After yet another decade of leaming, experimenting, and inves tigating since my first book, Arterial System Dynamics, the many new medical breakthroughs and technological advances have inspired me to write this book to bridge the gap between basic research and clinical applications. The application of physical principles and quantitative approaches to the understanding of the arterial circulation and its interactions with the heart in normal and diseased conditions form the basis of The Arterial Circulation. Knowledge of the physiology and rheology of arteries, as well as all of their structural-functional corre lates, is a necessary prerequisite to the proper hemodynamic interpretatiqn of pressure-flow relations and the pulsatile transmis sion characteristics in different arteries. The natural coupling and interactions of the heart, the coronary circulation, and the arterial system necessitate analysis of alterations to global functioning. Modeling provides a tool for isolating and predicting parameter changes and is employed throughout the book. Experimental data are provided for model validations, and also for more realistic interpretations. Techniques and new methods for clinical hemo dynamic measurement and diagnosis are included to help the reader un derstand the physical principles underlying such abnormal cardiovascular functions as hypertension, stenosis, and myocardial ischemia. The progressive changes in vascular properties during aging are also discussed. Modem approaches utilizing computer mode ling and allomery are presented with selected examples, such as combined hypertension and aortic valve stenosis, and ventricular hypertrophy."

In this issue, guest editors bring their considerable expertise to this important topic. Provides in-depth reviews on the latest updates in the field, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize

Cardiac Markers is a comprehensive, up-to-date summary of clinical information on serum cardiac markers for coronary artery disease. This book reviews in detail the biochemistry, clinical significance, and analytical measurements for each marker, as well as the advantages and limitations of existing and proposed markers. Comprehensive descriptions of therapeutic approaches to manage patients are presented. Also included are up-to-date listings of primary references and commercial methodologies, the latest data on the pathophysiology of unstable angina, and a discussion of the new emergency-room chest pain centers. Anyone who needs to know how to examine, diagnose, treat, and manage patients with acute chest pain and heart attacks will find this book indispensable.

High-Quality Transesophageal Echocardiography presents a step-by-step approach aimed to help readers understand how to perform a high-quality transesophageal echocardiogram. The book explains the steps, tips, tricks, and troubleshooting tactics for performing a transesophageal echocardiogram effectively and with highest diagnostic utility, while ensuring patient safety and comfort. High-Quality Transesophageal Echocardiography is suitable for a wide audience from early learners of the technique who want to accelerate their progress and boost their confidence to those already qualified in the procedure who want to pick up tips to increase the quality and effectiveness of their practice.

The treatment of end-stage heart failure with advanced surgical therapies has evolved significantly over the last several years and is a dynamic subspecialty within cardiac surgery. "Surgical Treatmentfor Advanced Heart Failure "describes the surgical management of advanced heart failure, including coronary artery revascularization, mitral valve repair, aortic valve replacement, ventricular remodeling, cardiac resynchronization, mechanical circulatory support with short-term devices for acute stabilization, long-term mechanical support as a bridge to transplant and for destination therapy, left ventricular assist devices, complete cardiac replacement with the total artificial heart, and cardiac transplantation. With contributions from a distinguished group of heart failure cardiologists and transplant surgeons, it is an authoritative resource for cardiac surgeons, cardiologists, and surgeons.

Leading researchers are specially invited to provide a complete understanding of a key topic within the multidisciplinary fields of physiology, biochemistry and pharmacology. In a form immediately useful to scientists, this periodical aims to filter, highlight and review the latest developments in these rapidly advancing fields.

