|
1799 |
Caleb Hillier Parry, in his
Inquiry into the Symptoms and Causes of the
Syncope Anginosa, Commonly Called Angina
Pectoris, Illustrated by Dissections(1799),
recounts the classical anecdote in which,
during the course of an autopsy, he discovered
something hard and gritty in the coronary
arteries and ". . . well remembered looking up
to the ceiling, which was old and crumbling,
conceiving that some plaster (sic) had fallen
down."5 He discovered, however, that
the vessels had hardened, or ossified, and
later in the same book he states that, ". . . a
principle cause of the syncope anginosa is to
be looked for in disordered coronary arteries."
|
 |
| 1815 |
London surgeon Joseph Hodgson
published an important monograph on vascular
disease, claiming that inflammation was the
underlying cause of atherosclerosis and it is
not a natural degenerative occurrence of the
aging process. He also identified that this
disease process occurred in the intima, between
the lumen and the media of the diseased
vessels.
|
|
| 1844 |
Plaque rupture was reported
for the first time during the autopsy of
Bertel Thorvaldsen, the celebrated neoclassical
Danish artist and sculptor who dies of sudden
cardiac death in the Royal Theater in
Copenhagen in 1844. On autopsy, his death was
attributed to the rupture of an atherosclerotic
plaque in the left coronary artery. It was
stated that the vessel wall contained “several
atheromatous plaques, one of which quite
clearly had ulcerated, pouring the atheromatous
mass into the arterial lumen”.
|
 |
|
1841 |
Carl Von
Rokitansky in 1841 championed the Thrombogenic
Theory. He proposed that the deposits observed
in the inner layer of the arterial wall derived
primarily from fibrin and other blood elements
rather than being the result of a purulent
process. Subsequently, the atheroma resulted
from the degeneration of the fibrin and other
blood proteins as a result of a preexisting
crasis of the blood, and finally these deposits
were modified toward a pulpy mass containing
cholesterol crystals and fatty globules. This
theory came under attack by Virchow.
|
 |
| 1856 |
Rudolf Virchow's description of the
pathogenesis of atherosclerosis was an in-depth
study of the histologic characteristics of the
atherosclerotic lesion in all its stages. For
the first time he utilized the name of
"endarteritis deformans." By this he meant
that the atheroma was a product of an
inflammatory process within the intima
and that the fibrous thickening evolved as
a consequence of a reactive fibrosis induced by
proliferating connective tissue cells within
the intima. He maintained that mechanical
forces initiated the irritative stimulus and
that the endarteritis was part of a repair
mechanism. His theory has elements that are
acceptable to current thinking, but it also has
features that have been invalidated. However,
suffice it to say that Virchow's concept of
local intima injury as the initiating "irritative"
stimulus is still accepted and it has been
extended to include other factors besides
mechanical factors. His
hypothesis formed the basis of
response-to-injury hypothesis of Russel Ross
more than a century later. |
 |
| 1841 |
Description of angina
pectoris by William Heberden:
They who are afflicted with it
are seized while they are walking (more
especially if it be uphill and soon after
eating) with a painful and most disagreeable
sensation in the breast, which seems as if it
would extinguish life, if it were to increase
or continue; but the moment they stand still,
all uneasiness vanishes.
|
 |
|
1852 |
Sir Richard
Quain in his paper "On Fatty Diseases of the
Heart," records his observation of the
deposition of fatty material in the blood
vessels, which he attributed to, ". . . local
modification of nutrition." He linked the fatty
heart to a number of effects, including,
"languid and feeble circulation, a sense of
uneasiness and oppression in the chest,
embarrassment and distress in breathing, coma,
syncope, angina pectoris, sudden death. . . ."
|
|
|
1912 |
James B. Herrick
established that thrombosis and occlusion were
not necessarily fatal, thus enabling a clinical
distinction between ischemia and infarction.
