The field of electrocardiography is at a cross roads. We have reached an era in cardiovascular about the electrical state of the heart not likely to be available in any other imaging techniques. medicine where it is claimed that "imaging" is king. The innovative and useful ultrasound And, in the body surface potential map, we have an imaging technique that goes beyond struc techniques continue to develop, and, in the wings lie magnetic resonance, position emission, ture-the only other being, perhaps, magnetic resonance, which has the potential for metabolic and, perhaps, other modalities. Consequently, there are those who state that, other than the imaging. Clinical electrocardiography is impor problems related to cardiac rhythm, electro tant not only as a diagnostic tool for it can truly cardiography as a discipline is passe. In addi give insight into the effect of the disease in question on the heart muscle itself. tion, although there is continued superb work in the basic science related to arrhythmias, only Therefore, it seemed now to be appropriate to a handful of scientists are interested in the bring together leaders in the various fields of myocardial source per se. And few scientists are electrocardiography with the only constraint interested in what happens to that myocardial being a concentration on newer concepts and electrical source on its trip from the endo ideas.

Coronary artery disease is the most common cause of morbidity in the developed and developing world. In the acute situation, in contrast to the stable presentation, there is a need for urgency with clear benefits from intervention. However it is imperative that risks are assessed and addressed as part of the long term strategy. Preventing acute coronary syndromes is more important than dealing with them.
This concise, practical pocketbook opens with the background and mechanisms leading to the acute event and how an understanding of the pathophysiology can direct the overall management and not just the acute presentation. The books intention is to highlight the practical aspects of management and establish straightforward management plans. It therefore looks at the syndromes via a team approach to address all of the issues and optimise care.

Genetics and Genomics for the Cardiologist is a concise, but comprehensive volume for the clinical cardiologist or medical student interested in learning how molecular genetics is now being applied to prevention and treatment of heart diseases, from DNA tests to pharmacogenomics and gene-based therapeutics. The volume, written in a plain language, contains detailed figures. A rich glossary, three appendices, many references and several URLs provide additional sources of information.

The kidney, similar to the heart, plays a three-fold role in essential hypertension. First, it participates in the patho genesis of arterial hypertension. Second, it suffers as a target organ of long-standing hypertension, and third, it experiences the effects of antihypertensive therapy. Perhaps most contested at the present time is the involvement of the kidney in the patho genesis of essential hypertension. More than a century ago, William Osler put forward three basic hypotheses about the "genuine contracted kidney. "l 1. "The hypertrophy can be regarded as an effect to overcome a sort of stop-cock action of the vessels when under the influence of an irritating ingredient in the blood greatly contracted and increased the peripheral resistance. " Clearly this hypothesis of an "irritating ingredient" is perhaps the most convincing nowadays, and numerous attempts have been made to identify a specific vasoconstrictive agent in the blood in essential hypertension. 2. "The obliteration of a large number of capillary territories in the kidney materially raised the arterial pressure. An additional factor of dimin ished excretion of water also heightened the pressure within the blood vessel. " Today we know that fluid volume overload in the presence of reduced renal mass seems to be the most likely mechanism accoun ting for renal parenchymal hypertension and, as shown by Guyton's group, for certain forms of experimental hypertension. 3."

Prevention and treatment of cardiometabolic disorders by lifestyle management is the most understood and effective applications of this emerging field. The focus of this book on prediabetes, diabetes and cardiometabolic diseases is timely and will be a welcome addition to clinicians who wish to gain more knowledge and competence in the area. This book will focus on the metabolic syndrome, which is the largest non-communicable disease of our time, and lifestyle approaches that drastically reduce the risks and adverse effects of this condition. Presents a detailed review of clinical evidence and guide for implementation. Provides a toolkit to counter both the high cost of medications and the need to address metabolic disorders associated with insulin resistance early, before or simultaneous to when medications are indicated.

