Latin America has made important contributions to cardiology, in the field of basic sciences as well as in clinical cardiology and cardiovascular surgery. In this issue of Circulation, a number of articles from prestigious physicians and researchers from Latin America are presented. Many of these investigations have been performed in their countries of origin, and it is legitimate to say that they have an additional value because of the difficulties faced by developing countries that lack the resources and necessary support to perform research at a high level.
Latin America faces important health problems directly related to cardiology. Chagas disease is an important health problem in some countries. Rheumatic fever has shown an important decline in prevalence but has given way to atherosclerosis. Prevalence of risk factors for atherosclerosis has reached a surprisingly high level, comparable to that of industrialized countries, and prevention strategies are urgently required to tackle this aptly described “epidemic of the 21st century.” Two original articles on this topic address this problem, currently the main concern of healthcare systems in Latin America.
Whereas it is understood that public resources should be mainly directed toward prevention and treatment, a need exists for the development of basic research. Some countries, understanding this, have assigned special funds to this area. For example, in a small country like Chile, with a population of just 16 million people, the annual budget for basic science research of the National Fund of Scientific and Technological Development is currently $45 million. This amount supports ≈350 projects, 47% of which are devoted to research within the basic sciences. In this issue, the review article on the role of the Na+/H+ exchanger in myocardial hypertrophy exemplifies the kind of basic research being accomplished in Latin America.
This issue also provides excellent examples of the necessary interplay between the basic and clinical sciences. Topics discussed include chronic Chagas heart disease, high-altitude disease, coronary heart disease surgery, and the hemiblocks. Authors of the 3 articles on Chagas Disease address the effort to eradicate triatomine bugs and provide an overview of how investigations on the insect vectors of Trypanozoma cruzi are combined with studies on the clinical aspects of Chagas disease, as well as on the pathogenesis of the disease and the search for new therapies.
The issue also includes an article that highlights studies on high-altitude disease, contributing to a better understanding of the pathophysiology of pulmonary hypertension. Another article notes how surgery for coronary heart disease has been enriched by angiogenesis and gene therapy, and finally, an article on hemiblocks begins with a clinical observation and progresses to a discussion of a number of anatomic and electrophysiological studies of intraventricular conduction.
In closing, the editors of Circulationwould like to express their deep appreciation to all of the contributors to this special issue. We are pleased to present these articles from Latin America, which reflect some of the best work being done and the progress that is being made in cardiology centers in that part of the world.