|
 |
| 1916 |
Jay
McLean discovered heparin. |
 |
|
1928 |
S. Keefer and W.H. Resnik
published their landmark paper "Angina
Pectoris: A Syndrome Caused by Anoxemia of the
Myocardium." Here they confirmed that anoxemia
was the underlying cause of angina, but could
itself be caused by such diverse conditions as
coronary artery disease, vasospasm, and
decreased oxygen saturation of the blood. Acute
myocardial infarction was linked to coronary
artery obstruction and angina, which
underscored the danger of sudden death in
patients with angina.
|
 |
| 1929 |
Werner Forssmann performed first documented
human cardiac catheterization in Eberswald,
Germany. |
 |
| 1941 |
Cournand and Richards employ the cardiac
catheter as a diagnostic tool for the first
time, utilizing catheter techniques to measure
cardiac output. |
 |
| 1948 |
The National Heart Institute
(NHI, which would later become the National
Heart, Lung, and Blood Institute [NHLBI]) and
the American Heart Association (AHA) were
officially established. The federal government
allocated approximately $500,000 to support
heart research—about the same amount allocated
to fund research on the Long Island potato bug
|
|
|
Angina pectoris
probably first afflicted a "prosperous
cave man who very likely dropped dead ...
after gorging himself with a roast of
venison and on his way to date one of his
harem"
Paul
Dudley White (1886-1973)
|
|
| 1948 |
The Framingham study,
initiated and operated by the NHLBI For the
first time, a large cohort of healthy men and
women were studied prospectively and the
results were unarguable: the risk for
developing clinically evident CAD was a
continuous curvilinear function of blood
cholesterol levels
This
study, of course, happens to be one that I have
torn apart as a gigantic fraud.
Click here for my report on this.
|
 |
| 1953 |
In their
landmark paper, William F. Enos, Robert H.
Holmes and James Beyer demonstrated presence of
coronary artery disease among young United
States soldiers killed in action in Korea
(later observed in the casualties of Vietnam
War too)
|
 |
 |
| 1954 |
Gofman and collaborators at
the Donner Laboratories in Berkeley,
California, began their classic studies of
lipoprotein patterns using the analytic
ultracentrifuge
|
|
|
1956 |
Dr. Ancel Keys, (Monsieur
Cholesterol!) links the fat composition of diet
to serum cholesterol level for the first time
"If
some developed countries can do without heart
attacks, why can't we?"
Click here for my report on this.
|
 |
|
1956 |
Dr. Paul Zoll publishes the
first report of the successful ending of
ventricular fibrillation in humans by
externally applied countershock.
|
|
| 1956 |
Forssmann, Cournand and Richards share the
Nobel Prize. Cournand states in his acceptance
speech "the cardiac
catheter was...the key in the lock." |
 |
| 1958 |
Mason Sones and his colleagues developed
selective coronary angiography |
Photo, courtesy of Angioplasty.Org |
| 1960 |
Hughes Day with support from
Dr. Gray Dimond established the first Coronary
Care Unit in Bethany, Kansas
|
|
| 1961 |
AHA
endorsed the so-called prudent diet for all
Americans
Click here for my report on this. |
 |
| 1961 |
The term "Risk Factor" is
used for the first time by William Kannel and
colleagues at the Framingham Study
Click here for my report on this.
|
|
| 1963 |
Kurt Amplatz further
developed an angiography technique
using a femoral approach made possible by the
Seldinger in 1953
|
|
| 1964 |
Charles T. Dotter performed
the first case of Transluminal Angioplasty. He
used coaxial catheters of increasing diameters
to "bougie" narrowed leg arteries in
patients with peripheral artery
disease, analogous to the Benique technique for
the urethra of 1846
|
Photo, courtesy of Angioplasty.Org  |
| 1964 |
The first coronary bypass was
performed by Edward Garrett and
colleagues
|
|
| 1966 |
Paris Constantinides
described fissuring of
atherosclerotic plaques leading to coronary
artery thrombosis
|
 |
| 1967 |
A
South African surgeon named Christiaan Barnard
performed the first human heart
transplant |
 |
| 1967 |
Fredrickson et al combined
paper electrophoresis, precipitation with
heparin sulfate, and preparative
ultracentrifugation to classify 5 clinical
disorders of lipoprotein metabolism based on
the classes of lipoproteins involved
|
|
| 1967 |
Transluminal Angioplasty was
imported into East Germany by
Porstmann and to West Germany by
Zeitler. Both performed hundreds of procedures,
and Zeitler introduced Gruentzig to
the technique
|
|
| 1967 |
Dr.
