2007 Distinguished Scientist Lecture—Adventures in Cardiovascular Research, 1951–2007
I began my participation in cardiovascular research in 1951 when, as a medical student at New York University, I spent an elective working in the research catheterization laboratory at Bellevue Hospital. I have been privileged to have been present at the beginning of several important developments of the field. These include:
elucidation of the hemodynamics of valvular heart disease and their use in the selection of patients for what was, in the 1950s, new and high-risk surgical treatment;
synthesis of the unusual clinical findings, pathophysiology, and natural history of hypertrophic cardiomyopathy;
3) broadening of the concept of heart failure from a simple impairment of pump function to one involving disturbances in 2 neurohormonal systems (the sympathetic nervous and the renin-angiotensin-aldosterone systems), as well as the development of the concept that inflammation can play a central role in the pathogenesis of this condition; and
development of the concept that myocardial infarction is a dynamic process and that its evolution and clinical outcome can be altered by timely intervention designed to restore the balance between myocardial oxygen supply and demand.
Currently, the application of advanced cardiac imaging techniques, the development of less invasive interventions, and the application of genetics and of large clinical trials to cardiovascular disorders are altering radically our approaches to the disorders mentioned above. Despite these revolutionary changes in the field, certain principles of the research process have remained unchanged over the past half-century. These include the critical importance of dedicated and generous mentors of young investigators, as well as of environments that attract highly motivated colleagues and trainees and that provide the encouragement, time, facilities, and resources to conduct research.