The molecular basis for atrial fibrillation continues to be largely unknown, and therapy remains unchanged, aimed at controlling the heart rate and preventing systemic emboli with anticoagulation. Familial atrial fibrillation is more common than previously suspected. While atrial fibrillation is commonly associated with acquired heart disease, a significant proportion of individuals have early onset without other forms of heart disease, referred to as "lone" atrial fibrillators. It is also well recognized that atrial fibrillation occurs on a reversible or functional basis, without associated...

Cardiovascular disease affects 20% of all Americans and is the leading cause of death in the USA. Every year approximately 1,500.000 Americans suffer from an acute myocardial infarction, and over 25% of the total number of deaths in this country are attributable to coronary artery disease. Unstable angina causes over 650,000 hospital admissions, and in the absence of medical therapy, the rate of progression from unstable angina to infarction is 12-20%. Since plaque disruption, plaque erosion, and acute intracoronary thrombus formation play major roles in the pathophysiology of both unstable...

For over a quarter of a century, echocardiography has made an unparalleled contribution to clinical cardiology as a major tool for real-time imaging of cardiac dynamics. Echocardiography is widely used to assess cardiac function, and provides noninvasive information which is invaluable for the diagnosis of various disease states. In spite of its numerous advantages, in the clinical arena echocardiography has remained mostly qualitative and subjective. However, continued progress in our understanding of the interactions between ultrasound and tissue characteristics have brought about several...

The goal of gene transfer is protein expression. a process brought about by the insertion of a gene coding for a foreign protein into target cells resulting in the synthesis of the foreign protein For gene therapy, a tmnsferred therapeutic gene must be expressed at a level beneficial for the patient. This chapter provides an introductory overview of the rapidly evolving field of non-viral approaches for gene delivery to rnarnrnalian cells. Although currently there are fewer ongoing clinical trials using non-viral approaches than those using viral based systems, the number of non-viral trials...

All physicians practicing medicine encounter patients suffering from cardiovascular disease. This book has been outlined in such a way that vascular surgeons, general internists, neurologists and cardiologists should be able to use it. The book covers the complete scope of cardiac diseases in addition to chapters on hypertension and atherosclerosis. In many patients there is a family history of cerebrovascular accidents, myocardial infarction or peripheral arterial disease. Also in patients reporting collaps, palpitations and arrhythmias the family is crucial and can provide clues to a...

In the last few years, derivatives of L-carnitine, such as acetyl-L-carnitine and propionyl-L-carnitine, have been made available to doctors for treatment of specific pathologies. The effects of this family of related carnitine compounds on cardiovascular systems and diseases constitute the major issue addressed in this volume.
Although several books on carnitine have been published, a treatise focusing on experimental and clinical aspects of the carnitine family and cardiovascular diseases was lacking. The present book provides the reader with a concise update in this field. The...

In recent years there have been tremendous advances in cardiac imaging techniques covering the complete spectrum from echocardiography, nuclear cardiology, magnetic resonance imaging to contrast angiography. With respect to these noninvasive and invasive cardiac imaging modalities, marked technological developments have allowed the cardiologist to visualize the myocardium in a far more refined manner than conventional imaging was capable of. Echocardiography has extended its domain with intravascular ultrasound, cardiovascular nuclear imaging has added positron emission tomography to its line...

W. F. ARMSTRONG While stress echocardiography is not the first technique to be applied to patients for the diagnosis of coronary artery disease, it represents an impor- tant clinical tool, likely to become of increasing pertinence in today's era of cost containment and mandated cost-effectiveness of diagnosis. It may be the most rapidly expanding area of clinical echocardiography today. Stress echocardiography as we know it today represents the natural con- clusion and merger of observations made over fifty years ago. In 1935 Tenn- ant and Wiggers demonstrated that the immediate result of a...

MICHEL E. SAFAR and MICHAEL F. O'ROURKE One of the principal problems of hypertension is the precise definition of blood pressure as a cardiovascular risk factor. Clinicians indicate peak systolic pressure and end diastolic pressure in the brachial artery as the principal criteria for blood pressure measurement. Consequently, these values are as indicators for clinical management and therapeutic adjustment. This used methodology, based on indirect blood pressure measurements at the site of the brachial artery relates only to the highest and lowest pressure in that vessel, and does not give...

In the past few years it has become clear that left ventricular dysfunction, even of severe degree, may be reversible after coronary revascularization in some patients. As a result, myocardial viability has captured the imagination of researchers and clinicians seeking to unravel the cellular and subcellular mechanisms and define appropriate diagnostic modalities. These diagnostic modalities include: cardiac catheterization, positron-emission tomography, magnetic resonance imaging, two-dimensional echocardiography and single-photon imaging. This book, for the first time, brings together a...