W. KUPPER Coronary artery vasoconstriction is not only the mechanism responsible for Prinzmetal's variant angina, but may also be involved in stable angina pectoris and myocardial infarction. However, the underlying patho-physiological mecha- nisms and the importance of coronary vasoconstriction in these syndromes is still largely unknown. Several hypotheses have been proposed. Sympathetic nervous activity plays a key role in the regulation of coronary blood flow, but mechanical or humoral constrictive factors may be active as well. a-adrenergic tone Adrenergic nerve fibers accompany coronary vessels of any size. The stimulation of cardiac sympathetic nerves causes an increase in coronary blood flow. If, however, chronotropic and inotropic effects of adrenergic stimulation are sup- pressed pharmacologically by beta-adrenoceptor blockade, a reduction in flow is observed. Thus, the primary effect of sympathetic stimulation on the coronary arteries is the alpha-adrenergic mediated vasoconstriction. Functionally inner- vated alpha-adrenoceptors have been documented both in large coronary con- ductance arteries and in the small resistance vessels. Animal studies and a human study have documented that a permanent constrictor tone is present on the coronary circulation both at rest and during exercise; this condition could be prevented with alpha-adrenoceptor blockade or was absent after heart transplan- tation. Therefore, alpha-adrenoceptor mediated coronary constriction is an at- tractive hypothesis as a possible pathophysiological mechanism of inappropriate coronary vasoconstriction and cororiary vasospasm.

In this issue of Heart Failure Clinics, guest editors Drs. Ragavendra R. Baliga and Dipti Itchhaporia bring their considerable expertise to the topic of Digital Health, sometimes referred to as eHealth. Top experts in the field cover key topics in the field such as using AI to better predict/develop biomarkers; telehealth in heart failure; EHR in heart failure; artificial intelligence and mechanical circulatory support; and more. Contains 11 relevant, practice-oriented topics including devices to improve symptoms and reduce morbidity and mortality in heart failure; utilizing artificial intelligence to enhance equity in minority populations; 3-D printing in heart failure; machine learning in cardiac imaging; and more. Provides in-depth clinical reviews on digital health, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

Cardiovascular disease is the leading cause of death in the United States and is the focus of ongoing research. Consequently, treatment of cardiovascular disorders is among the most highly evidence-based area of medicine and pharmacy practice.

Quick Reference to Cardiovascular Pharmacotherapy provides important guidelines and standards of care in the pharmacological management of cardiovascular diseases. It begins with the management of cardiovascular risk factors and continues with important pharmacotherapeutics. In addition, the authors tackle crucial pharmacotherapeutic problems related to managing patients with cardiovascular diseases, such as drug-induced cardiovascular side effects and alternative pharmacotherapy for managing cardiovascular diseases. With numerous tables and charts utilized throughout, the pocketbook also contains important dosing information applicable specifically to cardiac patients.

Furthermore, based on their experience, the contributors offer important clinical pearls to help deal with commonly encountered clinical problems in daily practice. Quick Reference to Cardiovascular Pharmacotherapy provides health care professionals and students a concise, quick, and authoritative summary of how to utilize pharmacological agents for the management of cardiovascular disease.

Intravascular ultrasound imaging (IVUS) plays very important roles in clinical cardiology. This book describes the newest advances in vascular ultrasound imaging and the surrounding technologies for high frequency vascular ultrasound imaging. Most important topics of the book are technical applications of IVUS (elasticity imaging, chromaflow...) and the basic data (vibration, acoustic microscopy) that should provide very important information to understand clinical IVUS imaging.

Improving our insights into the genetic predisposition to cardiovascular disease is one of the most important challenges in our field in the next millennium, not only to unravel the cause of disease but also to improve the selection of patients for particular treatments. Nowadays, for example, subjects with a cholesterol above a particular plasma level are exposed to a cholesterol lowering regime based upon the beneficial outcome of epidemiological studies which include subjects not prone to the disease, despite a plasma cholesterol above the accepted level. Identification of the patients who are genetically predisposed to the consequences of this disorder will reduce the number of subjects unnecessarily treated and, hence, the costs of health care. Because in most cardiovascular diseases the genetic component is a consequence of more than one gene defect, only limited progress has as yet been made in identifying subjects genetically at risk. For example, in hypertension only in less than 10% of the patients the genetic defect has been identified. It has been known for quite some time that in heart and blood vessels fetal genes are as high blood pressure and upregulated or induced when they are exposed to such disorders ischemia. Little is known about the function of these genes in the cardiac and vascular adaptation to these disorders; only guesses can be made.

