The textbook provides an interdisciplinary and integrated perspective of modern vascular cure. Written by experts the text proceeds from fundamental principles to advanced concepts. The book is divided into four parts, each focusing on different basic concepts of vascular cure. All fundamental principles of the area are clearly explained to facilitate vascular diagnostics and treatment in clinical practice. It is aimed at junior practitioners and experts.
In cardiovascular prevention, there is classically a small number of cardiovascular risk factors to treat, such as hypertension, diabetes, hyperlipidemia and smoking excess, which are widely detected and treated. Recently, it has been widely recognized that new mechanical factors should be detected and treated and involves specifically pulsatile arterial hemodynamic (PAH) parameters such as: arterial stiffness, pulse pressure, and, to a lesser extent, augmentation index and pulse pressure amplification. The pedagogic aspect of this new CV specialty involves 3 principal parts: a. –Basic concepts and pathophysiological mechanisms of PAHb. –Clinical aspects and end-organ damage in PAHc. – Clinical pharmacology and therapeutics of PAH This book represents the first that spans basic science and clinical management of this new CV subspecialty. Much has been learned regarding the management of these patients in recent years and this book presents extensive data on the techniques needed to maximize outcomes.
New updated edition first published with Cambridge University Press. This new edition includes 29 chapters on topics as diverse as pathophysiology of atherosclerosis, vascular haemodynamics, haemostasis, thrombophilia and post-amputation pain syndromes.
This book is a dedicated resource for those sitting the Part A of the MCEM (Membership of the College of Emergency Medicine) examination. It forms an essential revision guide for emergency trainees who need to acquire a broad understanding of the basic sciences, which underpin their approach to clinical problems in the emergency department. Common clinical scenarios are used to highlight the essential underlying basic science principles, providing a link between clinical management and a knowledge of the underlying anatomical, physiological, pathological and biochemical processes. Multiple choice questions with reasoned answers are used to confirm the candidates understanding and for self testing. Unlike other recent revision books which provide MCQ questions with extended answers, this book uses clinical cases linked to the most recent basic science aspects of the CEM syllabus to provide a book that not only serves as a useful revision resource for the Part A component of the MCEM examination, but also a unique way of understanding the processes underlying common clinical cases seen every day in the emergency department. This book is essential for trainees sitting the Part A of the MCEM exam and for clinicians and medical students who need to refresh their knowledge of basic sciences relevant to the management of clinical emergencies.
Biology of the Arterial Wall is intended as a general reference text concerned with the biology of the vascular cells and the blood vessel wall under physiological and pathological conditions. One of the major functions of the arteries is to maintain a continuous blood flow to the organs whatever the pressure conditions, thanks to the vasomotor tone of the smooth muscle cells. Great advances have been made over the last decade in the understanding of the endothelial cells as integrators and transducers of signals originating from the blood stream. The pluripotent control functions of the endothelial cells in the vessel wall are now well recognized. A review of endothelial functions and dysfunctions is presented. Cell biology and molecular genetic studies have now identified an array of molecules elaborated by endothelial cells and vascular smooth muscle cells and by the blood-borne elements which interact with artery cells, defending the artery against injury and modulating evolving abnormal processes. Molecules which induce or inhibit endothelial and/or smooth muscle cells are currently under great scrutiny. Angiogenesis, which plays a major role in tumor growth, but may also be beneficial as a healing process in muscle ischemia, is discussed. Apoptosis, or programmed cell death, has only recently been recognized as an essential process in blood vessel modeling and remodeling. An overview of apoptosis in the vascular system is presented. It is increasingly evident that the adjustments of the blood vessel wall are made in the presence of deforming disease processes such as hypertension and atherosclerosis. The second part of the book is concerned with the blood vessel wall in disease conditions. Several chapters review the role of the vessel and vascular cells in inflammation, and vascular remodeling during arterial hypertension and aging. One chapter is devoted to atherogenesis, atheroma and plaque instability, followed by the pathophysiology of post-angioplasty restenosis, which is a crucial issue in modern interventional cardiology.
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.
The book is written by leading experts in the field presenting an up-to-date view of the subject matter in a didactically sound manner. It presents a review of the current knowledge of the behaviour of soft tissues in the cardiovascular system under mechanical loads, and the importance of constitutive laws in understanding the underlying mechanics is highlighted. Cells are also described together with arteries, tendons and ligaments, heart, and other biological tissues of current research interest in biomechanics. This includes experimental, continuum mechanical and computational perspectives, with the emphasis on nonlinear behaviour, and the simulation of mechanical procedures such as balloon angioplasty.
Research centering on blood flow in the heart continues to hold an important position, especially since a better understanding of the subject may help reduce the incidence of coronary arterial disease and heart attacks. This book summarizes recent advances in the field; it is the product of fruitful cooperation among international scientists who met in Japan in May, 1990 to discuss the regulation of coronary blood flow.
Main headings: I. Basic concepts of pulsatile arterial hemodynamics. - II. Pathophysiological mechanisms. - III. Arterial stiffness, wave reflections, cardiovascular risk and end-organ damage. - IV. Clinical aspects of arterial stiffness and wave reflections. - V. Therapeutic aspects of arterial stiffness and wave reflections.
Vascular management and care has become a truly multidisciplinary enterprise as the number of specialists involved in the treatment of patients with vascular diseases has steadily increased. While in the past, treatments were delivered by individual specialists, in the twenty-first century a team approach is without doubt the most effective strategy. In order to promote professional excellence in this dynamic and rapidly evolving field, a shared knowledge base and interdisciplinary standards need to be established. Pan Vascular Medicine, 2nd edition has been designed to offer such an interdisciplinary platform, providing vascular specialists with state-of-the art descriptive and procedural knowledge. Basic science, diagnostics, and therapy are all comprehensively covered. In a series of succinct, clearly written chapters, renowned specialists introduce and comment on the current international guidelines and present up-to-date reviews of all aspects of vascular care.