This issue is organized on a debate format, with experts in the field arguing the pros and cons of active controversies that challenge modern management of aortic disease.? Among the controversies discussed are genetic testing, use of biomarkers, optimal methods of brain protection in aortic arch surgery, and pre-enrollment echocardiogram to exclude aortic disease for all young adults engaging in vigorous athletic or strength training.

This issue of the Thoracic Surgery Clinics will cover the following topics: physiology of pleural space, risk factors for prolonged air leak after pulmonary resection, surgical techniques to avoid parenchymal injury during lung resection, intraoperative measures for preventing air leaks, sealants and buttressing materials in pulmonary surgery, postoperative strategies to treat persistent air leaks, the management of chest tubes after pulmonary resection, digital and smart chest drainage systems to monitor air leaks, portable chest drainage systems and outpatient chest tube management, and prolonged air leak after LVRS and in the ventilated patients.

Heart failure affects over 5 million patients in the United States alone, and is a chronic and debilitating disease. While a number of pharmacologic therapies have shown varying degrees of effectiveness, many recent advances in the treatment of heart failure has focused on device based therapies. In Device Therapy in Heart Failure, William H. Maisel and a panel of authorities on the use and implementation of device based therapies provide a comprehensive overview of the current and developing technologies that are used to treat heart failure. Individual chapters provide an in-depth analysis of devices such as CRT's and ICD's, while broader topics such as the pathophysiology of heart failure and its current medical therapies are also discussed. Additional topics include Pacing and Defibrillation for Atrial Arrhythmias, Atrial Fibrillation Ablation, and Percutaneous Treatment of Coronary Artery Disease.

This groundbreaking book weaves together three important themes. It describes major developments in the diagnosis and treatment of heart disease in the twentieth century, explains how the Mayo Clinic evolved from a family practice in Minnesota into one of the world's leading medical centers, and reveals how the invention of new technologies and procedures promoted specialization among physicians and surgeons. Caring for the Heart is written for general readers as well as health care professionals, historians, and policy analysts. Unlike traditional institutional or disease-focused histories, this book places individuals and events in national and international contexts that emphasize the interplay of medical, scientific, technological, social, political, and economic forces that have resulted in contemporary heart care. Patient stories and media perspectives are included throughout to help general readers understand the medical and technological developments that are described. The book is a synthetic study, but it is written so that readers may pick and choose the chapters of most interest to them. Another feature of the book is that readers may follow the stories without looking at the notes. Those who are interested in delving deeper into the main topics will find a wealth of carefully chosen references that offer greater detail and additional perspectives. The descriptions and interpretations that fill the book benefit from the fact that the author has been a practicing cardiologist and medical historian for almost four decades. This is mainly a twentieth-century story, but it begins earlier-before physicians who were identified as cardiologists, a time when medical specialization was just emerging in America. The final chapter, which addresses present-day concerns about health care costs, counterbalances earlier ones that might be read as celebrations of new technologies.

The book is divided in 4 parts. In the first one, the importance of the analysis of the cardiac dynamics using the ambulatory monitoring technique is presented. The second part contains the description of foundations of impedance cardiography (ICG), the models used to describe the ICG technique and the description of available systems for ambulatory monitoring of cardiac hemodynamics. The third part is devoted to the validation of the ambulatory ICG method, the verification of the quality of long term ICG recordings and the discussion of the limitations of this technique. In the last part, some clinical and research applications of the ICG ambulatory monitoring are presented. The simultaneous recordings of electrocardiogram (ECG) and ICG in the transient cardiac arrhythmia events illustrate the potential applications of that method for quantitative analysis of hemodynamics when the implementation of the stationary methods would be either difficult or not possible to do. The book is followed by references, alphabetical index and appendices containing the technical data of the available systems for portable monitoring of cardiac hemodynamics.

Pharmacologic treatment of heart failure has progressed over the last two decades, but regimens have become more complex.? With pharmacogenetics, the time is rapidly approaching when information on genetic variability will be used to predict therapeutic response and select the right drug for the right patient.? In this issue of Heart Failure Clinics, several leading pioneers of this next revolution in heart failure treatment present the current state-of-the-art on the use of genomic information to target therapeutics.? The issue begins with two articles on the basics of what every clinician needs to understand to apply genomic information to patient care and a historical overview of the move toward genetically targeted therapies.? The articles that follow address specific therapeutic interventions such as neurohormonal inhibitors and beta blockers.? The next series of articles address the genomics of hypertension, left ventricular hypertrophy, and how genomic differences may underlie the apparent racial differences in heart failure and therapeutics.? The final third of the issue turns to how genomics will assist treatment of specific clinical scenarios, including myocarditis, transplant rejection, device therapy and pulmonary arterial hypertension.? The issue concludes with a discussion of genome-wide association studies.

