Author + information
- Received September 5, 2012
- Revision received November 6, 2012
- Accepted November 8, 2012
- Published online February 26, 2013.
- Berndt Lüderitz, MD⁎ (, )
- David R. Holmes Jr, MD and
- John Harold, MD
- ↵⁎Reprint requests and correspondence:
Dr. Berndt Lüderitz, University of Bonn, Department of Medicine and Cardiology, Sigmund-Freud-Strasse 25, D-53105 Bonn, Germany
This report is based on the lecture “History and Future of ACC and the German Cardiac Society: Common Roots, Common Future,” presented at the 78th Annual Meeting of the German Cardiac Society (in joint session with the American College of Cardiology), April 12, 2012.
The German Cardiac Society is the oldest national cardiac society in Europe, founded on June 3, 1927, in Bad Nauheim by Dr. Bruno Kisch and Professor Arthur Weber. They were actively supported by Dr. Franz Groedel, who together with Kisch became co-founders of the American College of Cardiology in 1949. Both Groedel and Kisch would be proud to see the fulfillment of their visions and dreams, which was commemorated at the joint session of the two societies held during the 78th annual meeting of the German Cardiac Society in Mannheim, Germany. “It is ironic that their dreadful years in Germany and their loss to German Cardiology helped to contribute to advances in American and international Cardiology,” said Dr. Simon Dack, American College of Cardiology president in 1956 and 1957. The legacy of Groedel might be reflected by his own words: “We will meet the future not merely by dreams but by concerned action and inextinguishable enthusiasm.”
Cardiology's medical and scientific task is and will remain as grand as the imagination, skills, and courage of those who are its advocates.
(Personal communication, 2003)The German Cardiac Society (GCS) was established on June 3, 1927, in Bad Nauheim, Germany, during an educational meeting for physicians focused on electrocardiography that had been organized by Professor Arthur Weber. At the end of the fifth seminar on cardiac arrhythmias, chaired by Weber, the new association was founded. Professor Bruno Kisch took the podium and told the participants that the founding of the German Society for Circulation Research was planned. He took for granted that the participants in a heart disease seminar would have the most interest for such a plan and that he, if no one objected, would declare the society founded with the agreement of the participants. The participants were so surprised by this announcement that no one thought of objecting. The whole process took under 3 minutes. Professor Kisch became the secretary general of the new society and held the first annual meeting in Bad Nauheim, at the location of the original electrocardiography meeting developed by Professor Weber. The German Society for Circulation Research, now the GCS, celebrated its 85th anniversary in 2012 (1). Today, the GCS is the second oldest cardiac society in the world after the American Heart Association. With more than 8,000 members, the GCS is also the second largest cardiac society in Europe.
Physicians interested in the heart and circulation at the beginning of the 20th century were classified as internal medicine specialists because cardiology had not yet evolved as a subspecialty. At this time, cardiology in Germany had not yet managed to form an independent society, unlike in the United States. The American Heart Association was established in 1925, as a union of a scientific society combined with a layman's orientation aimed at the general population and the prevention of heart and circulatory diseases. The term cardiology did not exist in Germany until the mid-20th century. Professor Rudolf Zuckermann was named professor of cardiology in 1962 at Martin Luther University in Halle/Saale (then in East Germany). The first chair of cardiology in West Germany was Professor Franz Loogen, who headed the Department of Cardiology at the University of Düsseldorf. From then on, the term cardiology became fixed, and people working in cardiology were referred to as cardiologists. Loogen became the first German president of the European Society of Cardiology in 1984. At the same time that Professor Loogen became chair in Düsseldorf, chairs of cardiology were also created in Munich and Bonn.
