Most of the progress in cardiac energetics in recent years has been spurred by the pressure-volume area concept, the natural extension into energetics of earlier pioneering work delineating the time-varying elastance framework for ventricular contraction. The book draws together a broad spectrum of researchers - basic, applied and clinical - having a shared interest in the energetics of cardiac muscle and ventricle, providing an overview of the current state of the art.

Proceedings of a NATO ARW held in Crete, Greece, June 22-July 1, 1996

The Pumps and Pipes collaboration and conference brings together energy, medicine, and higher education in a unique shared effort, exploring ideas and research common to these important fields and stimulating discussion and sharing technologies that can further the reach and goals of each individual area. The Proceedings explores the common attributes of oil and gas technology, computational sciences and cardiovascular medicine and probe the areas where there is room to cross-fertilize and develop research and commercial programs.

Biology of Cardiovascular and Metabolic Diseases combines physiology and pathophysiology of selected metabolic and cardiovascular diseases with health relevance. Written in a concise and easy to read manner, the book allows readers to gain an understanding on a number of topics, including cardiovascular physiology and pathophysiology and how it relates to the development of insulin resistance, diabetes and other metabolic diseases. The book also highlights the relevance of obesity in the development of cardiovascular and metabolic diseases and emphasizes the benefits of exercise as a preventative measure and way to treat underlying conditions.

Histopathology of Bronchial Asthma; P.K. Jeffery. Airway Neuropeptides; P. Barnes. Potential Role of Mast Cell Proteases in Asthma; J. Nadel. Human Mast Cells, Basophils, and their Mediators; V. Casolaro, et al. Platelets and Asthma; J. Morley, et al. Leukotrienes and Asthma; J. Rokach, et al. Plasma Exudation in Asthma and its Pharmacological Control; C. Persson. Synthesis and Regulation of IgE in Asthma; G. Del Prete. Osmotic and Ionic Factors in Bronchial Responsiveness; S. Bianco, et al. Airway Responsiveness, Late-Phase Response, and Inflammation in Allergic Asthma; V. Brusasco, et al. Injury and Repair of the Airway Epithelium in Asthma; S. Rennard, et al. Bronchial Asthma and Pulmonary Gas Exchange; R.R. Rodriguez. Asthma Management; A. Tattersfield. The National Asthma Education Program; S. Hurd. Management of Asthmatic Children; K.F. Kerrebijn. 12 additional articles. Index.

It is generally easy to define the efficacy of a new the- peutic agent. However, what is even more difficult and more challenging yet more important is to define its safety when administered to millions of patients with multi-faceted d- eases, co-morbidities, sensitivities and concomitant medi- tions. The commonest cause of new drug discontinuations, cause for disapproval from marketing and removal from the market after approval is a drug's effect on cardiac repolari- tion which is essentially identified by increasing the duration of the QTc interval duration on the standard 12-lead elect- cardiogram (ECG). Cardiac Safety of Noncardiac Drugs: Practical Guide- Joel Morganroth, MD lines for Clinical Research and Drug Development is designed to present the current preclinical, clinical, and re- latory principles to assess the cardiac safety of new drugs based primarily on their effects on the ECG. Practical gu- ance to define cardiac safety at all stages of clinical research and drug development are featured and discussed by inter- tionally recognized experts with academic, industrial, and regulatory experience. Each chapter contains the best ava- able evidence, the author's personal opinions, areas of c- troversy, and future trends. Although some of the areas are highly specialized, this book has been designed for a broad audience ranging from medical and graduate students to cli- cal nurses, clinical trial coordinators, safety officers, data managers, statisticians, regulatory authorities, clinicians, and Ihor Gussak, MD, PhD scientists.

This volume provides methodologies for ES and iPS cell technology on the study of cardiovascular diseases. Chapters guide readers through protocols on cardiomyocyte generation from pluripotent stem cells, physiological measurements, bioinformatic analysis, gene editing technology, and cell transplantation studies. Written in the highly successful Methods in Molecular Biology series format, chapters include introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible laboratory protocols, and tips on troubleshooting and avoiding known pitfalls. Authoritative and cutting-edge, Pluripotent Stem-Cell Derived Cardiomyocytes aims to help researchers set up experiments using pluripotent stem cell-derived cardiac cells.

This is a comprehensive guide written by leading specialists to offer new hope to those who have suffered a heart attack or who feel they are at risk. This important book offers case examples of people from all walks of life who are leading active and normal lives - even after suffering a heart attack.

