Download or read book Quantitative Coronary and Left Ventricular Cineangiography written by Johan H. C. Reiber and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 473 pages. Available in PDF, EPUB and Kindle. Book excerpt: In recent years there has been an increasing interest in quantitative analysis of coronary cineangiograms and already for a longer time of left ventricular cin eangiograms. The needfor quantitationofcoronary arterialdimensions has been stimulated by the introduction ofnew therapeutic procedures in the catheteriza tionlaboratory, suchas the balloon dilatationtechnique (PTCA) and thromboly tic therapy, by the need to study the vasoactive responses of pharmaceutical agents, and also by the desire to study the progressive nature ofcoronary artery disease with the ultimate goal to find ways to bring a halt to the progression of coronary atherosclerosis or even achieve regression of the disease. Parallel with these clinical developments, rapid technical developments in computerarchitect ures and semiconductor memories have made it possible to digitize and store cineframesor selected portions thereof in image processors and to analyze these pictorial data quantitatively at affordable prices. More than 15 years of research have been directed by various groups towards the semi- or fully-automated delineation of the left ventricular boundaries on a frame-to-frame basis. Yet not a single system with fully-automated capability is commercially available. In the mean time many different left ventricular wall motion models have been developed, again with little consensuson which model is to be preferred as no golden standard exists.

Download or read book Quantitative Coronary and Left Ventricular Cineangiography written by Johan H C Reiber and published by . This book was released on 1986-04-30 with total page 482 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book State of the Art in Quantitative Coronary Arteriography written by Johan H. C. Reiber and published by Springer. This book was released on 1986-09-30 with total page 296 pages. Available in PDF, EPUB and Kindle. Book excerpt: Over the past twenty years, technical advances in coronary arteriography have contributed to our understanding of the pathophysiologic aspects and natural history of coronary artery disease. Probably more than 700. 000 coronary arterio grams are performed annually throughout the world. Usually, these arteriograms are interpreted visually to determine the morphologic extent and severity of coronary artery disease. These subjective determinations, which are hampered . by relatively large intra- and interobserver variations, are used as a basis for critically important therapeutic decisions: Which arteries are to be revascular ized, which lesions are suitable for coronary bypass surgery or for percutaneous coronary angioplasty? To improve on this clinical decision making, on the treat ment and follow-up of such patients, new, objective and reproducible techniques for the assessment of the extent and severity of coronary artery disease, both in terms of anatomy and functional significance of the lesions, must be made widely available. With such new procedures and technologies the efficacy of new thera peutic procedures, the effects of vasodilating and constricting drugs, and the results of long-term studies on the regression and progression of atherosclerotic plaque can be determined in an objective and cost-effective manner.

Download or read book The Interventional Cardiac Catheterization Handbook E Book written by Morton J. Kern and published by Elsevier Health Sciences. This book was released on 2017-05-02 with total page 531 pages. Available in PDF, EPUB and Kindle. Book excerpt: Packed with useful information, The Interventional Cardiac Catheterization Handbook, 4th Edition, by Drs. Morton J. Kern, Michael J. Lim, and Paul Sorajja, is the perfect hands-on resource for physicians, nurses, and technicians who need to understand and perform these complex procedures. Easy-to-read text, hundreds of clear images, and narrated videos from Dr. Kern ensure that health care workers at all levels have quick access to easily accessible guidelines on procedures and patient care. Features a wealth of quick-reference tables, and more than 500 images – making this handbook a must-have reference for physicians and staff members in every cath lab. Includes a chapter dedicated to interventional pharmacology. Includes new content on correction of mitral regurgitation with Mitra ClipTM, enhanced coverage of aortic valve stenosis with TAVR, expansion of biodegradable and drug-eluting stents, enhanced descriptions of lesion assessment, chronic total occlusion intervention, and radial access approach to intervention. Covers the latest treatment of mitral valve regurgitation and mitral stenosis, new procedural enhancements for the treatment of aortic valve stenosis, and chronic total occlusion intervention technique updates.

