Kardiologi

This book is based on papers presented at a Symposium held in Seoul, Korea in 1992. The idea for the symposium developed naturally from work in which Professor Yung E Earm, at Seoul National University, had been involved both in my laboratory in Oxford and in his own laboratory in Seoul concerning the possible role of certain amino acids, like taurine that are strongly concentrated by the cells of the heart, and the relationship between such acids and membrane ionic currents. The first obvious question was whether it is possible to identify the transport mechanisms involved for taurine and whether they are electrogenic. The second question is what function could be served by such processes: does taurine play an essential role in cardiac tissue and is this important in protecting the heart from disease? With his colleagues in the Korean Physiological Society, Professor Earm set about the task of fmancing and organizing a meeting at which some of the world's leading cardiac electrophysiologists and taurine specialists could discuss these questions. The fmance was generously provided by the Dong-A Pharmaceutical Company, one of the leading scientific companies in Korea.

From the Proceedings of the Meeting of the American Section of the International Society for Heart Research (ISHR) at Hilton Head, South Carolina, September 21-24, 1983

Since it was introduced less than 100 years ago, analysis of the circulatory response to exercise as a measure of cardiac function has undergone remarkable development. Most recently this approach has incorporated the burgeoning technology of the last half of the 20th century to meet the physiological and diagnostic needs of scientist and clinicians. The ease of administration, economy and abundant data that characterize exercise testing for its relative staying power as the most frequently utilized noninvasive method of cardiovascular evaluation. The basic modalities of exercise electrocardiography of treadmill and bicycle have been extended by noninvasive cardiac imaging techniques, including scintigraphy and echocardiography, that have provided new insights in myocardial function during exertion and pharmacologic stress. At the same time, traditional exercise electrocardiography has also been refined by innovations that have broadened its applications. Exercise Testing: Current Concepts and Recent Advances affords the reader a state-of-the-art presentation of the diverse and expanding methods of exercise testing and their roles in patient management. The contributors to this volume include individuals who have made seminal contributions to the field during the last several decades. Indeed, it is legitimate to designate this group as a `Who's Who of Exercise Testing'. It is our hope that this book will enhance the reader's understanding of contemporary methods of exercise testing, as well as provide a glimpse into future directions of this science, that this knowledge is applied to optimal diagnosis and management of our patients.

The groundbreaking dietary program designed to help keep the heart healthy without drugs, surgery, or expensive treatments. Illustrated.

Das Buch stellt konventionelle und neue Mappingverfahren umfassend und ausfuhrlich anhand praktischer Beispiele dar. Es werden Grundlagen wie Rontgenanatomie und biophysikalische Voraussetzungen erlautert, die fur die tagliche Praxis unabdingbar sind. Anschlieend wird das praktische Vorgehen von der Diagnosestellung bis zur Ablation bei unterschiedlichen Tachykardien aufgezeigt.

Die Blutdruckselbstmessung erweitert die Moglichkeiten der Diagnostik, der Therapie sowie der Compliance des Patienten bei arterieller Hypertonie erheblich. Durch den groen methodischen Fortschritt mit Einfuhrung oszillometrischer Meverfahren und Vollautomation der Blutdruckselbstmegerate ist die Memethodik zuverlassiger und relativ einfach geworden. Dieses Buch - beschreibt die verschiedenen Metechniken am Arm, am Unterarm und am Finger - es wertet die modernen Blutdruckselbstmegerate - und es erarbeitet Vorschlage, wie die Selbstmessung umgesetzt werden kann.Ziel des Buches ist, einen besseren Uberblick uber die auf dem Markt zugelassenen Gerate und damit eine Optimierung der Langzeitkontrolle der Hypertoniker zu erreichen. Es richtet sich an alle Arzte und ihre Mitarbeiter, die Hochdruckpatienten betreuen.

