Two Ways to Make Great Contributions

Abstract

This commentary is about 2 investigators, Robert Furchgott and Stanton Glantz, who have written some of the most highly cited articles in Circulation Research . Furchgott and Glantz changed our scientific world and our society. As I read the list of most highly cited articles in the 60 years of publication of Circulation Research , 2 stories came to mind. The first story is of a great discovery, and the second is of a great contribution to reduction of cardiovascular disease. First is Robert Furchgott’s finding that endothelium is critical in normal vasomotor function of arteries. His finding was followed by a series of studies that demonstrated the importance of endothelial dysfunction in atherosclerosis, hypertension, and other diseases. Second is a story about Stanton Glantz, who made major contributions to our understanding of ventricular diastolic function, which foreshadowed our understanding of diastolic heart failure. However, for me, the truly inspiring story is how Glantz successfully challenged the tobacco industry, with enormous consequences for cardiovascular health. Furchgott’s1 Brief Review, which is the article in Circulation Research with the third greatest number of citations, begins in his modest, understated manner: “A few years ago, we discovered that the relaxation by acetycholine of isolated preparations of arteries is strictly dependent on the presence of endothelial cells.” Several years before the Brief Review was published, Paul Vanhoutte had invited Furchgott to a small meeting to talk about his finding, which had been presented as an abstract. I talked with Furchgott, and thought that his finding was interesting, but not likely to be of great importance. I reasoned that there is not much acetylcholine in blood vessels, or in blood to which endothelium is exposed and, therefore, it was not likely that this vasorelaxing effect of acetylcholine in the aorta ex vivo was of …