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(Circulation. 2004;110:3.)
© 2004 American Heart Association, Inc.

Editorial

The Eagle’s View, or How to Use This Journal

Joseph Loscalzo, MD, PhD

From Boston University School of Medicine, Mass.

Correspondence to Joseph Loscalzo, MD, PhD, Boston University School of Medicine, Circulation Editorial Office, 560 Harrison Ave, Suite 502, Boston, MA 02118. E-mail circ{at}bu.edu

Circulation has always held a special place in my continuing education. For me and for many of us, it is the venue to which we turn for the most cutting-edge observations to inform our clinical practice and guide our research efforts. As the practice of cardiology has grown more fragmented and its research underpinnings grown more complex, however, the breadth of information has expanded to overwhelm the capacity of most of us. In addition, with this expanding universe of cardiovascular knowledge, Circulation has adapted to an ever-wider audience. These changes have been challenging to address for a journal that prides itself on being all things to everyone in cardiovascular medicine and research.

When I began my career, cardiology was a specialty that one could understand broadly, and cardiologists were often, if not always, excellent generalists in both internal medicine and the subspecialty. Moreover, cardiovascular investigators were also broadly competent in, or at least understood, the essential techniques and experimental approaches of cardiovascular research. Like eagles, cardiologists and cardiovascular investigators soared above the landscape, scanning it for what was relevant to their needs as well as what stimulated their curiosity.

Subspecialization is a natural, if not inevitable, consequence of the evolution of scientific fields that incorporate increasingly complex technologies. Learning and maintaining proficiency in these technical skills require time and commitment, whether it be in the field of echocardiography or in proteomics. Since the founding of Circulation, the rate at which new knowledge is being generated and disseminated has become truly extraordinary. As a result, we in cardiology (let alone medicine in general) can no longer claim that understanding the entire field is possible. The time-consuming need to maintain technical competency and to follow the cutting-edge advancements of a very narrowly defined segment of the field limits one’s ability to keep up with the field broadly. Or does it?

Although I do not disagree with the need to maintain competency and focus on one’s specific area of expertise, I strongly disagree with the prevailing view that focus precludes broad understanding of a discipline, that there is simply too much to know, and that no one can hope to keep up with an entire field without sacrificing competency in a narrowly defined domain. There was a time during the Renaissance when, it has been said, a well-educated individual could know everything there was to know. Closer to the current era, Goethe was probably the last individual who could plausibly make such a claim. This is an obviously irrelevant goal for contemporary cardiologists and cardiovascular investigators, to be sure; however, it is possible to have at least a passing knowledge of the major scientific changes in a field that will influence practice. In fact, one can argue that as practitioners we must maintain this broad knowledge of our field to care for our patients optimally.

In my view, it is our job at the editorial office of Circulation to ensure that our readers are apprised of new scientific knowledge in cardiovascular medicine and biology and willingly avail themselves of the opportunity to acquire it, both within their own specific areas of expertise and beyond those areas of expertise. We remain mindful of the purpose for which the journal was founded, as stated more than 50 years ago by its first editor, H.M. Marvin: "Circulation, then, is addressed to all those interested in the cardiovascular system in health and disease—the research scientist, the specialist, the practicing physician."¹ We extend that purpose to encourage individuals who read the journal to keep up with the field broadly. Doing so can only enrich their practice, enhance their research, and deepen their understanding of this complex and exciting biomedical discipline.

The editorial staff of Circulation all strongly believe that our readers should be informed as fully as possible of the cutting-edge advances in the field, and we will make every effort to do so in an efficient and effective way. We will facilitate your continuing education broadly, regardless of your specific cardiovascular expertise. In an effort to pique your interest in the field’s advances and offer a quick reference tool for highlights, we will include brief summaries of the most important articles published each week—cutting-edge studies in basic, clinical, or epidemiological research–that either directly affect the practice of cardiovascular medicine or promise to do so in the near future. Furthermore, frequent reviews and summaries of important clinical and scientific observations related to clinical practice will fill these pages. Four new series—Contemporary Reviews in Cardiovascular Medicine, Basic Science for Clinicians, Controversies in Cardiovascular Medicine, and New Drugs and Technologies—will be published, each at least once per month, to meet this educational goal. In addition to these new series, we will continue Images in Cardiovascular Medicine and Clinician Update, as well as Book Reviews. We wish to appeal to all cardiovascular practitioners and investigators, recognizing that a broadly informed reader may appreciate unique associations not obvious to one not so informed. With these changes, we hope to encourage all of our readers to continue to soar, eagle like, above the cardiovascular landscape. We trust you will find the view stimulating.

Reference

1. Marvin HM. Foreword. Circulation. 1950; 1: 1.

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