European Heart Journal (2014) 35, 1769–1775
doi:10.1093/eurheartj/ehu221
A year of celebration at Mayo Clinic
In the first of a series of three articles focusing on Mayo Clinic as it
celebrates major milestones in its long history, Mark Nicholls speaks to
Professor of Medicine Dr Bernard Gersh about the organization’s
structure and outlook Research and what the future holds for the
institution amid a changing medical and reimbursement landscape in
the USA will be in the following two articles
Mayo Clinic Arizona
Mayo Clinic
Rochester, Minnesota
For Mayo Clinic, 2014 is a big year of celebration.
Based in Rochester, Minnesota, with campuses in Arizona and
Florida, it is celebrating its 150th anniversary as a clinic yet perhaps
more significantly from a cardiology perspective, the Mayo heart
programme is commemorating its 100th anniversary.
Consistently ranked as one of the country’s leading heart programmes with .240 specialists working together to treat virtually
every heart condition and disease, the Mayo cardiovascular division
has spent the last century advancing treatments and techniques.
The cardiovascular specialty traces its formation back to 1914
when the first electrocardiogram was performed on what one of
its leading cardiologists described as a ‘sofa-sized piece of equipment
shipped over from England’—a technological innovation regarded at
Mayo Clinic as the point of separation between cardiology and internal medicine.
Since then, it has evolved as part of the wider Mayo Clinic based in
Rochester and with newer centres in Scottsdale and Phoenix in
Arizona, and Jacksonville, Florida.
By offering many state-of-the-art innovations and services, it
attracts patients from all over the upper mid-west, nationally and
internationally.
Professor of Medicine Dr Bernard Gersh, MB, ChB, DPhil,
explained how clinical cardiology is structured around a large outpatient practice with a corresponding in-patient practice with most
cardiologists participating in both, supported by the various laboratories: catheterization, echo, nuclear, and stress lab.
Mayo Clinic Jacksonville, Florida
‘What we have done at Mayo is reorganise our cardiovascular division along the lines of disease entity so we have an ischemic heart
disease council; circulatory failure group which deals with heart
failure and its various sub divisions including those patients undergoing transplant; heart rhythm (electrophysiology); and structural heart
disease which includes the valve, hypertrophic cardiomyopathy, the
amyloid, Marfan’s and adult congenital heart disease clinics’.
‘Our in-patient and outpatient practice covers every single subspeciality of cardiology, with imaging to support all of these disciplines’.
The cardiovascular section has some 200 monitored beds at the
Rochester campus, with the satellite campuses being smaller but
organized along the same lines. There is also Mayo Clinic Health
System, which includes a number of smaller hospitals in the rural
areas around Rochester and a strong outreach programme with
Mayo cardiologists travelling out to these hospitals to see patients
once or twice a week.
Dr Gersh explained there were a number of factors in choosing to
locate satellite campuses in Arizona and Florida.
‘Firstly there was the understanding that large numbers of our
patients from the Mid-west, as they get older, were wintering in
places like Florida and Arizona so it was a way of providing continuity
of Mayo care’, he said.
‘Secondly, there were approaches from the community to develop
and set up clinics in the area and also, 20 –30 years ago, there was the
perception that it might be more difficult from an insurance perspective for people from around the country to come up to Mayo and that
Published on behalf of the European Society of Cardiology. All rights reserved. & The Author 2014. For permissions please email: [email protected].
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health care could be more regionalised’. While Scottsdale and Jacksonville are not as large as Rochester, the idea is not just to provide
continuity of care for the ‘snow-birds’ who relocate there in the
winter—though this was one of the drivers in opening these new
centres—but that they will also be fully self-sustainable. Scottsdale,
for example, has its own cardiac transplant programme.
The overall concept of the clinic, he added, is that eventually there
will be several clinics with one portal of entry and a unified record
system. Steps are already in hand to standardize approaches to
care across the institutions.
Dr Gersh believes the cardiovascular division at Mayo Clinic offers
a consistently high level of care across the board with a number of
particular strengths.
‘I think we have an enormous experience in conditions like hypertrophic cardiomyopathy, adult congenital heart disease, valvular
heart disease and then rarer conditions like Marfan’s Syndrome and
amyloid heart disease. We see large numbers of patients with
these conditions’, said Dr Gersh.
Mayo Clinic—a private not-for-profit organizations employing
61 000 across the USA—developed gradually from the medical
practice of Dr William Worrall Mayo, who settled in Rochester in
the early 1860s with his sons Dr William James Mayo and Dr
Charles Horace Mayo joining his practice in 1883 and 1888, respectively.
