Restenosis after Intervention with New Mechanical Devices
Restenosis after Intervention with New Mechanical Devices

Author: P.W. Serruys

Publisher: Springer Science & Business Media

Published: 2012-12-06

Total Pages: 500

ISBN-13: 940112650X

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From the Foreword by Eric J. Topol In the past five years, interventional cardiology has entered a new era of evaluating percutaneous transcatheter technologies to treat coronary artery disease and prevent restenosis. Cardiologists attempting to follow this new and exciting field may easily be confused by the growth and expansion of new devices, the technical details relevant to each device and enthusiastic claims of success. This monograph is a comprehensive and objective assessment of restenosis from the perspective of these new technologies including stenting, atherectomy, rotational abrasion and lasers, written by innovators and pioneers. The international breadth of experience is reflected in the summary of experiences from both sides of the Atlantic, at times with conflicting observations and results which in itself is valuable, given the diverse experience to date. In addition to the lucid summaries of the early and late results of these new devices, important issues in the methodology of restenosis research are addressed, including limitations of quantitative coronary arteriography in evaluating the new devices and important advances in alternatives to arteriography such as intravascular imaging. As a whole, this monograph is exceptionally worthwhile owing to its complete, up-to-date, balanced and visionary elements. There is no question that the new coronary device era has ushered in some excitement, and some despair. This book serves a pivotal purpose by weaving so many new concepts together, establishing the groundwork for further development of mechanical approaches to limit restenosis. I heartily recommend this text to all interventional cardiologists interested in practical and research aspects of restenosis.

Coronary Bypass Surgery in the Elderly
Coronary Bypass Surgery in the Elderly

Author: P.J. Walter

Publisher: Springer Science & Business Media

Published: 2012-12-06

Total Pages: 270

ISBN-13: 9401102090

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Coronary artery bypass surgery in the elderly: Too often or too seldom? It is a testimony to scientific advances that raising a simple inquiry today, such as whether coronary artery bypass surgery is done too often or too seldom in elderlypatients, requiresanexplorationofwhatviewsonemightholdonseveral medical as well as non-medical issues. Unlike earlier years when doctors were clinically free to decide what should be done with a patient, health has become an expensive human right, decisions about which also involve the patient, the epidemiologist, the health policy administrator, politicians, the exchequer, and the philosopher. In its broadest definition health has come to mean the core of well-being and, therefore, the goal ofany socio-economic system. Until only a decade ago, medical opinion regarding how often coronary artery bypass surgery (CABG) was indicated or useful was unclear. Becauseof multi-organ senescence, the elderly were expected to have a higher rate operative morbidity and mortality and, having crossed an advanced life span, might not live very long after the operation. Decision making on medical grounds first depends on knowing if a patient can survive an operation compared to how long they would survive without it, i. e.

What’s New in Cardiac Imaging?
What’s New in Cardiac Imaging?

Author: Ernst E. van der Wall

Publisher: Springer Science & Business Media

Published: 2012-12-06

Total Pages: 563

ISBN-13: 9401124566

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Since the introduction of myocardial perfusion imaging and radionuclide angiography in the mid-seventies, cardiovascular nuclear medicine has undergone an explosive growth. The use of nuclear cardiology techniques has become one of the cornerstones of the noninvasive assessment of coronary artery disease. In the past 15 years major steps have been made from visual analysis to quantitative analysis, from planar imaging to tomographic imaging, from detection of disease to prognosis, and from separate evaluations of perfusion, metabolism, and function to an integrated assessment of myocardial viability. In recent years many more advances have been made in cardiovascular nuclear imaging, such as the development of new imaging agents, reevaluation of existing procedures, and new clinical applications. This book describes the most recent developments in nuclear cardiology and also addresses new contrast agents in MRI. What's New in Cardiac Imaging will assist the clinical cardiologist, the cardiology fellow, the nuclear medicine physician, and the radiologist in understanding the most recent achievements in clinical cardiovascular nuclear imaging.

