The excerpt from the speech of Rostislav S. Karpov ‘50 years in Medicine’ at the opening ceremony of the Reported Scientific Session of Cardiology Research Institute in 2007 reads as follows:
‘In October, 1979, the Ministry of Health of the USSR issued the regulation signed by a Minister B. V. Petrovsky on ‘Establishing a Branch of the All-Union Cardiology Research Center of the Academy of Medical Sciences of the USSR in Tomsk’. It was not that easy. Enormous organizational work under supervision of A. I. Potapov preceded this event. Other Siberian cities competed for this and also had Cardiology schools like in Irkutsk (K. R. Sedov), Novosibirsk (Yu. P. Nikitin), Novokuznetsk (G. A. Goldberg), and Omsk (V. M. Yakovlev).
This event was facilitated not only by a seminal standing of the Tomsk scientific and clinical school, but also, without a doubt, by an active stand of E. K. Ligachev who personally met and discussed this question with the President of the Academy of Medical Sciences of the USSR N. N. Blokhin and with the Director of the All-Union Cardiology Research Center E. I. Chazov. In June, 1979, on behalf of E. I. Chazov, a delegation of highly respected cardiologists came: I. K. Shkhvatsabaya (Full Member of the Academy, Director of Cardiology Institute n.a. A. L. Myasnikov) and R. G. Oganov (rising Full Member of the Academy, Secretary of the All-Union Cardiology Research Center). They visited the main therapeutic departments of the Tomsk Medical Institute including Department of the Intermediate Level Therapy. They also met all possible applicants for scientific management of the branches. V. V. Pekarsky and I presented our joint studies in rheumatic diseases, valvular heart diseases, and cardiac pacing. Closing meeting occurred in a welcoming friendly atmosphere during out-of-town trip by holiday cruiser where, besides the guests, A. I. Potapov, V. V. Pekarsky, and I were also present.
After that, everyday life with tireless efforts began. All general organizational questions were handled by A. I. Potapov and V. M. Zhukov who was appointed to the position of future Deputy for General Affairs. V. I. Polyakov was invited to serve as Chief Physician of Clinic and was followed by V. K. Mashukov 1.5 year after. I was given a task to build a team of medical doctors and scientists and to direct research studies of the branch. At first, I was doing pro-bono work. Our headquarter was located in the main building of the Siberian Branch of the All-Union Oncology Research Center of the Academy of Medical Sciences of the USSR (5 Kooperativny Ln.) where the applicants were hired every week.
The core of future leaders was created for the subdivisions of the branch: V. V. Pekarsky, Ya. S. Vasiltsev, I. Yu. Stuks, and I. F. Levitsky). To attract financing and personnel at that time, the topic of scientific research had to be approved at the Committee for Science and Technology of the USSR. Then, we chose the most relevant topic consistent with the requirements of the Committee for Science and Technology of the USSR: ‘To develop and implement the method and specialized device for one-step delivery of cardiac pacing and artificial circulatory support with intra-aortic balloon pump in the clinics of the All-Union Cardiology Research Center of the Academy of Medical Sciences of the USSR in Tomsk’. To solve this task, the branch was given 50 positions in staffing schedule for science. Staffing schedule for clinic was given by the Ministry of Health of the USSR according to the accepted practices. Business trips to Moscow and the meetings with the supervisors and scientists of the lead agency began. It has to be said that these were well known scientists-cardiologists who were always ready to help colleagues: V. S. Gasilin, I. K. Shkhvatsabaya, R. G. Oganov, M. Ya. Ruda, N. M. Mukharlyamov, A. S. Smetnev, M. A. Akhmetelli, B. A. Sidorenko, and others). During the entire period of joint work, V. V. Gromyko gave a helping hand. He was Deputy of E. I. Chazov and an outstanding administrator and economic person. In the time following, Vasily Vasilievich successfully worked as Deputy President of the Academy of Medical Sciences of the USSR and Deputy Minister of the Ministry of Health of the USSR.
Structure of the branch, in miniature, resembled the structure of the lead institution. Instead of departments, divisions were planned: Division of Theoretical (Experimental) Cardiology, Department of Clinical Cardiology (with clinic for 200 beds), and Department of Preventive Cardiology. To supervise departments and laboratories and as scientific fellows, the young and bright scientists were invited: V. V. Pekarsky, Ya. S. Vasiltsev, E. F. Levitsky, V. A. Markov, E. O. Gimrikh, V. I. Kun, V. F. Mordovin, A. T. Teplyakov, V. A. Dudko, I. V. Lobova, A. P. Vasiliev, A. A. Sokolov, N. V. Kanskaya, N. P. Larionov, V. D. Slepushkin, Yu. B. Lishmanov, B. I. Laptev, D. P. Dremov, S. V. Taranov, G. K. Zoloev, V. I. Turchinsky, I. N. Konobeevskaya, and others.