The long history of cardiovascular disease care and treatment at
Mayo Clinic is now being detailed in a book to coincide with the sesquicentennial (150th anniversary) and the centenary of cardiac care.
It is being written by medical historian and Mayo cardiologist Dr
CardioPulse
Bruce Fye, MD. There are also displays, events, and exhibitions
being held to mark the anniversaries.
While there was no specialty of cardiology in 1914, Mayo Clinic has
evolved in the decades since to become generally recognised as
having one of the leading cardiovascular divisions in the USA.
Dr Gersh said: ‘Mayo has been a driving force in cardiology and cardiovascular disease for a long, long time and also a pioneer of the
science of vascular medicine’.
‘Together with the University of Minnesota, Mayo was a driver and
pioneer in open heart surgery; one of the very first series published
came from the Mayo Clinic in the 1950s so cardiothoracic surgery has
always been one of the flagships of the entire Mayo Clinic enterprise’.
‘For the last 60 years we have played an important role at the forefront of many multiple new developments in many aspects of cardiovascular disease, including cardiac surgery and imaging’.
And with a large training programme, with up to 60 trainees at any
one time, Mayo is playing an important part in nurturing a new generation of practitioners.
Through the three main shields of clinical practice, research, and
education, Mayo Clinic’s mission is to provide state-of-the-art high
value care, advance the science, and to educate the next generation
of cardiologists.
The ‘Young Acute Cardiovascular Care
Association group’ of the Acute Cardiovascular
Care Association
Delivering state-of-the-art education and science requires the active
collaboration of the younger generation
Involving young researchers in the scientific activities of the association is the best way to succeed in building state-of-the-art education
and science. This is why, during the last Acute Cardiovascular Care
Congress in Madrid, October 2013, the Acute Cardiovascular Care
Association (ACCA) of the ESC approved the creation of the
‘Young ACCA’ group, to support the existing ACCA committees
to best meet the needs of the young community.
Prof. H. Bueno, ACCA president-elect acting president and
Prof. C. Vrints, ACCA past-president, said: ‘The aim of ACCA is to
transfer knowledge and expertise to best serve the future generations of cardiologists in Europe. Having young doctors involved and
working closely with the board will certainly influence our strategy,
in particular, it will guide the delivery of education and science in
the right direction.
Beyond this, ACCA is willing to help the Young ACCA members in
developing their careers in the field of acute cardiovascular care;
understanding their needs is crucial to succeed’.
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A new and dynamic group
Our aim is to spread the ACCA’s mission to the young generation, to
ensure collaboration with existing young groups and to promote
young excellence in acute cardiovascular care.
spirit’ and the interdisciplinary cooperation of the young generation.
To begin, there will be a common session of all young subspecialties
during this years’ ESC Congress. In a session entitled ‘Recent
advances in Cardiology: what does the busy cardiologist need to
know about . . .’ the chairs/members of the young groups (EAPCI,
EACVI, EHRA, and ACCA) will give an overview on different hot
topics within the subspecialties. After these presentations, experts
in the field (Prof. Héctor Bueno for ACCA) will summarize the
main points and show future perspectives.
Acute Cardiovascular Care
Association and the ‘Young’
First ACCA Young meeting, January 2014: Dr Ana Viana
Tejedor, Madrid, Spain, Dr Janine Pöss, Chair; Lübeck,
Germany, Dr Konstantin Krychtiuk, Vienna, Austria,
(Winner ACCA YIA 2012), Dr Roberto Diletti, Rotterdam,
Netherlands, Dr Maria Rubini-Gimenez, Basel, Switzerland
(Finalist ACCA YIA 2012) (clockwise from left to right)
The first meeting of the ‘Young ACCA’ group took place in Frankfurt
to get to know each other, to exchange ideas and brainstorm on how
the group could help the ACCA address the young and develop their
community.
The group had already started supporting the ACCA by providing
educational material. In particular, .100 young cardiologists are
working together with ‘senior’ contributors on the 79 different chapters of the online e-learning platform (ESCeL) which will be launched
at the ACC Congress in Geneva, 18 –20 October 2014. Such close
collaboration between key European experts and young authors is
a path towards quality excellence and accuracy in education.
The ACCA planned a full Educational Track and sessions with cases
presented by young cardiologists during the last Congress in Madrid.