Rene Favaloro conducts the first saphenous vein
graft (bypass) surgery in Cleveland |
 |
| 1967 |
Introduction of the Judkins
Technique of coronary angiography
|
|
| 1968 |
Sen and colleagues, after
extensive experiments in animals, described
first transmyocardial revascularization through
transmural channels created with a 16-gauge
intravenous cannula
|
|
| 1973 |
Watanabe discovered a strain of mutant
rabbit (now called Watanabe-heritable
hyperlipidemic rabbit) with a consistently
inherited hyperlipidemic trait and inbreed
them. It became one of the first animal models
for atherosclerosis.
Click here for my report on this.
|
|
| 1974 |
Andreas Gruentzig
performed the first peripheral human balloon
angioplasty
|
|
| 1976 |
Gruentzig presented the results of animal
studies of coronary angioplasty at American
Heart Association meeting |
Photo, courtesy of Angioplasty.Org |
| 1976 |
Russell Ross published his response-to-injury
theory |
 |
| 1976 |
Bondjers and Hansson
elaborated on the role of immune system in
atherosclerosis and plaque formation
|
|
| 70s |
Ross, Fuster and others
showed the link between atherosclerosis and
coagulation system mainly platelet driven
growth factors
|
|
| 70s |
Willerson et al, postulated
that "an alteration in
atherosclerotic plaque morphology led to
platelet adhesion, thromboxane A2
accumulation, growth of thrombus and
dynamic vasoconstriction" and that this
sequence of events caused the
conversion from a stable to an unstable
coronary syndrome
|
|
| 1977 |
Ferid Murad showed that
nitroglycerin releases nitric oxide, which
relaxes smooth muscle cells. In 1980, Robert F
Furchgott, discovered EDRF and in 1986 Louis J
Ignarro showed EDRF to be identical to NO. This
series of discoveries culminated in 1998 Nobel
Prize in Physiology or Medicine.
|
 |
 |
 |
 |
| 1977 |
On September 16
Andreas Gruentzig at the University Hospital of
Zurich, Switzerland, inserted a catheter into a
patient's coronary artery and inflated a tiny
balloon, successfully opening a blockage and
restoring blood flow to a human heart. (The
first PTCA case)
|
|
| 1978 |
Attilio Maseri and his colleagues
demonstrated coronary vasospasm
angiographically in patients with unstable
coronary syndromes.
|
 |
| 1979 |
Peter Rentrop used
intracoronary infusion of streptokinase
|
|
| 1980 |
DeWood et al demonstrated angiographically
that patients with acute myocardial
infarction usually have
intracoronary thrombi
|
|
| 1981 |
Mirhoseini and Cayton used a
laser to create transmyocardial channels in
animals
|
|
| 1982 |
Over-the-wire coaxial balloon
systems introduced, brachial guiding catheters
and steerable guide wires were developed
|
|
| 1983 |
Hopkins and Williams published a list of
246 suggested coronary risk factors. The list
has grown into a much larger one by now,
depicting the mystery which researchers face
|
|
| 1983-5 |
Falk and Davies et al showed
at postmortem studies that patients
with unstable angina and myocardial infarction
almost always have atherosclerotic
plaque fissuring or ulceration
|
 |
|
1985 |
Michael S. Brown and Joseph
L. Goldstein were awarded the Nobel Prize in
Physiology or Medicine for their for their
landmark research detailing the
key role of the LDL receptor in
cholesterol metabolism and control.
|
 |
 |
|
1985 |
Palmaz and Schatz applied for a patent (granted
three years later) on their invention: Palmaz-Schatz
stent |
Photo, courtesy of Angioplasty.Org |
|
|
1986 |
Juan Badimon invented his
perfusion chamber
|
|
| 1986 |
Okada and colleagues used
laser to create transmyocardial channels in
humans
|
 |
| 1986 |
Simpson introduced coronary
atherectomy devices
|
|
| 1986 |
On March 28, Jacques Puel
implanted the first coronary stent
in a patient in Toulouse, France
|
 |
| 1987 |
Seymour Glagov introduced "remodeling
phenomenon".