Download or read book Quantitative Coronary Arteriography written by Johan H. C. Reiber and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 388 pages. Available in PDF, EPUB and Kindle. Book excerpt: In June 1989, a third conference concentrating on the progress in quantita tive coronary angiography and related techniques was held in Rotterdam, again very successful as the two preceding events in 1985 and 1987. Tech nical as well as clinical aspects of digital and digitized coronarography, morphometry, parametric imaging and functional quantification of the human coronary circulation were presented and discussed by prominent exponents of those groups who have been active in this particular field for many years. This book contains the chapters representing the lectures held by leading experts during the symposium that update the knowledge currently available, including most recent aspects in angioscopy and intravascular ultrasound imaging. It also includes a historical review on the development of angiogra phic techniques from the very early days on to our times given by one of the pioneers in heart catheterization and angiography, Dr. Kurt Amplatz. Those who had the chance to listen to his talk, will surely remember his impressive, humorous lecture as one of the highlights of this meeting.

Download or read book Advances in Quantitative Coronary Arteriography written by Johan H. C. Reiber and published by Springer. This book was released on 2012-10-28 with total page 640 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this fourth book in the series on quantitative coronary arteriography (QCA) with the earlier three volumes published in 1986, 1988 and 1991, the latest developments in this exciting field are covered. Both the methodolog ical and clinical application aspects of these advances are presented in a comprehensive manner in a total of 37 chapters by world renowned experts. The book is subdivided into a total of eight parts, beginning with the more methodological issues, such as QCA and other modalities (3 chapters), cine film versus digital arteriography (3 chapters), quality control in QCA (4 chapters), and coronary blood flow and flow reserve (3 chapters). Since QCA has been well established as the technique for the assessment of regression and progression in atherosclerotic disease, and of restenosis after recanaliz ation procedures, major clinical trials in both groups are described extensively by their principal investigators in a total of 11 chapters. In addition, the QCA results after the application of various recanalization techniques are presented in another eight chapters. In the last part the experiences with various intracoronary prostheses with the emphasis on QCA are discussed in five chapters. This large increase in application oriented chapters means that QCA is well alive and gaining momentum. Although the accuracy and precision of the analytical methods steadily improve with the increasing complexity of the algorithms, there is still always the human factor involved in these processes in terms of frame selection, segment definition, etc.

Download or read book Quantitative Coronary Angiography in Clinical Practice written by P.W. Serruys and published by Springer Science & Business Media. This book was released on 2013-04-17 with total page 754 pages. Available in PDF, EPUB and Kindle. Book excerpt: Quantitative coronary angiography has become an invaluable tool for the interventional cardiologist, providing objective and reproducible measurements of coronary artery dimensions, which can be used to study progression or regression of coronary atherosclerosis, as well as the immediate and long term effects of percutaneous interventions. Until recently, this powerful imaging technology was confined to a small number of so-called high level institutions. Fortunately, with the development of digital cardiac imaging equipment and adaptation of cine-angiographically based computer software for on-line use in the catheterization room, quantitative coronary angiography is now available to all interventionalists. This book is a timely guide for the impending QCA user, providing practical as well as theoretical and scientific information. A comprehensive evaluation of the clinical usefulness of QCA is covered, from the fundamental principles through experimental validation studies, application to clinical trials of a wide range of pharmacological and interventional therapies in the full spectrum of clinical presentation of coronary disease syndromes, evaluation of the therapeutic efficacy of various new devices for coronary intervention, together with extensive presentation of its physiological, functional and anatomical correlations, by comparison with other intracoronary measurement and imaging techniques. In addition, evolving theories and concepts in the ever topical `restenosis phenomenon' after percutaneous intervention, based on serial QCA studies, are presented and discussed and a potentially unifying methodological approach to further study of this ubiquitous problem is offered. This book, thanks to the collaboration of many experts in the field of intracoronary imaging and measurement, provides stimulating, interesting and practical information, both for the academic scientist and practising clinician.