Following the advent of percutaneous balloon vel oped and are available for clinical use, as well angioplasty, interventional cardiovascular pro as those that are still in investigational phases. cedures have become of great interest to the Clinical case reports are presented by expert in cardiologist, radiologist, and cardiovascular vestigators on the use of various catheter systems surgeon. One of the most extensively explored in the coronary and peripheral circulation. alternatives to bypass surgery is laser-mediated Part V (Chapters 17-23) is the most up-to angioplasty. The fascination with laser radia date review of the clinical experience with vari tion has greatly contributed to its popularity, ous laser delivery systems. There is an emphasis but has also burdened it with unrealistic ex on patient selection, criteria for lesion choice, pectations. Many commercial laser systems are and follow-up data. A detailed description of available to the clinician and the researcher, laser recanalization techniques is presented for which often makes the choice of a laser system the various systems in the clinical setting.

Much has been written about reperfusion injury in the past decade but unfortunately the information has been generally presented in the form of original specialist papers and little if any integral publication exists on the topic, summarising and analysing the clinical impact of the condition and its management. The pathophysiology and molecular mechanisms of reperfusion injury are complex and, regarding diagnosis, individual diagnostic techniques have been proposed but without a proper assessment of the relative values of these methods. A publication dealing with integral diagnostic strategies would be welcome by the managing physician. Management of the condition is also problematic, as strategies that appear to work in the experimental models do not translate into beneficial interventions in patients. There is a need for these issues to be addressed and discussed in a monographic fashion. Management of Myocardial Reperfusion Injury will tackle these issues in a modern and systematic way and the information will be delivered in a fashion that will be appealing to the reader.

In this issue of Cardiac Electrophysiology Clinics, guest editors Drs. Domenico G. Della Rocca, Giovanni B. Forleo, and Andrea Natale bring their considerable expertise to the topic of Arrhythmic and Vascular Complications of Coronavirus Disease 2019 (COVID-19). Top experts in the field cover key topics such as prevalence and clinical implications of COVID-19 myocarditis; electrocardiographic and echocardiographic features of COVID-19 patients; imaging findings of COVID-19-related cardiovascular complications; the role of digital health during COVID-19 pandemic; and more. Contains 14 relevant, practice-oriented topics including prevalence, management, and outcomes of supraventricular arrhythmias in COVID-19 patients; prevalence, management, and outcomes of ventricular arrhythmias in COVID-19 patients; COVID-19 associated endothelial dysfunction and microvascular injury; COVID-19, acute myocardial injury, and infarction; and more. Provides in-depth clinical reviews on arrhythmic and vascular complications of COVID-19, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

This publication is intended as a guide to common diagnostic, operative and percutaneous techniques used in creating and maintaining vascular access for hemodialysis. When writing the text, the authors have focused on surgeons in training, fellows, interventional radiologists and clinically active nephrologists. Dialysis nurses and other clinicians involved in the care of end stage renal disease and dialysis patients will also greatly benefit from this handbook. This 2nd edition of the text contains expanded sections on ESRD, access surveillance and surgical and diagnostic devices, as well as new sections on peritoneal and dual lumen catheter placement, commonly used drugs and dialysis, hemo- and peritoneal dialysis techniques and CPT and ICD coding for statistical and billing purposes. These changes reflect the highly technical nature of clinical management in this evolving specialty.

New Frontiers in Angiogenesis starts with a comprehensive overview of the field and continues with topics that have been minimally explored. The topics deal with dynamics of vasculogenesis using imaging techniques, bone marrow-derived endothelial cell precursors as potential therapeutic tools, regulation of post-angiogenic vessel regression, vascular mimicry, design and construction of artificial vessels, bioengineering of angiogenesis, and lymphangiogenesis recapitulating angiogenesis in health and disease states. Each chapter is written by leading experts of the subjects. It is hoped that this volume will challenge all of us interested in the field of angiogenesis and cardiovascular biology, in particular those in academia and industries, to think "outside the box" and explore angiogenesis from a fresh angle. It is hoped that New Frontiers in Angiogenesis is thought provoking and serve as a road map for discovering new findings to help betterments of human health.

