Myocardial Protection by Calcium Antagonists


Book Description

About the Book There are vast amounts of new data emerging in the study of calcium antagonist drugs. The major issues involved are no longer just the effects of calcium antagonist drugs in angina or hypertension but their possible postinfarct protective effects, both to provide prophylaxis and to improve left ventricular function. New trials have also changed our thinking. One major trial suggested that the use of one of these agents in postinfarct patients with no history of heart failure in the acute infarct stage was not only safe but could confer positive protection from reinfarction and possibly from sudden death. Another study, also in postinfarct patients but with a different agent, has drawn attention to a further unexpected benefit, namely improvement of mechanical diastolic function. In the area of hypertension, the emphasis has shifted to the regression of left ventricular hypertrophy, now recognized as an independent risk factor for cardiovascular mortality, and to diastolic dysfunction. Looking to the future, calcium antagonists may exert protection against end-stage heart failure by limiting left ventricular hypertrophy and by vascular beneficial effects. There is emerging interest that the combination with ACE inhibitors may exert additive effects on control of hypertension and on diabetic hypertensive renal lesions. Reviews of Other Books by the Author Drugs for the Heart--"A gem" (New England Journal of Medicine) The Heart--"The subjects are brilliantly illuminated and made exciting by excellent line diagrams" (The Lancet) Angiotensin-Converting Enzyme Inhibitors: Scientific Basis for Clinical Use--"A milestone" (British Medical Journal)




Myocardial Protection


Book Description

Myocardial protection is regarded as one of the most important, yet also most controversial aspects of cardiac surgery. There has been considerable improvement in myocardial protection strategies over recent years, utilising a variety of new approaches to treat cardiac diseases, and this text is intended to embrace the state of the art in this field. The book summarises the state of knowledge on all aspects of myocardial protection, including the latest in the treatment of cardiac diseases, robotics, pediatric surgery and the treatment of cardiac failure. Robotic surgery, valvular surgery, pediatric surgery and coronary surgery are all covered by renowned experts, producing a comprehensive, forward-looking view of the field of myocardial protection. This book should function to update physicians and surgeons interested in the field of cardiac surgery on the current state of knowledge on myocardial protection.







The ESC Textbook of Preventive Cardiology


Book Description

"EACPR, European Association for Cardiovascular Prevention and Rehabilitation -- European Society of Cardiology."




Essential Clinical Anesthesia


Book Description

The clinical practice of anesthesia has undergone many advances in the past few years, making this the perfect time for a new state-of-the-art anesthesia textbook for practitioners and trainees. The goal of this book is to provide a modern, clinically focused textbook giving rapid access to comprehensive, succinct knowledge from experts in the field. All clinical topics of relevance to anesthesiology are organized into 29 sections consisting of more than 180 chapters. The print version contains 166 chapters that cover all of the essential clinical topics, while an additional 17 chapters on subjects of interest to the more advanced practitioner can be freely accessed at www.cambridge.org/vacanti. Newer techniques such as ultrasound nerve blocks, robotic surgery and transesophageal echocardiography are included, and numerous illustrations and tables assist the reader in rapidly assimilating key information. This authoritative text is edited by distinguished Harvard Medical School faculty, with contributors from many of the leading academic anesthesiology departments in the United States and an introduction from Dr S. R. Mallampati. This book is your essential companion when preparing for board review and recertification exams and in your daily clinical practice.




Heart Physiology and Pathophysiology


Book Description

Heart Physiology and Pathophysiology, 4E, provides the foundation for the scientific understanding of heart function and dysfunction, and bridges the gap between basic cardiovascular science and clinical cardiology. This comprehensive text covers all the important aspects of the heart and vascular system. The most important and relevant disorders are presented, with emphasis on the mechanisms involved. The first three editions of this book developed a reputation as the leading reference in cardiovascular science for researchers and academic cardiologists. This recent edition has been updated, expanded, and includes a number of new contributors. It has also been remodeled to expand its usage as a text reference for cardiology residents, practicing cardiologists, and graduate students.Key Features* The most comprehensive book available on this topic* Clear, concise, and complete coverage of all important aspects of cardiovascular physiology/pathophysiology* Completely updated version of the foremost reference on cardiovascular science, including new information on pathophysiology and electrophysiology* Useful tool in bridging the gap between basic science, pathophysiology, and clinical cardiology




Early Interventions in Acute Myocardial Infarction


Book Description

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.







Cardiac Ischemia: From Injury to Protection


Book Description

Cardiac Ischemia: From Injury to Protection has been divided into six parts. The first part describes the differences between hypoxia and ischemia, animal models, the effects of ischemia on myocardial function and metabolism, and the electrophysiological consequences of ischemia. The second part deals with the mechanisms of cardiomyocyte death in ischemia, structural aspects of irreversible ischemic injury, necrosis and apoptosis of cardiac cells, the role of calcium, and the concept of calcium antagonism. The third chapter is a brief description of reperfusion injury, its clinical relevance, and possible prevention. The fourth part summarizes changes in myocardial vasculature during ischemia and reperfusion. The fifth part is the survey of two main possibilities for increasing cardiac resistance to ischemia and hypoxia, i.e. long-lasting adaptation to chronic hypoxia and short-lasting preconditioning. The last part of the book deals with comparative and ontogenetic aspects of cardiac sensitivity to oxygen deprivation; this chapter also summarizes the ontogenetic differences and limitations in endogenous and exogenous protection of the ischemic/hypoxic heart.




Myocardial Protection and the KATP Channel


Book Description

The ATP-sensitive potassium channel (KATP) was discovered in 1983. Since then, an enormous amount of research has been undertaken to characterize it in detail. This volume consolidates both the current knowledge and most recent advances on the subject, and its relationship to myocardial protection. To this end, the editors have assembled investigators at the forefront of ongoing basic and clinical research to provide scholarly and candid comments concerning each of the pertinent issues, including: a comprehensive review of the biology of the channel with respect to the structure-activity relationship as well as overall chemistry of the channel; the role of opening this channel and its effect on smooth muscle (covering both the effects on myocardial stunning and its ability to protect against myocardial infarction); the relationship of KATP channel opening and the protection to the myocardium afforded by the phenomenon of ischemic preconditioning; the relationship between the KATP channel and electrophysiological consequences with specific reference to arrhythmogenicity; and the clinical implications of the use of agents that mimic the opening of this channel, with reference to its protective nature and its use in the treatment of angina. Audience: Clinicians and basic scientists who have a direct interest in the KATP channel as well as those groups who are interested in the entire concept of myocardial protection and its relationship to academic and clinical medicine.