Download or read book Myocardial Ischemia written by Naranjan S. Dhalla and published by Springer Science & Business Media. This book was released on 2013-11-11 with total page 352 pages. Available in PDF, EPUB and Kindle. Book excerpt: Whenever the coronary flow is inadequate to provide enough oxygen to meet the energy demands of the tissue, the heart becomes ischemic. Manifestations of myocardial ischemia include depression in contractile activity, changes in metabolic pattern, abnormalities in ultrastructure, and alterations in membrane potential. Ischemic changes during the early phase are reversible but as the period of ischemia is extended, the injury becomes irreversible. The transition from reversible to irreversible ischemic injury is usually associated with some membrane defects. It is worthwhile to consider that the irreversible damage to the ischemic myocardium occurs when the sarcolemmal membrane is altered in suoh a way that it would promote 2 a net gain of ca + in the cardiac cell upon reinstitution of blood flow. Suoh a lesion could result when mechanisms for the entry as well as removal 2 of ca + from the myocardial oell become defective. In this regard, 2 depression of the sarcolemmal ca + pump would favour the oocurrenoe of 2 intracellular ca + overload. Furthermore, inhibition of the Na+-K+ pump would lead to elevation of myoplasmic Na+ which oould then increase the 2 2 intracellular concentration of ca + through the sarcolemmal Na+-ca + exchange mechanism. In faot recent studies have revealed an inhibition of 2 the sarcolemmal Na+-ca + exchange mechanism in the ischemic heart and this 2 change could also contribute towards the occurrence of intracellular ca + 2 overload.

Download or read book Silent Myocardial Ischemia written by J. Morganroth and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 243 pages. Available in PDF, EPUB and Kindle. Book excerpt: Although some investigators have questioned the importance and even the existence of silent myocardial ischemia, documentation presented at this two day symposium leaves little doubt about its existence and importance. It has been estimated that about 3 million of the estimated 4 million angina sufferers in the United states have frequent episodes of silent myocardial ischemia. Although it is not possible to define how many Americans die due to silent ischemia, it has been suggested that the mortality rate may exceed hundreds of thousands of victims annually. Unfortunately, there still remains a lack of definitive information as to why some ischemic events are painless. Some suggest the concept that the location and size of the myocardium at jeopardy relates to pain, that the pain threshold varies from patient to patient or that there are neurological deficits in the myocardium of some patients with silent ischemia. Abnormalities in myocardial perfusion and function can occur without pain. An interesting observation presented by several investigators has been that when a coronary artery is occluded in man, no ischemic pain is perceived for the first 30 seconds. Only after a 30 second period or so of occlusion does angina occur. An even more confusing observation is that some 30 second periods of occlusion of the same vessel in the same patient results in angina while the next occlusion can be a totally silent event.

Download or read book Cardiac Electrophysiology Circulation and Transport written by S. Sideman and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 384 pages. Available in PDF, EPUB and Kindle. Book excerpt: The cardiac system represents one of the most exciting challenges to human ingenuity. Critical to our survival, it consists of a tantalizing array of interacting phenomena, from ionic microscopic transport, membrane channels and receptors through cellular metabolism, energy production to fiber mechanics, microcirculation, electrical activation to the global, clinically observed, function, which is measured by pressure, volume, coronary flow, heart rate, shape changes and responds to imposed loads and pharmaceutical challenges. It is a complex interdisciplinary system requiring the joint efforts of the life sciences, the exact sciences, engineering and technology to understand and control the pathologies involved. The Henry Goldberg Workshops were set up to address these challenges. Briefly, our goals are: 1. To foster interdisciplinary interaction between scientists from different areas of cardiology, identify missing links, and catalyze new questions. 2. To relate micro scale cellular phenomena to the global, clinically manifested cardiac function. 3. To relate conceptual modeling and quantitative analysis to experimental and clinical data. 4. To encourage international cooperation so as to disperse medical and technological know how and lead to better understanding of the cardiac system. Today we celebrate the 7th birthday of a dream come true; a dream to bring together the diversified expertise in the various fields of science, engineering and medicine, to relate to the numerous interactive parameters and disciplines involved in the performance of the heart.

Download or read book Quality of Life after Open Heart Surgery written by P.J. Walter and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 509 pages. Available in PDF, EPUB and Kindle. Book excerpt: primary goal of all forms of therapy is not just prolonging life, but improving the quality of life, has forced analysis of what constitutes quality of life, a concept whose structure pervades all walks of life and eludes definition. Global well being, happiness, morale, vitality, fullness of social life, and satisfaction must be integrated and assessed for the effects of the disease and the therapy, in the context of specific personality traits, attitudes to life, family situation, and socio-economic and political freedom. A growing inter est in research on this subject has led to a clearer understanding of the components which come to determine quality of a patient's life, and how they can be measured in a reproducible manner so that valid comparisons can be made. Keeping these recommendations of analysing quality of life within the context of patients who have undergone open heart surgery, it seemed appro priate to me to separate the influence of various forms of open heart surgery into five aspects of life which can comprehensively reflect the quality of life outcome of the operation. These five 'components' are (1) Physiological state, which summarises the traditionally reported incidence of operative mortality and morbidity, objectively and subjectively measured physical ca pacity, and the residual symptoms, treatment and long-term survival. (2) Intellectual functioning relates to the psychoneurolgocial deficit in memory, reasoning or judgement because of cerebral microembolism and hypo perfusion during cardiopulmonary bypass.