This volume represents a part of the scientific proceedings of the Sixth Annual Meeting of the American Section of the International Society for Heart Research that was held in Oklahoma City from September 13-15, 1984. The chapters have been grouped according to the content of invited symposia on cardiovascular topics ranging from electrophysiology, autonomic control of the circulation, aging of the myocardium, mechanisms of cardiovascular injury, cultured heart cell studies, etc. Abstracts of all the papers presented at this meeting are included in Volume 16 (Supp. 1) of the Journal of Molecular and Cellular Cardiology. Since our understanding of the pathobiology of cardiovascular injury requires integrating knowledge from both basic and clinical sciences, the information presented in this volume extends from fundamental biochemical processes to pharmacological agents required to treat complex cardiac arrhythmias. At the molecular level, the structural lipids of the sarcolemma may be altered during myocardial ischemia; the role of free radicals in this process is one emerging area of active study. At the subcellular level, plasma membranes provide the anatomical basis for maintenance of optimal potentials of excitable cells; the anatomy and physiology of the sarcolemma ultimately determines the response to drugs and metabolic perturbants. At the cellular level, much progress has been made in our understanding of cultured and adult myocytes during ischemia and hypoxia; in particular, the electrophysiology of these model systems is well understood and several chapters address this approach.

Molecular biology has revolutionized research into vascular disease. Over the past 20 years molecular techniques have enabled us to both elucidate - lecular mechanisms in vascular disease and identify appropriate therapies. The vast explosion in technical knowledge and the array of protocols that become more advanced and intricate by the day lead us into new and exciting areas of research that were previously unobtainable. Vascular Disease: Molecular Biology and Gene Transfer Protocols - scribes today's most powerful molecular methods for the investigation of the pathogenesis of vascular disease. The protocols are highly detailed, allowing beginners who have little experience in either vascular biology or molecular biology to embark on new molecular projects. This book is also suited to more experienced molecular biologists who wish to grasp new methods for stu- ing the involvement of genes in normal vascular physiology and in diseased states. It is well established that cardiovascular disease progression has a s- stantial genetic influence. Part I describes three methods that have been used successfully to identify specific mutations in candidate genes involved in c- diovascular disorders. These mutations include both single-stranded conf- mational polymorphism analysis and heteroduplex detection methods. In addition, technology to map new genes to specific regions of chromosomes by high-resolution mapping is described.

During the 25 years since acute coronary care was focused into Coronary Care Units there have been three major Phases: I. prevention of death caused by arrhythmias; II. prevention of death due to myocardial failure; and III. limitation of infarct size. In the latter two Phases, there has been infringement upon the time honored concept of a prolonged period of rest for the patient in general and the heart in particular to minimize myocardial metabolic demands. During the second Phase of coronary care, patients with myocardial failure received aggressive measures to increase cardiac work via increase in preload, decrease in afterload, and direct increase in inotropy. It was believed that true cardiogenic shock was so irreversible that it should be prevented by vigorous efforts to improve the cardiac output despite the risk of extending the area of ischemic myocardium. However, Phase II produced minimal overall reduction in mortality. In the initial part of Phase III, myocardial infarct (MI) size limitation was attempted by reducing myocardial metabolic demands via either beta adrenergic or calcium channel blocking agents. We are currently several years into the second part of Phase III of coronary care where the principle means of limiting MI size is restoration of coronary blood flow.

Not too long ago, it was thought that inflammation of blood vessels was the sole manifestation of systemic autoimmune diseases. Today, however, we know that disorders of coagulation, injuries to both neutrophils and endothelial cells, and certain lipids and amino acids are all intricately involved in the development of vascular disease. How are all these processes linked? What strategies can we employ or develop to halt the progression of vascular damage? What are the best ways to control acute vasculitis and vasospasm therapeutically? What are the risks and benefits of various strategies for the prevention of clotting? How soon should we initiate preventive strategies that protect blood vessels from arteriosclerosis in people with acute rheumatic diseases? What should be the nature of those strategies?

