With shock and disbelief, we learned that our colleague and dear friend Wolfgang Kiowski passed away. He had finished his daily work at the Klinik-in-Park in Zürich by implanting a cardiac defibrillator in a patient with severe heart disease. On his way home on his bike, he got a heart attack (ventricular fibrillation) and underwent resuscitation. Despite successful cardiac catheterization and opening of a clotted coronary artery, it was all too late to save his life and he died few days later.
Wolfgang Kiowski was born in Recklinghausen, Germany. He graduated from the Westphalia University Medical School in Münster, Germany in 1974, and in 1975 he defended his Doctor of Medicine thesis. After a year of internship, Professor Hans Losse recognized his talent and in 1976 secured for him a fellowship in the Hypertension Division of the University of Michigan Hospital in Ann Arbor, USA. In Ann Arbor, Wolfgang worked with Stevo Julius, Lennart Hansson, Murray Esler, O.T. Randall, M. Gary Nicholls, Andrew Zweifler, and other distinguished people in hypertension research. At that time, according to a summary by his mentor Professor Stevo Julius, contrary to findings in animals, lower body negative pressure studies suggested that in humans cardiopulmonary mechanoreceptors are not involved in renin release. It was possible that this dichotomy was attributable to the fact that lower body negative pressure chambers decreased also the intra-abdominal pressure which, in turn, could have affected renin regulating baroreceptors in the kidneys. Wolfgang found a way to avoid decreasing the intra-abdominal pressure. He serially connected a few narrow pediatric blood pressure cuffs, which could be wrapped around volunteer’s thighs. The inflation of cuffs pooled blood in the lower legs, decreased the right atrial pressure, and elicited a quick increase of plasma renin. Next, Wolfgang found 4 patients who had functioning renal transplants after bilateral nephrectomy and convinced them to participate in research. Cuff inflation in these patients with denervated kidney transplants did not increase renin levels. This proved that thigh cuff inflation elicited a reflex-mediated renin increase, and that thus in man cardiopulmonary mechanoreceptors exert a powerful reflex control of renin release. In 1978, Wolfgang’s article about these experiments was published in the prestigious Journal of Clinical Investigation.
In 1979, Professor Fritz Buhler recruited Wolfgang to the University Hospital in Basel, Switzerland. Over the next 13 years there, he completed residency in internal medicine, fellowship in cardiology, and became physician in charge of the coronary care unit of the University Hospital. In 1993, he became the director of heart failure and cardiac transplant program in the Division of Cardiology, University Hospital Zürich, Switzerland, and since 2002 he worked in the Cardiology Centre Zürich, which under his leadership became a premier unit for clinical cardiovascular care in Switzerland.
Further to the summary by Professor Stevo Julius, Wolfgang Kiowski published 224 articles. They reflect his interest in underlying mechanisms of human hypertension and its target organ consequences. He evaluated the importance of altered α-adrenergic vasoconstriction in various phases of hypertension and studied endothelial function in healthy men, hypertension, congestive heart failure, and myocardial infarction. In parallel, Wolfgang carefully and objectively evaluated various approaches to heart disease and cardiac transplantation. He studied the effect of anti-ischemic drugs in silent myocardial ischemia, the use of low level exercise in heart failure, and in several studies systematically studied the place of various endothelin antagonists for heart failure and cardiac transplantation.
Wolfgang was a brilliant clinician who served his patients until the last moment. This cannot better be described than by his younger colleague in Zurich, now Professor Dan Atar, who names it “Besonnenheit.” When working with the trainees in the catheter laboratory named after the legendary former chief Andreas Grüntzig and when dramatic situations occurred, Wolfgang always had the ability to diagnose the problem and find the right solution to save the patient.
Wolfgang was active in teaching and lecturing in his home country, around Europe, and globally, and he, over a long decade, served in the leadership of the European Society of Hypertension (ESH). He was instrumental in building the ESH organization by, over many years, taking on the important job of being treasurer and always securing a sound economy for the society. He organized and served as the president of the ESH Foundation anchored in Switzerland, out of which ESH was driven, and with this insight in economy he founded ESH Research Scholarships for young investigators. Wolfgang was active at ESH congresses and organizational activities, and he participated in the writing process of ESH position articles, including the successful hypertension guidelines issued by ESH and European Society of Cardiology. Over the years, we met him and his wife Monika; despite always being involved in research or educational activity, they generously shared their memories and showed photos from their latest family and sport adventures. Wolfgang travelled around the world with his sons Peter and Gregor; for him and his family, outdoor activity was a must and no distance was too long to get there, from surfing on the waves in Hawaii to exploring the mountains in Switzerland.
In a sudden and unexpected way, we have lost a colleague and good friend. On behalf of all officers and members of the European Society of Hypertension and other colleagues and friends who worked with Wolfgang Kiowski in Europe and in the USA, we express our sadness over this irreversible fact but also express our optimistic view that his research and discoveries have improved the treatment of hypertension to the benefit of many patients.
Sverre E. Kjeldsen
Past-President of the European Society of Hypertension
University of Oslo, Ullevaal Hospital
Past-President of the European Society of Hypertension
- © 2013 American Heart Association, Inc.