For the next congress, Geneva, 18 –20 October 2014, ACCA is planning to dedicate specific sessions to the young generation as well as
providing a platform for informal meetings and social events.
Inter-disciplinary cooperation of
the young generation
An important feature is the firm cooperation of the committee with
other young subspecialty groups in order to strengthen the ‘team
Acute Cardiovascular Care Association’s force resides in its interdisciplinary approach and patient centred interest—The Association encompasses the entire process of acute cardiovascular
care from cardiac event to patient stabilization, involving a
number of professions (nurses, emergency physicians, intensivists,
and others).
The membership of ACCA and in particular of the young community should reflect this multiplicity. Today, ACCA consists of .4300
professionals, cardiologists, and non-cardiologists; 25% of the total
membership is under 35, among them, 25% are between 22 and 29,
and 75% are between 30 and 35.
Said Janine Pöss, chair of the Young ACCA
group: ‘We strongly believe we can increase
those numbers. The process of acute cardiovascular care is a crucial period for
patient outcome and every young physician
working in this field should have the opportunity to receive proper educational material, to be informed of the newest evidence, to exchange scientific
and clinical material with peers and seniors, and to have proper training to learn the best practices and deliver the best patient care to
further improve outcomes. Therefore, we look forward to welcoming the new ACCA generation amongst our members’.
We thank the ACCA for the creation, trust, and support given to
the ‘Young ACCA’ group and eagerly look forward to a fruitful
cooperation.
The ‘Young ACCA’ Group
Roberto Diletti, [email protected]
Konstantin Krychtiuk, [email protected]
Janine Pöss, [email protected]
Maria Rubini-Gimenez, [email protected]
Ana Viana Tejedor, [email protected]
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Why are disease rates in Russia worse
than the rest of Europe?
The contributing factors were reviewed at EuroPRevent 2014,
Amsterdam, by Prof. Nana G.V. Pogosova FESC, Head Federal Health
Centre, National Research Centre for Preventive Medicine, Moscow
In recent decades, people in the European region have been living
longer and healthier lives. Nevertheless, in some countries, including
Russia, mortality rates are higher than the European region average.
Non-communicable diseases (NCDs) account for the largest
share of mortality, causing 80% of all deaths in Europe and
Russia. The main causes of mortality in Russia in 2012 were cardiovascular diseases (CVD)—55.4% (including CHD—29.5% and cerebrovascular diseases—16.9%), cancers—15.3%, chronic lung diseases—
5.9%, diabetes—0.6%, and external causes—10.2%.
Standardized mortality rates are substantially higher in men—two
times higher for CVD and four times higher for external causes. In
recent years 40% of deaths in Russia have occurred in people ,60
years old ( vs. 13% in high-income European countries), suggesting
that many of these deaths are preventable.
While popular belief presumes that NCDs afflict mostly highincome populations, the evidence suggests that NCDs rise rapidly
and kill people at a younger age in low-/middle-income countries
and countries with a changing economy.
Changes in mortality in Russia have been registered during periods
of political and economic alterations, especially during the 1990s.
There is strong evidence for a correlation between the burden of
NCDs and risk factors, although the prevalence of most important
risk factors did not change substantially during that period. In this
regard, it has been suggested that the main driver of unfavourable
changes has been psychosocial risk factors (loss of social position,
income, anxiety, and depression). A high prevalence of anxiety and
depressive symptoms has been found in the general population and
in primary care patients through large multicentre studies
COMPAS, COORDINATA. Additionally, during the last decade
the young Russian generation has been actively targeted by marketing
for tobacco, alcohol and junk food, while rapid urbanisation has
increased sedentary lifestyles.
Seven risk factors significantly contribute to premature mortality
in Russia: elevated BP (35.5%), hypercholesterolaemia (23%),
smoking (17.1%), lack of fruits/vegetables (12.9%), obesity (12.5%),
harmful alcohol use (11.9%), and low physical activity (9%).
Since 2003 mortality rates in Russia have started to decline (CVD
mortality declined by 21%). Between 2000 and 2012 life-expectancy
increased by 4.9 years and reached 70.2 years: in men 64.6 (+5.5), in
women 75.9 (+3.6). It is not surprising that the rates vary widely
across such a large country as Russia. Thus, life-expectancy from
birth in Moscow reached 76 years (6 years higher than the average).
