pioneer in cardiology: philip poole-wilson, ma, md,...

Philip Poole-Wilson, emeritus professor of cardiology at the National Heart and

Lung Institute in the Faculty of Medicine of Imperial College, London, UK, honorary

consultant physician, Royal Brompton Hospital, formerly British Heart Foundation

Simon Marks Professor of Cardiology, and past president of both the European Society

of Cardiology and the World Heart Federation, talks to Barry Shurlock, MA, PhD.

European Perspectives in CardiologyEuropean Perspectives in Cardiology

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Circulation March 3, 2009

Pioneer in Cardiology: Philip Poole-Wilson, MA, MD, FRCP, FESC, FACC, FMedSci

“I Am Pleased to Have Had a Part in Introducing the

6-Minute-Walk Test for the Assessment of Heart Failure”

Gowns flapping, morning lectures, practicals, rugby in

the afternoon, Latin grace, calling tutors “Sir,” Beyond

the Fringe in New York, NY, the Cuban Missile Crisis, the

assassination of US President John F. Kennedy, and cardio -

logists down the road in Addenbrooke’s Hospital,

Cambridge, UK, with little

more than a stethoscope and an

electrocardiograph. A young

man in this scenario of

Cambridge, England, in the

1960s, Philip Poole-Wilson,

MB, BChir, MA, MD, FRCP,

FESC, FACC, FMedSci, now

occupies a world in which

medics wear open-necked

shirts and swap first names

with patients, in which science

and medicine have become

bedfellows, and in which car-

diologists have a huge and

ingenious technology available

to them. Professor Poole-Wilson,

emeritus professor of cardiology

at the National Heart and Lung

Institute in the Faculty of

Medicine of Imperial College,

London, UK, has thus experi-

enced a technical and social

revolution during his lifetime. From the confines of a tradi-

tional English education, his professional career has led

him to straddle the world, though he quips, “I haven’t been

to Antarctica or the Galapagos Islands—but I don’t sup-

pose I’ll get there now.”

Professor Poole-Wilson has had one of his most fruitful

overseas links with India, from where he recently returned.

He delivered 6 lectures, met many fellow researchers, and

spent several days working on a new project on heart

failure—the origins of symptoms, activation of the inflam-

matory system in untreated

disease, prevalence and

causes, and the prevalence

and detection of rheumatic

heart disease in school chil-

dren. He knows India well

and believes the country has

huge potential and a great

future. He says, “I don’t think

Europe and the developed

world in general appreciate

the speed with which other

parts of the world are catch-

ing up. There are some very

clever people in India and

China—the genes go back a

long way and are definitely

there! The West has had a

huge advantage since the

17th century, and if we don’t

get the necessary structures

in place, we will decline.”

“I Decided a Career in Pure Physiology Might Be

Difficult and Switched to Medicine”

Although Poole-Wilson came from a medical family (his

father worked as one of the first genitourinary surgeons in

England), he went to university with the intention of

Photograph of about half the members of the undergraduate Part

II Physiology class of 1963 at Cambridge University, Cambridge,

UK. Professor Poole-Wilson (third from right) says “I decided a

career in pure physiology might be difficult and switched to medi-

cine.” Despite never studying biology at school, he managed to

obtain an exhibition at St Thomas’ Hospital Medical School,

London (on the south bank of the River Thames, opposite the

Houses of Parliament) on the condition that he obtain the then-

necessary A-level (junior qualification) in biology (“including

botany!”) and “mug up” on anatomy. He qualified as a doctor in

1967. Photograph courtesy of Professor Poole-Wilson.

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“A Breadth of Ideas and a Very International View

That I Would Never Have Found in London”

For his MD (in the UK equivalent to a PhD), granted at the

University of Cambridge (but with research at St Thomas’

Hospital), Poole-Wilson studied the movement of hydrogen

and potassium ions in the heart, a subject that has some par-

allels with the studies of ionic mechanisms in nerve cells that

had won the Nobel Prize in Cambridge in 1963.