"....We conclude that
human coronary arteries enlarge in relation to
plaque area and that functionally important
lumen stenosis may be delayed until the lesion
occupies 40 percent of the internal elastic
lamina area."
|
|
| 1988 |
The first
guidelines of the National Cholesterol
Education Program (NCEP) to educate both
patients and physicians on the importance of
treating hypercholesterolemia were published
Click here for my report on this.
|
 |
|
1988 |
Rotary ablation was conceived
by Auth and reduced to practice for
treating hard and calcified lesions
|
|
|
1988 |
Ambrose and Fuster,
William C. Little,
Haft and others suggested that myocardial
infarction frequently develops on lesions with
non-critical stenosis.
|
 |
| 1989 |
On the basis of
his studies of the triggers of acute
cardiovascular disease,
Muller et al described "atherosclerotic
plaques become vulnerable to rupture" 5
years later he coined the term of:
vulnerable plaque
|
 |
| 1989 |
Paul Yock and others
introduced IVUS for plaque characterization
|
 |
| 1990s |
Peter Libby showed series of
evidence correlating atherosclerosis with
active inflammation
|
 |
| 1991 |
Optical coherence tomography
(OCT) was described in
Science by D. Huang et al. Later, in 1996
Mark E Brezinski, James G. Fujimoto and
colleagues proposed it for optical biopsy of
vascular pathologies including atherosclerotic
plaques. This new technique is still growing
fast with many scientists working on it.
|
 |
| 1992 |
Jane L. Breslow and colleagues created
ApoE-deficient mice by homologous
recombination in ES cells. It was the first
mouse model developing human-like
atherosclerotic lesions.
Maeda, Zhang and colleagues also reported
similar findings.
|
 |
| 1994 |
Virmani et al provided
significant insight into underlying pathology
of sudden cardiac death in their autopsy
series. She introduced plaque erosion for the
first time later confirmed by
Basso and van der Wal. Fuster et al
documented that the lipid-rich core
was the most thrombogenic component
of the plaque and that it also expressed
intense tissue factor activity. Plaque rupture
came to the cardiology rounds.
|
 |
| 1994 |
Allard van der Wal and colleagues
demonstrated a direct link between coronary
plaque rupture or erosion and active
inflammation inside plaques.
|
|
| 1994 |
Liermann et al in Cologne,
Germany applied brachytherapy to peripheral
arteries
|
|
| 1994 |
Scandinavian Simvastatin Survival Study (4S)
showed remarkable improvement in survival of
CHD patients treated with Simvastatin. One of
the first evidences towards the
plaque-stabilizing effect of statins. Later it
was supported by the findings form
Long-Term Intervention with Pravastatin in
Ischaemic Disease (LIPID) in patients with
coronary heart disease and a broad range of
initial cholesterol levels, and
Cholesterol and Recurrent Events (CARE) in
patients with average cholesterol levels,
West of Scotland Coronary Prevention Study (WOSCOPS)
in men with hypercholesterolemia, and
Air Force/Texas Coronary Atherosclerosis
Prevention Study (FCAPS/TexCAPS) in men and
women with average cholesterol levels.
Click here for my report on this.
|
|
| 1995 |
PK Shah et all, suggested
macrophage infiltration in plaques may cause
plaque rupture by releasing matrix
metalloproteinases.
|
 |
| 1996 |
Ward
Casscells and James Willerson showed ex-vivo
that human carotid atherosclerotic
plaques have temperature heterogeneity and
plaques with thinner cap and higher macrophage
infiltration give off more heat. Two years
later Morteza Naghavi invented ThermoBasket
catheter and showed invivo temperature
heterogeneity in Hypercholestrolemic Dogs and
Watanabe Rabbits. Coincidentally Stefanadis et
al in 1999 confirmed significant temperature
heterogeneity invivo in patients with unstable
angina and acute MI. |
 
|
  |
| 1997 |
Condado et al from Caracas,
Venezuela used brachytherapy in
coronary angioplasty and published it in
Circulation |
 |
| 1997 |
Ridker and others have shown
consistent epidemiologic findings supporting
the role of inflammation in atherosclerosis.