In the past three decades, interventional cardiology has grown tremendously due to development of new devices and expansion of indications based on clinical trials.? This issue of Cardiology Clinics provides an updated view of advanced techniques in the rapidly changing and growing field of interventional cardiology.? The articles included discuss important topics such as emerging techniques for vulnerable plaque detection, coronary bifurcation lesions, drug eluting stents, and left ventricular assist devices.

This book provides comprehensive reviews on our most recent understanding of the molecular and cellular mechanisms underlying atherosclerosis and calcific aortic valve disease (CAVD) as visualized in animal models and patients using optical molecular imaging, PET-CT, ultrasound and MRI. In addition to presenting up-to-date information on the multimodality imaging of specific pro-inflammatory or pro-calcification pathways in atherosclerosis and CAVD, the book addresses the intriguing issue of whether cardiovascular calcification is an inflammatory disease, as has been recently supported by several preclinical and clinical imaging studies. In order to familiarize researchers and clinicians from other specialties with the basic mechanisms involved, chapters on the fundamental pathobiology of atherosclerosis and CAVD are also included. The imaging chapters, written by some of the foremost investigators in the field, are so organized as to reveal the nature of the involved mechanisms as disease progresses.

The Poincare plot (named after Henri Poincare) is a popular two-dimensional visualization tool for dynamic systems due to its intuitive display of the dynamic properties of a system from a time series. This book presents the basis of Poincare plot and focus especially on traditional and new methods for analysing the geometry, temporal and spatial dynamics disclosed by the Poincare plot to evaluate heart rate variability (HRV). Mathematical descriptors of Poincare plot have been developed to quantify the autonomic nervous system activity (sympathetic and parasympathetic modulation of heart rate). Poincare plot analysis has also been used in various clinical diagnostic settings like diabetes, chronic heart failure, chronic renal failure and sleep apnea syndrome. The primary aims of quantification of the Poincare plots are to discriminate healthy physiological systems from pathological conditions and to classify the stage of a disease. The HRV analysis by Poincare plot has opened up ample opportunities for important clinical and research applications. Therefore, the present book can be used either for self-study, as a supplement to courses in linear and nonlinear systems, or as a modern monograph by researchers in this field of HRV analysis.

In the last 35 years, declining deaths from heart disease have translated into 13 million lives saved and extended. Medical treatments and lifestyle changes have dealt successfully with the serious heart problems of Vice President Richard Cheney, talk show host David Letterman, Disney-ABC CEO Michael Eisner, and countless other less famous people. In the past, those with serious heart disease would have died young, but today can live long and active lives. Few families have not benefited from improvements in the way we treat and prevent heart problems, yet we often hear that poor lifestyles and the limitations of modern medicine threaten our health and well-being. Although room for improvement always remains, this book provides evidence to the contrary: we have made and continue to make tremendous progress in dealing with heart disease. In reviewing the progress being made in this crucially important area of health, Pampel and Pauley offer an optimistic view of the potential for continued improvement and for longer, healthier lives. Despite the prevalence of heart disease, deaths from this cause have declined greatly in past decades. From its peak in 1968, the heart disease mortality rate has fallen by 52% for men and 48% for women. That translates into over 13 million lives saved and extended. The lives saved are not limited to the very old. To the contrary, heart disease mortality has fallen faster among the young and middle aged.

Together, the volumes in this series present all of the data needed at various length scales for a multidisciplinary approach to modeling and simulation of flows in the cardiovascular and ventilatory systems, especially multiscale modeling and coupled simulations. The cardiovascular and respiratory systems are tightly coupled, as their primary function is to supply oxygen to and remove carbon dioxide from the body's cells. Because physiological conduits have deformable and reactive walls, macroscopic flow behavior and prediction must be coupled to nano- and microscopic events in a corrector scheme of regulated mechanism. Therefore, investigation of flows of blood and air in anatomical conduits requires an understanding of the biology, chemistry, and physics of these systems together with the mathematical tools to describe their functioning in quantitative terms. The present volume focuses on macroscopic aspects of the cardiovascular and respiratory systems in pathological conditions, i.e., diseases of the cardiac pump, blood vessels, and airways, as well as their treatments. Only diseases that have a mechanical origin or are associated with mechanical disorders are covered. Local flow disturbances can trigger pathophysiological processes or, conversely, result from diseases of conduit walls or their environment. The ability to model these phenomena is essential to the development and manufacturing of medical devices, which incorporate a stage of numerical tests in addition to experimental procedures.