In 1973, Poole-Wilson received a British-American

Travelling Research Fellowship (funded by the British

Heart Foundation and the American Heart Association) at

the Cardiovascular Research Laboratory of the University

of California, Los Angeles—affectionately called the “Heart

Lab.” The family went to California. There, he continued

studies of potassium flux in the myocardium, working and

greatly influenced by the head of the department, distin-

guished experimentalist and scientist Glenn A. Langer,

MD, and also by Kenneth I. Shine, MD, a clinical scientist

at that time who later would become dean, president of the

American Heart Association [1985–1986], and head of the

Institute of Medicine in Washington, DC.

“‘Rumble and Click’ Cardiology Was Prominent.

Clinical Thinking Had Not Yet Moved Into the

Metabolic Era”

At the age of 32 years, Poole-Wilson was appointed a sen-

ior lecturer in the Cardiothoracic Institute and honorary

consultant at the National Heart Hospital, London, UK,

under the leadership of the head of department, Peter

Harris, MD. At the time, Poole-Wilson did not know that,

12 years later, he would take charge of the department.

Professor Poole-Wilson recalls, “When I arrived at the

National Heart Hospital in 1976, I have to say that British car-

diology was not at its peak. Looking back, consultants were

rather conservative and would be considered old-fashioned

becoming a physical chemist. From Marlborough College,

Marlborough, UK (a public school, which in England

means a fee-paying private school), he won a major schol-

arship to Trinity College, Cambridge, UK, to read natural

sciences. He recalls, “My father worked in Manchester, and

we lived in Cheshire. I had a most happy childhood, and at

Marlborough I was taught by some brilliant schoolmasters,

several of whom went on to be headmasters of other

schools. At Cambridge, I studied maths, physics, chem-

istry, and biochemistry. At that time, in Part 1 of natural

sciences, one had to study a range of subjects, so I added

physiology, having never done any biology. I got a first in

Part 1 but chose to do physiology in Part 2 and did not do

so well, getting only a lower second. When asked why, I

usually say that I enjoyed myself too much—I rowed,

played cricket and rugby, and had many friends, especially

in other subjects, such as law and moral sciences. I like to

think ‘I got educated!’ I graduated in the year (1963) that

Hodgkin [OM, KBE, FRS] and Huxley [OM, FRS], who

were in the physiology department, won the Nobel Prize

with Eccles [AC, FRS, FRACP, FRSNZ, FAAS]. I decided

a career in pure physiology might be difficult and switched

to medicine.”

Professor Poole-Wilson’s early medical training all

took place in London, at St Thomas’ Hospital, the Royal

Brompton Hospital, and the Hammersmith Hospital. He

says, “In a way, I have spent my entire medical career

going back into physiology! Having studied mathematics

and physics at Cambridge the simple understanding of

blood flow and haemodynamics was pretty straightforward.

It was perhaps natural to specialise later in the cardiovascu-

lar area.”

In 1974 Professor Poole-Wilson was taught to use the perfused

interventricular septum (shown above) to study ion fluxes. He says,

“It [the ‘Heart Lab’] was a wonderful laboratory to work in, and

it changed my life. It was very lively. I was able to attend various

major meetings in the United States and to discover a breadth of

ideas and a very international view that I would never have found

in London. I made many friendships that have lasted for decades. I

was tentatively offered a position at the University of California,

Los Angeles, but my wife and I decided that I should seek a post in

the United Kingdom, and we returned to London.” Photograph

courtesy of Professor Poole-Wilson.

Photograph of the Pooole-Wilson family. Professor Poole-Wilson

married Mary in 1969 and says “I have been supported by her

throughout my career.” They have 3 children, the first born in

1973. In 1974, the family moved to California, for 15 months

when Poole-Wilson received a British-American Travelling

Research Fellowship at the Cardiovascular Research Laboratory

of the University of California, Los Angeles. Photograph courtesy

of Professor Poole-Wilson.



