The Heart of Duke
When Duke University Hospital opened in 1930, heart disease was nearly untreatable — physicians had few options for heart attacks, little understanding of cardiac electrical activity, and no way to replace failing hearts.
Duke’s standing in cardiovascular medicine is reflected in the national leadership roles faculty are elected to serve. Manesh Patel, MD, HS’97-’06, chief of the Duke Division of Cardiology and the Richard Sean Stack, MD, Distinguished Professor, is the 2026 president of the American Heart Association, and he will be succeeded in 2027 by Svati H. Shah, MD, HS’01-05, MHS’05, associate dean for translational research, and the Ursula Geller Distinguished Professor of Research in Cardiovascular Diseases. Professor Sana Al-Khatib, MD, HS’93-’00, is president of the national Heart Rhythm Society.
“I hope when people hear the term Duke Heart, they know the caring that goes into the way we think about improving your cardiovascular health and our community's cardiovascular health,” said Patel. “That's bringing the best knowledge and science we have to you.”
Data Over Dogma
Duke's leadership in cardiovascular innovation rests on a decades-old culture Shah describes as “data over dogma.”
Beginning in the 1940s with longtime Department of Medicine Chair Eugene Stead, MD’s emphasis on rigorous evidence, Duke rejected anecdote-driven medicine in favor of disciplined data collection and analysis, which eventually gave rise to the Duke Databank for Cardiovascular Disease and later Duke Clinical Research Institute (DCRI).
As cardiology pioneer, DCRI founder and recent FDA Commissioner Robert M. Califf, BS’73, MD’78, HS’78, HS’80-’83, put it, Duke's leadership comes from a culture built on ideas, evidence, and a mission-driven global network of Duke-trained alumni he calls “the Duke Marines.”
“It is the belief that you can fundamentally change how medicine is practiced, not just do it well,” Califf said. While much of medicine has grown more risk-averse, he added, Duke has held onto that “original spark.”
Stead spent two decades recruiting an entire generation of physician leaders. Joining him in 1964 was heart surgeon David Sabiston Jr., MD, who built an extraordinary international career, training 41 academic division chiefs and department chairs nationwide.
Rewriting the Rules
By the late 1960s, Duke was rewriting the rules of heart care. John Boineau, MD’59, and Andrew Wallace, MD’59, HS’59-’61, HS’63-’64, showed that Wolff-Parkinson-White syndrome could be treated surgically, and in 1968 Will Sealy, MD, HS’36-’37, HS’41-’42, performed the world's first successful surgical ablation of the condition — launching arrhythmia surgery as a field and making Duke a global hub for electrophysiology training.
Joseph Kisslo, MD, and Olaf von Ramm, PhD’73, revolutionized echocardiography techniques, Stead pushed to computerize patient data, and Wallace secured National Institutes of Health funding for coronary care monitoring units. In 1976 that effort became the Duke Databank for Cardiovascular Disease — the first large-scale system to track patient outcomes.
Building Momentum
Duke’s momentum grew through the 1980s and '90s as Califf transformed DCRI into the world's largest academic clinical research organization. In 1985, Andrew Wechsler, MD, HS’68-’74, performed North Carolina's first heart transplant, launching programs later expanded under Joseph Rogers, MD, and Carmelo Milano, HS’90-’92, HS’94-’99.
In 1987, with the visionary insight of Joseph Greenfield, MD, HS’56-’59, Duke Heart was organized by anesthesiologist Jerry Reves, MD, cardiologist Thomas Bashore, MD, HS’75-’77, and surgeon Robert Jones, MD, HS’65-’66, HS’68-’75, aligning the clinical enterprises and greatly expanding Duke’s reach in both clinical care and research.
In 2012, cardiologist Robert J. Lefkowitz, MD, along with former Duke fellow Brian Kobilka, MD, HS’84-’87, received the Nobel Prize in Chemistry based on their cellular signaling work that reshaped cardiovascular therapeutics worldwide — becoming the basis of a many FDA approved small molecule therapies.
Innovation Built on Collaboration
Today, Duke’s cardiovascular leadership is built on close collaboration across cardiology, surgery, imaging, genetics, data science, and other disciplines.
This culture has produced the nation's first adult and pediatric heart transplants using donation after circulatory death, the first U.S. implantation of a next-generation artificial heart, the world’s first partial heart transplant, and the world's first combined heart-and-thymus transplant.
Milano, chief of the Division of Cardiovascular and Thoracic Surgery, has helped build one of the world's leading transplant programs: more than 2,000 heart transplants, among the shortest wait times in the country, care for over 1,500 LVAD patients, and a leadership role in donation- after-cardiac-death transplantation. “This is an environment in which, if there is a problem that does not have a good solution, we have a culture of wanting to find and do clinical trials with novel approaches which may help improve outcomes,” he said.
Looking Forward: Prevention and Precision
Cardiovascular disease remains the leading cause of death in the U.S. Duke's determination to meet this challenge increasingly lies in precision and prevention.
Shah, who leads the OneDukeGen initiative, is advancing efforts to combine genomics, biomarkers, imaging, and advanced technologies to predict risk and tailor treatment. Patel describes a parallel push on prevention, from cardiometabolic research involving GLP-1 therapies to AI tools that detect subtle signs of heart dysfunction in imaging.
As Duke enters its second century, the question of how to turn the tide on cardiovascular disease remains at the heart of its mission. Patel said Duke, with a culture long tailored to answer that question, is poised to make the advances that will shape the field in the years ahead.
“I can think of no other group of people I would want to be around than my colleagues at the AHA and at Duke University to think about how we do this better,” Patel said.