The Arterial System in Hypertension
The Arterial System in Hypertension

Author: Michel Emile Safar

Publisher: Springer Science & Business Media

Published: 2012-12-06

Total Pages: 239

ISBN-13: 9401109001

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MICHEL E. SAFAR and MICHAEL F. O'ROURKE One of the principal problems of hypertension is the precise definition of blood pressure as a cardiovascular risk factor. Clinicians indicate peak systolic pressure and end diastolic pressure in the brachial artery as the principal criteria for blood pressure measurement. Consequently, these values are as indicators for clinical management and therapeutic adjustment. This used methodology, based on indirect blood pressure measurements at the site of the brachial artery relates only to the highest and lowest pressure in that vessel, and does not give any information of the blood pressure curve itself; this carries more information than peak systolic pressure and end diastolic pressure. As a first step in better analysis of the blood pressure curve, research workers in experimental hypertension defined in addition to peak systolic pressure and end diastolic, another blood pressure value, mean arterial pressure, i. e. the average pressure throughout the cardiac cycle, and about which pressure fluctuates. This is the pressure recorded by Hales [1] and by Poiseuille [2] in their pioneering studies. By application of Poiseuille's Law, this definition of mean arterial pressure led to the concept that increased mean arterial pressure (and therefore hypertension) was related, at any given value of cardiac output, to an increase in vascular resistance, i. e. to a reduc tion in the caliber of the small arteries.

Myocardial viability
Myocardial viability

Author: A.S. Iskandrian

Publisher: Springer Science & Business Media

Published: 2012-12-06

Total Pages: 209

ISBN-13: 9401111707

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In the past few years it has become clear that left ventricular dysfunction, even of severe degree, may be reversible after coronary revascularization in some patients. As a result, myocardial viability has captured the imagination of researchers and clinicians seeking to unravel the cellular and subcellular mechanisms and define appropriate diagnostic modalities. These diagnostic modalities include: cardiac catheterization, positron-emission tomography, magnetic resonance imaging, two-dimensional echocardiography and single-photon imaging. This book, for the first time, brings together a diverse array of information in a comprehensive and concise fashion using a template of ten chapters written by experts in the field. It will be required reading for cardiologists, radiologists, nuclear medicine specialists, cardiac surgeons, anesthesiologists, internists and basic researchers and their trainees who are involved in the management of patients with coronary artery disease in whom myocardial viability is a clinically relevant issue.

Myocardial Protection and the KATP Channel
Myocardial Protection and the KATP Channel

Author: Derek Yellon

Publisher: Springer Science & Business Media

Published: 1995-12-31

Total Pages: 232

ISBN-13: 9780792337911

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The ATP-sensitive potassium channel (KATP) was discovered in 1983. Since then, an enormous amount of research has been undertaken to characterize it in detail. This volume consolidates both the current knowledge and most recent advances on the subject, and its relationship to myocardial protection. To this end, the editors have assembled investigators at the forefront of ongoing basic and clinical research to provide scholarly and candid comments concerning each of the pertinent issues, including: a comprehensive review of the biology of the channel with respect to the structure-activity relationship as well as overall chemistry of the channel; the role of opening this channel and its effect on smooth muscle (covering both the effects on myocardial stunning and its ability to protect against myocardial infarction); the relationship of KATP channel opening and the protection to the myocardium afforded by the phenomenon of ischemic preconditioning; the relationship between the KATP channel and electrophysiological consequences with specific reference to arrhythmogenicity; and the clinical implications of the use of agents that mimic the opening of this channel, with reference to its protective nature and its use in the treatment of angina. Audience: Clinicians and basic scientists who have a direct interest in the KATP channel as well as those groups who are interested in the entire concept of myocardial protection and its relationship to academic and clinical medicine.

The Pacemaker Clinic of the 90’s
The Pacemaker Clinic of the 90’s

Author: N.M. van Hemel

Publisher: Springer Science & Business Media

Published: 2012-12-06

Total Pages: 277

ISBN-13: 940110347X

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Since the first pacemaker implantation in October 1958 by Senning and Elmqvist in Sweden, cardiac pacing for bradycardia has become a well-established therapy. The impressive growth of clinical experience and the rapid development of pacemaker devices have greatly contributed to this situation. The electrical therapy appears to be so easy that insertion of the lead and its connection to the pacemaker generator requires little effort, skill or insight. However, after implantation a patient's condition seldom remains stable, which requires a flexible pacing program to cover all new cardiac events, and broad insight from clinician and technical colleagues. The Pacemaker Clinic of the 90's teaches anatomical and electrophysiological aspects of pacing, supports the prevention of complications, and points to new developments in the field. Apart from classical indications for cardiac pacing, the book discusses the validity of the latest indications, supporting the cardiologist and the associated professional in selecting the appropriate pacing mode and pacemaker follow-up in individual patients. The Pacemaker Clinic of the 90's will be a helpful companion for years to come.

