It was an Oscar award-winning moment for the aorta recently as it was finally officially recognized by the medical community in the European Union and the United States as an independent human organ. As with any kind of public recognition, it has taken a bit of time for the aorta to recover from the excitement. A few weeks after the dust had settled, we sat down with the newly minted organ for a fireside chat.
How does it feel to finally be placed at the level of other major organs?
Aorta: Let’s face it. It was about time. I am thrilled to no longer have to jockey for position among my peers. Being called an organ places me on par with the brain, heart and lungs for the first time in history. If I weren’t the superhighway for the body’s oxygen-enriched blood to get, supporting the steadiness of the blood flow along its journey throughout the body, I’d get really excited just thinking about it. But I’ve got a job to do so I have to maintain a calm demeanor to ensure the blood flows smoothly.
How did this recognition come about?
Aorta: The recognition as a full-blown organ came after I was defined in the guidelines for aortic surgery treatments of the European Association for Cardiothoracic Surgery (EACTS) and the US Society of Thoracic Surgeons (STS), published in February 2024. That’s good news for patients who are combatting aortic diseases. I do my best to keep people healthy, but sometimes that’s hard.
How does being named an organ help patients?
Aorta: Look. You’ve got to know I am a massive blood vessel that runs from the heart’s left ventricle downwards to the pelvic area. Up until now, aortic disease treatment was either done in cardiac surgery or in vascular surgery, depending the disease type or where the disease is located. By getting promoted to the status of vital organ, I hope that this treatment becomes a separate specialty altogether, or at least in coordination with other specialties. A holistic view would help with, for instance, aortic rupture. And believe me when I say, I wouldn’t recommend a rupture to anyone. It’s a real drag.
Another final comments?
I finally feel seen as a whole. It’s about time I got the recognition I deserve as a vital organ that also makes sure the whole show keeps running in concert with the others. Although I am flattered to get so much attention, but to be honest, it’s not really about me at all. The main thing is that patients get the best possible treatment available.
Thank you for this conversation.
Aorta: It’s been a real blood pressure. I mean pleasure!
Maybe you have something to reveal about the aorta or other cardiology-related research. If yes, we would love to hear from you. Check out our journals Cardiology, Journal of Vascular Research and Pulse.
The aorta’s credentials are vast. Did you know…?
- Length: The aorta, extending about 30-40 centimeters from the heart to the abdomen, is the body’s longest artery.
- Diameter: Its diameter ranges from 2 to 3 centimeters in the ascending part and 1.5 to 2.5 centimeters in the descending part.
- Blood Volume: Holding around 50 to 75 milliliters of blood per cardiac cycle, it plays a crucial role in systemic circulation.
- Blood Flow: Carrying approximately 5 liters of blood per minute, it accounts for a significant portion of total cardiac output.
- Elasticity: Its elastic properties allow it to stretch and recoil, maintaining continuous blood flow despite changes in pressure.
- Pressure: Blood pressure within the aorta can reach up to 120-130 mmHg during systole.
- Oxygen Transport: It delivers oxygen-rich blood from the heart to various organs and tissues throughout the body.
- Cross-Sectional Area: Gradually decreasing from the ascending to the descending part, it facilitates smooth blood flow transition.
- Aging Effects: With age, the aorta may undergo changes like stiffening of arterial walls, increasing the risk of cardiovascular issues.
- Vital Function: Understanding the aorta’s structure and function is crucial for maintaining overall cardiovascular health.
Our thanks go to the official media release of the University of Freiburg that inspired this interview. For reference and for everybody who is interested we also link the official guidelines.
We recently had the opportunity to interview Dr. Heinrich Taegtmeyer, Professor of Medicine at McGovern Medical School, UTHealth, Houston. He is an Associate Editor of Cardiology since 1993, serving under three different editors. In 2021, Drs. Taegtmeyer and Atar initiated the section “Icons in Cardiology”, to reflect on major discoveries by investigators whose work in the past paved the way for the future.
Can you tell us about yourself? How did you become interested in cardiology?
I grew up in Germany during and after WWII as a child of a middle-class family. My grandfather was a physician, my father had studied forestry. My father had a strong influence on my interest in nature. Later on, my love for the basic sciences was kindled by two outstanding teachers in medical school at the University of Freiburg, one was Albrecht Fleckenstein (Physiology), and the other was Helmut Holzer (Biochemistry). To keep us students awake, they laced their lectures with anecdotes. Equipped with their lantern slides and a blackboard, our professors taught us more than facts. They also shared with us some of their latest discoveries, from calcium antagonists to protect the heart, to mitochondrial respiration to produce ATP.
You describe yourself as a physician-scientist. Can you explain why?