Download or read book Lasers in Cardiovascular Medicine and Surgery Fundamentals and Techniques written by George S. Abela and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 503 pages. Available in PDF, EPUB and Kindle. Book excerpt: Following the advent of percutaneous balloon vel oped and are available for clinical use, as well angioplasty, interventional cardiovascular pro as those that are still in investigational phases. cedures have become of great interest to the Clinical case reports are presented by expert in cardiologist, radiologist, and cardiovascular vestigators on the use of various catheter systems surgeon. One of the most extensively explored in the coronary and peripheral circulation. alternatives to bypass surgery is laser-mediated Part V (Chapters 17-23) is the most up-to angioplasty. The fascination with laser radia date review of the clinical experience with vari tion has greatly contributed to its popularity, ous laser delivery systems. There is an emphasis but has also burdened it with unrealistic ex on patient selection, criteria for lesion choice, pectations. Many commercial laser systems are and follow-up data. A detailed description of available to the clinician and the researcher, laser recanalization techniques is presented for which often makes the choice of a laser system the various systems in the clinical setting.

Download or read book Subcellular Basis of Contractile Failure written by Borivoj Korecky and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 329 pages. Available in PDF, EPUB and Kindle. Book excerpt: This monograph contains 20 selected papers presented at the Symposium on Subcellular Basis of Contractile Failure which was held in Ottawa during May 11-13, 1989 and is designed for the benefit ofthose who were unable to attend this event. It is now increasingly becoming clear that an excessive amount of calcium is intimately involved in the pathogenesis of a wide variety of heart diseases. Accordingly, the investigations concerning the role of calcium chan nels and their regulatory mechanisms in heart function as well as of the intra cellular calcium overload in cardiac dysfunction are presented here. Since sodium is also considered to influence the cardiac contractile force by chang 2 ing the intracellular concentration of calcium through the Na +-Ca+ exchange 2 mechanism in the cell membrane, the role of Na +-Ca+ exchange in heart func tion as well as pathology of contractile failure is discussed. In view of the new ly discovered implications of the oxygen free radicals in cellular injury, papers concerning the role of these radicals in heart disease are included in this book. For the purpose of clarity, different chapters have been organized under three main headings: (I) Role of cations in heart function, (II) Cardiac hypertrophy and cardiomyopathies, and (III) Ischemic heart disease and cardiac failure.

Download or read book Risk Benefit Analysis for the Use and Approval of Thrombolytic Antiarrhythmic and Hypolipidemic Agents written by J. Morganroth and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 306 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Symposium on New Drugs provides a forum for academic investigators, research and development personnel from the pharmaceutical industry and members of the Food and Drug Administration to discuss important clinical research issues. The Ninth Annual symposium on New Drugs addressed the problem of determining the risk versus benefit for use of three important classes of cardiovascular agents: thrombolytic, antiarrhythmic, and hypolipidemic agents. The use of thrombolytic agents has become one of the major advances in clinical intensive cardiologic care in the 1980s. While the lysis of clot(s) obstructing a major coronary artery should reverse or prevent the damage of acute myocardial ischemia and infarction, one must carefully consider the potential risks of such agents in regards to their potential benefits. The time when a thrombolytic agent should be administered to maximize benefit as well as how one defines a dose response relationship using intravenous critical care medicines were discussed as important clinical trial issues. The benefit versus risk data on currently available thrombolytic agents was reviewed and the potential roles for adjunctive agents addressed. Overall strategies regarding post- x thrombolytic care and relationships to sudden cardiac death were also detailed. The panel discussion sections provided a comprehensive view of the current thinking of the various participating groups in this symposium. Sudden cardiac death remains the number one cause of mortality in western industrialized societies.