Molecular Cardiology for the Cardiologists
Molecular Cardiology for the Cardiologists

Author: Bernard Swynghedauw

Publisher: Springer Science & Business Media

Published: 2012-12-06

Total Pages: 266

ISBN-13: 1461520193

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Molecular Cardiology for the Cardiologist provides a short, easily readable summary of what the new biology brings to cardiology. With this in mind, special efforts have been made to present many comprehensive schemes and drawings, as well as teaching tables. The five parts of the book provide a general introduction to the new language of biology; the normal structure of the heart and blood vessels; the physiopathology and the new therapeutic avenues that have been opened up by the new biology. A concise summary of the keys that assist the cardiologist or student who seeks to learn and read more about this field. Provides practical examples to illustrate the clinical interest of the new approach.

Animal models in cardiovascular research
Animal models in cardiovascular research

Author: D.R. Gross

Publisher: Springer Science & Business Media

Published: 2013-04-17

Total Pages: 512

ISBN-13: 9401707308

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Interest in the humane and scientifically justifiable use of research animals has intensified since the publication of the first edition of this textbook. This completely revised and updated text provides information essential to any researcher interested in using animal models for cardiovascular research, or any research which requires normal cardiovascular function. The format and presentation have been changed to make the text more easy to read and use. An introductory chapter offers general principles of animal selection, pre and post-operative care, preanesthesia, chemical restraint, analgesia, and the recognition of pain. The number of references cited has been almost doubled over the previous text and the chapter tabulating normal cardiovascular parameters from intact, awake animals, of those species commonly used in research, has been greatly expanded. Other chapters providing comprehensive data on the cardiovascular effects of opioids, tranquilizers, anesthetic agents and other drugs commonly used in cardiovascular research have been expanded with special emphasis on species variability to drug effects. The chapters on both naturally occurring and iatrogenic models of cardiovascular disease have also been expanded and updated.

Cardiovascular Imaging
Cardiovascular Imaging

Author: Johan H. C. Reiber

Publisher: Springer Science & Business Media

Published: 2012-12-06

Total Pages: 579

ISBN-13: 9400902913

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In the past, coronary arteriography was the only modality available to provide high quality images of the coronary anatomy. Quantitative coronary arteriography (QCA) was developed, implemented, validated and extensively applied to obtain accurate and reproducible data about coronary morphology and the functional significance of coronary obstructions. Over the last few years extensive basic technological research supported by clinical investigations has created competing modalities to visualize coronary morphology and the associated perfusion of the myocardial muscle. Currently, the following modalities are available: X-ray coronary arteriography, intracoronary ultrasound, contrast- and stress-echocardiography, angioscopy, nuclear cardiology, magnetic resonance imaging, and cine and spiral CT imaging. For all these imaging modalities, the application of dedicated quantitative analytical software packages enables the evaluation of the imaging studies in a more accurate, reliable, and reproducible manner. These extensions and achievements have resulted in improved diagnostics and subsequently in improved patient care. Particularly in patients with ischaemic heart disease, major progress has been made to detect coronary artery disease in an early phase of the disease process, to follow the atherosclerotic changes in the coronary arteries, to establish the functional and metabolic consequences of the luminal obstructions, and accurately to assess the results of interventional therapy. Aside from all these high-tech developments in cardiac imaging techniques, the transition from the analogue to the digital world has been going on for some time now. For the future, it has been predicted that the CD-R will be the exchange medium for cardiac images and DICOM-3 the standard file format. This has been a major achievement in the field of standardization activities. Since these developments will have a major impact on the way images will be stored, reviewed and exchanged in the near future, an important part of this book has been dedicated to DICOM and the filmless catheterization laboratory. Cardiovascular Imaging will assist cardiologists, radiologists, nuclear medicine physicians, image processing specialists, physicists, basic scientists, and fellows in training for these specialties to understand the most recent achievements in cardiac imaging techniques and their impact on cardiovascular medicine.