Professor André Jouve (1909-2001): A French cardiologist who was a pioneer of clinical vector-electrocardiography and cardiovascular epidemiology.

André, Julien, Auguste Jouve was born in Marseilles on June 10, 1909 son of Xavier Marie Francois Louis Jouve MD and Marie Louise Charlotte Vigliengo his wife. He had a brilliant medical career in Marseilles: Resident at Marseilles Hospitals in 1931, major of his promotion, then an Assistant in 1943 and a Chief in 1951, to become Associate Professor of Medicine in 1946 and finally Full Professor of Clinical and Experimental Cardiology in 1954. Fellow of several Cardiological Societies, he became President of the French Society of Cardiology in 1968, Vice-President of the European Society of Cardiology in 1972 and finally President of the French College of Vascular Pathology in 1973. He had been a WHO Expert for degenerative and cardiovascular diseases from 1958 to 1981 and a National correspondent of the Academy of Medicine in 1977. He was decorated by the Légion d'Honneur (Officer in 1975). He retired in 1981 and died in 2001. Clinical vector-electrocardiology and cardiovascular epidemiology were the main areas of his interest where he made essential contributions such as the famous treatise on ECG. The Heart Cantini Center was considered his leading creation and action, where the first French heart transplantation was performed in 1968, the first French epidemiological investigation on coronary risk factors took place, the idea of starting prevention at pediatric age was clearly outlined and the need of concentrating on psychological and dysmetabolic factors was precisely advocated for indexing later development of ischemic heart diseases. These achievements are reviewed and put into perspective.

Professor Herman Burger (1893-1965), eminent teacher and scientist, who laid the theoretical foundations of vectorcardiography--and electrocardiography.

Einthoven not only designed a high quality instrument, the string galvanometer, for recording the ECG, he also shaped the conceptual framework to understand it. He reduced the body to an equilateral triangle and the cardiac electric activity to a dipole, represented by an arrow (i.e. a vector) in the triangle's center. Up to the present day the interpretation of the ECG is based on the model of a dipole vector being projected on the various leads. The model is practical but intuitive, not physically founded. Burger analysed the relation between heart vector and leads according to the principles of physics. It then follows that an ECG lead must be treated as a vector (lead vector) and that the lead voltage is not simply proportional to the projection of the vector on the lead, but must be multiplied by the value (length) of the lead vector, the lead strength. Anatomical lead axis and electrical lead axis are different entities and the anatomical body space must be distinguished from electrical space. Appreciation of these underlying physical principles should contribute to a better understanding of the ECG. The development of these principles by Burger is described, together with some personal notes and a sketch of the personality of this pioneer of medical physics.

[Contributions of the Mexican electrovectorcardiography]. / Contribuciones de la electrovectocardiografía mexicana.

We narrate the main stages of the long journey that led to the structuring of modern electrovectorcardiography based on the fundamentals established by Willem Einthoven (1860-1927), who held the physiology chair of the Leyden University (The Netherlands), and presented his string electrocardiograph in 1901. The Mexican electrovectorcardiography became strong thanks to the endeavor of Dr. Demetrio Sodi Pallares, a disciple of F.N. Wilson of Ann Arbor. Dr. Sodi Pallares founded the Mexican School of Electrovectorcardiography, which was a cornerstone in the field and was widely recognized internationally for several decades. This fact is due to the rational and not empirical approach to the electrical exploration of the heart, thanks to the application of the inductive-deductive Galilean procedure. It was then possible to obtain these results, through the study of myocardial depolarization and repolarization processes, under normal conditions and with bundle branch block, performed by Dr. Gustavo A. Medrano and collaborators, in the 1950 decade. The electrovectorcardiographic manifestations of the non complicated myocardial infarct were the object of studies, as well as those of the infarction complicated with rhythm and conduction disorders. Likewise, proximal and distal or peripheral blocks were studied. The current disciples of that School are now studying of cardiac arrhythmias with promising results.

A hundred years of progress in electrocardiography. 2: The rise and decline of vectorcardiography.

