During several decades of this century, the classical physiological studies on the cardiovascular system have greatly improved our knowledge on the function of this system under normal and pathological conditions. This knowledge was the basis of the breakthrough for diagnostic techniques like the Swan-Ganz catheter, coronary arteriography, left and right heart biopsies, and invasive measurements of contractility, as well as therapeutic tools including aortocoronary bypass surgery, percutanous transluminal coronary angioplasty, and a broad field of pharmacological interventions for the whole spectrum of cardiovascular diseases, especially chronic heart failure. It was during the last decade that the scientific world focused on the evolution of molecular biology of the cardiovascular system so that cardiovascular physiology seemed to become less important. Regarding the myocardium, molecular alterations of important functional proteins (phenotype changes), as well as signal transduction pathways of contractility and cardiac growth have been elucidated. The functional importance of a number of genes has undoubtedly been proven with the help of transgenic animals. Mechanics and Energetics of the Myocardium provides an overview for those researchers and practioners interested in the broad field of molecular biology and physiology of the cardiovascular system.

This book focuses on issues in clinical practice and research that are of general interest. The articles primarily focus on understanding the pathogenic mechanisms of diseases, their prevention, and therapy. The topics addressed include cardiovascular regulation with regard to blood pressure and heart rate variability, and to coupling blood pressure changes with subarachnoid fluid oscillations. In addition, the book discusses recent advances in the diagnostics of and targeted molecular therapy for renal and pancreatic malignancies, growth disorders, vitamin D and calcium homeostasis in children in the context of neonatal urolithiasis, and neurosurgical interventions in multifarious age-related diseases of the vertebrae. Neuropsychological aspects of patients' quality of life and of shaping medical staff's attitude toward patients are also addressed. The respective articles are intended to build a bridge between basic and clinical research. Further, the book enhances the current body of knowledge on diagnostics and patient treatment and offers valuable new perspectives on practical clinical issues. As such, it offers a unique resource for clinicians, family physicians, medical scholars, and professionals engaged in patient management.

Recent advances have revolutionized diagnostic and therapeutic approaches in pediatric cardiology. Powerful new diagnostic techniques include color Doppler echocardiography, computerized tomography, and magnetic resonance imaging. Catheter-directed treatment of cardiac lesions with balloons and stents has become the treatment of choice, and cardiac arrhythmias in infancy and childhood are treated with radio-frequency ablation. To provide an update on these and other recent developments, the First Asian-Pacific Symposium on Pediatric Cardiology was held in Taipei in November 1994, attended by pediatricians, cardiologists, and surgeons, many of them of world renown. This book, a collection of the papers presented at the symposium, will contribute to improved recognition, understanding, and treatment of many important congenital and acquired heart problems in children. It will be of special interest to pathologists, pediatricians, cardiologists, and surgeons whose work involves care of infants and children with heart disease.

Cardiovascular diseases have a major impact in Western countries. Mathematical models and numerical simulations can aid the understanding of physiological and pathological processes, complementing the information provided to medical doctors by medical imaging and other non-invasive means, and opening the possibility of a better diagnosis and more in-depth surgical planning.This book offers a mathematically sound and up-to-date foundation to the training of researchers, and serves as a useful reference for the development of mathematical models and numerical simulation codes. It is structured into different chapters, written by recognized experts in the field, but it features a common thread with consistency of notation and expressions and systematic cross-referencing. Many fundamental issues are faced, such as: the mathematical representation of vascular geometries extracted from medical images, modelling blood rheology and the complex multilayer structure of the vascular tissue, and its possible pathologies, the mechanical and chemical interaction between blood and vascular walls; the different scales coupling local and systemic dynamics. All these topics introduce challenging mathematical and numerical problems, demanding for advanced analysis and simulation techniques. This book is addressed to graduate students and researchers in the field of bioengineering, applied mathematics and medicine, wishing to engage themselves in the fascinating task of modeling how the cardiovascular system works.

