Following remarkable advances in medical care. the past decade has witnessed a significant improvement in the survival of patients with many different forms of heart disease. In the majority ofcases. however. the advances have been pa lIiative and not curative. The resu It has been the prod uction of an ever-increasing population of patients with heart disease. many of whom suffer from myocardial dysfunction and latent or overt heart failure. Heart failure is now a major cause of morbidity and mortality in cardiac patients. This book aims to combine in a single volume data relating to both pathophysiological mechanisms and the clinical management of the patient with heart failure. It includes chapters dealing with molecular. biochemical. and pathophysiological aspects of heart failure. ven tricular function and its assessment. and the clinical aspects of heart failure in different cardiac disorders, including ischemic heart disease. valvular heart disease. and the cardiomyopathies. There are sections on pharmacotherapy. the role of arrhythmias, exercise physiology. and neurohumoral mechanisms. The book also deals with newer inter ventional techniques. newer surgical procedures and some current problems relating to cardiac assist devices and heart and heart-lungs transplantation."

A. Schneeweiss Although the syndrome of congestive heart failure has been recognized many years ago, the approach for its evaluation and treatment has until recently, been partial and 'fragmentary'. Various aspects of the disease have been treated according to the evaluation tools and therapeutic measures available at each period. This approach resulted in some of the greatest achievements in the management of heart failure but also left many aspects neglected and also resulted in several paradoxes. Examples of the achievements and limitations of the 'fragmentary' ap proach are the use of diuretics and hemodynamic measurements. The devel opment of diuretics has provided us with an important tool for helping pa tients whose predominant problem was edema. The success of diuretics masked the fact that their use may often be hemodynamically unsound and that they may reduce cardiac output. Only many years after their introduction has the use of diuretics found its appropriate place. Hemodynamic monitoring has gone via the same path. The great contribu tion of continuous bedside hemodynamic measurements to understanding heart failure resulted in over-usage by many clinicians, who found themselves treating hemodynamic charts rather than patients. It took almost a decade to realize that hemodynamic improvement, even in the chronic setting, does not necessarily mean symptomatic improvement or an increase in exercise capac ity."

This book deals with heart failure in all its aspects, in- cluding chapters relating to receptor physiology and patho- physiological mechanisms, ventricular function and its assessment and the clinical aspects of heart failure in ischemic heart failure, cardiomyopathy, rheumatic heart disease and the timing of valve replacement. The pharmaco- therapy of heart failure deals with inotropic drugs, ACE in- hibitors, nitrates and calcium antagonists. Extending into the newer interventional techniques and surgical techniques the book includes chapters on balloon valvuloplasty, the po- tential use of the laser, the Jarvik artificial heart, car- diomyoplasty, left ventriculoplasty and heart and heart/lung transplantation.