Throughout the 20th century electrocardiography has been almost exclusively preoccupied by the single dipole concept as a model to account for body surface manifestations of cardiac electrical activity. Vectorcardiography, based on the single dipole approximation as an equivalent cardiac generator, has prevailed for over one half of this century as one of the most prominent components of electrocardiographic research. In retrospect, vectorcardiography has had conceptually an important impact on the progress in electrocardiography although it never became widely used in clinical practice. Recent comparative studies have confirmed that the diagnostic information contents of the standard 12-lead electrocardiogram and the vectorcardiogram are practically identical if adequately powerful, identical diagnostic classification procedures are used in extracting diagnostic information. After serving a useful role as a conceptual model, vectorcardiography is gradually fading away, being replaced by more realistic cardiac source models and by body surface leads supplementing in a better way the information content of the standard ECG leads.

[An overview of the history of electro-vectorcardiography. Tribute to the memory of the unforgettable Dr. Gustavo A. Medrano Castro]. / Un excursus en la historia de la electrovectocardiografía. Homenaje a la memoria del inolvidable Dr. Gustavo A. Medrano Castro.

The history of the investigations about of the so-called irritability of animal tissues showed by English physician Francis Glisson in the 17th century, is summarized. During the 18th century, reliable studies on the bioelectric properties of these tissues began, due to the Swiss scientist Albrecht von Haller and continuated by the Italian naturalist Felice Fontana. In the second half of this century, multiple controversies of the partisans of the animal electricity against the partisans of the contact electricity took place. The Danish scientist Oersted in 1820 proved the close relation of magnetism to electricity, which led to construction of electrometers. These instruments allowed to register and measure record of the electric current. On this way, at middle 21st century, the true animal electricity was identified as the injury current. Later it was possible to record the electric current, risen in the myocardium, out the thorax first by means of the Lippmann' capillary electrometer and later thanks to the Einthoven's string galvanometer at the beginning of the 20th century. So the modern electro-vectorcardiography took off, due to English Thomas Lewis, the North-American Frank N. Wilson and the Mexican Demetrio Sodi Pallares. The last one allowed to rationalize the electro-vectorcardiographic exploration on experimental bases.

Contribuciones de la electrovectocardiografía mexicana / Contributions of the Mexican electrovectorcardiography

Se relatan las etapas principales del largo camino que llevó a la estructuración de la electrovectocardiografía moderna a partir de las bases establecidas por Willem Einthoven (1860-1927), catedrático de fisiología en la Universidad de Leyden (Holanda), quien presentó su electrocardiógrafo de cuerda en 1901, tiempo en que se llegó a asentarse la electrovectocardiografía mexicana gracias a los desvelos del Dr. Demetrio Sodi Pallares, discípulo de F.N. Wilson en Ann Arbor. El Dr. Sodi creó la Escuela Mexicana, la cual tuvo primacía en dicho campo y fue reconocida internacionalmente durante algunas décadas. Tal hecho se debe al enfoque racional y no empírico de la exploración eléctrica del corazón, gracias a la aplicación del procedimiento galileano de carácter inductivodeductivo. Allí fue posible llegar a través del estudio de los procesos de despolarización y repolarización miocárdicas, en condiciones normales y con bloqueo de rama, realizado por el Dr. Gustavo A. Medrano y sus colaboradores. En la década de 1950, se estudiaron las manifestaciones electrovectocardiográficas del infarto miocárdico no complicado y complicado por trastornos del ritmo y de la conducción, así como de los bloqueos proximales o tronculares y distales o periféricos. Los discípulos actuales de dicha Escuela se ocupan ahora de problemas de arritmología cardiaca con resultados muy prometedores.

We narrate the main stages of the long journey that led to the structuring of modern electrovectorcardiography based on the fundamentals established by Willem Einthoven (1860-1927), who held the physiology chair of the Leyden University (The Netherlands), and presented his string electrocardiograph in 1901. The Mexican electrovectorcardiography became strong thanks to the endeavor of Dr. Demetrio Sodi Pallares, a disciple of F.N. Wilson of Ann Arbor. Dr. Sodi Pallares founded the Mexican School of Electrovectorcardiography, which was a cornerstone in the field and was widely recognized internationally for several decades. This fact is due to the rational and not empirical approach to the electrical exploration of the heart, thanks to the application of the inductive-deductive Galilean procedure. It was then possible to obtain these results, through the study of myocardial depolarization and repolarization processes, under normal conditions and with bundle branch block, performed by Dr. Gustavo A. Medrano and collaborators, in the 1950 decade. The electrovectorcardiographic manifestations of the non complicated myocardial infarct were the object of studies, as well as those of the infarction complicated with rhythm and conduction disorders. Likewise, proximal and distal or peripheral blocks were studied. The current disciples of that School are now studying of cardiac arrhythmias with promising results.