This book presents a thorough review of coronary angioscopy, ranging from instructions on its use to the latest advances. Starting with the structure and fundamental principles of angioscopy, it shows readers how to apply the image to comprehensive care of coronary-artery patients. Plentiful color photos and illustrations will enable readers to investigate and classify plaques and thrombi and to evaluate coronary stent- and drug-based therapies. The authors are leading researchers on angioscopy. This book offers the perfect guide not only for new clinicians but also for cardiologists who have already adopted this technique for medical examination and treatment. Angioscopy is a unique medical technique for visualizing the interior of blood vessels and helps physicians not only to diagnose the pathology but also to measure the effectiveness of Percutaneous coronary intervention (PCI) or antiarteriosclerotic drugs. Furthermore, the recently developed molecular angioscopy approach allows us to observe Low-density lipoprotein (LDL) oxide, collagen, and macrophages, and is rapidly growing in importance.

Preoperative and intraoperative echocardiography has become an indispensable tool for guiding mitral valve surgery and has fostered the development of many innovative surgical techniques. Mitral valvuloplasty is now an established surgical method for the treatment of mitral insufficiency but the success is largely dependent on the extent of the underlying disease of the mitral valve. The book by Dr. Ng and coauthors is an extraordinary presentation of the relation between echocardiographic display of mitral valve pathology and reconstructive mitral valve surgery. The atlas provides an excellent illustrative guide to teach echocardiographic-anatomic correlations and educates the reader on the techniques of mitral valve repair. The quality of the illustrations, particularly the surgical photographs is exquisite. The book will be helpful for cardiologists and cardiac surgeons.

Peripheral and Cerebrovascular Intervention draws upon experts from diverse fields to provide readers with a comprehensive foundation for understanding and performing endovascular procedures-from the basic steps to the most current and advanced techniques. Individual chapters focus on primary intervention sites, including lower extremity, renal/mesenteric, subclavian/upper extremity, carotid/vertebral, intracranial and venous interventions. Additionally, chapters covering critical limb ischemia and abdominal and thoracic aortic aneurysms are included. By incorporating valuable clinical information, such as indications, contraindications, complications and discussions of surgical techniques and procedures, this book is a valuable resource for the busy practitioner and will be of interest to all interventional and general cardiologists, radiologists and neurologists; vascular surgeons; internists and residents and fellows.

Cardiovascular drug therapy has markedly progressed in the recent decades. Not only have new drugs been introduced to clinical practice, but new classes of drugs have been developed. While in 1960 the practicing cardiolo­ gist had a selection of about only ten drugs, in 1987 about 150 drugs are routinely used in cardiovascular diseases. Elderly patients, however, usually do not enjoy the full benefit of this progress. This might be due to lack of knowledge, a conservative approach, or the worldwide tendency not to try new drugs in the elderly. It is now clear that the majority of patients that will be treated in car­ diovascular clinics will be, in the near future, elderly patients. Even now, elderly patients form about one-third of the patients with cardiovascular diseases. These patients are approached, however, according to criteria devel­ oped for younger populations. This is despite the fact that elderly patients differ from younger ones in most aspects, including pathology, epidemiol­ ogy, pathophysiology, diagnostic approach, management, pharmacology, pharmacokinetics, rehabilitation, and supportive treatment. It is the purpose of this book to present to the clinician all drugs with which there is clinical experience in the elderly or which might be potentially useful for the elderly with cardiovascular diseases. The data are presented without the authors taking a position. This should allow the clinicians to make their own selection and individualize treatment, vii viii Preface based on a wide data base. Comparative data are presented only when specific comparative studies were performed.

Calcium is crucial in governing contractile activities of myofilaments in cardiomyocytes, any defeats in calcium homeostasis of the cells would adversely affect heart pumping action. The characterization of calcium handling properties in human induced pluripotent stem cell-derived cardiomyocytes (iPS-CMCs) is of significant interest and pertinent to the stem cell and cardiac regenerative field because of their potential patient-specific therapeutic use.