This book presents a collection of expert reviews on different subcellular compartments of the cardiomyocyte, addressing fundamental questions such as how these compartments are assembled during development, how they are changed in and by disease and which signaling pathways have been implicated in these processes so far. As such, it offers the first overview of the cell biology of heart disease of its kind, addressing the needs of cell biology students specializing in vascular and cardiac biology, as well as those of cardiologists and researchers in the field of cell biology.

The past 50 years have witnessed a breathtaking evolution in the approaches to the patient with an acute ST elevation myocardial infarction. In the 1960s, the now commonplace cardiac intensive care unit was but a nascent idea. Without much to offer the patient but weeks of absolute bedrest, substantial morbidity and high rates of mortality were the norm. Just 30 years ago, seminal discoveries by DeWood and colleagues suggested that the culprit was plaque rupture with thrombosis, not progressive luminal compromise. Subsequent fibrinolyt- based strategies resulted in a halving of the mortality of acute myocardial infarction. With the introduction of balloon angioplasty in the late 1970s, a few interventional cardiologists braved the question: why not perform emergency angioplasty as a primary reperfusion strategy? Indeed, reports of successful reperfusion via balloon angioplasty appeared (mostly in local newspapers) as early as 1980. Despite being thought of as heretical by mainstream cardiology, these pioneers nonetheless persevered, proving the benefit of ''state-of-the-art'' balloon angioplasty compared with ''state-of-t- art'' thrombolytic therapy in a series of landmark trials published in the New England Journal of Medicine in March of 1993. Publication of the first edition of Primary Angioplasty in Acute Myocardial Infarction in 2002 to some extent anticipated the widespread acceptance of primary percutaneous coronary intervention as the standard of care. Since then, in all respects, the evolution of emergency percutaneous revascularization has only accelerated. The universal replacement of balloon angioplasty with stent implantation was clearly one key.

Interstitial lung disease (ILD) is a broad category of lung diseases that includes more than 150 disorders characterized by scarring or fibrosis of the lungs. In Pulmonary Arterial Hypertension and Interstitial Lung Disease: A Clinical Guide, renowned experts provide a state-of-the-art overview of the problems seen by physicians in the clinical management of ILDs. Divided into two sections, the first part provides and update on general issues and introduces both interstitial lung disease and associated pulmonary hypertension. A detailed analysis of the pathology of the various interstitial lung diseases is also provided. The second part addresses specific categories of disease. Bronchiolitis, hypersensitivity pneumonitis, and other conditions are covered, and the use of inspiratory and expiratory high resolution CT scan is discussed as well. This important new text is an invaluable resource for the practicing physician who must be aware of the broad and troubling manifestations of interstitial lung disease.

This book introduces the latest research in molecular, cellular, and tissue engineering of the vascular system. Topics covered include the roles of endothelial surface glycocalyx as a mechano-sensor and transducer for blood flow, a barrier to water and solute transport across the vascular wall and to the interaction between circulating cells and the vessel wall, the roles of nuclear envelope proteins and nuclear lamina in regulating vascular functions under blood flow-induced forces, and the roles of smooth muscle cells and extracellular components in arterial vasoconstriction. Other topics covered include non-surgical vascular interventions for coronary artery diseases, genesis and mechanisms of atherosclerotic plaque microcalcifications and human abdominal aortic aneurysms, experiments and modelling for red blood cell and tumor cell movement in microcirculation, transport across the blood-brain barrier and its role in Alzheimer's disease, mathematical models for cell survival after hyperthermia, application of hypothermia in enhancing treatment for brain and spinal cord injuries, and damage of eardrums due to blast waves. This is an ideal book for biomedical engineers and researchers, medical researchers, and students in biomedical engineering and medical sciences.

This book synthesizes the major research advances in molecular, biochemical and translational aspects of aging and heart failure over the last four decades and addresses future directions in management and drug discovery. It presents clinical issues and molecular mechanisms related to heart failure, including the changing demographics in the aging population with heart failure; hypertension and prevention of diastolic heart failure in the aging population; polypharmacy and adverse drug reactions in the aging population with heart failure; changes in the heart that accompany advancing age from humans to molecules; aging-associated alterations in myocardial inflammation and fibrosis and aging-related changes in mitochondrial function and implications for heart failure therapy. The book succinctly summarizes the large volume of data on these key topics and highlights novel pathways that need to be explored. Featuring contributions from leading clinician-scientists, Aging and Heart Failure: Mechanisms and Management is an authoritative resource on the major clinical issues in heart failure therapy in the elderly for cardiologists, gerontologists and internists.

