Bücher der Reihe Developments in Cardiovascular Medicine

During the past decade enormous progress has been made in the development of new cardiovascular drugs and in our understanding of the clinical pharma cology and the pharmacokinetics of old drugs.

Since the first pacemaker implantation in October 1958 by Senning and Elmqvist in Sweden, cardiac pacing for bradycardia has become a well-established therapy.

In the thirty years since the advent of efTective pharmacologic treatment for hypertension, the world ofthe hypertensive has been transformed beyond recog nition.

The specific topics addressed in this volume, the quality of the contributions, and the superb expertise of the contributors make this monograph one of the most outstanding publications that the International Society of Hyper tension has sponsored.

Left ventricular hypertrophy (LVH) is usually considered to be a compen satory adjustment of heart muscle to an inreased work load.

ROELANDT LIST OF CONTRIBUTORS Anliker, M., MD, Department of Cardiology, University Hospital Zurich, R!imistrasse 100, 8091 Zurich, SWITZERLAND. Carroll, J.D., MD, Department of Cardiology, University Hospital of ZUrich, R!imistrasse 100, 8091 Zurich, SWITZERLAND.

Why a book on contrast echocardiography? This is only natural, since shunt detection and analysis of flow relationships are relatively more important in congenital heart diseases, and cur rently represent the most important uses for contrast echo cardiography in day-to day practice.

This treatise on hypertension arrives at a time when there is an increasing recognition the world over of the importance of detecting and treating high blood pressure. Professor Amery is one of the leaders in the field of hypertension and serves on the Council of the International Society of Hypertension.

The pacemaker that is the source of this regular ex citation is localised normally within the sinus node (" sino-atrial node " node of Keith and Flack), a most intriguing small piece of tissue in the caval corner of the right atrium.

With the beginning of the 1980's it was becoming increasingly evident that the lack of approval of new cardiovascular agents for use by clinicians in the United States for the treatment of cardiovascular disorders was becoming a problem.

In the second section, the potentials and problems encountered in the use of long-term ambulatory electrocardiography for solving clinical questions and for predicting the occurrence of clinically important arrhythmias are extensively as continuous ST segment monitoring, blood dealt with.

The particular selection of techniques on our complete cerebrovascular non-invasive evaluation was chosen primarily to provide an integrated approach relying primarily on Doppler ultrasonic audio signals, but in addition utilizing a pertinent history and physical examination of the patient.

Proceedings of the First Symposium on New Drugs and Devices, held in Philadelphia, PA, USA (1980)

Rhythm was the first expression of cardiac activity which fell under man's obser vation, and the heart beat has always represented the very essence of life itself as it accelerates or slows during moments of rest, effort, joy and pain until it comes to a halt at the moment of death.

Over the last ten years, it has become increasingly obvious that sudden death represents the major challenge confronting cardiology in the last part of the XXth Century.

Since Paul Cranefield published his monograph, The Conduction of the Cardiac Impulse, in 1975, much has been learned about the role of the slow inward current in cardiac electrophysiology.

Whether blood pressures are measured by doctors or by technicians, are recorded at home, in the working place or in a hospital, in sitting, standing or supine position, and is taken during the same examination-all of these whether a blood sample factors can influence blood pressure measurement.

Since the development in 1974 of a new radiopharmaceutical, 20lTI and the application of 99mTc-pyrophosphate for myocardial imaging, these imaging agents are widely used for the detection of acute myocardial infarction.

In this book, he and his co-authors discuss the effects of balloon-induced ischemia on the electrocardiographic changes, coronary blood flow dynamics, cardiac muscle metabolism and left ventricular function, as well as measures to counter these effects and provide for reperfusion in unstable angina and acute myocardial infarction.

In industrialized countries, ischemic heart disease is by far the most common organ-specific cause of death. The failure of a heart with an ischemic area may be due to the amount and location of contractile tissue becoming paralyzed or even necrotic, or to arrhythmias provoked by the ischemic condition, or by a combination of both factors.

Chapters 14, 15 and 16 address applications of Doppler echocardiography during the stresses of brief coronary occlusion, myocar dial infarction and post infarction recovery, while chapters 17 and 20 illustrate applications of stress Doppler techniques in valvular heart disease.

Sudden death is probably the greatest challenge facing modem cardiology today. This book is an updating of the problem of sudden death from a multifactorial standpoint. Risk markers and triggering mechanicsms of sudden death are reviewed, with special emphasis on the role of electrical instability, ischemia and depressed ventricular function.

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.