Also, the main directions were formed gradually as follows:
- integrated fundamental studies to elucidate the mechanisms of onset and development of cardiovascular diseases
- studies of the patterns of the development and incidence of cardiovascular diseases in Siberia and Far East
- the development of the efficacious methods for prevention, early diagnosis, treatment, and rehabilitation of cardiovascular diseases
- the development of new organizational forms for prevention and periodic health examination for people living in Siberia and Far East
Official opening of the Siberian Branch of the Cardiology Research Center in Tomsk was held on June 13, 1980. The solemn ceremony of the opening occurred with the participation of the Vice Chairman of the Council of Ministers of the RSFSR L. P. Lykova, Minister of Health of the RSFSR V. V. Trofimov, and the First Secretary of the Oblast Committee of the Communist Party E. K. Ligachev.
On the eve, the first patients were admitted to the Department of Hypertension. Therefore, the guests were getting acquainted with already functioning clinic. It was a very solemn event. Auditorium was decorated with the portraits of the outstanding representatives of Tomsk Scientific School: M. G. Kurlov, A. A. Kulyabko, N. V. Vershinin, and A. I. Nesterov.
The parallel was unintentionally symbolic. In 1880, Tomsk Imperial University, the first higher educational establishment in the east of the Russian Empire, was founded. Exactly 100 years after that, the academic scientific medical center in Tomsk was founded. Sure enough, we had a feeling of pride for the contemporaries and involvement in this historic event. At the same time, we understood the degree of responsibility. The task was set to do our best to preserve and develop remarkable traditions of Tomsk Science and Clinical School of M. G. Kurlov, D. D. Yablоkov, E. G. Salishchev, A. G. Savinykh, and other brilliant persons in Siberian Medicine. Those years were the beginning of high technological progress in cardiology. In diagnostics, angiography and echocardiography triumphally advanced; in treatment, we witnessed the success of thrombolytic therapy of myocardial infarction. It is well known that, in 1975, E. I. Chazov with colleagues performed intracoronary thrombolysis for the first time in the world; interventional arrhythmology was breaking new ground; surgery of coronary arteries was actively developing. In this regard, we assigned a mission to master and implement the main state-of-the-art technologies in cardiology. Without that, it was impossible to develop fundamental clinical studies. Besides, the branch was assigned with the task to be a head institution in cardiology in Siberia and Far East. Inquiries for hospitalization of patients from other regions and republics were received.
During the first year of work, main functional technologies were mastered, namely: modern stress tests, echocardiography, endocardial and transesophageal tests of atrial stimulation, electrophysiology studies with registration of intracardiac potentials including those from bundle of His, and programmed cardiac pacing. Less than for a half of a year, the building for angiography and radionuclide studies was built. It allowed to actively implement coronary ventriculography and to begin the development of endovascular surgery. At first, the method for intracoronary thrombolysis was implemented. Then, along with the technological progress, we implemented angioplasty (first of all, angioplasty of the renal arteries), stenting, and, at last, endovascular surgery of congenital heart diseases. The implementation of coronary angiography formed the foundation for promising scientific studies for diagnosis and treatment of myocardial infarction. In this direction, under my supervision, four dissertations for the degree of doctor of medical sciences were defended (V. A. Markov, I. V. Maksimov, A. N. Repin, and T. M. Poponina). Simultaneously, the fundamental studies on pharmacological regulation of calcium-dependent processes in myocardial ischemia and reperfusion began (N. P. Larionov, B. I. Laptev, S. A. Afanasiev). Together with clinicians (V. A. Markov, I. V. Maksimov, A. N. Repin), it allowed to propose new method for prevention of reperfusion complications after thrombolytic therapy with calmodulin inhibitors of phenothiazine class (chlorpromazine, phrenolon, and trifluoroperazine). It also allowed to develop an original method of bolus thrombolytic therapy; evidence suggested the superiority of systemic thrombolytic therapy at prehospital stage. As a result, in-hospital lethality from myocardial infarction decreased from 19% to 11%. The method was widely implemented in the region.
At the same time, further development of scientific research in Siberia required their coordination. The Chairman of the Presidium of the Siberian Branch of the Academy of Medical Sciences of the USSR, Full Member of the Academy of Medical Sciences Yu. I. Borodin proposed to develop an original science-and-practice program in Cardiology. As soon as in 1981, the program ‘To develop organizational and scientific methods for increase in the efficacy of cardiological service in Siberia and Far East (RONMAKS)’ was formed. Famous Siberian cardiologists, full members of the Academy of Medical Sciences of the USSR Yu. P. Nikitin and K. R. Sedov as well as Professors G. A. Goldberg and V. M. Yakovlev were involved in the program. The work was supervised by the organizational and methodological department of the All-Union Cardiology Research Center of the Academy of Medical Sciences of the USSR headed by Professor N. N. Bogdanov. The program was revised every five years and played a significant role in the consolidation of cardiology studies in the region as well as in the implementation of scientific discoveries in practical healthcare. At the same time, there was a remarkable tradition established by the Full Member of the Academy E. I. Chazov to hold research councils for cardiology in different cities of the USSR, mostly in the capitals of the union republics at the premises of cardiology institutes. I think it was a unique opportunity to exchange experience between the leading cardiology centers of the country. Due to this experience, we hosted the off-premise conferences in the cities of Siberia and Far East (Novokuznetsk, Kyzyl, Yakutsk, Ulan-Ude, Irkutsk, Omsk, Vladivostok, Khabarovsk, and Barnaul), which played an essential role in establishing and development of cardiology services in Siberia and Far East.