Professor Arthur Ernst Weber (1879 to 1975) was an internist who focused on heart disease and balneology (the treatment of diseases by bathing). He received his medical education in Marburg, Leipzig, and Greifswald and a doctorate in medicine in 1904. He was well known for his research in clinical electrocardiography, cardiac arrhythmias, radiography, and phonocardiography (Fig. 1). Weber worked for almost 60 years at his spa in Bad Nauheim and was renowned for treating patients with heart disease (2). He became a full professor of balneology and physical therapy at the University of Giessen in 1943 and is regarded as a founder of the first independent department of cardiology in Germany. Professor Weber published more than 150 scientific reports and books and received numerous honors and awards. A prestigious award of the GCS is named in his honor (3). In 1927, there was a controversy between a group of physicians in Vienna, Austria, and another group in the Netherlands concerning re-entrant tachycardia. Professor Weber invited all parties to Bad Nauheim to discuss the issues, but the invitation was refused. The transition from the Bad Nauheim electrocardiography meetings to a European cardiologic symposium was too great a divide, so Weber decided that Germany should form its own professional society to further circulation research (4).
Professor Bruno Zacharias Kisch (1890 to 1966), who worked at the Institute of Physiology, Biochemistry and Pathological Physiology in Cologne, Germany, played a pivotal role in the founding of the GCS with Professor Weber. Professor Kisch was also interested in heart disease and electrocardiography and was one of the main speakers at the Bad Nauheim meeting (Fig. 2). Kisch, who was Jewish, had to flee the Nazi regime and immigrated to New York in 1938. His mother and sister were killed just days later in a concentration camp. Kisch's own practice in New York expanded rapidly, and he developed an interest in electron microscopy of the heart and cardiac ultrastructure. He could find no journal willing to publish his work and thus founded his own journal, which was initially sponsored by a wealthy colleague.
The third key player in the creation of the GCS during the 1927 Bad Nauheim meeting was Professor Franz Maximilian Groedel (1881 to 1951). Groedel was a professor of radiology at the University of Frankfurt and a colleague of Kisch. Groedel was acknowledged as a pioneer in electrocardiography, cardiac radiology, and physical therapy. He received his medical degree from the University of Leipzig in 1904 and became an accomplished researcher and practitioner in cardiac radiology and clinical electrocardiography. By 1932, he had published nearly 300 scientific reports and was a full professor at the University of Frankfurt. He developed the concept of the unipolar chest lead or precordial electrode in the early 1930s. Groedel summarized 2 decades of electrocardiographic research in a book published in Germany in 1934 and in the United States in 1948 (Fig. 3). This book was used by a whole generation of physicians. Groedel theorized that each cardiac ventricle generated an independent or “partial” electrocardiogram, a finding that was later refused. Subsequent studies involved direct recording of electrocardiograms from the surface of the heart during surgery, particularly from the surface of the atria and ventricles.
Groedel headed a private rehabilitation clinic for heart patients in Bad Nauheim. He became a close friend of William G. Kerckhoff, an American millionaire of German origin from Chicago, who brought his family to the spa at Bad Nauheim. Groedel was subsequently given $4 million by the widow of Mr. Kerckhoff for the creation of a cardiology research center in Bad Nauheim, which became the Kerckhoff Institute. The local government made a matching gift of 1 million gold marks to support the new institute. This became the model for similar heart centers around the world. Groedel was appointed director of William G. Kerckhoff Herzforschungsinstitut, consisting of 3 departments: clinical, experimental, and epidemiological research (Fig. 4). One of the most important patients was U.S. president Theodore Roosevelt, who enjoyed visiting the spa in Bad Nauheim.
Although a Roman Catholic, Groedel was considered to be Jewish because of his mother's religious background. He fled Germany for the United States in 1933, when Adolf Hitler assumed power, and he became a well-established heart specialist on Park Avenue in New York City. He had a distinguished list of devoted patients and physicians who admired his work including President Franklin Delano Roosevelt, who, because of his polio, was interested in the spa system. Although Groedel was asked to create a spa in Saratoga Springs, New York, for political reasons relating to anti-Semitism, this idea never came to fruition (5). Groedel developed a relationship with Dr. Philip Reichert, a radiologist trained at Cornell University and the Rockefeller Institute. Reichert built Groedel an impressive apparatus to map the electrocardiogram from multiple sites on the chest wall, and this enabled his continued research on cardiac impulse conduction.