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today—the smart suit, the entourage, the Harley Street

practice, and, perhaps, a rose in the lapel! My wife, Mary,

rather admires those characteristics as indicative of com-

petence and conscientiousness. The celebrated London

cardiologist Paul Wood had died in 1962, but his ghost was

everywhere. ‘Rumble and click’ cardiology was prominent.

Clinical thinking had not yet moved into the metabolic era,

and attempts to understand the function and biochemistry

of the heart under normal conditions and in disease states

were still in their infancy. Peter Harris was appointed as the

first British Heart Foundation Simon Marks Professor of

Cardiology in 1966 and initially worked from one room,

with a table, a chair (the sort you sit on), and a secretary.

Professor Winifred Nayler [DSc] had joined the depart-

ment from Australia so that, by 1976, there was a lively

group of scientists at work. Now, with all the changes we

have had, the department has 10 professors and has become

part of Imperial College London.”

“Harris was a great thinker and innovator—but not

always popular—and was very keen on what we now call

translational research. Our approach over the years has

been to bring clinicians and scientists together to work

together in ‘both ways’—that is, so that clinicians could

learn more about science and scientists could appreciate

clinical problems. The main difficulty has been the large

difference in pay structures—often, brilliant scientists were

working shoulder to shoulder with junior clinicians for far

less pay. It was an art form to get them to work together.

And we did it with camaraderie, and with the excitement

engendered by the pursuit of knowledge! There were, of

course, many institutional changes—first there was the

Institute of Cardiology (1966–1973), then the

Cardiothoracic Institute (1973–1988), next the National

Heart and Lung Institute (NHLI) by itself (1988–1997),

and, finally, as a division of the Faculty of Medicine of

Imperial College London (since 1997).”

Professor Poole-Wilson was the first head of the NHLI

from 1997 to 2000. These various academic bodies were

always closely linked to the associated hospitals. In 1988,

the National Heart Hospital closed and moved to join the

Royal Brompton Hospital in Dovehouse Street, in the

Chelsea district of London; the NHLI also moved. There

were many who resisted and mourned the demise of the

National Heart Hospital, which was famous worldwide.

“I Always Viewed the Changes Positively:

An Individual Shouldn’t Stay in the Same Place for

Their Entire Working Life—Change Stops You

From Becoming Rusty!”

The roll call of the most conspicuous of Professor Poole-

Wilson’s studies, published with others, certainly shows little

sign of rust. Over the years, he has led a productive group

of clinicians and scientists.

A central theme in his early work involved the role of

hydrogen, potassium, and calcium ions in ischaemic heart

muscle studied in animal experiments and then in man. The

year 1979 proved extremely productive: in that year, he and

his colleagues demonstrated the effect of acidosis on the

myocardium in animals, leading to a new understanding of

the role of hydrogen, potassium and calcium in the function

and death of ischaemic cells. Three years later, his group

made the first continuous measurement of pH in a human

heart, using a catheter tip electrode and, thereby, demonstrat-

ing the very early development of acidosis during ischaemia.

During the late 1980s, he turned to heart failure, show-

ing how one could activate the neurohormonal system by

treatment with diuretics and describing fluid volumes in

untreated patients in India. This was a team achievement by

colleagues/friends who had come together and worked in

London: Professor Inder Anand. MD, FACC, FRCP, DPhil,

now professor of medicine at the University of Minnesota,

Minneapolis, MN; Professor Roberto Ferrari, MD, PhD,

Left, The National Heart Hospital, London, where Professor Poole-Wilson was appointed senior lecturer and honorary consultant in

1976. In 1988, it closed and moved to join the Royal Brompton Hospital, London. Right, Professors Peter Harris, Inder Anand, Roberto

Ferrari and Philip Poole-Wilson—all members of the team studying untreated heart failure in India in the late 1980s. Photographs courtesy

of Professor Poole-Wilson.