Comprehensive development of cardiology in the region required creation of a network of cardiologic dispensaries. In 1982, we proceeded to organize the first cardiology dispensary in the regions of Siberia and Far East in Tomsk at the premises of our branch. Being an experienced general internist and health administrator, Dr. N. D. Plotnikova PhD was assigned to lead it. She graduated from the postgraduate course under supervision of Full Member of Academy of Medical Sciences of the USSR D. D. Yablokov and worked as a chief internist of the Public Health Administration. The model of dispensary with a department for prevention and two registers (for myocardial infarction and heart rhythm disorders) was developed. To accommodate the dispensary, the building in downtown was provided. The opening of the dispensary occurred in 1983. For the following years, cardiology dispensaries were organized in Novosibirsk, Novokuznetsk, Barnaul, and Krasnoyarsk. The specifics of the regions of Siberia and Far East involves huge remote territories, extremely low density of population (on average 1.8 persons per square kilometer), inaccessibility, and isolation of residential areas including district and regional centers from each other, the absence of good routes of communication, and predominance of air and water transportation. All these challenges raised the question on search for special ways to implement the organization of specialized cardiological care in specific conditions of Siberia. The idea emerged to develop the model for mobile system of delivering specialized medical help and annual physical examinations of dispersed population. Considering specifics of the region where population historically concentrated along the banks of large river, we decided upon the model of waterborne cardiologic dispensaries with automatic system for examination, information processing, and data storage. For this purpose, the Ministry of Inland Navigation Fleet provided the motor vessel, which was reequipped in the Samusky Ship-Repair Yard according to a special project with active involvement of its Director V. V. Amosov. The development and implementation of the project were put under care of E. F. Levitsky who built the team of enthusiasts (A. A. Kashkan, P. I. Lukyanenok, I. A. Trubacheva, T. V. Ozhigova, S. M. Khlynin, A. N. Murovanniy, and others) and brilliantly accomplished the task. In 1985, the motor vessel “Cardiologist” took water and did its maiden trip in the Ob river basin within the Tomsk region. The motor vessel was equipped with state-of-the-art equipment (laboratory analyzer, cycloergometers, echocardiograph, and other devices). The project was presented in the panel of the Ministry of Health of the RSFSR, which approved it and issued the guidance manual. This original approach was later implemented in different regions of the country not only for waterborne, but also for the vehicular and railroad transport. In Tomsk, at the premises of the clinical hospital, the department of mobile specialized medical care was established.
In early 1980s, the period of large industrial exploration began in Siberia and, first of all, in the Tyumen region, which de facto became fuel and energy sector of the country. Considering the specifics of the territory, severe weather conditions, and common rotating schedule of work, the necessity to create cardiology research division emerged. We brought a proposal to organize the cardiology division of the Siberian Branch of the All-Union Research Center of the Academy of Sciences of the USSR in Nizhnevartovsk. The addressing this issue at the level of the Tyumen Oblast Committee of the Communist Party of the Soviet Union showed relevance of the creation of such a center in Tyumen. At first, it was formed as cardiology division of the Siberian Branch of the All-Union Research Center of the Academy of Sciences of the USSR. To organize it, Senior Research Fellow of the branch A. A. Buganov was dispatched.
In 1986, the branch was transformed into Cardiology Research Institute as a part of Tomsk Scientific Center of the Siberian Branch of the Russian Academy of Medical Sciences.
For over 30 years, Cardiology Research Institute has been serving as the leading institution to address cardiology issues in Siberia and Far East.
Starting from 1995, the institute has been actively involved in the implementation of the international prevention program CINDI (Countrywide Integrated Noncommunicable Disease Intervention) of the World Health Organization; the project CINDI-Tomsk was established (under supervision of R. S. Karpov) in a framework of CINDI Russia (director: R. G. Oganov). The program targeted the development and wide implementation of the efficacious and economically-justified methods of prevention of chronic non-infectious diseases and aimed at bridging the gap between the achievements of medical science and real-life health practices.
Currently, the distinctive feature of the institute is its high-tech care. All kinds of cardiovascular surgery, interventional radiology, and arrhythmology are available for adults and children starting from neonatal period. Many technologies have been implemented in clinical practice including endovascular closure of atrial septal defect and ductus arteriosus. Strong scientific and clinical bases as well as highly skilled professional community are the main competitive advantages of Cardiology Research Institute, which allows to perform unique in their sophistication surgeries based on the latest scientific discoveries.