Proteomics is a rapidly expanding investigation platform in cardiovascular medicine. Driven by major improvements in mass spectrometry (MS) instrumentation and data analysis, the proteomics field has flourished in recent years particularly in the study of complex diseases. These recent advances are characterized by the development of quantitative MS-based methods that promoted the field from primarily identifying proteins to also providing measurements of relative changes in protein levels between different cell states. This progress is reflected in the application of proteomic techniques to vascular pathology. Vascular Proteomics: Methods and Protocols provides up-to-date methods and protocols for the analysis of arteries, cells, lipoproteins, body fluids, and metabolites, with a particular focus on MS-based methods of protein and peptide quantification. Written in the successful Methods in Molecular Biology (TM) series format, chapters include introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible protocols, and notes on troubleshooting and avoiding known pitfalls. Authoritative and easily accessible, Vascular Proteomics: Methods and Protocols is a representative selection of methods that can be a useful resource for experienced proteomics practitioners as well as newcomers interested in becoming acquainted with the practice of proteomic techniques for cardiovascular research.

Molecular and Translational Vascular Medicine will serve as a state-of-the-art resource for physicians and translational medical researchers alike who are interested in the rapidly evolving field of vascular medicine. The text provides new insight into the basic mechanisms of classic vascular pathophysiologic processes like angiogenesis, atherosclerosis, thrombosis, and vasculitis. Furthermore, it covers new areas of investigation including the role of the ubiquitin proteasome system in vascular disease, endothelial progenitor cells for disease treatment, and the genetic basis of thoracic aortic aneurysms. Lastly, this volume includes sections on the newly emerging field of therapeutic angiogenesis, and the developing technology of nanoparticle-based imaging and therapeutic treatment of the diseased vasculature. All chapters are written by established experts in their fields, including pathologists, cardiovascular surgeons, and internists as well as translational biomedical researchers in a wide range of disciplines. While comprehensive, the material is presented in a manner that simplifies the complex pathophysiologic mechanisms that underlie common vascular diseases. Molecular and Translational Vascular Medicine will be of great value to a broad audience including internists, cardiovascular and vascular surgeons, pathologists, residents and fellows, as well as translational biomedical researchers.

This book is the first comprehensive overview of the emerging field of cuffless blood pressure monitoring. Increasing clinical evidence proves that longitudinal measurements of blood pressure allow for earlier detection and better management of multiple medical conditions and for superior prediction of cardiovascular events. Unfortunately, today's clinical and industry standards for blood pressure monitoring still require the inflation of a pneumatic cuff around a limb each time a measurement is taken. Over the last decades clinicians, scientists and device manufacturers have explored the feasibility of technologies that reduce or even completely eliminate the need of cuffs, initiating the era of cuffless blood pressure monitoring. Among the existing literature, this book is intended to be a practical guide to navigate across this emerging field. The chapters of the handbook have been elaborated by experts and key opinion leaders in the domain, and will guide the reader along the clinical, scientific, technical, and regulatory aspects of cuffless blood pressure monitoring.

Enhancing Fertility through Functional Medicine: Using Nutrigenomics to Solve 'Unexplained' Infertility provides cutting-edge information and solutions to help support the worldwide rise of fertility challenges. It addresses common, yet not commonly known, root-causes of oxidative stress that are at the heart of reproductive issues (and all chronic health issues). These solutions can help enhance the outcomes of Assisted Reproductive Technologies (ART) or support women to avoid them altogether. Enhancing Fertility through Functional Medicine: Using Nutrigenomics to Solve 'Unexplained' Infertility will show you how to improve cell health (including egg and sperm), lower inflammation, balance nervous system functioning, and optimize genetic expression, allowing the body to return to its naturally fertile state. It details information on numerous root causes of health-derailing inflammation and oxidative stress, while the appendices discuss the genetic and biochemical pathways related to these topics. Each chapter also provides easy "Action Steps" that can be implemented immediately. Chapter topics include iron dysregulation; oxalates; mold/mycotoxins; phase 2 liver detoxification pathways; fat utilization; introductory information on genetics, epigenetics, and nutrigenomics; everything one needs to know about histamine intolerance; and how these factors adversely affect metabolic and reproductive functions. Enhancing Fertility through Functional Medicine: Using Nutrigenomics to Solve 'Unexplained' Infertility is the handbook for people wanting to achieve and sustain a healthy pregnancy. It highlights lesser-known causes of fertility challenges the reader can learn how to investigate. This book also serves as a reference guide for practitioners, providing them with additional tools to add to their repertoires when other protocols have not been effective. It may also provide clarity as to why other protocols did not work, and will enable the practitioner to custom-tailor protocols for each patient.