Chronic kidney disease with a worldwide prevalence of 10% in the general population is emerging as a major public health priority. Renal dysfunction is associated with a high risk for cardiovascular complications. The relationship between renal insufficiency and cardiovascular disease, termed the cardiorenal syndrome exists whether impairment of renal function is a consequence of primary renal parenchymal disease or primary heart disease. Several pathophysiologic mechanisms have been postulated to explain the relationship between renal dysfunction and cardiovascular disease. Recent studies indicate an integrated response of the vascular smooth muscles and glomerular mesangial cells to traditional and uremia related cardiovascular risk factors. Traditional risk factors can incite renal impairment and cardiac damage. As renal function deteriorates, uremia-related risk factors play an increasing role both in reduction in glomerular filtration rate and cardiovascular damage. Several uremia related factors such as uncontrolled hypertension, disturbed glucose insulin metabolism, microalbuminuria, phosphate retention, secondary hyperparathyroidism, myocardial and vascular calcification, hypertensive-uremic cardiomyopathy, inflammation, oxidant injury, and neurohormonal dysregulation have been implicated in the pathogenesis of the cardiorenal syndrome. Recent data suggest that management of the cardiorenal syndrome requires aggressive control of traditional risk factors as well novel approaches to prevent or reverse uremia ¿related processes.This book provides a comprehensive update analysis of our current understanding of the cardiorenal syndrome including epidemiology, pathophysiologic mechanisms, and therapeutic approaches.

In Deutschland leben derzeit ca. 180.000-270.000 Erwachsene mit angeborenen Herzfehlern, die entweder gar nicht, nur unvollstandig oder komplett korrigiert wurden. Diese groe und standig wachsende Zahl ist Ausdruck der Erfolge einer gemeinsamen Versorgung durch Kinderkardiologen und auf angeborene Herzfehler spezialisierte Herzchirurgen. Doch uberblickt auch der betreuende Hausarzt oder der Internist die spater entstehenden Probleme und Folgezustande?Um diese Wissenslcken zu schlieen haben die drei kardiologischen Fachgesellschaften, die Deutschen Gesellschaften fr Kardiologie (DGK), Pdiatrische Kardiologie (DGPK) und Herz-, Thorax- und Gefchirurgie (DGTHG) eine Task-Force gebildet, die gemeinsam mit Vertretern der sterreichischen und schweizerischen Fachgesellschaften die Leitlinie zur Diagnostik und Therapie in Klinik und Praxis"e; erarbeitet und in einem formalen Prozess unter externer Moderation konsentiert hat. Erstmalig im deutschsprachigen Raum schildert diese Leitlinie ausschlielich rztlich-wissenschaftliche Aspekte und gibt - abgesichert durch umfangreiche Literaturrecherche und -bewertung - den zum Zeitpunkt der Abfassung gltigen Stand medizinischen Wissens wieder.

Der EKG-Knacker bietet ein Konzept zur schnellen und sicheren Notfall-EKG-Interpretation. Von den physiologischen Grundlagen und dem Normalzustand über Rhythmusstörungen bis hin zum Herzinfarkt wird die Elektrokardiographie verständlich erklärt und mit anschaulichen Bildern belegt. Der EKG-Knacker-Entscheidungsbaum stellt Ja/Nein-Alternativen dar, deren Beantwortung eine eindeutige Diagnose ergibt. Ein Überblick über die wichtigsten Medikamente für eine notfallmedizinische Akuttherapie schließt den diagnostischen Teil ab. Überarbeitete und aktualisierte Neuauflage mit neuen Themen wie AICD (automatic implantable cardioverter defibrillator), Lyse-Therapie für Herzinfakt und neuen Abbildungen ausklappbarer Buchdeckel mit dem EKG-Knacker-Entscheidungsbaum, dereine schnelle und sichere EKG-Diagnose erlaubt Bewährte Didaktik mit klarer Struktur, anschaulichen Bildern, Glossar und Index Kitteltaschen-Format

Autopsy derives from the greek word autopsia, which means act of seeing with one's own eyes. It remains the most objective and accurate method to understand human. disease. Unfortunately, the volume of autopsies in teaching hospitals has decreased dramatically over the past years. The crucial factors that account for this are the recent progress and development of new technologies, especially in diagnostic imaging, immunology, cell biology and genetics. Additionally, the perpetual fear of legal liability by physicians accounts for its further decline. Consequently, physicians and medical students are engaged in fewer autopsies and are not reaping the rich educational rewards that accompany these examinations. The purpose of the autopsy is not only to establish the cause of death, but also to determine the nature and course of the disease process. Our goal with this book is to emphasize the importance of the post-mortem exam and the correlation between pathologic material and clinical data by analyzing actual cases with problem-based methodology. The focus of this handbook is on cardiovascular disease, and when appropriate, other disease categories are included if they have an impact on cardiovascular function. The approach is more than the usual clinico-pathological correlation. Rather, we attempt to present the material from the perspective of the autopsy table. We use the clinical data as the initial framework and the autopsy findings to develop a true understanding of the disease and the associated pathophysiology of the condition.