In his book “Science and the Quiet Art” (1996), the late Oxford hematologist, Sir David Weatherall, draws attention to the tension between science and the art of caring for patients. This tension is pervasive in academic medicine.
As a physician-scientist, I aim to improve the care and quality of life of patients afflicted with cardiometabolic disease, which includes diabetes, dyslipidemia, hypertension, and heart failure. While scientists are supposed to work in the lab, caring for patients as a scientist is another challenge. From my time as a medical resident until 50 years later (2021), my clinic has always been on Monday mornings. This, of course, is sheer luck. Since I entered medical school, I have considered it important to secure a solid clinical training before embarking on an equally solid training in research. In a way, the principles derived from basic research are directly applicable to treating patients. Witness the discovery of penicillin, of insulin, of adrenergic receptors to cite a few. One of those principles that arose from our work in the lab in recent years, is unloading the failing heart from metabolic stress. Witness also the success of bariatric surgery or the quiet revolution of gliflozins for the treatment of heart failure. I like the adage that today’s research becomes tomorrow’s principle in medical practice.
What challenges and developments do you foresee for the field of cardiac metabolism in the next few years?
A broad range of investigators in cardiac metabolism have prepared the ground for a paradigm shift in our understanding of heart disease, especially of heart failure. I would like to make three points. First, today we recognize that diabetes, heart disease, and cancer, all have deep roots in metabolism. In fact, metabolic remodeling precedes, initiates, and sustains functional and structural remodeling. Secondly, we also recognize the two branches of metabolism that crossover at many points: the catabolic branch, which generates ATP (an organic compound that provides energy) from the oxidative metabolism of fuels, and the anabolic branch, which makes and renews all the structural elements of the heart, and which uses ATP in this process. Simply said: The heart is a self-renewing engine which converts chemical energy into mechanical energy. A fascinating concept. Third, the current wave of obesity, type 2 diabetes, hypertension, and heart failure have made us all aware of metabolic stress as the main driver of premature death and disability from heart disease.
Can you elaborate?
Many investigators today are taking a more holistic approach to cardiac metabolism. They have moved from a single molecule, like cholesterol, to much broader concepts, like unloading the heart from neurohumoral or metabolic stress- which I have already mentioned.
In short, we are living in exciting times, in which paradigm shifts are imminent. The question is: Are our minds prepared to see those paradigm shifts? As the famous biochemist Albert Szent-Györgyi (1893-1986) is supposed to have said: “Discovery means seeing what everyone sees and thinking what no one thinks”. This, I think, is the main reason for the “Icons in Cardiology” section.
In 2021 you have initiated the section “Icons in Cardiology” in the Cardiology. What led you to think of such a project?
The academic environment has changed considerably during the last 50 years. It is worth the effort to preserve the unity of research, patient care, and teaching, and this is one of the purposes of the “Icons in Cardiology” section.
Also, as mentioned before, I believe that learning from the minds and lives of the giants on whose shoulders we stand will help us identify those concepts which are of lasting value, avoiding reinventing the wheel on ‘re-discoveries’.
In cardiology, we are very fortunate to have had leaders with creative minds, like Rudolf Virchow and Sir William Osler in the 19th century, Einthoven, Langendorff, Forssmann in the 20th century, and all the “icons” whose ingenuity we plan to present in this new section.
Thinking beyond the cardiology subject field, what do you think is the role of medical history in current clinical research and practice?
In my postgraduate career, I had the good fortune to meet some of the exceptional scientists. A common trait among them was that they dared to be different at a critical time in their lives. To name a few, Hans Krebs, Hermann (Hugh) Blaschko, Richard Bing, and many others who were out of their jobs when the Nazis ascended to power in Germany. When they no longer felt welcome at home, they moved abroad and flourished in their careers in science. Another person who dared to be different was a surgical resident, Werner Forssmann, who performed the first cardiac catheterization on himself – and lost his job over it. “You can do those little tricks in a circus, but not in a respectable academic department”, the chairman said at his dismissal. Forty years later, this story was told to me by Dr. Max Fischbach in Boston who was present when it happened. Forssmann was awarded the Nobel Prize in Physiology in 1956, together with André Cournand and Dickinson Richards. Another one of my heroes is Helen Taussig, who overcame many obstacles in her training and professional career as the world’s first pediatric cardiologist, and later on, led a successful campaign to stem the tide of thalidomide-induced birth defects – all by her own initiative.
By learning about the lives of ‘Icons’ we hope it may be possible to identify the traits that characterize the courage of ‘great minds’ and use this knowledge when searching for a great mentor.
Thank you very much for this interesting interview!
Check out Prof. Taegtmeyer’s tips on how to succeed in academia.