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FESC, now chair of cardiology, University of Ferrara, Italy,

and Cardiovascular Research Centre, Salvatore Maugeri

Foundation, IRCCS Gussago (BS), Italy, and the new pres-

ident of the European Society of Cardiology; and Professor

Harris, who died in 2002. Professor Poole-Wilson also

demonstrated important histological changes in the skeletal

muscle of patients with heart failure.

Then, in the early 1990s, Professor Poole-Wilson’s

group started to publish the first of many articles that

described the functions of isolated myocytes taken from

patients with heart failure undergoing transplantation.

In 1994, Professor Poole-Wilson and his colleagues

brought together their work on heart failure in a seminal

article published in the British Heart Journal and entitled

“Symptoms and quality of life in heart failure: the muscle

hypothesis,”1 which explained heart failure symptoms in

terms of persistent activation of the neurohormonal sys-

tems from signals emanating from skeletal muscle. Later

articles put forward the hypothesis that cytokine activation

in heart failure is partly due to endotoxins entering the

body through the gut or lung; strong evidence was adduced

to support the idea.

One can see that Professor Poole-Wilson’s research in

myocardial ischaemia and heart failure followed a clear

logical pathway, but there were other fruitful side shoots.

In 1986,2 he published an article proposing the use of the

6-minute-walk test for assessment of patients with heart

failure. Unknown to him, Guyatt and colleagues3 in

Canada had published a similar article a few months earli-

er. Professor Poole-Wilson comments, “We both copied the

idea from the lung doctors, but the test is now used world-

wide, and that is what matters.”

In 2000, Professor Poole-Wilson and others described

the first implantation of the Jarvik 2000 valveless ventricu-

lar assist device4 for the intended lifetime treatment of a

patient with heart failure; the patient lived for another 7½

years. Professor Poole-Wilson comments, “He died of

renal disease, [which is] the major reason why a heart

transplant was not done.”

A few years later, Professor Poole-Wilson served as lead

investigator for reports on the influential Carvedilol Or

Metoprolol European Trial (COMET)5 and on the trial of

the effect of long-acting nifedipine on mortality and cardio-

vascular morbidity in patients with stable angina requiring

treatment—ACTION—A Coronary disease Trial

Investigating Outcome with Nifedipine.6 Another impor-

tant trial he led, SENIORS—Study of Effects of Nebivolol

Intervention on Outcomes and Rehospitalisation in Seniors

with heart failure—showed “the benefit of a beta-blocker

(nebivolol) in heart failure regardless of age and ejection

fraction.”7

Asked to identify which of his research findings he rates

highest, Professor Poole-Wilson says, “I am very proud of

the papers published a long time ago showing the involve-

ment of calcium in the death of heart cells due to hypoxia

and ischaemia. A pleasing topic was the demonstration that,

in man, acidosis and the intracellular loss of potassium ions

were largely responsible for the changes in the electrocardio-

gram and contractility within 2 to 3 beats of heart muscle

becoming ischaemic. I am also proud to have been

involved, with others, in one of the first groups to work

with single cardiac myocytes. A group at Oxford had been

preparing myocytes from the hearts of animals, and we

obtained information from them and adjusted the ‘cookery’

to break up the matrix of the human heart and prepare

single cells. Recently, these techniques have been used to

show the effects of a gene inserted into cells from patients

with heart failure, and that has led to early trials by col-

leagues at Harvard of gene therapy for heart failure in man.

I am pleased to have had a part in introducing the 6-minute-

walk test for the assessment of heart failure. At the time,

there was much work, especially in the United States, with

relatively complex, impracticable methods of measuring

exercise tolerance—the 6-minute-walk test is so easy; all

you need is a level corridor of a certain length!”