Investigation of the mechanisms of cellular response to different mechanical stimuli, as well as mechano-electrical feedback (MEF) in the intact heart is one of the main topics in fundamental and clinical cardiology. The present volume of "Mechanosensitivity in Cells and Tissues: Mechanosensitivity of the Heart" c- bines excellent reviews written by worldwide leaders in this ?eld. The 3rd volume is a great addition to this excellent series of books edited by Andre Kamkin and Irina Kiseleva. This volume successfully combines reviews, aimed at academic, physiology and clinical cardiology communities, devoted to mechanosensitivity of the normal and diseased heart at the ion channel, cell, tissue and organ levels. Kamkin and Kiseleva have made signi?cant contributions to the investigation of mechanosentive ion channels in cardiomyocytes and ?broblasts. Their ba- ground, in addition to extensive collaborations helped them to ?nd and consolidate valuable research ?ndings from prominent specialists in the ?eld of cardiac mechanosensitivity. In the last decade, interest in the role of MEF in the heart has increased sign- cantly. MEF within cardiac tissue is a complex phenomenon in which electroph- iological changes are triggered by myocardial stretch. This phenomenon has been studiedintheclinicalcommunityforoveracenturyandmayhavebothpro-rhythmic and arrhythmogenic consequences. While signi?cant advances have been made in understanding of the effects of mechanical forces on cardiac cells, many questions remain regarding the mechanisms whereby mechanical forces are transduced into changes which alter the behavior of various cardiac cells.

The first Taurine Symposium organized by Dr. Ryan Huxtable and the late Dr. Andre Barbeau was held in Tucson, Arizona, in 1975. Since that auspici ous event, nine international symposia on the role of taurine in biology have taken place. The locations for these meetings have been Tucson (two times), Rome, Philadelphia, Tokyo, Vancouver, Mexico City, Helsinki, and Florence. In 1977, due to the large number of scientists in Japan who were interested in the role of this unique amino acid in biological systems, we organized the Japanese Research Society on Sulfur Amino Acids with the encouragement and financial assistance of the Taisho Pharmaceutical Co., Ltd (Tokyo). Annual meetings have been held, and the membership has expanded from 78 to 414 in 1987; the number of presentations has increased during this time span from 29 to 74. The symposium in Tokyo in 1982, "Sulfur Amino Acids, Biochemical and Clinical Aspects" 1], was held to celebrate the 5th Annual Meeting of our Society. I would like to emphasize that in Japan we have an active Research Society especially directed to the study of sulfur amino acids. We have published our own semi-annual journal entitled Sulfur Amino Acids. Our society is an inter disciplinary research society since taurine is a highly diversified compound that interconnects physiology, biochemistry, pharmacology, nutrition, and medicine. One exciting fringe benefit of taurine research and the society has been the fostering of contacts with distinguished scientists from many varied medical fields."

Cardiovascular Solid Mechanics: Cells, Tissues, and Organs is a vital resource for courses on cardiovascular solid mechanics or soft tissue biomechanics. Focusing on the response of the heart and blood vessels to mechanical loads from the perspective of nonlinear solid mechanics, its primary goal is to integrate basic analytical, experimental, and computational methods to offer a more complete understanding of the underlying mechanobiology. While dealing primarily with cardiovascular mechanics, both the fundamental methods and many of the specific results are applicable to many different soft tissues, making this book an excellent general introduction to soft tissue biomechanics overall. Divided into three parts, Cardiovascular Solid Mechanics presents a practical and rational approach to biomechanics. Part I, Foundations, briefly reviews historical points of interest, basic molecular and cell biology, histology, and an overview of soft tissue mechanics. In order to provide not only a working framework, but also to give key references for those who wish to develop and extend biomechanics, included are mathematical preliminaries and salient results from continuum mechanics, finite elasticity, experimental mechanics, and finite elements. Part II, Vascular Mechanics, reviews the anatomy, histology, and physiology of arteries, illustrating and discussing constitutive formulations and stress analyses for healthy mature arteries. Considerable attention is given to the concept of residual stress and the mechanics of a number of vascular disorders, including atherosclerosis, aneurysms, and hypertension, as well as the mechanics of popular endovascular therapies such as balloon angioplasty. Part III, Cardiac Mechanics, reviews the requisite anatomy, histology, physiology, and pathology, and discusses the constitutive relations and stress analyses in the normal, mature heart. Finally, the book points the reader to areas of study that require more advanced theoretical, experimental, and computational methods, such as electromechanics, thermomechanics, mixture theory analysis of solid-fluid coupling, and damage mechanics. This book is designed as a text for an upper-division course on cardiovascular solid mechanics but will also serve as a good introduction to soft tissue biomechanics. Exercises at the end of each chapter will clarify complex concepts for both students and more experienced readers. Clinicians, life scientists, engineers, and mathematicians will also find this an invaluable guide, with concise and practical chapters, all of which are amply referenced. Cover illustration: Schema of a developing pathology of the arterial wall under mechanical stress.