Tricuspid valve disease has long been ignored as a surrogate for the left atrioventricular valve (the mitral valve) and mainly a benign, indolent disease. This concept is currently outdated, as we know that the pathology of the tricuspid valve, primitive or secondary, sometimes isolated, brings with it a poor prognosis if not treated. To date, the complexity is recognized not only of the valve itself, but also of its pathophysiology and the environment of the right heart and its interaction with the left heart. In order to better define the therapeutic path of a patient suffering from tricuspid valve disease, we have tried to offer a comprehensive overview to the reader, starting from historical considerations (Chapter 1) about the vision of the circulatory system and from the evidence accumulated over the centuries until the recognition of the continuum between signs and symptoms related to the valve. As the basis of a modern approach to the understanding of the valve itself, we have traced the embryological and morphogenetic stages towards the anatomo-clinical correlates (Chapter 2). Subsequently, the epidemiology and clinical approach to tricuspid valve disease (Chapter 3) were illustrated, followed by the diagnostic procedure, state-of-the-art imaging techniques (Chapter 4) and more advanced techniques (Chapter 5). In particular, I thought it was necessary to dedicate a chapter to the pathology of the tricuspid valve secondary (functional) to left heart disease (Chapter 6), probably the most frequent form encountered by the clinicians. We have not neglected to discuss about tricuspid valve infections (Chapter 7), with particular reference to the microbiology, diagnosis and treatment. We considered it necessary that the role of the valve in congenital adult disease should also be addressed (Chapter 8), whether in natural history, modified by surgery or as an acquired disease. Neoplastic pathology may also involve the valve and the pathologist provides (Chapter 9) the knowledge and systematization of the most frequent primary and secondary tumors. Coming to the therapeutic act, after dealing with special pathology of the valve, (Chapter 10) we present the pharmacological approach, a necessary act, sometimes as a sole therapeutic option and sometimes propedeutic to surgery. Tricuspid valve plays an absolutely primary role in two aspects of the advanced treatment of refractory heart failure, namely its clinical and prognostic impact on ventricular care systems (LVAD) and cardiac transplantation (Chapter 11) has been discussed. The last two chapters are dedicated to non-medical treatment, with a particular focus on indications, risk selection and stratification as well as adequate surgical techniques (Chapter 12) and new perspectives of intervention through transcatheter techniques (Chapter 13). Overall, there is a need for an integrated and multidisciplinary approach to a complex nosological entity that is itself interdependent on pathophysiological systems, which the clinician, cardiologist, cardiac surgeon, internist and researcher cannot ignore.

Atrial fibrillation is a common supraventricular arrhythmia characterized by rapid and irregular atrial activation without a clear P-wave on an electrocardiogram. New Research on Atrial Fibrillation and Ischemic Heart Disease begins by discussing the risk factors, symptoms, and treatment of atrial fibrillation. Following this, the authors review the recently established relationship of atrial fibrillation with endurance sports activities in middle-aged athletes, connecting findings from various evidence in order to investigate this phenomenon since the pathophysiology of atrial fibrillation in middle-aged athletes is still unclear. Also explored are the associations between cerebrovascular risk factors and abnormal carotid and transcranial Doppler sonography and brain magnetic resonance imaging findings in individuals aged between 44 and 71 years without preceding neurological and psychiatric disorders. The association between perceived occupational noise exposure and hypertension among hospital nurses is examined, as hospital noise pollution is increasing worldwide. The concluding study aims to update and extend the existing burden of disease calculations by the WHO for road traffic noise-attributed myocardial infarction and stroke. All analyses were limited to 24 European countries and the year 2012.