Current, relevant, and evidence-based, The Interventional Cardiac Catheterization Handbook, 5th Edition, offers clear guidance on interventional cardiology in an easy-to-understand, concise format. This must-have handbook is an invaluable resource for physicians, nurses, and technicians in every cath lab, offering quick access to easily accessible guidelines on procedures and patient care. Packed with useful information, hundreds of clear images, and narrated videos from Dr. Kern, this practical manual ensures that health care workers at all levels have the tools they need to understand and perform these complex procedures. Covers a wide range of coronary and peripheral vascular interventional procedures, from the most common to the latest specialized interventions. Incorporates the most up-to-date equipment with detailed, step-by-step techniques, cautionary notes, and outcomes. Includes recent procedures such as TAVR, MitraClipT, atherectomy, applications of new non-hyperemic pressure ratios, and approach to LV mechanical support. Features an easy-to-read outline format, bulleted summary boxes, and quick-reference tables, making this complex subject accessible and understandable. Employs a multidisciplinary heart team approach, offering practical and authoritative guidance on the many nuances to these challenging procedures. Includes dedicated chapters on catheters, guide wires, balloons, and stents; interventional pharmacology; PCI; and complications. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

Interventional cardiology is a creative, innovative, and rapidly advancing frontier of cardiology. There has been mind-boggling proliferation of tech nology in this field, the use of which requires extraordinary skills and know how. In order to keep pace with the innovative genius of interventional cardiologists, it is indeed desirable to have specialty issues updating us on technology-orientated therapeutic procedures. Contemporary interventional cardiology care is a highly specialized art, dependent on critical decision making, selection of the most appropriate inter ventional procedure, and the operator possessing extraordinary skills and compassion. This first volume of the new series, Supported Complex and High Risk Cor onary Angioplasty, attests to the preceding statement. Dr. Fayaz Shawl has mastered the procedure and has been very thoughtful and innovative in the clinical application of the percutaneous cardiopulmonary bypass support tech nique. This book provides to an interventionist the basic principles of car diopulmonary bypass, identification of the high risk coronary angioplasty patient, and other alternate support devices for myocardial protection. Dr. Shawl and his team of talented contributors are to be complimented for providing us with this impressive volume on high technology. There will be ongoing specialty issues in this series highlighting the devel opments, complications, and advances in interventional cardiology.

The Formation of the Heart and its Regulation reviews in considerable detail the major events in heart development and their control via genes, cell-cell interactions, growth factors and other contributing elements. In addition, there is an extensive and useful overview of the field of heart development taken as a whole. The book will appeal to all students and researchers working on cardiovascular development and to pediatric cardiologists.

The definite treatment ofaortic disorders goes back to the resection ofisthmic coarctation by Clarence Crafoord in 1944. It took another third of a century until all portionsofthe aortabecameaccessible to highly standardized surgery. This progress, delayed as it was in relation to most other cardiovascular in- terventions, depended on the availability of safe protective methods for the heart and central nervous system, of reliable vascular grafts and atraumatic instruments, novel suture material and tissue adhesives. The development ofadvanced surgical techniques went hand in hand with, and depended upon, the emergence of proper diagnostic tools, starting with aortography andultimately culminating inCT-scanning, transesophageal echo- cardiography and magnetic resonance imaging. These tools now allow for the rational planning and conductofany aortic intervention which may be surgical or, more recently, catheter-guided. Nienaber's and Fattori's new book aptly is addressing both the diagnos- tic procedure as well as the treatment of aortic disease. The authors are well known experts in the fields of advanced diagnostics of aortic pathology, both spearheading a remarkably innovative group of aortic interventionalists as well. On account of their expertise, their chapters are able to answer any question rising in conjunction with these subjects.

The electrocardiogram (ECG) remains the most accessible and inexpensive diagnostic tool to evaluate the patient presenting with symptoms suggestive of acute myocardial ischemia. It plays a crucial role in decision making about the aggressiveness of therapy especially in relation to reperfusion therapy, because such therapy has resulted in a considerable reduction in mortality from acute myocardial infarction. Several factors play a role in the amount of myocardial tissue that can be salvaged by reperfusion therapy, such as the time interval between onset of coronary occlusion and reperfusion, site and size of the jeopardized area, type of reperfusion attempt (thrombolytic agent or an intracoronary catheter intervention), presence or absence of risk factors for thrombolytic agents, etc. Most important in decision making on reperfusion therapy and the type of intervention is to look for markers indicating a higher mortality rate from myocardial infarction. The ECG is a reliable, inexpensive, non-invasive instrument to obtain that information. Recently it has become clear that both in anterior and inferior myocardial infarction, the ECG frequently allows not only to identify the infarct related coronary artery, but also the site of occlusion in that artery and therefore the size of the jeopardized area. Obviously, the more proximal the occlusion, the larger the area at risk and the more aggressive the reperfusion attempt.