The Symposium on New Drugs provides a forum for academic investigators, research and development personnel from the pharmaceutical industry and members of the Food and Drug Administration to discuss important clinical research issues. The Ninth Annual symposium on New Drugs addressed the problem of determining the risk versus benefit for use of three important classes of cardiovascular agents: thrombolytic, antiarrhythmic, and hypolipidemic agents. The use of thrombolytic agents has become one of the major advances in clinical intensive cardiologic care in the 1980s. While the lysis of clot(s) obstructing a major coronary artery should reverse or prevent the damage of acute myocardial ischemia and infarction, one must carefully consider the potential risks of such agents in regards to their potential benefits. The time when a thrombolytic agent should be administered to maximize benefit as well as how one defines a dose response relationship using intravenous critical care medicines were discussed as important clinical trial issues. The benefit versus risk data on currently available thrombolytic agents was reviewed and the potential roles for adjunctive agents addressed. Overall strategies regarding post- x thrombolytic care and relationships to sudden cardiac death were also detailed. The panel discussion sections provided a comprehensive view of the current thinking of the various participating groups in this symposium. Sudden cardiac death remains the number one cause of mortality in western industrialized societies.

This volume contains selected papers presented at the Sendai International Sympo sium on Molecular and Cellular Mechanisms of Cardiovascular Regulation held from May 10-12, 1995, to honor the contributions ofProfessorNorio Taira, Chairman of the Department of Pharmacology (1972-1995), Tohoku University School of Medicine, Sendai, Japan. The Department of Pharmacology at Sendai has a long tradition of significant contribution to the development of drug therapy for cardiovascular diseases. The late Professor Koroku Hashimoto, the predecessor of Professor Norio Taira, first suggested the mode of action of calcium antagonists and their potential usefulness in therapy of ischemic heart disease and hypertension at an early stage of their development. The need for greater understanding of the pathophysiology of cardiovascular dis eases is more critical now than ever before because modern advances in basic and clinical sciences have prolonged the average life expectancy. Using a wide range of molecular and electrophysiological techniques, major advances are occurring frequently in the field of cardiovascular physiology and pharmacology. Such multifaceted approaches are preferred because human cardiovascular diseases are complex, requiring multiple interventions and an in-depth understanding of molecular mechanisms underlying the disease. The first section of this book focuses on molecular mechanisms of ion channel regulation. Eight of ten chapters in this section are devoted to the recent advances in molecular characterization and regulation of various types of potassium channels in cardiac, vascular, and neuronal tissues. A discussion of the structure and function of sodium and calcium channels is also included.

This monograph contains 20 selected papers presented at the Symposium on Subcellular Basis of Contractile Failure which was held in Ottawa during May 11-13, 1989 and is designed for the benefit ofthose who were unable to attend this event. It is now increasingly becoming clear that an excessive amount of calcium is intimately involved in the pathogenesis of a wide variety of heart diseases. Accordingly, the investigations concerning the role of calcium chan nels and their regulatory mechanisms in heart function as well as of the intra cellular calcium overload in cardiac dysfunction are presented here. Since sodium is also considered to influence the cardiac contractile force by chang 2 ing the intracellular concentration of calcium through the Na +-Ca+ exchange 2 mechanism in the cell membrane, the role of Na +-Ca+ exchange in heart func tion as well as pathology of contractile failure is discussed. In view of the new ly discovered implications of the oxygen free radicals in cellular injury, papers concerning the role of these radicals in heart disease are included in this book. For the purpose of clarity, different chapters have been organized under three main headings: (I) Role of cations in heart function, (II) Cardiac hypertrophy and cardiomyopathies, and (III) Ischemic heart disease and cardiac failure."

In Clinical Pharmacology of Cerebral Ischemia, a distinguished international panel of authors define our current understanding of neuronal damage after ischemia and critically review the significant recent progress in cerebrovascular accident (CVA) drug trials, both for animal models and in the clinical setting. These leading basic science and medical authorities survey such important new drugs as calcium-influx inhibitors, free-radical scavenging drugs, glutamate and glycinergic antagonists, and immune suppressors. They also evaluate all the latest findings concerning calcium homeostasis, glutamate toxicity, gene activation, and the role of free radicals, glycine, and hormones. Chapters devoted to the neuroimaging of stroke, clinical trials, and the role of cerebral immune activation complete this informative collection of cutting-edge reviews.