Groedel became active in the New York Cardiological Society and was named its president in 1945. Groedel, together with Kisch, created the American College of Cardiology (ACC) on November 28, 1949, a snowy Monday afternoon in New York City. Fourteen cardiovascular pioneers met in Groedel's office to form a revolutionary new professional society dedicated to the practicing physician. A group of trustees of the New York Cardiological Society who supported him became the founding trustees of the college. Groedel was elected president and Reichert secretary. Groedel gave up his clinical practice to devote all his time to recruiting membership for the fledgling new organization. All recognized and certified cardiologists were invited to apply for membership. In 1951, Groedel and Kisch were preparing for the first ACC annual meeting, planned for December. Groedel died after complications from a tragic accident on October 12, 1951, in New York City. He reportedly slipped and fell, hitting his head against the glass door of a bookcase. He remained semicomatose and confused, and his condition rapidly deteriorated over the next several days. Kisch succeeded him as president of the ACC, and the first annual meeting was a major success, with 275 attendees. Just a few short years later, in the late 1950s, ACC educational programs drew as many as 2,500 attendees, a tribute to the founders' plan. By 1951, the ACC had become an established and respected national professional organization, whose aims were to encourage and participate in the continuing education of physicians and surgeons and other scientists in fields related to cardiovascular disease. The subsequent growth and prestige of the ACC have fulfilled the visions and aspirations of Groedel and Kisch. In 1955, the ACC Board of Trustees established the prestigious Groedel Medal, a silver medal featuring a bas relief of Groedel (Fig. 5). The first recipient was Dr. John F. Fulton of Yale University, an outstanding medical historian who was the convocation lecturer at the fifth annual meeting in 1956.
Clinical practice, science, and education have been a major focus of both the GCS and the ACC, a tribute to the vision of the initial pioneers and founding fathers of both societies. This focus requires robust scientific communication. At the beginning of the 20th century, there were several early national and international journals dedicated to clinical and basic research on problems of the heart and circulatory disorders. These included Archives de Maladies du Coeur et des Vaisseaux, founded in 1907 in Paris; Zentralblatt für Herz- und Gefäβkrankheiten, published in Vienna for the first time in 1909 (beginning in 1927 Zeitschrift für Kreislaufforschung, then Zeitschrift für Kardiologie, and now Clinical Research in Cardiology); Heart, begun in London in 1910; and the American Heart Journal, founded in 1925. Kisch himself created the journal Experimental Medicine and Surgery in 1943. The American Journal of Cardiology had its origins in the Transactions of the American College of Cardiology beginning in 1951. These contained the reports presented at the annual meetings and news of the educational activities of the college. Kisch was the first editor and was succeeded by Dr. Simon Dack in 1954. During Dack's term as ACC president, the American Journal of Cardiology was founded by the college as its official journal, and Dack was made editor-in-chief. The official journal continues to this day, now known as the Journal of the American College of Cardiology.
The shared legacies of science and education and practice as well as the shared founders of both the GCS and the ACC continue to the present time and beyond. The German vision and approach to practice and research and education was transferred to the ACC and resulted in objectives that were nearly identical between the 2 societies (Table 1). The circle is in many ways now complete, in that Germans brought the vision to begin and grow the ACC, and now the ACC grows internationally, with a German chapter as well as other international partners (Table 1).
Dr. Simon Dack (ACC president, 1956 to 1957; editor-in-chief of the American Journal of Cardiology, 1958 to 1982; and editor-in-chief of the Journal of the American College of Cardiology, 1983) wrote, “Both Franz Groedel and Bruno Kisch (see Fig. 6) as well as Philip Reichert would be very proud if they were alive to see the fulfillment of their visions and dreams that led to the birth of the College in 1949—it is ironic that their ‘dreadful years in Germany' and their loss to German Cardiology helped to contribute to advances in American and International cardiology” (6).
Finally, Franz Groedel expressed the motto for the annual ACC meeting 2012 in Chicago with a quotation shown in all conference rooms at the meeting: “We will meet the future not merely by dreams but by concerned action and inextinguishable enthusiasm” (Fig. 7).
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Abbreviations and Acronyms
- American College of Cardiology
- German Cardiac Society
- Received September 5, 2012.
- Revision received November 6, 2012.
- Accepted November 8, 2012.
- American College of Cardiology Foundation
- Lüderitz B.,
- Arnold G.
- Fye W.B.
- Lüderitz B.
- Arnold G.
- Arnold G.
- Schlepper M.,
- Dack S.