Download or read book Use and Approval of Antihypertensive Agents and Surrogate Endpoints for the Approval of Drugs Affecting Antiarrhythmic Heart Failure and Hypolipidemia written by J. Morganroth and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 230 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Symposium on New Drugs provides for an annual forum for academic investigators, research and development personnel from the pharmaceutical and related health care industries, and members of the Food and Drug Administration to discuss important clinical research issues. The Tenth Annual Symposium on New Drugs addressed the problem of whether it was still appropriate to approve antihypertensive agents soley on the endpoint of lowering cuff blood pressure. The initial discussions at this symposium related to the approaches and methods to studying antihypertensive agents. Dr. William Frishman provided a detailed list of the new approaches to the treatment of hypertension and pointed out the many new concepts that are currently active in the development of many new antihypertensive agents. Dr. William White detailed the growing importance of ambulatory blood pressure monitoring to define hypertension and to determine the change in blood pressure due to pharmacologically active agents. Dr. Jay Cohn pointed out the flaws in using cuff blood pressure and detailed the potential virtues of using vascular compliance to identify patients requiring treatment for hypertension. Dr. Thomas Pickering also discussed the potential value of evaluating changes in left ventricular hypertrophy a finding which identifies high risk patients who need to be included in clinical trials. Dr. Michael Weber detailed the issues and suggested refinements in the approaches to clinical trial designs for antihypertensive agents and Dr. Raymond Lipicky discussed the definition of dose-duration and the role of non-Mem and Peak/Through measurements in defining an antihypertensive drug effect.

Download or read book The Heart in Hypertension written by Michel Emile Safar and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 424 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hypertension is the major cause of left ventricular hypertrophy. While the electrocardiogram is an extremely insensitive measure of anatomic left ven tricular hypertrophy, it provides a time-tested important marker of an adverse cardiovascular outcome. There has been a recent temporal decrease in the incidence of electrocardiographic evidence of L VH even within the hyperten sive population; no doubt this is the result of large antihypertensive treatment experts. Anatomical evidence of left ventricular hypertrophy is best docu mented pre-morbidly using echocardiographic techniques. It therefore ap pears that between 20 and 50 percent of the hypertensive population has left ventricular hypertrophy by echo cardiographic techniques. The prognostic significance of the echocardiographically determined increase in left ventric ular mass is just beginning to be evaluated. Early information suggests that there is an increased rate of cardi~)Vascular morbidity in patients with echo car diographic evidence of increased left ventricular mass. However, this in formation is only preliminary, and as yet only a limited number of events have been reported. Far more supporting information will be required before the full impact of echocardiographically-detected left ventricular hypertrophy can be determined. Nevertheless, it must be stated that the electrocardiogram still has the greatest predictive value of cardiovascular morbid and mortal events when the pattern of left ventricular hypertrophy plus repolarization abnormal ities are present.

Download or read book Early Interventions in Acute Myocardial Infarction written by Elliot Rapaport and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 271 pages. Available in PDF, EPUB and Kindle. Book excerpt: Our understanding of the pathophysiology of acute myocardial infarction has grown enormously in recent years. This has led to an increasingly aggressive approach to management, designed to blunt the extent of infarction by salvaging acutely ischemic myocardium. Alternatives now include throm bolysis, PTCA with and without prior thrombolysis, and emergency bypass surgery, as well as the more aggressive use of a variety of drugs. This book consists of a series of chapters by experienced cardiologists and cardiovascular surgeons that present today's state of the art in managing acute myocardial infarction. It is written with the purpose of presenting practical approaches of value to the clinician related to the more complex problems faced in dealing with patients undergoing myocardial infarction. xi EARLY INTERVENTIONS IN ACUTE MYOCARDIAL INFARCTION 1. MANAGEMENT OF ARRHYTHMIAS IN THE CORONARY CARE UNIT NORA GOLDSCHLAGER, RODERICK WOODS, AND NEAL BENOWITZ With the advent of coronary care units, mortality from cardiac arrhythmias occurring during acute myocardial infarction has been unquestionably and dramatically reduced. In addition, continuous electrocardiographic monitoring has resulted in the recognition of specific arrhythmias related to acute ischemic heart disease and thus to the development of appropriate strategies for their management. This chapter will review certain specific aspects of those bradyarrhythmias and atrial and ventricular tachyarrhythmias that are seen most commonly in acute myocardial infarction. Pharmacologic therapy, including the use of some of the newer antiarrhythmic agents, will be discussed, as will pacemaker ther apy of both bradyarrhythmias and tachyarrhythmias.