The application of magnetic resonance spectroscopy (MRS) to the cardiovascular system is a relatively new phenomenon. Its ability to noninvasively examine myocardial metabolism has led to its use to answer basic questions in animal models of normal and diseased myocardium. Extension of these investigations into the realm of human myocardial metabolism has been made possible by the advent of relatively high-field magnets with spectroscopy capabilities and sufficient bore dimensions to allow human studies. While ongoing and future studies promise to enhance our understanding of myocardial metabolism, their success will, in part, depend on a thorough understanding of the technical and biologic aspects of cardiovascular MRS, as well as the current state of research in the many areas encompassed by this discipline. It is with concept that the present monograph has been written. The organization and content should lend this book to both the beginning reader who is interested but not conversant in cardiovascular MRS, as well as to the active investigator who wishes to refer to a volume that deals with the many issues of this field in a concise but complete manner. The monograph is structured with a general overview of the field, followed by a section addressing the technical issues of cardiovascular MRS. The next section is devoted to biologic issues of both normal and abnormal myocardial metabolism, primarily devoted to investigations employing phosphorus-31. This is followed by a section dealing with more specialized issues, generally involving other nuclei such as protons, carbon, and sodium. Finally, the clinical applications of cardiovascular MRS are addressed.

A little bit more than two years after the first edition, we are pleased to publish the second edition of this book. More than half of the chapters have been remodeled and completed as the result of technical improvements and recently acquired clinical data. During these two years, the number of coronary pressure measurements performed worldwide both during diagnostic and interventional procedures has increased almost exponentially. Most of the initial problems associated with this new approach have been overcome. Many colleagues have explored new research avenues and in many catheterization laboratories the method has matured from a research toy to a clinical tool. Classical indications such as the intermediate stenosis and guidance of PTCA or stent implantation, have been largely extended and coronary pressure measurement has proven to be useful in multi vessel disease, diffuse disease, long and serial stenosis, after myocardial infarction, and in many other diagnostic and interventional situations encountered in the catheterization laboratory. Quite unexpectedly, this approach has also enforced the ties with our surgical colleagues in the selection of patients suitable for minimal invasive surgery or hybride revascularization. Also in mild and intermediate left main disease, there is a role for coronary pressure measurement in the process of decision making. We would like to express our gratitude to all those many colleagues who trusted and applied this new approach for the benefit of their patients. Aalst, Eindhoven, Bernard De Bruyne. Nico H. J. Pijls. March, 2000. Table of Contents (overview) 1 1.

Effective new treatments of heart disease are based on a refined understanding of cellular function and the heart's response to environmental stresses. Not surprisingly therefore, the field of experimental cardiology has experienced a phase of rapid expo nential growth during the last decade. The acquisition of new knowledge has been so fast that textbooks of cardiology or textbooks of cardiovascular physiology are often hard-pressed to keep up with the most important conceptual advances. Witness the explosive increase in knowledge about signaling pathways of cardiac growth, transcrip tional regulation of cardiac metabolism, hormonal signaling, and the complex responses of the heart to ischemia, reperfusion, or ischemic preconditioning. This book is meant to bridge the gap between original literature and textbook reviews. It brings together inves tigators of various backgrounds who share their expertise in the biology of myocardial ischemia. Each chapter is a self-contained mini-review, but it will soon become apparent to the reader that there is also a common thread: Molecular and cellular cardiology has never been more exciting than now, but ever more exciting times are yet to come. The Editors ACKNOWLEDGEMENTS - Publication of this book was generously supported by Sanofi-Aventis Hellas. - Eikon creative team provided the technical assistance in preparing the manuscripts. - We thank Dr. Bernard Swynghedauw for all his scientific support.

Is it advisable to go back from bedside to the bench? During the last decade, few topics encountered such a broad interest in bio- gy and medicine as angiogenesis. The amazing ability of the body to restore blood flow by induction of blood vessel growth as part of an adaptive process has alarmed physicians dealing with diseases in which angiogenesis is either exaggerated (as in tumors) or too slow (as in ischemic diseases of heart and brain). Not surprisingly, pro- and antiangiogenic strategies have found their way into clinical trials. For instance, for the USA, the NIH website in early 2004 displayed 38 clinical studies involving either pro- or antiangiogenic th- apies. Given the expected overwhelming wealth of clinical data, the question may be asked whether further exploration of biological mechanisms is required or whether results from the bedside are instructive enough to proceed. This question depends also on the progress of pro- and antiangiogenic clinical trials. In the following, I give a short overview about some of the progress that has been made in this field. Since Judah Folkman proposed antiangiogenic tumor therapy thirty years ago, it has become increasingly evident that agents which interfere with blood vessel formation also block tumor progression. Accordingly, antiangiogenic therapy has gained much attention as a potential adjunct to conventional c- cer therapy.