|
|
|
1998 |
Paul Corso performed the
first beating-heart bypass surgery
|
|
| 1999 |
Fuster and colleagues reinforced earlier MRI
investigation of plaque for invivo non-invasive
detection of vulnerable plaque with large lipid
pool and thin fibrous caps.
|
 |
| 1999 |
Russel Ross published his last review in
NEJM titled: "Atherosclerosis: An
Inflammatory Disease"
|
 |
| 2000 |
June 26, a day to remember:
The Code is Cracked.
The entire human genome is mapped.
|
 |
| 2000 |
The British government issued
a recommendation that all coronary
lesions undergoing angioplasty be
stented for safety and cost reasons, if at all
feasible
|
|
| 2001 |
Zero
percent restenosis is reported by use of
sirolimus-eluting stents |
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References: |
|
| 1 |
King SB 3rd, Meier B.
Interventional treatment of
coronary heart disease and peripheral vascular
disease.
Circulation. 2000 Nov 14;102(20 Suppl):IV81-6. |
|
| 2 |
Theroux P, Willerson JT,
Armstrong PW
Progress in the treatment of
acute coronary syndromes : A 50-year
perspective (1950-2000).
Circulation. 2000 Nov 14;102(20 Suppl):IV2-IV13. |
|
| 3 |
Stapleton MP.
Sir James Black and propranolol.
The role of the basic sciences in the history
of cardiovascular pharmacology.
Tex Heart Inst J. 1997;24(4):336-42. |
|
| 4 |
Braunwald E.
Shattuck lecture--cardiovascular
medicine at the turn of the millennium:
triumphs, concerns, and opportunities.
N Engl J Med. 1997 Nov 6;337(19):1360-9. |
|
| 5 |
Frazier OH, March RJ, Horvath
KA
Transmyocardial
revascularization with a carbon dioxide laser
in patients with end-stage coronary artery
disease.
N Engl J Med 1999 Sep
30;341(14):1021-8 |
|
| 6 |
Labarthe D. Epidemiology and prevention of
cardiovascular diseases. Aspen, Maryland, 1998. |
|
| 7 |
Stephen Klaidman. Saving the heart: The battle
to conquer heart disease. OUP, Oxford, 2000 |
|
| 8 |
Valentin Fuster and Antonio M. Gotto, Jr. Risk
Reduction> Circulation 2000 102 [Suppl IV]:
IV-94 - IV-102. |
|
| 9 |
R. Wayne Alexander and Victor J.
Dzau.
Vascular Biology: The Past 50
Years. Circulation 2000 102 [Suppl IV]: IV-112
- IV-116. |
|
| 10 |
Fye B. A historical perspective
on atherosclerosis and coronary artery disease.
In Atherosclerosis and coronary artery disease,
Fuster et al, Lippincott-Raven Publ.,
Philadelphia 1996
(With permission from Dr. W.
Bruce Fye to use pictures from his personal
collection) |
|
| 11 |
Dahlerup. Society
Minutes. Ugeskrift for Læger
1844;10:214-218; translation from Danish by Dr.
Ole Faergeman, Aarhus Amtssygehus
University Hospital; personal correspondence
(report on the first description of plaque
rupture) |
|
| 12 |
National Library of Medicine |
|
| 13 |
ehac.chestpain.org |
|
| 14 |
www.ptca.org |
|
| 15 |
Hodgson J. A Treatise on the Diseases of
Arteries and Veins. T.
Underwood, 1815,pp.58,59,89. In: BOOK Hayden MR,
Tyagi SC. (1998), Chapter: 18
Atherosclerosis: Implications of Angiotensin
II and the AT-1 Receptor. AngiotensinII
Receptor Blocade: Physiological and Clinical
Implications. Dhalla N.S. Zahradka P. Dixion
I.M.C. Beamish R.E. eds. Kluwer Academic,
Publishers Boston Mass. Oct. 1998. (Courtesy of
Dr. M.R. (Pete) Hayden) |
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