These positive trends could be related to the state’s strategy aimed
at (i) establishing a real priority for prevention in healthcare and
(ii) improving the availability of contemporary medical aid. In 2009
10, 695 health centres with a special focus on primary prevention
were started in all regions of the country. In 2011, the first national
guidelines on CVD prevention were developed and endorsed
by the Russian Society of Cardiology and the National Society for
Preventive Cardiology. A large state screening programme started
in 2013 and during the year 20 million people were involved. The
programme includes behavioural counselling on risk factors.
The Vascular Biology Working Group Twentieth
Anniversary
Dr Carl J. Pepine reports on the achievements of the Vascular
Biology Working Group at the National Faculty Meeting,
Washington, DC. The Vascular Biology Working Group
celebrated its twentieth anniversary at its meeting just
preceding the American College of Cardiology Annual
Scientific Sessions (ACC14) in Washington, DC, on
28 March 2014
CardioPulse
Dr Carl Pepine, Professor of Cardiovascular
Medicine, the University of Florida, founded
the Vascular Biology Working Group
(VBWG) in 1994 and chaired the programme. In his opening welcome, he reemphasized that the VBWG is a postgraduate
educational forum for clinicians focused
in cardiovascular medicine. Most of the
rapidly evolving science of molecular cardiology and its relevance
to cardiovascular disease was not available when the majority of
clinical cardiologists completed their formal training.
‘Our model has been to create a venue for the exchange of this new
basic science and integrate discovery into clinical practice’, says Prof.
Pepine. ‘The overarching goal is to provide novel programs where the
latest in cardiovascular biology is presented by highly motivated
experts from the major academic programs around the world’.
This information is then discussed with other members of the
faculty audience. From these activities, educational materials have
been generated that are utilized to update and train faculty who
would then disseminate this material to the regional opinion
leaders and select clinical practitioners and on to the mainstream
of medical practice.
This format of ‘training the trainers’ or ‘physicians teaching physicians’ has been the operating framework for all VBWG educational programmes since its inception. The educational content
development is done in accordance with the principles and requirements set forth by the Accreditation Council for Graduate Medical
Education (ACGME), including the material that does not provide
actual CME credit. Sponsorship for these educational activities
comes from educational grants provided from multiple industry
partners.
Details of each educational programme’s components vary based
on the specific needs of each topic area. Since its inaugural meeting in
1994, the VBWG has held over 1500 conferences worldwide with
.25 000 participants. In addition to the National Faculty Meetings
held in conjunction with each annual scientific session of the ACC
and the American Heart Association, VBWG has done multiple programmes at the European Society of Cardiology (ESC) annual sessions (in Munich, Amsterdam, Stockholm, Berlin, etc.), and in
Canada and Mexico. The VBWG has also provided Hospital Grand
Rounds Series, Regional Faculty Meetings, Office Practice Seminars,
CME Monographs, Journal Supplements, and other focused enduring
materials. Its web site (www.vbwg.org.) contains a curriculum of
.2000 slides, videos, core curricula, data alerts, etc.
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Dr Thomas F. Lüscher, editor-in-chief of
European Heart Journal, provided the keynote
address. His topic was ‘Percutaneous Renal
Artery Denervation for Resistant Hypertension: Did Symplicity HTN 3 Scorch the
Future’. Dr Lüscher has been a member of
the VBWG Advisory Board since its inception.
† The first Session on ‘Novel Methods to Modify Risk’ was led by
Deepak L. Bhatt, MD, MPH, of the Harvard Medical School,
Boston, MA, USA. He discussed ‘New Approaches to Modifying
Risk by Improved Glycaemic Management: SGLT2 Inhibition,
Incretin Therapy and the Future’.
† ‘Future Pharmacological Options for Heart Failure’ was presented
by Christopher O′ Connor, MD, Duke University, Durham, NC,
USA. ‘PCSK9
† Inhibitors and the Unmet Need for LDL-C Reduction′ was
addressed by Evan A. Stein, MD, PhD, from the University of
Cincinnati, Cincinnati, OH, USA.
† The second Session, entitled ‘Stroke Prevention’, was led by David
R. Holmes, Jr, MD, Mayo Clinic, Rochester, MN, discussing ‘Is Left
Atrial Appendage Occlusion Really an Alternative to Lifelong
Anticoagulation’.
† Michael Ezekowitz, MD, PhD, of the Thomas Jefferson Medical
College, Philadelphia, PA, USA spoke on ‘Translating Clinical
Trial Results of Novel Anticoagulants for Stroke Prevention into
Clinical Practice’.
