postgraduate training in Cardiology at the University of Iowa. He was recruited to Baylor College of Medicine in 1977, where he remained for the rest of his career, practicing nuclear cardiology, serving as goalie for the University of Texas Medical School Soccer Team, and inspiring his trainees (in both medicine and soccer). Those who studied under Mario have populated nuclear cardiology and general cardiology with his sense of commitment to the whole patient, his clinical astuteness, and his warmth. I cannot know whether they receive as many heart-felt letters of thanks from patients as Mario did, but then, few physicians have been so beloved.
Mario knew how to balance and enjoy life to the fullest. He and his wife, Regina, a renowned pathologist, traveled the world. Together, they were a model couple. He enjoyed classical music serenades, nature, an early morning jog, and a leisurely stroll. Mario loved literature and was always fascinated by History and the diverseness of cultures and civilizations. In the tradition of Brazilian natives, he was the ultimate Brazilian soccer fan and player.
The struggle for life has a way of stripping from us those parts of the personality that are mere ornaments. In Mario’s case, the crucible of cancer found nothing it could burn away: no dross polluted the kindness, wisdom, grace, or dedication to the fullness of life that formed Mario’s core. Mario was matter-of-fact about his illness. He continued reviewing articles for Circulation, co-editing the third edition of his book with Dr Ami Iskandrian, a long time friend, and spending time with his colleagues up to his last month of life. And his colleagues continued reaching out to him as well: for his 58th birthday his laboratory staff stole into his yard in the wee hours of the morning to fill his garden with hundreds of balloons. At sunrise, Mario’s wife, Regina, awoke him and led him to the window to see the early morning light coruscate off the dew-covered spheres. A moment of beauty for a man who appreciated the beauty of life.
Two weeks later, The American Society of Nuclear Cardiology honored Verani’s unique contributions by giving him the Distinguished Service Award. (Because of the unfortunate events of September 11, the award ceremony was postponed until October 29th.) Mario marshaled his dwindling reserves to appear at the celebration with his usual grace and wit. I think he saw it as a goodbye party, one last chance to share good cheer with Regina and their children, his colleagues and friends. Twenty-four hours later, he relinquished his hold on life.⇓
Thank you, Mario, for 58 great years.