ABC | Volume 113, Nº3, September 2019

Editorial Mesquita & Souza Cardiology and the cardiologist – yesterday, today and tomorrow Arq Bras Cardiol. 2019; 113(3):335-338 In the second half of the 19th century, the third stage of Cardiology emerged: the experimental medicine, the source of the brilliance of writers such as Claude Bernard and Carl Ludwig. The German and French schools made experimental medicine an independent area and two researchers described the Frank-Starling Law, the first law of the heart. In the 19th century, scientific advances derived from new disciplines such as microbiology, immunology, histology and biochemistry. Other sciences were incorporated into the study of Cardiology, such as physics and electricity, which contributed to the discovery of the x-ray and the chord galvanometer. In the future, these would constitute the basis of cardiac radiology and electrocardiography. In the end of the 19th century, the combination of anatomoclinical data and the recording of stetho-acoustic findings using graphic methods (phonomecanographic) consolidated a new pathophysiological approach, and a detailed description was made of a growing number of cardiovascular conditions. It is possible to assert that the official study of Cardiology, as a science and medical specialty, started with the vital contribution of Dr. Carlos Chagas’ studies, who diagnosed the chagasic cardiomyopathy in 1909, and was responsible for the first translational studies and the publication of the first broad scientific study of a cardiac disease in Brazil. In addition, he was responsible for introducing the first electrocardiogram, installed in the laboratory of Manguinhos, a valuable and unequivocal contribution to Brazilian Cardiology. 4,5 Industry development and migration from rural to urban areas, with the creation of metropolitan areas, in the early 1920s, led to a huge change in the eating and working habits of the Brazilian population, with the spread of heart diseases among the society. 6 In the same period, the dissemination of the electrocardiograph made it possible to develop specific studies, which resulted in a branch of clinical medicine that became an area of major interest for numerous physicians, who began to search for specialty programs in Brazil and abroad. This movement, throughout the 1930s, led to the emergence of the medical specialty, thanks to the particular interest of this enthusiastic group for this specific study, which caused emerging resources to be redirected to the investigation of cardiovascular diseases, through phonomechanography and electrocardiography. From this moment, a great process of creation of annual specialty courses began, which initially were offered in São Paulo and Rio de Janeiro, even before the constitution of the Chair and the formation of this Society, on August 14, 1943. The access to these great transnational networks, and the whole American continent, benefited the investigation, the learning and trainings that took place until the end of World War II, and was the result of the internationalization process of the SBC, which maintained the possibility of interchange between Brazilian and North‑American doctors and, consequently, of its actions together with the American College of Cardiology. 7 Cardiology and cardiologists experienced deep changes in the beginning of the 20th century, due to the employment of the electrocardiogram as the cornerstone of cardiovascular rationale. Another important change was the progressive loss of relevance of the French school for Cardiology and the emergence of the North-American and Mexican schools of Cardiology. The Mexican Institute of Cardiology, founded by Ignacio Chaves, in 1944, became a research and education pole in the area of electrocardiography and a model center of cardiovascular education, attracting Brazilian young people for its residence in cardiology, as well as people from other nationalities. Between the 1940’s and 70’s, it would become a global reference center and contribute to important advances for the pathophysiology of congenital diseases, pulmonary hypertension, hemodynamics and electrophysiology. The influence of the North-American school starts to consolidate in the post-war period, when it incorporates economic resources to professionalize clinical research and construction and new centers of cardiology, as well as into the development of cardiac catheterization and myocardial revascularization surgery. The Harvard group led by Professor Eugene Braunwald consolidates in the discovery of new mechanisms of disease and in multicenter therapeutic studies. Figure 1 – Different SBC logos throughout its history. 336