† In the following session, ‘Looking Over the Horizon in 2014’,
Andreas M. Zeiher, MD, Goethe University, Frankfurt, Germany,
was scheduled to review ‘Key Lessons Learned From Cell Therapy
Clinical Trials: Advances in Delivery Systems and Applications’.
† Next Dr Jean-Claude Tardif from the Montreal Heart Institute,
Montreal, Quebec, shared his work on ‘A Novel Approach to
Preventing Aortic Stenosis’.
† Then John R. Teerlink, MD, from the UCSF School of Medicine,
San Francisco, CA, USA presented a provocative talk entitled
‘Serelaxin: ‘Breakthrough Therapy’ or ‘Also-ran’.
The formal programme was followed by a reception with ‘time for
conversation’. Over 150 participants from .15 countries participated in this twentieth anniversary programme.
Prof. Carl J. Pepine, MD MACC, Division of Cardiovascular Medicine
University of Florida, Gainesville, FL, USA, www.medicine.ufl.edu,
[email protected]
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Landmarks in the history of Cardiology, III
From William Harvey to the nineteenth century, where the
foundation of modern cardiology began
In 1599, William Harvey (1578–
1657) from Folkestone, England
joined the prestigious Padua University to study medicine. It was a
period where ancient medical
texts were studied with a more
critical and a less philological approach, combined with extended
anatomy studies in human cadavers. A pupil of the famous anatomist and embryologist Fabricius
d’ Acquapendente (1537–1619),
Harvey was influenced by his
master’s discovery of vein valves.
Receiving his medical diploma in 1602, he returned to England and
pursued his research.1
In 1628, Harvey published his
monumental work Exercitatio anatomica de motu cordis et sanguinis in
animali, where he refuted Erasistratus and Galen. His treatize was
innovative by its conciseness, its
clarity and the method of experimentation. Harvey discovered
the blood circulation and showed
that the heart is a pump: ‘It has
been shown by reason and experiment that blood by the beat of the
ventricles flows through the lungs and heart and is pumped to the
whole body . . . the blood in the animal body moves around in a
circle continuously and . . . the action or function of the heart is to
accomplish this by pumping. This is the only reason for the
motion beat of the heart’.2 By this statement, Harvey rejected the
ancient theory that the heart is the body’s heat and put forward a
haemodynamic approach to the study of the cardiovascular
system. Also, being an excellent clinician, he was the first to
notice rupture of the ventricle wall after myocardial infarction,
described a case of aortic atheroma and observed the connection
between emotions and cardiovascular function.1 Contesting wellestablished ideas, Harvey was named ‘circulator’ (charlatan in
Latin) and received the fiercest attack by Jean Riolan (1580 –
1657) and Guy Patin (1601 – 1672), physicians in the Parisian
medical school and followers of Galen’s theories.3
In 1661, 4 years after Harvey’s
death, the Italian anatomist Marcello Malpighi (1628–1694) found
the missing link for circulation
using a microscope. In his work,
De pulmonibus observationes anatomicae, he was the first to demonstrate that blood did not leak out
of its vessels into the air spaces as
was believed, but made its way
from artery to vein through
Figure 1 Drawing from
minute structures known as capilOpera Omnia (1686)
laries4 (Figure 1). Eight years later,
showing the lungs of a
frog and its network of
the English physician Richard
capillaries.
Lower (1631– 1691), follower of
Harvey and pioneer in blood transfusion, showed that the colour of blood returning to the heart via the
pulmonary vein was bright red and concluded: ‘the purple colour of
the blood did not occur as a result of weakening by passing through
the lungs but because it was mixed with inspired air’.5,6
In France, the polemic on circulation ended in 1672 thanks to King’s
Louis XIV intervention. A supporter of new ideas, he decreed the
opening of Jardin du Roi (King’s garden) and appointed the young
surgeon Pierre Dionis (1643–1718) to spread Harvey’s theory by
giving public lectures on blood circulation.7
During the Age of Enlightenment, important discoveries on cardiology were achieved. The French anatomist Raymond Vieussens
(1641–1715) described in detail the pericardium, heart’s chambers,
coronary vessels and muscle fibres of the heart and documented clinically and pathologically cases of mitral stenosis and aortic valve insufficiency, thus being the first to correlate clinical symptoms of heart
disease with anatomy. Moreover, he illustrated his observations
with outstanding engravings.8
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In 1733, Reverend Stephen
Hales (1677–1761), vicar of Teddington and a brilliant experimental
physiologist undertook a series of
experiments on animals which led
to the first direct measurement of
blood pressure (Figure 2). Hales
studied at Bene’t College (Corpus
Christi) in Cambridge and in addition to theology and philosophy,
he received a liberal education as
Figure 2 The distinhe attended anatomy, physics, and
guished
experimental
chemistry lectures. He quickly
physiologist Reverend
became fascinated with the reStephen Hales.