Vascular Manifestations of Systemic Autoimmune Diseases provides answers to all these questions. Ronald Asherson, Richard Cervera,Steven B. Abramson, Jean-Charles Piette, and Douglas Triplett- all international experts in the field-have assembled a collection of works that provide a comprehensive analysis of vascular irregularities. Now that most individuals survive the onset of acute systemic autoimmune diseases and live for decades more, halting the long-term attack on vasculature is increasingly important.
Vascular Manifestations of Systemic Autoimmune Diseases not only describes the clinical symptoms of vascular diseases; it also covers in one volume the many mechanisms involved in the pathogenesis of these disorders and addresses the newest treatments available for them.

The molecular basis for atrial fibrillation continues to be largely unknown, and therapy remains unchanged, aimed at controlling the heart rate and preventing systemic emboli with anticoagulation. Familial atrial fibrillation is more common than previously suspected. While atrial fibrillation is commonly associated with acquired heart disease, a significant proportion of individuals have early onset without other forms of heart disease, referred to as "lone" atrial fibrillators. It is also well recognized that atrial fibrillation occurs on a reversible or functional basis, without associated structural heart disease, such as with hyperthyroidism or of atrial fibrillation following surgery. It remains to be determined what percentage in these individuals is familial or due to a genetic predisposition. Mapping the locus for familial atrial fibrillation is the first step towards the identification of the gene. Isolation of the gene and subsequent identification of the responsible molecular genetic defect should provide a point of entry into the mechanism responsible for the familial form and the common acquired forms of the disease and eventually provide more effective therapy. We know that the ionic currents responsible for the action potential of the atrium is due to multiple channel proteins as is electrical conduction throughout the atria. Analogous to the ongoing genetic studies in patients with familial long QT syndrome, it is highly likely that defects in each of these channel proteins will be manifested in familial atrial fibrillation.

Advances in cellular physiology and molecular biology have now disclosed the metabolic changes and adaptational responses of the heart to various kinds of stresses. Topics covered in this volume include the regulation of myocardial proteins in mechanical overload, the alteration of adrenoceptors in the stressed heart, metabolic adaptation in cardiac hypertrophy, intracellular calcium metabolism in the ischemia-reperfused myocardium, calcium overload as a cause of myocardial stunning, acquisition of ischemic tolerance by ischemic preconditioning, factors that accelerate myocardial injury, and ventricular remodeling in the ischemic heart. As an update of the latest findings in basic cardiology, this book will benefit both researchers and clinical practitioners.

The VIth World Symposium on Cardiac Pacing in Montreal 1979 opened with a course, meant to be an introduction for newcomers and an updating re fresher and link between the various fields of knowledge needed by experienced persons for cardiac pacing. Invited guest lecturers were selected for their world recognized expertise in the individual subjects. This book is a collection of the various presentations on historical, clinical, electrophysiological and technical aspects of cardiac pacing. Together they cover the fundamentals of cardiac stimulation. We hope that this book may become an introductory guide to the field of cardiac pacing and that it may contribute to a better understanding of the pacemaker system and a better treatment of the pacemaker patient. Claude C. Meere Hilbert J. Th. Thalen ACKNOWLEDGEMENT The editors of 'Fundamentals on Cardiac Pacing' acknowledge the under standing and support of their families, during the long nocturnal hours and weekends during which this book was prepared. A special note of appreciation is extended to our secretaries, especially Mrs. Carolyn Gaarenstroom-Arriens and Miss Katrien Schuurman for their 'emergency typing' and Miss Lynn Bacon and Mr. Boudewijn Commandeur from Martinus Nijhoff Publishers, who succeeded in completing the book in time for the Montreal meeting. Only those involved are able to realize the importance of their contribution. CONTRIBUTORS David L. Bowers, B.S.E.E., Vitarel Inc. San Diego, California, U.S.A. Guy Fontaine, M.D., Groupe Hospitalier, Pitie-Salpetriere, Paris, France."