“Cardiac Disease and Heart Failure Are Exemplars of

What Is a General Paradigm in Chronic Disease States”

Professor Poole-Wilson recalls the great difficulty he had

publishing research on the prevalence of heart failure. “I

think it was a matter of we, as cardiologists, invading the

territory of epidemiologists with something as ill-defined

as heart failure—they wanted to know what we were trying

to detect—but the criticisms were wrong! We went on to

show that heart failure was a much more common condi-

tion than was then perceived—at the time, it was regarded

as the Cinderella of cardiology and only an end-stage dis-

ease. We had an equally difficult time publishing on damage

Left, Professor Poole-Wilson in

India on a lecture tour. Right

Professors Poole-Wilson (centre),

Sidney Smith (president of the

American Heart Association

1995–1996) and Shahryar Sheikh

(president of the Asian-Pacific

Society of Cardiology [1999–

2003], the Pakistan Society of

Cardiology [2002–2004], and the

World Heart Federation [2007–

2008]) in Japan. Photographs

courtesy of Professor Poole-Wilson.



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to skeletal muscle. I’m not sure that people understood the

pathology of muscle and that all organs are involved in

heart failure. We were the first to show that neurohormonal

activation in heart failure was largely due to treatment with

diuretics. We were able to show the effect of treatment in

studies in Northern India, where patients with severe heart

failure still walk into clinics having never seen a doctor. We

now know that in heart failure there is neurohormonal acti-

vation, a large part being due to drug treatment, but that

other systems such as the immune system are also activated.

The critical question is, ‘Why?’ Peter Harris thought it was

due to an initial drop in blood pressure—we have

expanded that hypothesis and now think that the reduced

cardiac output leads to a deterioration in the function of

all body organs and activates those body systems refined

by evolution to allow the survival of the species under

adverse conditions; the critical systems are maintenance

of the blood pressure, the exclusion of infectious agents,

and the prevention of haemorrhage. Cardiac disease and

heart failure are but exemplars of what is a general para-

digm in chronic disease states. And it is one of the easiest to

study. This, for me, is an exciting change of perspective.”

Professor Poole-Wilson believes that the far-reaching

implications of the heart studies that he and others have

carried out now mean that cardiologists must reinvent

themselves as cardiovascular physicians (as the British

Cardiac Society recently morphed to the British

Cardiovascular Society), making use of knowledge from a

wider range of other specialties.

“I Am a Little Argumentative by Nature and Wallow

in the Joy of Debate, Believing That Scientific

Argument Is Best Resolved by Challenge”

One cannot doubt that Professor Poole-Wilson has had a

hugely original career, though in an age of seemingly

endless grant applications, his philosophy of research

management might seem rather old-fashioned. He shows

enthusiasm for the “gossipy coffee room” and describes

his department as “like a rose garden—you are not sure

where the finest flower will grow and what it will be like.”

He comments, “I believe strongly in the freedom of

research direction and judging people on their outcome.

It’s a matter of finding bright people and telling them to ‘go

away for 5 years’ and come back and tell you what they’ve

found. I’m often asked how a particular idea arose, and it’s

generally impossible to say. I am a little argumentative by

nature and wallow in the joy of debate, believing that sci-

entific argument is best resolved by challenge.”

Along with pursuing a distinguished research career and

publishing more than 500 articles, Professor Poole-Wilson

has amassed a huge list of other achievements. Where to

begin? Where to end? Of the many prizes and honours he

has received, he remembers particularly the Le Prix Europe

et Medecine 2001 de l’Institut des Sciences de la Santé,

Paris, France, and the Mackenzie Medal of the British

Cardiovascular Society, awarded in 2007. Since his

appointment as head of the department, no fewer than 29 of

the staff have gone on to professorships.

