Kardiologi

Bearbeitet von zahlreichen Fachwissenschaftlern

Durch die weltweite Einrichtung von Herzzentren wurde schon in den 60er Jahren ein Zusammenhang zwischen häufigem Auftreten ventrikulärer Ektopien und fatalen ventrikulären Arrhythmien deutlich [13]. Die Ergebnisse des National Heart Institute in den USA zeigten, daß bei Patienten nach Myokardinfarkt eine einzige Extrasystole im EKG ein erhebliches Risiko des plötzlichen Herztodes innerhalb der folgenden 2-5 Jahre bedeuten kann. Mehrere Holter-Monitoring-Studien, die Mitte der 70er Jahre durchgeführt wurden, zeigten, daß 50-70% dieser Patienten während oder nach der Entlassung ventrikuläre und mehr als 25% komplexe Ektopien hatten. Patienten mit komplexen ventrikulären Arrthythmien unterliegen während den fol­ genden 1-3 Jahren einem etwa 3- bis 4fach höheren Risiko an einem plötzlichen Herztod zu sterben [9, 14, 25]. Das Auftreten des plötzlichen Herztodes bei vielen dieser Patienten konnte in der Klinik durch intravenöse Applikation von Antiar­ rhythmika verhindert werden [2]. Das weitere Schicksal der Patienten hängt jedoch von der Effektivität einer peroralen Langzeittherapie ab. Diese Tatsache löste in den letzten Jahren erhebliche Anstrengungen in der pharmazeutischen Forschung aus, nach besseren Antiarrhythmika zu suchen. Allerdings sind entsprechend der Natur von Herzrhythmusstörungen die Aussichten, ein ideales Antiarrhythmikum herzu­ stellen, äußerst gering. Trotzdem sollten heute gewisse Anforderungen an ein Antiarrhythmikum gestellt werden. Da heute eine Vielzahl von wirksamen Substanzen zur Verfügung steht, gilt für die Langzeitbehandlung neben Wirksamkeit als wichtigstes Kriterium die Verträglich­ keit eines Antiarrhythmikums, die an einer großen Zahl von Patienten mit Arrhyth­ mien und unterschiedlichen Grund-und Begleiterkrankungen geprüft sein sollte.

The pathology of congenital heart disease has attracted much attention over the past years, as exemplified by various excellent textbooks. Most texts include a description of the position and course of the atrioventricular con­ duction tissues, but usually propose rules in a general setting. No systematic and meticulous description of the atrioventricular conduction tissues as they relate to the margins of septal defects in various types of congenital cardiac malformations is, to the best of our knowledge, yet available. Such detailed information is of value for cardiologists, pathologists, and surgeons alike. The cardiologist needs the information for electrophysio­ logical studies, including electrocardiographic tracings, as one of the tools in refining diagnosis. The pathologist should have a full understanding of the disposition of the atrioventricular conduction tissues in complex congenital malformations, not only in order to able to communicate with cardiologists and cardiac surgeons in a given case, but also because pathologists are in a unique position to enhance the understanding of atrioventricular conduction in complex congenital heart disease by means of continuous close cooperation with those in the clinical and surgical arena. For the surgeon, in-depth knowledge of atrioventricular conduction and its variability is imperative, particularly in view of the ongoing refinements in surgical techniques and options for repair, as well as improvements in the understanding of preopera­ tive and postoperative cardiac performance.

A path-breaking and comprehensive review of the pathophysiology and management of patients with acute coronary syndromes (ACS). Drawing on the key results of recent clinical trials, world-renowned clinicians and clinical investigators establish state-of-the-art management guidelines for patients with ST-elevation MI or non-ST-elevation ACS. Their discussion includes a detailed review of the pathophysiology of ACS and a survey of the diagnostic tools available to assess patients. Management of Acute Coronary Syndromes captures the major advances that have occurred in our understanding of the pathophysiology, diagnosis, and management of patients with acute coronary syndromes. This book is certain to help cardiologists, primary physicians, emergency medicine physicians, and many others to better serve their patients with today''s most efficacious treatments.

The 2nd edition reviews important vascular disorders encountered in clinical practice, including aortic aneurysms and dissection, peripheral arterial occlusive disease and lymphedema. This book beautifully illustrates recent advances in vascular biology and technology, including enhanced resolution ultrasonography and less invasive therapeutic strategies are just two of many updates. Includes full-color images depicting surgical techniques, X-rays and first-quality photographs relating to vascular disease and its counterparts.

The second edition of the Atlas of Interventional Cardiology reflects the most recent advances and improvements in both techniques and devices. The atlas includes an overview of the coronary arterial response to injury as well as invasive lesion assessment, specifically coronary physiologic assessment and intravascular ultrasound. General techniques and equipment selection are also presented, including emphasis on the evolution of stent design. With more than 500 illustrations, clinical photographs, instructive diagrams and charts, this updated reference covers a wide range of topics, including distal protection devices, invasive lesion assessment, peripheral arterial interventions, and extraction atherectomy.

In this edition of the Atlas of Hypertension, Dr. Norman Hollenberg and more than 20 leading authorities have worked together to capture the most updated and pertinent information in the field of hypertension. This new edition is a modern and complete visual library of up-to-date information on the most current pharmacologic and treatment advances in the field. With over 600 vivid illustrations, clinical photographs, instructive diagrams and charts, this updated reference provides a detailed and accurate insight into treatment and management of hypertension, covering a full range of topics. Together with detailed legends and extensive reference listings, the illustrations deliver comprehensive guidance to effective diagnosis and treatment of a wide breadth of these clinical challenges.

We are in the early years of a new millen Tremendous interest is now focused on nium and atherosclerotic disease is now the characteristics of atherosclerotic thought to underlie more adult deaths plaques, as we recognize that many clinical than any other disease on the planet.

In this edition of the Atlas of Hypertension, Dr. Norman Hollenberg and more than 20 leading authorities have worked together to capture the most updated and pertinent information in the field of hypertension.

Although clinicians have recognized the importance of inflammatory mediators in the pathogenesis of heart disease for well over 200 years, it has taken nearly as many years for clinicians and scientists to focus on the basic biological mechanisms by which inflammatory mediators contribute to the pathogenesis of cardiac disease states.

Though the possibility of using cultured endothelial cells to study endothelial cell function in vitro was recognized many years ago, the inability to culture unambiguously identifiable endothelial cells limited investigators in their studies of endothelial function.

The arteries to the upper extremities can be involved at multiple levels by a variety of diseases. Because of the critical sensitivity of motor function and sensation in the arms and hands, minor degrees of ischemia can have major clinical significance. It is essential to understand the exact pathologic process and the sites of involvement to provide proper therapy. This issue will include articles such as: The diagnosis of vaso-occlusive disease within the hand, Botox in the management of vascospastic disorders, Vascular injuries in sports activities, Present options for the management of hypothenar hammer syndrome and many more!

Provides cardiologists with practical information on prevention that can be easily applied to their patients. This title covers such topics as: diabetes, lipid-lowering therapy, RAAS blockade, emerging therapies for atherosclerosis prevention, and heart disease in women.