This book is an articulate, concise, contemporary introduction to the study of important variables underlying cardiovascular reactivity. Its strength is in the combination of a scholarly but nonpedantic approach to cardiovascular psychophysiology and a solid understanding of be havioral medicine approaches to the study of hypertension. The topics covered are central to the study of relationships between behavior and cardiovascular reactivity; the list of suggested readings at the end of each chapter provides excellent guidance for more detailed study of specific issues. It has now been more than a dozen years since Plenum Press published Paul Obrist's seminal monograph Cardiovascular Psycho physiology. The volume had a major impact in relating cardiovascular regulation to behaving individuals and in developing thoughtful hy potheses concerning such factors as they might pertain to hypertension. The impact of that work extended across scientific disciplines as well as aross continents. At the time the Obrist book was published, a young psychologist, J. Rick Turner, was completing his Ph. D. thesis in psychol ogy at the University of Birmingham, England, on heart rate reactions to psychological challenge. After continued collaboration for the next several years with his former Ph. D. mentor, Douglas Carroll, Turner joined the Obrist laboratory at the University of North Carolina. Al though Obrist unfortunately died during Turner's tenure in the labora tory, collaboration continued with Kathleen Light and Andrew Sher wood. The enlightened legacy of the North Carolina laboratory can clearly be seen in this text."

Outlines the basics of nutrition for healthcare professionals. Directed towards an international audience; written from the holistic perspective. There has been a definite shift in our perception and understanding of foods and diet. More attention is being given towards how we grow and cultivate food sources whilst being mindful about the environmental impact this may have - this book is timely, the medical community is now giving due importance to dietary content.

Collateral blood vessels develop by growth of pre or newly formed structures in almost all vascular provinces as a consequence of progressing stenosis of the main artery. These alternative routes of blood supply are potentially able to alter the course of vascular disease. Collateral development is a time consuming process, and arterial stenosis and occlusion often progress faster than growth of the alternative routes. The authors' ultimate goal is to provide a better understanding of collateral growth in order to pave the way for improving the conditions for these potentially selfhealing processes. These were programmed by nature but have not been perfected, probably because defenses against arterial disease had not been put under the pressure of natural selection.

The first invasive evaluation of cardiac arrhythmias in humans was performed in 1967 in Paris (Prof. P. Coumel) and Amsterdam (Prof. D. Durrer). This was the start of a rapid increase in our knowledge of the diagnosis, mechanism and treatment of cardiac arrhythmias. In that same year Prof. Hein J.J. Wellens became cardiologist in the Wilhelmina Gasthuis in Amsterdam. Initially in Amsterdam (1967-1977) and later on in Maastricht (from 1977), he was the driving force for many breakthroughs in clinical cardiac electrophysiology. With an active interplay between the knowledge derived from the 12-lead electrocardiogram and the recordings made with invasive electrophysiology, he composed new ideas leading to major contributions in clinical cardiac electrophysiology and, more generally, in arrhythmology. He published over 650 scientific papers and 14 books, and had numerous functions within scientific boards of prestigious journals. In addition he trained more than 120 cardiologists in clinical cardiac electrophysiology. On the occasion of the congress `2000, Future of Arrhythmology: Lessons From the Past, Promises For Tomorrow', we highlight the scientific work of Prof. Hein J.J. Wellens. A selection of more than 60 articles over the whole time span has been selected. These articles are accompanied by comments from an expert, co-worker and/or former fellow in order to place the paper in a scientific time frame, including the relationship of the author with Prof. Hein J.J. Wellens.