In this groundbreaking work, distinguished contributors explore the myriad relationships between networks of social support and the development, treatment, and rehabilitation of individuals with cardiovascular disease. Chapters span the range from conceptual to methodological issues, and take into account gender, environmental, and cultural differences. The book will provide a wealth of information for clinicians and students in the fields of behavioral medicine, psychophysiology, and cardiovascular disease.

This book provides an approach to discussing new targets for molecular strategies in heart failure therapy. On the basis of most recent data, international experts in this field elaborate on the most relevant pathophysiological alterations in heart failure on a molecular level and discuss potential strategies. These include technical aspects of gene transfer, gene transfer approaches to treating pump failure and arrhythmias, and gene transfer to prevent apoptosis. Furthermore, the topics myocyte transplantation and cell cycle regulation are discussed.
The book contains twenty-one chapters including state-of-the-art review articles as well as original papers.

This comprehensive volume provides a detailed review on the general work up of chronic kidney disease-associated resistant hypertension. This title is separated into four parts; the first of which provides definitions, epidemiology, characteristics, risk stratification and outcomes of resistant and apparent treatment resistant hypertension. The next two sections explore pathophysiology and diagnosis, treatment in the light of new guidelines, as well as procedures and devices for neural modulation. Part four discusses public health approaches to resistant hypertension, educational programs, and resistant hypertension for general practitioners. Resistant Hypertension in CKD brings up-to-date information to nephrologists, internists, cardiologists and a wide array of other clinicians and health professionals taking care of chronic kidney disease patients.

The publication embodied here represents the life work of a premier Russian scientist studying Sudden Cardiac Death. As one can gather from more than 35 first authored publications cited in the References, Dr. Rajskina has been involved with the investigation of mechanisms responsible for Sudden Cardiac Death for over 30 years. She has brought a classical approach to the sub ject, considering the effects of blood supply disturbances, electrophysiological changes that occur after regional ischemia, metabolic alterations, and the role of the autonomic nervous system in modulating these changes. These studies naturally lead to a consideration of interventions, based on her research, to prevent ventricular fibrillation after coronary artery occlusion. This is a wide ranging treatise indicative of a lifetime of study of the problem and filled with the richness of scientific experiments generated in its pursuit. There is so much in here that will be of interest to the arrhythmologist interested in Sudden Cardiac Death, whether this is on a single channel level, in vitro study of hearts, in vivo investigation of intact animals, or at the bedside. And throughout it all, statements are copiously documented with more than 850 references. That alone is worth hours of computer searching. I am very proud to have been asked by this outstanding scientist to write a brief Preface to her monumental contribution. All of us involved in the study of arrhythmic mechanisms responsible for Sudden Cardiac Death can hold Dr."

This volume focuses on latest research in therapeutic devices for cardiovascular, i.e. vascular and valvular and cardiac diseases. In the area of vascular therapies, aspects covered relate to latest research in small-diameter tissue-regenerative vascular grafts, one of the greatest persisting challenges in cardiovascular therapies, stent grafts and endovascular stents for percutaneous arterial interventions. Contributions on valvular therapies focus on tissue engineered and tissue regenerative prosthetic heart valves and valvular prostheses for trans-apical implantation including the challenges posed on the prosthesis design. The section on cardiac diseases aims at covering therapeutic advances for myocardial infarction and prevention of heart failure and on in vivo biomechanics of implantable cardiac pacemaker devices. A further section complements these three areas by presenting constitutive modelling of soft biological tissues of the cardiovascular system, an area imperative for advanced numerical and computational modelling in the development and optimisation of cardiovascular devices and therapies.

Vascular Liver Disease: Mechanisms and Management covers all of the disease entities that stem from abnormalities that affect the hepatic vasculature. This multi-authored text includes the mechanisms and management of intrahepatic vascular disease, including the most common cause of vascular disease of the liver, cirrhosis. Other less common diseases of the liver vasculature are also covered such as sinusoidal obstruction syndrome (previously known as veno-occlusive disease), portal vein thrombosis, the Budd-Chiari syndrome and congenital vascular malformations. These entities, although rare, are a challenge to physicians and physician scientists. Although many textbooks have been written on the consequences of cirrhosis on the liver vasculature, this is the only volume that focuses on the liver vasculature as a separate entity, providing an innovative approach to liver disease management. Vascular Liver Disease: Mechanisms and Management will be of great value to clinical investigators and basic scientists interested in the liver circulation as well as clinical gastroenterologists and hepatologists, hepatobiliary surgeons and transplant surgeons, and to interventional radiologists with a particular interest in the liver.