Between 1994 and 1996, Professor Poole-Wilson

served as president of the European Society of Cardiology

(ESC), and from 2003 to 2005 he served as president of

the World Heart Federation. He recalls these as very dif-

ferent experiences; he says, “Although the ESC started in

1950, it was not until 1990 that there was an annual con-

ference and, a few years later, the European Heart House

in Nice, France was opened. I remember, as president-

elect of the ESC, helping Professor Michel Bertrand [MD]

lay the foundation stone—what a moment! Now, the influ-

ence of the ESC is massive. There were some problems,

which still exist. In 1994, when guidelines on the preven-

tion of heart disease were first published by the ESC, there

were differences with the US guidelines published at the

same time. We had to iron that out. It’s best if guidelines

are similar across the world—otherwise politicians con-

cerned with health will take what they wish. After all, the

risk factors for atheromatous heart disease are the same

everywhere—there’s no great difference between India,

Africa, the European Union, and the United States. And

yet, in other areas of cardiovascular medicine, real differ-

ences still persist.”


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Professor Poole-Wilson says, “Although the ESC started in 1950, it was not until 1990 that there was an annual conference and, a few yearslater, the European Heart House in Nice, France (left) was opened. I remember, as president-elect of the ESC, helping Professor MichelBertrand [MD] lay the foundation stone (right)—what a moment! Copyright © 2009, European Heart House, Nice, France. Photographscourtesy of Professor Poole-Wilson.



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“The World Heart Federation was an entirely different

challenge. It’s much smaller than the ESC and not so rich;

it’s much harder for it to raise money. It needed major

changes and a new mission, so that it has now become an

influential and powerful organisation punching well

beyond its weight. One third of the world [population] dies

of heart disease and 80% of these deaths are in developing

nations! We need to touch the consciences of the ESC and

the American Heart Association—which are 10 times richer

than the World Heart Federation. I was disappointed in the

Millennium Development Goals, which concentrated on

infectious diseases and hardly mentioned chronic disease;

chronic diseases across the world are now at least as impor-

tant. This was a serious and mistaken omission. But attitudes

are slowly changing for the better”

“I Enjoy Most of the Things I Do and Am Unbelievably

Fortunate That My Work Is My Hobby!”

As Professor Poole-Wilson steams beyond his mid-60s, still

in the midst of the powerhouse of London cardiology, he

has an enviable attitude to all things, commenting, “I have

never done a day’s work in my life! I enjoy most of the

things I do and am unbelievably fortunate that my work is

my hobby! I dislike the word ‘retirement,’ though, now that

I am an emeritus professor, I have almost no administrative

responsibilities. My university has generously allowed me

to continue to hold grants and have an office; and I still have

PhD students to supervise. I am carrying on my research,

with projects in India, etc, and I am really rather busy.”

Professor Poole-Wilson gives his hobby as “cardiovascu-

lar medicine,” and it seems hard to believe that he has any

leisure, but he says he does. Typically, when asked for

details, he can provide a list of his interests, and he

even has a slide: favourite film, Dr Zhivago; actors,

Julie Christie, Shirley MacLaine, and Jean Moreau;

book, Candide by Voltaire (especially the tutor Dr

Pangloss, whose motto is “all is for the best in the

best of all possible worlds”); opera, Norma by

Bellini; and composers, Brahms and Wagner. He

also has strong interests in ornithology and spends

time (“not enough”) in his cottage in Wiltshire, in the

West of England, where he enjoys gardening (no

doubt heeding Voltaire’s dictum that “we must culti-

vate our garden”). Among the activities he will pursue,

one has a curiously topical flavour—namely, the

archaeology of Iron Age Britain in relation to climate

change. He has a hunch that all those settlements on

the tops of hills in Southern England developed there

not just to see off invaders from adjacent villages but

to avoid the quagmire in the valleys below, populated

with dangerous beasts and infective agents. Perhaps

someone will fund him to go away for 5 years to find

out the truth of the matter.

References1. Coats AJ, Clark AL, Piepoli M, Volterrani M, Poole-Wilson PA.

Symptoms and quality of life in heart failure: the muscle hypothesis. Br

Heart J. 1994;72(2 suppl):S36–S39.