Despite recent advances in the diagnosis and treatment of various cardiac illnesses, including ischemic, valvular and cardiomyopathic disease, the most cost-effective means of employing laboratory testing and treatment modalities remains an issue in most practice settings. With the advent of managed care and vigilant third-party payer evaluation of the use of diagnostic tests and hospital length of stay, the most effective medical and economic method of managing everyday cardiac illness is a question that arises daily in practice. To this end, we have selected well-known and widely published experts in cardiac diagnosis and therapy to develop practical and informative approaches outlining the most cost-effective methods of patient management. The topics include the entire range of cardiac diseases and emphasize the economic impact on decision-making. We develop guidelines and present general strategies for the practicing cardiologist and general internist. Additionally, the editors, who have 10 years of experience in this area, discuss the methods necessary to bring critical pathways and practice guidelines into clinical use. Both hospital and out-patient phases of illness are considered. Special concerns of hospital, private practice managed care and group practice settings are specifically addressed.

The world is faced with an epidemic of metabolic diseases such as obesity and type 2 diabetes. This is due to changes in dietary habits and the decrease in physical activity. Exercise is usually part of the prescription, the first line of defense, to prevent or treat metabolic disorders. However, we are still learning how and why exercise provides metabolic benefits in human health. This open access volume focuses on the cellular and molecular pathways that link exercise, muscle biology, hormones and metabolism. This will include novel "myokines" that might act as new therapeutic agents in the future.

Cardiac output has always been a subject of interest to both clinicians and researchers in different branches of medicine and surgery. In the last decade more attention has also been paid to its application in pediatrics, neonatology, fetal medicine and pregnancy. Better understanding of the peripheral circulation has provided more insight into the patholophysiology of different diseases. Many cardiac and non-cardiac disorders affect cardiac outputs. Monitoring of the changes in cardiac output is also important in the acutely ill patient. There are several methods to measure cardiac output, each with advantages and pitfalls. This book deals with all relevant aspects of cardiac output in eight parts: part one describes the methods of measuring cardiac output and a comparison between the catheterisation based and the noninvasive techniques, while part two describes the changes in cardiac output due to physiological causes. Part three describes cardiac output in cardiac diseases and systemic hypertension. Cardiac output in acutely ill patients is discussed in part four. Effect of cardiac medications, temporary atrial pacing, permanent pacing, pharmacologic stress testing and anesthesia are covered in detail in part six, while changes in cardiac output in noncardiac diseases are described in part seven. Finally great attention has been paid in part eight to the regional circulation including cerebral, coronary, skeletal and splanchnic circulations. A separate chapter discusses in detail the dynamics of blood flow. This book will be useful both to the cardiologists as well as to physicians in other fields of surgery and medicine and to their trainees. Readers will find this book an interesting and a useful reference on the topic of cardiac output.

Dyspnoea (breathlessness) is an uncomfortable awareness of breathing that occurs in approximately 30-75% of terminal cancer patients. It is one of the most distressing symptoms for both patients and family members and can seriously impact on quality of life. Typically, dyspnoea is associated with congestive heart failure, end-stage chronic obstructive pulmonary disease, or lung cancer. This book provides palliative care doctors and specialist nurses with practical guidelines to help manage and treat patients with breathlessness. It includes the science behind the symptom in an attempt to explain the pathology and physiology of this complex condition. The book has been organized to address generalized aspects of breathlessness in advanced illness and more specific aetiologies and managements relevant to particular underlying diseases. It summarizes the epidemiology and the pathophysiology of breathlessness, measurement, research approaches, rehabilitation and exercise, clinical approaches that can be taken at the bedside, pharmacological and non-pharmacological approaches, and surgical interventions. The care of patients with dyspnoea requires input from a variety of disciplines such as palliative care, physiotherapy, respiratory medicine and nursing, and this is reflected in the multidisciplinary list of contributors.

