One of the major biomedical triumphs of the post-World War II era was the defmitive demonstration that hypercholesterolemia is a key causative factor in atherosclerosis; that hypercholesterolemia can be effectively treated; and that treatment significantly reduces not only coronary disease mortality but also all- cause mortality. Treatment to lower plasma levels of cholesterol - primarily low density lipoprotein (LDL) cholesterol - is now accepted as best medical practice and both physicians and patients are being educated to take aggressive measures to lower LDL. We can confidently look...

Molecular Cardiology for the Cardiologist, Second Edition provides a short, easily readable summary of what the new biology brings to cardiology. Special efforts have been made to include comprehensive diagrams and drawings, as well as teaching tables, and also to keep the size of the second edition within the modest limits of the first edition.
The book remains divided into 5 parts. The first part is a general introduction to the new terminology. The second part is devoted to the normal structure of the heart and vessels. Parts 3 and 4 deal with physiopathology. One of the...

Despite recent advances in the diagnosis and treatment of various cardiac illnesses, including ischemic, valvular and cardiomyopathic disease, the most cost-effective means of employing laboratory testing and treatment modalities remains an issue in most practice settings. With the advent of managed care and vigilant third-party payer evaluation of the use of diagnostic tests and hospital length of stay, the most effective medical and economic method of managing everyday cardiac illness is a question that arises daily in practice.
To this end, we have selected well-known and widely...

The last five years have witnessed an increasing interest in the subject of transmyocardial laser revascularization (TMR) as illustrated by the number of abstracts presented at the meetings of the American Heart Association and the American College of Cardiology (Figure). The ideas and concepts associated with this particular method of myocardial revascularization have changed dramatically over even this short period of time. The original premise of "de-evolving" mammalian hearts to recreate a reptilian-like myocardial circulation by making multiple channels through the myocardium has been...

This book is timely and challenging. Within its pages are commentaries and opinions on the scientific background and explanatory ideas for a complex of symptoms and investigations known as syndrome X. The commonest cause by far of angina pectoris is coronary artery obstruction due to atheromatous lesions both within the wall of the artery and intruding into the lumen; in such patients it is expected that there maybe ST segment depression on atrial pacing or on an exercise test indicating myocardial ischemia. Syndrome X was a term first used in an editorial written by Kemp in 1973. He was...

In 1962, 30 years after the discovery by du Vigneaud have pathologic consequences. One potentially sig- of a new sulfur amino acid, homocysteine; Carson and nificant health outcome of such mild to moderate Neil reported two siblings with mental retardation in hyperhomocysteinemia is an increased risk of occlu- northern Ireland with elevated urinary homocystine. sive vascular disease. Homocysteine concentrations in Nearly simultaneously, Gerritsen and Waisman patients with vascular disease were, on average, 31 % greater than in normal controls. Prospective assess- identified increased...

Angioplasty has completely transformed the treatment of coronary artery disease and is widely used, with more than 800,000 procedures performed worldwide per year. However, the enthusiasm for angioplasty is shadowed by restenosis, which remains a critical problem after the procedure, resulting in clinical recurrence in over a third of patients. Recently, the mechanisms of restenosis have been completely reappraised with an enriched understanding that the original concept of neointimal hyperplasia may not be accounting for the bulk of the problem.
There is a desperate need to heighten...

HE IMPLANTABLE CARDIOVERTER DEFIBRILLATOR, or T"lCD," is arguably the most technologically challenging type of therapy that physicians utilize today. At the same time, engineers who design ICDs are being called upon by clinicians to extend even further the technological envelope in quest of building the "ideal" device. To the extent, however, that physicians who utilize ICDs are not sufficiently comfortable with or familiar with the engineering principles that guide ICD function, the full clinical potential of even an ideal device will not be realized. In comple- mentary fashion, engineers...

Incidence and mortality of atherosclerosis and coronary heart disease (CHD) vary considerably among races, populations and ethnic groups. Some individuals with low levels of risk factors succumb early to disease while many others with a high risk profile do not. CHD clusters in families and is manyfold increased in first degree relatives of persons with an early onset of the disease. Such studies provide compelling evidence of the high degree of heritability of CHD and its risk factors.
This book consolidates the available evidence for the roles of genetics in atherosclerosis, its...

Occult atherosclerotic diseases impose great challenges in the cardiovascular practice. Although their pathology is not much different from that of the overt group of diseases, the clinical approach to their diagnoses remains a puzzle. This has mainly emerged as a result of the problems faced in trying to pick up the vulnerable subjects from among the general public. More definitive candidates to be evaluated are those belonging to one of the high risk groups. There are no statistical figures available on the incidence of occult atherosclerotic disease in the "non risky" general public and...