Heart failure incidence increases with age and because the oldest segment of the population in Western countries is the fastest growing, the prevalence of heart failure is expected to increase. Understanding the signs and symptoms of heart failure is therefore of increasing necessity for physicians. Hemodynamic monitoring provides data on blood flow and pressure to assist physicians in determining the status of the patient's heart and in managing heart failure. This issue provides a detailed picture of the various options for assessing hemodynamics, including clinical assessment, echocardiography, transthoracic impedance cardiography, pulmonary artery catheters, B-type natriuretic peptide levels, and implantable devices.

There are growing questions regarding the safety, quality, risk management, and costs of PCC teams, their training and preparedness, and their implications on the welfare of patients and families. This innovative book, authored by an international authorship, will highlight the best practices in improving survival while paving a roadmap for the expected changes in the next 10 years as healthcare undergoes major transformation and reform. An invited group of experts in the field will participate in this project to provide the timeliest and informative approaches to how to deal with this global health challenge. The book will be indispensable to all who treat pediatric cardiac disease and will provide important information about managing the risk of patients with pediatric and congenital cardiac disease in the three domains of: the analysis of outcomes, the improvement of quality, and the safety of patients.

Angiogenesis is the growth of new blood vessels and is an important natural process in the body. A healthy body maintains a perfect balance of angiogenesis modulators. In many serious disease states, however, the body loses control over angiogenesis. Diseases that are angiogenesis-dependent result when blood vessels either grow excessively or insufficiently. Understanding how angiogenesis "works" and how to control it, will have massive implications on the management, treatments, and ultimately the prevention of many common (and not so common) diseases.
Angiogenesis cuts across virtually every discipline. The Angiogenesis Foundation identified angiogenesis as a "common denominator" in our most serious diseases. Excessive angiogenesis occurs in diseases such as cancer, diabetic blindness, age-related macular degeneration, rheumatoid arthritis, psoriasis, and many other conditions. Insufficient angiogenesis occurs in diseases such as coronary artery disease, stroke, and delayed wound healing.

* Tried-and-tested techniques written by researchers that developed them, used them, and brought them to fruition.
* Provides the "builder's manual" for essential techniques. This is a one-stop shop that eliminates needless searching among untested techniques.
* Includes step-by-step methods for understanding the cell and molecular basis of wound healing, vascular integrin signaling, mechanical signaling in blood vessels, and vascular proteomics

Angiogenesis is the growth of new blood vessels and is an important natural process in the body. A healthy body maintains a perfect balance of angiogenesis modulators. In many serious disease states, however, the body loses control over antiogenesis. Diseases that are angiogensis-dependent result when blood vessels either grow excessively or insufficiently.
* Tried-and-tested techniques written by researchers that developed them, used them, and brought them to fruition
* Provides the "builder's manual" for essential techniques--a one-stop shop that eliminates needless searching among untested techniques
* Includes step-by-step methods for understanding the cell and molecular basis of wound healing, vascular integrin signaling, mechanical signaling in blood vessels, and vascular proteomics

Atrial fibrillation (AF) is the most common sustained arrhythmia, affecting approximately 2.3 million people in the US. One of the most serious side effects of AF is embolic stroke. Technology developed in the last 10 years has made AF treatable and potentially curable. This issue discusses many of the clinical issues in the management of AF, including cardioversion, anticoagulation, and ablation. Also included are current guidelines for treatment and a view of the future.

Understanding how angiogenesis "works" and how to control it will have massive implications on the management, treatments, and ultimately the prevention of many common (and not so common) diseases. Angiogenesis is the growth of new blood vessels and is an important natural process in the body. A healthy body maintains a perfect balance of angiogenesis modulators. In many serious disease states, however, the body loses control over angiogenesis. Diseases that are angiogenesis-dependent result when blood vessels either grow excessively or insufficiently.
* Tried-and-tested techniques written by researchers that developed them, used them, and brought them to fruition
* Provides the "builder's manual" for essential techniques--a one-stop shop that eliminates needless searching among untested techniques
* Includes step-by-step methods for understanding the cell and molecular basis of wound healing, vascular integrin signaling, mechanical signaling in blood vessels, and vascular proteomics