Helmut Drexler, MD
On September 13, 2009, our dear friend and colleague Helmut Drexler died suddenly while cycling in the outskirts of Hannover, Germany. Only 58 years old at the time of his death, Professor Drexler spent his life probing the biological mysteries of cardiovascular disease and pursuing potent new therapies to fight it. Thus, it is sad and sobering that this very disease appeared to have claimed his life in the end. Helmut was a dear friend and treasured collaborator to many of us, while to the greater cardiovascular community he was perhaps one of the top leaders and pioneers in translational medicine.
Helmut Drexler was born on February 24, 1951, in Karlsruhe, Germany. He attended medical school at the University of Freiburg, Freiburg, Germany, where he earned his medical degree in 1977. He then began working in the Department of Pathology at the University of Freiburg, switching to internal medicine and the Department of Cardiology and Angiology in 1979. In 1982, he accepted a research fellowship from the German Research Foundation to work with Dr Robert Zelis in the Division of Cardiology at the Pennsylvania State University College of Medicine and the Milton S. Hershey Medical Center, Hershey, Pa. A year later, he returned to Freiburg as a fellow in cardiology.
In 1991, he left Freiburg to work with Dr Victor Dzau at Stanford University, where a strong friendship was born. When he arrived at Stanford, Helmut was “a man with a mission” in that he aimed to assimilate all of molecular biology as it could be applied to vascular biology and cardiovascular medicine in general. He wasted no time. He worked in the laboratory day and night, completely ignoring the California sunshine. With his pale complexion and wild crop of hair, Helmut epitomized the absent-minded scientist, although his approach and scientific acumen were simply remarkable, to the extent that no detail went unnoticed. He was a consummate scientist in every regard, blending innovation, creativity, and technology to address areas of the greatest medical importance. Helmut and Victor shared an interest and intense repartee in renin-angiotensin control of vascular biology, and many of the pioneering ideas that led to the renin-angiotensin research field blossomed from their intellectual synergy and friendship.
Helmut returned to Freiburg in 1993 as an Associate Professor of Internal Medicine and Cardiology, and 3 years later he moved from Freiburg to Hannover, Germany, where he was appointed Chief of Cardiology. From 1997 through 2001, he also served as chairman of Medicine at Hannover, while he remained chief of the Cardiovascular Division and director of the Department of Cardiology and Angiology at Hannover Medical School at the time of his untimely death.
Helmut was a leader and an exceptional physician-scientist. His research interests evolved from cardiovascular physiology to more detailed studies of vascular and molecular biology in cardiovascular disease. In his early work, often in collaboration with Professor Hanjörg Just, Helmut contributed significantly to our understanding of the pathophysiology of coronary artery disease and chronic heart failure. In these studies, published in Circulation, the Journal of the American College of Cardiology, and other journals, he identified the relationships between vasomotor responses and blood flow, and he demonstrated the inability of atherosclerotic arteries to adjust normally to increased blood flow. In particular, he helped establish the critical role of endothelial dysfunction, and then he pursued the molecular pathways by which it acted, searching for therapeutic targets.
As an exemplary physician-scientist, Helmut was committed to identifying clinically relevant problems and then pursuing basic mechanistic understanding at the molecular level in order to develop new therapeutic interventions and clinical trials. He was principal investigator for the German–Austrian Captopril and Digoxin trial, and he was a national coordinator for international studies, including the Valsartan in Acute Myocardial Infarction (VALIANT) trial, the Omapatrilat Versus Enalapril Randomized Trial of Utility in Reducing Events (OVERTURE), and Research into Etanercept: Cytokine Antagonism in Ventricular Dysfunction (RECOVER). Perhaps the best illustration of Helmut’s translational acumen is his elegant elucidation of the molecular mechanisms of postpartum cardiomyopathy, published in Cell in 2007. He discovered that the lactation-promoting hormone prolactin is involved in the condition, which is characterized by heart failure of sudden onset through 6 months postpartum. Helmut’s work provided the foundation for the first specific treatment for patients with this orphan disease, which is often misdiagnosed, and it cemented his reputation as a translational researcher extraordinaire.
Recently, Helmut was pursuing the potential of stem cells or factors derived from them as therapies for cardiovascular disease. He served as European coordinator for the Transatlantic Network in Adaptive and Maladaptive Signaling in Cardiac Growth and Regeneration, funded by the Fondation Leducq, which included both of us as well as Nanette Bishopric of the University of Miami, Coral Gables, Fla; Peter Sugden of Imperial College London, UK; Jean-Luc Balligand of the University of Louvain in Brussels, Belgium; and his close collaborators in Hannover, Kai Wollert and Denise Hilfiker-Kleiner. Helmut was among the first to study the therapeutic effects of stem cells in humans with heart disease, and he is considered a pioneer in this field. He led the Bone Marrow Transfer to Enhance ST-Elevation Infarct Regeneration (BOOST) trial, which is generally acknowledged as the first controlled clinical trial demonstrating the benefits of bone marrow stem cell therapy in heart disease.
Part of Helmut’s success originated from his thorough and thoughtful approach to research, in which he carefully connected basic discoveries and their clinical significance. Those who knew him likely can still hear the echo of his research mantra: He did not want to believe, he wanted to know. He lived by this philosophy. His scientific investigations were rigorous and thorough, and they provided solid foundations on which to build toward clinical trials for the entire cardiovascular community.
But his success also stemmed from his collegiality and his readiness to seek outside expertise and take part in interdisciplinary research. As a result, he was known and respected internationally. Helmut was a natural leader and was invited to serve on many scientific committees. In April 2009, he served as president of the 75th annual Congress of the German Cardiac Society, a meeting of >7500 individuals from 25 countries. He was a member of the editorial boards of the European Heart Journal, the Journal of the American College of Cardiology, Circulation Research, and Circulation. Just a few months ago, he accepted an invitation to serve as European editor for Circulation.
Helmut Drexler was an exceptional scientist, physician, leader, husband, father, and friend. He was an extraordinary human being. He is survived by his loving wife, Christa, and his very bright daughter, Beatrice, who is in her final year of medical school. Helmut loved his family, he loved his work, and he loved life. His death also leaves a tragic void among his closest scientific friends and colleagues, not to mention the greater loss of his pioneering leadership within the entire cardiovascular medical community. As physicians and scientists, we should all rededicate our efforts in his memory, and by his example, toward addressing the very disease that ironically took him from us. We can think of no better way to memorialize his legacy and what he stood for his entire career.