This book gathers multidisciplinary articles that present advances of our understanding of diseases and the effective treatment of patients. The authors share recent clinical and experimental research findings, highlighting poorly understood areas with uncertain treatment outcomes, such as giant-cell bone tumors and their propensity to metastasize to the lungs; subterranean rehabilitation in pulmonary disorders; male reproductive hormone regulation during physical exercise in hyperbaric, hyperoxic environments, like underwater diving; and amelioration of cognitive decline owing to increased cerebral blood transit time after internal carotid artery stenting. Other topics include new concepts and innovations in the treatment of diabetes in pregnancy, and leg ulcers in chronic venous insufficiency, as well as molecular research on the toxic effects of oxidative stress, impaired cell autophagy, and experimental conditions resembling air pollution. Featuring the latest interdisciplinary advances in biomedicine, this book is a valuable resource for medical professionals, both academics and practitioners, and all allied health-care workers.

Heat shock proteins (HSP) were originally described in heat-shocked drosophila by Ritossa in the early 1960's. In the last 5 years it has become apparent that these heat shock proteins have important functions both in the normal cell and in the stressed cell. These proteins constitute an endogenous protective system; mutations in the heat shock proteins can be lethal, and there are no known organisms without heat shock proteins. The first observations on heat shock proteins and the heart were made in the 1980's and interest in these proteins increased over the decade. In the last few years there has been an exponential growth in number of papers published on heat shock proteins and the heart. Heat shock proteins have been implicated in a number of cardiovascular research areas including ischemia, hypertrophy, aging, and atherosclerosis, and this list is growmg. The purpose of this volume is to give an overview of our current understanding of the heat shock proteins in the cardiovascular system, and to summarize the approaches to the study of heat shock proteins in the heart. This volume assembles results from a number of different cardiovascular fields. and provides a comprehensive review of heat shock proteins in the cardiovascular system.

Omega-3 fatty acids can limit the inflammation that is the underlying cause of many severe diseases of modern civilization, including diabetes and cardiovascular disease. The Omega-Factor: Promoting Health, Preventing Premature Aging and Reducing the Risk of Sudden Cardiac Death presents information on the mechanisms whereby inflammation damages organs and the blood vessels serving them, as well as the hard science on the mechanisms by which the omega-3 fatty acids protect those tissues. It also features peer-reviewed evidence from clinical trials on these topics. The book gives cutting-edge information from state-of-the-art developments such as the test that can be done to measure the Omega 3 status of one's own tissues, the "Omega 3 Index", which can give many years of early warning so that one can take preventive steps and decrease the odds of a heart attack, stroke, or kidney disease. It explains why a Mediterranean diet plan rich in omega 3 and omega 6 fatty acids is protective, and it features a six-day meal plan with recipes that will improve body levels of omega 3s. This book helps readers understand the differences between various sources of omega-3 fatty acids, namely flax seed vs. fish oil vs. algae-derived oils. Features: * Provides evidence-based information on why blood vessels require omega-3 fatty acids to maintain health. * Details best sources of the various fatty acids, including plant-based sources. * Includes "at-home tests" to assess cardiovascular status. * Presents literature to how to improve chances of avoiding heart attacks, peripheral arterial disease, strokes, kidney disease, and Type-2 Diabetes. The Omega-Factor: Promoting Health, Preventing Premature Aging and Reducing the Risk of Sudden Cardiac Death is an essential resource for healthcare professionals, clinicians, and dietitians, as well as for the reader who aims to achieve the goal of a much longer health-span, not just a longer lifespan.