2. Lipkin DP, Scriven AJ, Crake T, Poole-Wilson PA. Six minute walking

test for assessing exercise capacity in chronic heart failure. Br Med J.

1986;292:653–655.

3. Guyatt GH, Sullivan MJ, Thompson PJ, Fallen EL, Pugsley SO, Taylor

DW, Berman LB. The 6-minute walk: a new measure of exercise capac-

ity in patients with chronic heart failure. Can Med Assoc J.

1985;132:919–923.

4. Westaby S, Banning AP, Jarvik R, et al. First permanent implant of the

Jarvik 2000 Heart. Lancet. 2000;356:900–903.

5. Poole-Wilson PA, Swedberg K, Cleland JG, Di Lenarda A, Hanrath P,

Komajda M, Lubsen J, Lutiger B, Metra M, Remme WJ, Torp-Pedersen

C, Scherhag A, Skene A; Carvedilol Or Metoprolol European Trial

Investigators. Comparison of carvedilol and metoprolol on clinical out-

comes in patients with chronic heart failure in the Carvedilol Or

Metoprolol European Trial (COMET): randomised controlled trial.

Lancet. 2003;362:7–13.

6. Poole-Wilson PA, Lubsen J, Kirwan BA, van Dalen FJ, Wagener G,

Danchin N, Just H, Fox KA, Pocock SJ, Clayton TC, Motro M, Parker

JD, Bourassa MG, Dart AM, Hildebrandt P, Hjalmarson A, Kragten JA,

Molhoek GP, Otterstad JE, Seabra-Gomes R, Soler-Soler J, Weber S; A

Coronary disease Trial Investigating Outcome with Nifedipine gas-

trointestinal therapeutic system investigators. Effect of long-acting

nifedipine on mortality and cardiovascular morbidity in patients with

stable angina requiring treatment (ACTION trial): randomised con-

trolled trial. Lancet. 2004;364:849–57.

7. Flather MD, Shibata MC, Coats AJ, Van Veldhuisen DJ, Parkhomenko

A, Borbola J, Cohen-Solal A, Dumitrascu D, Ferrari R, Lechat P, Soler-

Soler J, Tavazzi L, Spinarova L, Toman J, Böhm M, Anker SD,

Thompson SG, Poole-Wilson PA; SENIORS Investigators.

Randomized trial to determine the effect of nebivolol on mortality and

cardiovascular hospital admission in elderly patients with heart failure

(SENIORS). Eur Heart J. 2005; 26:215–225.

Barry Shurlock is a freelance medical journalist.

From left to right: Professor Paul Hugenholtz, Professor Michel Bertrand,

Professor Philip Poole-Wilson, Mrs Wilma Thieme, Professor Günter

Breithardt, Professor Lars Rydén, Professor Jean-Pierre Bassand, Professor

Michal Tendera. Professor Poole-Wilson says, “All have been presidents of

the ESC at some time between 1984 and 2006. Mrs Wilma Thieme kept us all

in order.” Missing are Professor Hans-Peter Krayenbuhl (deceased),

Professor Attilio Reale (deceased), and Professor Maarten Simoons.

Photograph courtesy of Professor Poole-Wilson.

Editor: Helmut Drexler, MD, FESC

Managing Editor: Lindy van den Berghe, BMedSci, BM, BS

We welcome comments. E-mail [email protected]

The opinions expressed in Circulation: European Perspectives

in Cardiology are not necessarily those of the editors or of the

American Heart Association.



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European Perspectives

Print ISSN: 0009-7322. Online ISSN: 1524-4539 Copyright © 2009 American Heart Association, Inc. All rights reserved.

is published by the American Heart Association, 7272 Greenville Avenue, Dallas, TX 75231Circulation doi: 10.1161/CIRCULATIONAHA.109.192070

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pioneer in cardiology: philip poole-wilson, ma, md,...

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