Generation of oxidants or reactive oxygen species is a natural process of human biology. Mitochondrial respiration, phagocytic activity and cyclooxygenase activation are all essential processes of life, which also generate oxidative species. In humans, chronic oxidative stress often coupled with deficiency of antioxidant defenses is associated with the aging process and can lead to the development of disorders such as cancer and arterial disease. Major cardiovascular conditions in which oxidative damage has been strongly implicated include atherosclerosis, myocardial ischemia and reperfusion,...

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The hemodynamic mechanisms of hypertension are often limited to the study of three dominant parameters: blood pressure, cardiac output and vascular resis- tance. Accordingly, the development of hypertension is usually analyzed in terms of a 'struggle' between cardiac output and vascular resistance, resulting in the classical pattern of normal cardiac output and increased vascular resistance, thus indicating a reduction in the caliber of small arteries. However, during the past years, the clinical management of hypertension has largely modified these simple views. While an adequate control of...

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...

The ultrasound velocity tomography allows measurement of cardiac geometries for various phases in the cardiac cycle. The present tomograph makes reconstruc- tions at intervals of 20 ms. Because of a lack of clear (intramural) landmarks (except the roots of the papillairy muscle), it is difficult to pinpoint spatial trajectories of particular points in the heart. Therefore, a second method was developed of injecting radiopaque markers in the heart and following their motion patterns during the cardiac cycle with help of a biplane X-ray equipment. The data obtained with both methods can be...

Despite considerable effort in primary prevention, coronary heart disease continues to be the leading cause of death in the industrialized nations. The patient who survives his first myocardial infarction carries approximately a tenfold risk of recurrence and sudden death when compared to the normal population. The concept of secondary prevention, therefore, has emerged as an active strategy aimed at the reduction of fatal and non-fatal recurrences of myocardial infarction. Apart from risk factors of relevance in primary prevention, secondary prevention is dependent on the extent of the...

Despite the significant decline in heart disease mortaht>' rates over the last 25 years, heart failure has remained a significant problem. We are now confronted with large numbers of terminally ill patients for whom conventional therapies for heart failure have been exhausted and for whom repeated hospital visits are necessary. There now is a major thrust towards a management strategy which embraces a comprehensive approach including vigorous preventive measures and earlier surgical interventions. This book outlines the major surgical options for the treatment of heart failure and brings...