The World Health Organization estimates that there are 2.1 billion individuals with obesity globally. Nearly three quarters of adults in the United States are overweight or obese. The average individual with obesity cuts ten years off their life expectancy, yet less than 40% of physicians routinely counsel individuals concerning the adverse health consequences of obesity. Obesity Prevention and Treatment: A Practical Guide equips healthcare practitioners to include effective weight management counselling in the daily practice of medicine. Written by lifestyle medicine pioneer and cardiologist, Dr. James Rippe and obesity expert Dr. John Foreyt, this book provides evidence-based discussions of obesity and its metabolic consequences. A volume in the Lifestyle Medicine Series, it provides evidence-based information about the prevention and treatment of obesity through lifestyle measures, such as regular physical activity and sound nutrition, as well as the use of new medications or bariatric surgery available to assist in weight management. Provides a framework and practical strategies to assist practitioners in safe and effective treatments of obesity. Contains information explaining the relationship between obesity and increased risk of heart disease, diabetes, cancer, osteoarthritis, and other chronic conditions. Chapters begin with bulleted key points and conclude with a list of Clinical Applications. Written for practitioners at all levels, this user-friendly, evidence-based book on obesity prevention and treatment will be valuable to practitioners in general medicine or subspecialty practices.

This book offers a historical account of the development of the On-X carbon mechanical heart valve, discussing the steps involved in developing the materials, and describes how the design of the valve has evolved over the years. It explores both the scientific and corporate problems researchers have encountered over the years in the journey of making a mechanical heart valve. The chapters provide a detailed description of the design of the mechanical leaflet-based prosthetic valve, with a particular focus on blood flow characteristics. This book includes an overview of the state-of-the-art in the chemistry and physics of carbon, and compiles the advances in carbon-based technology and its applications in cardiac and thoracic surgery. This is an ideal book for bioengineers working on the chemistry and physics of carbon, and other professionals involved with cardiac and thoracic surgery.

Easy-to-use, handheld echocardiographic equipment has recently become a reliable, faster, lower-cost initial assessment option for cardiologists and other healthcare providers. Point-of-Care Echocardiography: A Case-Based Visual Guide clearly explains and demonstrates how to incorporate and effectively employ this new technology in your practice. Real-life images from actual outpatient consultations and in-patient evaluations provide step-by-step guidance on using handheld echo to arrive at a definitive diagnosis and/or to exclude other possible diagnoses. Focuses on the use and application of the latest handheld echocardiography devices for screening and initial diagnosis at point of care. Includes clinical case studies with history, physical exam, a wide range of normal and abnormal laboratory, ECG and imaging findings along with multiple images and video clips obtained with handheld system by an expert cardiologist. Features 169 echocardiographic images and 48 videos depicting use of point-of-care echo and its cardiovascular imaging findings. Provides an overview of cardiac and vascular anatomy and physiology and imaging techniques, tips, nuances, and limitations of handheld systems. Covers normal and abnormal findings and when to refer for further study. Discusses and demonstrates how to perform transthoracic echocardiography for assessment of cardiac and valve function, intravascular volume, ultrasound imaging to detect pericardial and pleural effusion, during pericardiocentesis and imaging assessment of vascular connections to the heart. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures and videos from the book on a variety of devices.

Drs. Vitola and Delbeke assembled a group of standout contributors in order to create a resource that advances the knowledge and skills of experienced nuclear cardiologists and radiologists while also preparing residents for the cutting-edge field of nuclear cardiology. Diagnostic tools, physics and instrumentation, and radiopharmaceuticals and protocols central to the field are examined. The comprehensive text covers key applications of myocardial perfusion imaging, including applications in special populations and in emergency departments. Risk assessment, pitfalls, and artefacts are addressed. Additional chapters detail the value of cardiac MRI, multislice computed tomography, stress echocardiography, and PET and PET/CT to nuclear cardiology. Practical case presentations and a wealth of illustrations reinforce instruction on diagnostic guidelines and methods.