Bøger i Developments in Cardiovascular Medicine serien

Today, coronary artery disease is one of the major causes of mortality and morbidity in the Western World. In the last decade many major diagnostic and therapeutic advances have been made, considerably furthering our potential in the management of coronary artery disease. At the same time, a new generation of cardiac tools has appeared. The field which has, perhaps, undergone the most important technological innovations is echocardiography. Nowadays, in fact, the world of ultrasounds ofters the cardiologist a wide range of technical applicatons: two-dimensional real-time imaging, intra-and extra-cardiac Doppler flow measurements, real-time imaging of cardiac struc­ ture and flow by 2D color Doppler, high resolution cardiac imaging by transesophageal echocardiography, tissue characterization by analysis of ultrasound wave characteristics, information on myocardial perfusion by con­ trast echocardiography, etc. Thanks to these technical improvements and to its consequent increased potentiality, echocardiography now plays an impor­ tant and irreplaceable role in the management of all cardiac diseases. In the field of coronary artery disease, echocardiography can reliably be used not only in the acute phases of the disease to derive useful functional and prog­ nostic information but also as a stress diagnostic procedure (thanks to new stress modalities and the continuing improvement of reviewing digital sys­ tems) for the diagnosis of coronary artery disease and for the evaluation of various therapeutic interventions. Furthermore, other promising applications of ultrasounds in this disease are currently being investigated: tissue charac­ coronary artery anatomy terization, myocardial contrast echocardiography, and flow evaluation by specially-designed ultrasoundcatheters.

The noninvasive evaluation of hemodynamics in congenital heart disease is an application for which Doppler ultrasound is ideally suited.

In keeping with the concept of an integrated echocardiographic examination, the two-dimensional, M-mode and Doppler echocardiographic findings are included in many of the diseases.

This monograph represents an attempt to collect the methods developed within the past decade in which echocardiography was being used to guide or to assess the results of some cardiovascular interventions or to overcome the imaging limitations of transthoracic approaches.

There are few techniques that have influenced therapeutic strategies in modem cardiology to a similar extent as coronary arteriography. Bypass surgery as well as transluminal coronary angioplasty would not have been possible without coronary angiography serving as a 'midwife' in their evolu tion.

Whole muscle length-tension relations were equated with sarcomere-length-tension relations by fixation of muscle at a particular point on the curve and determination of sarcomere length by electronmicroscopy.

According to Schopenhauer problems are usually passing through three stages: - in the first stage they are ignored or just smiled at, - in the second stage they are fought, and in the third stage they are considered to be self-evident, just taken for granted.

In the last years the Spanish Society of Cardiology has shown a great interest in the continuous medical education in cardiology. We would like to thank the Spanish Society of Cardiology and the Catalan Cardiac Society for the generous assistance they have given us during all stages of book preparation.

Many noteworthy advances in our knowledge of the pericardium, its functions and diseases and their relation to heart failure have been made since the first edition of this book appeared in 1981; The first edition was favourably received, and I have frequently been asked to write a new edition.

However, around 1980 pessimists predicted the premature demise of cardiovascular nuclear imaging with the introduction of digital subtraction angiography and nuclear magnetic resonance imaging.

The hemodynamic mechanisms of hypertension are often limited to the study of three dominant parameters: blood pressure, cardiac output and vascular resis tance.

Basic Concepts in Doppler Echocardiography The objective of this textbook is to offer a detailed yet concise overview of the various applications of Doppler echocardiography. Biomedical Engineer Sonotron / Diasonics Paris , France and the Department of illtrasonology University Medical Center, Henri Mondor Paris , France Andreas Strauss M.

Mason Sones demonstrated that visualization of the coronary anatomy in living humans was not only feasible but sufficiently safe and reliable to be used as a clinical tool in the evaluation of patients with known or suspected ischemic heart disease, the thus far somewhat neglected area of coronary circulation became the focus of interest.

The book is so designed that clinicians may be able to read the relevant chapters in the second part of the book in isolation, using the basic science aspects contained in the first part of the book as reference chapters.

In recent years considerable progress and new developments in diagnostic and interventional cardiology have been observed, such as balloon angioplasty of coronary artery stenoses, reperfusion techniques in acute myocardial infarction, new pacing, and cardioversion-defibrillation techniques in ventricular tachyar rhythmias.

Proceedings of the Third International Symposium on Body Surface Mapping

Spencer, M.D. Normal anatomy, anatomical anomalies and collateral Pathways of the blood supply to the brain 43 Robert Ackerstaff, M.D. Normal blood flow in the arteries 57 Merrill P. Spencer, M.D. Normal physiology and pathophysiology of human cerebral blood fuw ~ P.C.M.

The ultrasound velocity tomography allows measurement of cardiac geometries for various phases in the cardiac cycle. We conclude that analysis of regional cardiac function, including regional myocardial blood flow, requires still a major research effort but the results obtained sofar justify, to our opinion, a continuation in this direction.

Members of this working-group have tried to study the many aspects of this intriguing disease, and it is in this volume that they present their recent results and current concepts (chapters 2, 3, 5 and 6). On July 6th, 1984, a symposium entitled 'Recent views on hypertrophic cardio myopathy' was held at the University Hospital Groningen.

Apart from risk factors of relevance in primary prevention, secondary prevention is dependent on the extent of the disease itself; This concept truly is the nucleus of secondary prevention, sine only a life worth living generates the motivitation needed to take all the steps necessary in secondary pre vention.

Proceedings of a symposium on `HDL Deficiency and Atherosclerosis', held in Munster, Germany, September 7, 1994

Coronary heart disease (CHD) remains a major cause of human mortality and morbidity worldwide.