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 1980’s and 90’s, noninvasive cardiovascular imaging, echocardiography, myocardial scintigraphy, computerized tomography and cardiac resonance were incorporated and became increasingly indispensable for diagnostic, prognostic and therapeutic evaluation. Parallel to this, we started to incorporate the principles of evidence-based medicine into the process of clinical decision making in the therapeutic area. The Brazilian Society of Cardiology establishes clinical guidelines to guide the cardiovascular practice, incorporating and ranking the recommendations to confront several cardiovascular diseases. Since the hospitalist practice of our cardiologists, cardiac surgery has been present and of vital importance for the development of our specialty, as well as hemodynamics, both being distinguished as the major departments in the first years of constitution of the SBC. Specialized sectors and equipment in hemodynamics and cardiac surgery, creation of specialized health care centers and units, such as the coronary unit and cardiac postoperative unit, provide specific care, adding knowledge and value to the specialty. With the arrival of the 1980's, there was the dissemination of the use of coronary angioplasty for the treatment of multiple vessel disease and acute myocardial infarction, using reperfusion techniques and thrombolytic therapy. The advances of interventionist hemodynamics through the use of pharmacological stents, valvuloplasty and prosthesis implantation emerged around the world, and quickly arrived in Brazil, promoting a huge evolution step towards the formation of the specialist in Cardiology, as well as the need for the constitution of teams dedicated to each area. 6-8 All this movement promoted the growing and the development of the SBC, leading to the creation of the first five specialized Departments: Cardiovascular Surgery Department (1969), Pediatric Cardiovascular Department (1973), Cardiovascular and Respiratory Physiology Department (1974), Angiocardiography and Hemodynamic Department (1976) and Hypertension Department (1981). 4 Nowadays, the SBC consists of 13 active departments, where a total of 14,000 associates are distributed in 26 regional clusters throughout Brazil, being the largest society in Latin America. Cardiology, in addition to having being the first specialty to establish a Chair at universities and teaching hospitals, was also responsible for the emergence of accreditation procedures for specialist titles and, nowadays, has the support of 8,429 doctors with a specialty degree in Cardiology. In addition, several institutions offer lato sensu post- graduation courses. In line with this demand for specialty courses, the SCB, alongside its regular publications Arquivos Brasileiros de Cardiologia (Brazilian Archives of Cardiology), International Journal of Cardiovascular Science , the SBC Journal and its guidelines, provides DE (distance education) courses, a broad schedule of events and congresses with online access. In order to respond the need for expanding translational research, the specialty counts with the possibility of network research, as in the case of stem-cell therapy, which involved several centers, the support to clinical trials and registries, in addition to epidemiologic studies on the most prevalent cardiovascular conditions in our field. In the context of standardization of conduct and creation of protocols, the SBC dedicates extreme determination for the development and publication of guidelines on approach and treatment of the main diseases with high morbidity and mortality nowadays. In the late 20th century, Brazilian Cardiology constructed a solid legacy and international relevance, a trajectory from which renowned fellows were elected representatives of this first century of our specialty (Figure 2). This new decade emerges with a new design for Cardiology in a digital, connected, patient-focused environment, based on major pillars – artificial intelligence, big-data, robotics, biosensors, telemedicine, devices, sensors and genomics. Together they will support the Precision Cardiology paradigm. The need to incorporate into our mindset the idea of the cardiologist approaching the world of innovation and entrepreneurship is a new challenge in the formation of our new cardiologists with emphasis on the development of female leadership in cardiology. From the assistance point of view, our integration with the population health and family doctors will increase, as well as our multidisciplinary approaches, enabling the implementation of lines of care and the monitoring of clinical outcomes and focused on patient safety. This means to know and dominate the triad formed by cardiovascular biomedical knowledge, technology (Digital medicine) and humanization. Knowledge moves forward quickly and unstoppable, in a global manner, supported and favored by numerous opportunities of knowledge exchange between peers and institutions worldwide. The technology, which promotes the evolution of Digital and Precision Medicine, favors the access to knowledge, the strengthening of diagnosis, the promotion of man-machine interaction and the possibility of personalizing therapy to its molecular level. And, finally, the rescue of essence: the humanization of such advanced and futuristic Cardiology. A new journey will be necessary into the daily practice of doctor-patient interaction in order to promote empathy, patient empowerment and sensitivity to the doctor inserted in this new context for this new decade. 9-13 337