search of pressure and flow in
living animals. Hales used a manometer to measure arterial and venous blood pressure, he calculated cardiac output and circulation rate by measuring the velocity
of the blood as it travelled along veins, arteries, and capillaries. He
also estimated the vascular diameter and introduced the term peripheral resistance as it applies to the arterial circulation. His book
Haemastaticks, published in 1733, revolutionized the study of circulatory dynamics setting him forth as the ‘father of hemodynamics’.9
After the French Revolution in
1789, new ideas began to prevail
and medical teaching was entirely
overhauled and unified. Medicine
flourished in Paris with the advent
of the great Anatomo-Clinical
School which emphasized physical
and clinical diagnosis.
In cardiology, one figure
prevailed:
Jean-Nicolas Corvisart
Figure 3 Baron Jean(1755–1821),
Professor of The
Nicolas Corvisart, founder
Medical School in Paris, physician
of modern cardiology.
of Emperor Napoleon I, an outstanding diagnostician and founder of clinical cardiology
(Figure 3).10 In 1806, his fundamental work Essai sur les maladies et
les lésions organiques du cœur et des gros vaisseaux was published.11
Among his various achievements in cardiology, Corvisart analysed
the difference between heart dilatation and hypertrophy; he used
the term aneurysm to describe cardiac enlargement, indicating that
enlargement of the heart and aneurysmal dilatation of an artery
were quite different processes; he gave an excellent description of
the three stages of what would now be called heart failure; he
described cardiac disease due to foreign bodies (polyps,
calcifications, and vegetations on valvular surfaces); he made a clear
distinction between the ‘osseous asperities’ of calcific valve disease
and true vegetations and he described pericarditis.8,11 Furthermore,
Corvisart popularized Leopold Auenbrugger’s (1722–1809) technique of chest percussion which until then was unnoticed. In 1808,
he translated Auenbrugger’s work Inventum Novum into French and
added his annotations.8 Using this technique Corvisart identified cardiomegaly, pericardial fluid and pulmonary effusions secondary to
heart failure.10 Physician of the Emperor but also of the poor in SaintSulpice District, Corvisart founded modern cardiology and left many
distinguished pupils and successors, such as, Jean-Baptiste Bouillaud
(1796–1881) who first described rheumatic heart disease and RenéHyacinthe Laennec (1781– 1826), the inventor of stethoscope.8
A new era began and cardiology was ready to pass on to the next
period, that of drugs and device discovery.
References
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2. Harvey W. Exercitatio anatomica de motu cordis et sanguinis in animalibus. Frankfort:
W. Fitzer; 1628.
3. Rullière R. La cardiologie jusqu’à la fin du 18e siècle. In: Histoire de la médecine, de la
pharmacie, de l’art dentaire et de l’art vétérinaire. Vol. VIII. Paris: Albin Michel/Laffont/
Tchou; 1978.
4. Karamanou M, Androutsos G. Completing the puzzle of blood circulation: the discovery of capillaries. IJAE 2010;115:175 –179.
5. Shectman J. Groundbreaking Scientific Experiments, Inventions, and Discoveries of the
Eighteenth Century. Westport, CT: Greenwood Press; 2003.
6. Lower R. Tractatus de Corde item De Motu & Colore Sanguinis et Chyli in cum Transitu.
Londoni: Redmayne; 1669.
7. Dionis P. L’anatomie de l’homme, suivant la circulation du sang et les nouvelles découvertes:
démontrée au jardin royal. Paris: Laurent d’Houry; 1715.
8. Gorny P. Histoire illustrée de la cardiologie. Paris: Dacosta; 1985; p221 –225.
9. Smith IB. The impact of Stephen Hales on medicine. J R Soc Med 1993;86:349 –352.
10. Karamanou M, Vlachopoulos C, Stefanadis C, Androutsos G. Professor Jean-Nicolas
Corvisart des Marets (1755 –1821): Founder of Modern Cardiology. Hellenic J Cardiol
2010;51:290 –293.
11. Corvisart JN. Essai sur les maladies et les lésions organiques du cœur et des gros vaisseaux.
Paris: Méquignon-Marvis; 1818.
CardioPulse contact: Andros Tofield, Managing Editor. Email: [email protected]