This book surveys healthy and diseased vascular systems in a multitude of model organisms and systems. It explores a plethora of functions, characteristics, and pathologies of the vascular system such as angiogenesis, fibroblast growth factor signaling, lymphangiogenesis, junctional signaling, the extracellular matrix, vascular permeability, leukocyte extravasation, axon guidance factors, the angiopoietin system, and chronic obstructive lung disease. Following a preface from leading researcher Dr. Holger Gerhardt, the text is divided into three sections- the first examining the development of the vascular system in a variety of contexts, the second delving into its homeostatic characteristics, and the third discussing its pathophysiologies. The sixteen chapters, which represent international clinical and research perspectives, highlight the importance of molecular and signaling pathways for translational basic science and clinical medicine. Additionally, the text explores new and exciting fields in vascular biology research. Comprehensive in both content and approach, Vascular Signaling in Health and Disease is ideal for graduate students, researchers, and clinicians interested in vascular biology, pneumology, and molecular biology.

This book presents a new method for analyzing the structure and function of the biological branching systems of fractal trees, with a focus on microcirculation. Branching systems in humans (vascular and bronchial trees) and those in the natural world (plants, trees, and rivers) are characterized by a fractal nature. To date, fractal studies have tended to concentrate on fractal dimensions, which quantify the complexity of objects, but the applications for practical use have remained largely unexplored. This book breaks new ground with topics that include the human retinal microcirculatory network, oxygen consumption by vascular walls, the F hraeus-Lindqvist effect, the bifurcation exponent, and the asymmetrical microvascular network. Readers are provided with simple formulas to express functions and a simulation graph with in vivo data. The book also discusses the mechanisms regulating blood flow and pressure and how they are related to pathological changes in the human body. Researchers and clinicians alike will find valuable new insights in these pioneering studies.

This book draws on the established European guidelines from the ESC that address the key issues in sudden cardiac death, such as identifying individuals at risk prior to an episode of a ventricular tachyarrhythmia or a sudden cardiac arrest, and responding in a timely fashion to the person suffering the event out-of-the-hospital. It presents an update on what is known about sudden cardiac arrest, from basic experimental studies to clinical trials, and serves as a complement to the ESC Core Syllabus on this subject.

Topics include epidemiology, genetics, arrhythmogenic mechanisms, risk stratification, autonomic nervous system and phenotypes. Disease states and special populations are also covered, as well as drug, device and ablation treatments, and cost effectiveness. All chapters are co-authored by experts from both Europe and the US.

The ESC Education Series
This book is part of the ESC Education Series. The series is designed to provide medical professionals with the latest information about the understanding, diagnosis and management of cardiovascular diseases. Where available, management recommendations are based on the established European Guidelines, which encompass the best techniques to use with each cardiac disease. Throughout the series, the leading international opinion leaders have been chosen to edit and contribute to the books. The information is presented in a succinct and accessible format with a clinical focus.

This volume is the fifth in a series on quantitative coronary arteriography (QCA). The following topics, which all currently are and continue to be issues of extensive discussions in the research and clinical communities, are covered in great detail in this volume: endothelial function; comparisons between digital and cine coronary arteriography; inter-laboratory variation between QCA Core Laboratories; the developments in digital archival media; intracoronary pressure, coronary blood flow and flow reserve; quantitative and qualitative features in regression/progression studies; QCA in recanalization studies; and finally the current position of rivalling modalities as coronary angioscopy, intraluminal imaging with ultrasound and fluorescence spectroscopy. This book provides a comprehensive, overview for all clinicians and physicists actively involved or otherwise interested in current developments in quantitative coronary arteriography.

Hemostatis and Desmopressin: Molecular Mechanisms of Cellular Responses to DDAVP; S. Hashemi, et al. Pharmacology and Pharmacodynamics of Desmopressin: Toxicity of Desmopressin and Related Peptides; L.B. Kinter, et al. Desmopressin in Renal Disease: Control of Bleeding in Uremic Patients; Y. Sultan. Desmopressin and Platelets: Desmopressin in the Treatment of Congenital and Acquired Defects of Platelet Function; M. Cattaneo, P.M. Mannucci. Desmopressin and Surgery: Desmopressin, von Willenbrand Factor, and Surgery; M. Weinstein. Desmopressin and Blood Donation: Effects of Desmopressin on Normal Donors in Plasma Exchange Donations; R.J. Sassetti, B.C. McLeod. Clinical Applications of Desmopressin in Hemophilia and von Willenbrand's Disease: Intravenous and Subcutaneous Desmopressin; M. Kohler, G. Mariani. SideEffects and Adverse Reactions of Desmopressin: DDAVP and Tachyphylaxis in Healthy Subjects; V. Vicente, et al. Recapitulation: General Recapitulation and Search for a Consensus; P.M. Mannucci, et al. 33 additional articles. Index.

Cardiac Valve Replacement: Current Status is the proceedings of the Fourth Interna tional Symposium on the ST. JUDE MEDICAL@ valve. The first three symposia on this topic were held primarily for designated investigators involved in clinical trials of the ST. JUDE MEDICAL valve. The last meeting, chaired by Michael E. DeBakey, M.D., was held in November 1982 [1], immediately before the valve was released for general clinical use in the United States by the Food and Drug Administration. These proceedings then are the first comprehensive compilation of clinical data since that time; and they include, particularly in the discussions, the experience of physicians other than the original clinical investigators. Over the past 5 years the character of these symposia has changed. Whereas the first two dealt almost entirely with the ST. JUDE MEDICAL valve, the last two have evolved into a more generic cardiac valvular surgery meeting, focusing primarily on valve replacement rather than valve repair [2]. Thus, these proceed ings contain a wide spectrum of topics, including a keynote presentation on criteria for selection of cardiac valve substitutes in 1984, complications of cardiac valve replacement and their treatment, a review of the current status of cardiac valve substitutes other than the ST. JUDE MEDICAL valve and a consideration of cardiac valve replacement in special circumstances. Among these special circum stances are four presentations on pediatric use of the ST. JUDE MEDICAL valve.

It is the mark of an instructed mind to rest satisfied with the degree of precision which the nature of the subject admits, and not to seek exactness where only an approximation of the truth is possible. Aristotle With the development of imaging techniques, the in vivo study of human anatomy and physiology has become possible with increasing "approximation of the truth. " Advances have been made not only in data acquisition, but also in processing as well as visualization of functional and morphological data. Following the successful application of planar two-dimensional imaging approaches, more recently three-dimensional data acquisition and correspond ing tomographic image reconstruction has become possible. With the rapid growth of computer support, advanced processing allows for user-friendly interaction with complex data sets. Classical x-ray imaging techniques have matured to excellent spatial resolution and contrast, which provide specific delineation of anatomical changes occurring in cardiovascular disease. In parallel, the use of tracer principles supported the successful introduction of nuclear medicine procedures for the functional characterization of physiology and pathophysiology. The application of such techniques were initially limited by relatively poor spatial resolution, but excelled in high sensitivity 30 years, scintigraphic imaging emerged from and specificity. In the last rectilinear scanning to planar gamma camera imaging and single-photon xvi Preface emISSIOn tomography (SPECT). Based on these advances and the experi mental success of autoradiography, the potential of scintigraphy as a clinical and research tool has been well appreciated.

Cardiac anatomy had already been a subject of and its control in health and disease has been great interest for centuries when Harvey de- published. Studies of hypertrophy, heart failure, scribed the dynamic nature of blood flow, but ischemia, and infarction have been vigorously the concept of defining ventricular function was pursued in experimental animals and in human first introduced with the measurement of a subjects, and as a result new areas for study have emerged. These include the process of hypertro- mare's blood pressure by Steven Hales in 1733. Amidst the important contributions of a number phy as an adaptive mechanism, the coronary vas- of European physiologists, the primal relation- cular reserve in hypertrophy, the role of the ship between the mechanical energy of the heart microvasculature in myocardial failure, active and the length of a myocardial fiber was enun- relaxation and other diastolic mechanisms that contribute to the syndrome of congestive heart ciated by E. H. Starling in 1912; this became known as the "law of the heart. " Perhaps the failure, ventricular interaction and the role of the normal pericardium, ischemic-stunned- first major refinement of this law was suggested by Sarnoff and co-workers, who introduced the reperfused myocardium, and vasoactive drugs in concept of homeometric autoregulation to ex- the treatment of heart failure.

Subjects of the book are Heart Failure and Atrial Fibrillation, two emerging pathologies in the field of cardiology, to which many investigators are now addressing their research. Their diffusion in the sick population represents a major public health problem at the beginning of the third millennium. The volume aims to present the latest approaches to the management of heart failure and atrial fibrillation, emphasising in particular the intrinsic relation existing between them, the results after 10 years of biventricular pacing, the innovative pacing techniques now available, and the use of new drugs, devices or ablation procedures for the prevention and treatment of atrial fibrillation recurrences.

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 brings together a diverse array of information in a comprehensive and concise fashion using a template of 10 chapters written by experts in the field. It should be of value to 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.