Coronary Stenosis Imaging Structure And Physiology

"Coronary stenosis. Imaging, structure and physiology" has been designed as a clinically and research orientated reference for all cardiologists, physicians, cardiovascular imagers, trainees and investigators working in the field of ischemic heart disease. In the scenario of facilitated access to the coronary arteries provided by new diagnostic techniques, this book cornes to fill an empty space in the medical literature: a textbook providing a comprehensive, multifaceted analysis of atherosclerotic and non-atherosclerotic coronary stenoses, addressing multiple issues that are of key importance in invasive and non-invasive diagnostic studies of the coronary vessels. Emphasis has been placed in integrating three separate aspects: imaging, structure and physiology. The chapters are written by top experts in invasive and non-invasive diagnostics, coronary anatomy, pathology and physiology, encouraged by the editors to adress each topic from a plural perspective to facilitate knowledge sharing between their respective disciplines. An associated website provides access to the electronic edition of the book, which includes moving images and updated material. This book is an indispensable companion for all those involved in the diagnosis and treatment of ischemic heart disease. With a foreword by Morton J. Kern, MD, PhD.

​Since the introduction of coronary angiography, a key technique in understanding coronary artery disease, a number of paradigms regarding its study and interpretation have taken place. Following an emphasis on improved angiographic and subsequent intracoronary imaging techniques, functional assessment of coronary circulation has demonstrated to have major implications for diagnosis and treatment of coronary artery disease. Fractional flow reserve, a pressure derived index of stenosis severity, constitutes the best example of the current importance of physiological assessment in clinical practice. However, the acceptance of FFR by cardiologists contrasts with important voids in knowledge on the basic principles of coronary physiology and of other available techniques that, as an alternative to FFR, allow a more comprehensive assessment of coronary circulation. This is particularly noticeable in the assessment of microcirculation, an unavoidable compartment of coronary circulation that is frequently affected in acute coronary syndromes of in the presence of cardiovascular risk factors or non-coronary heart disease. A deeper understanding of the relationship between epicardial vessel and microcirculatory involvement has started with the advent of newer imaging techniques like invasive optical coherence tomography, and non-invasive CT and NMR techniques. This book aims to be an indispensable tool for clinicians and researches in the field of coronary artery disease. It provides a balanced, comprehensive review of anatomy, physiology and available techniques, discusses both the diagnosis of epicardial vessel and microcirculatory disease, the impact of different diseases at different levels of coronary circulation, and the best way to address a separate or combined assessment of different levels of coronary circulation. ​

This book is intended as a guide for all cardiologists who are interested in coronary imaging and physiology, a sound understanding of which is vital for the optimal performance of appropriate coronary interventions. The basics of each relevant modality are presented, with clear explanation of clinical utility and evaluation of the evidence regarding clinical outcomes. All technical methods are described in detail, and the text is complemented by numerous helpful tables and illustrations. The effectiveness of intravascular coronary imaging in improving clinical outcomes is proven, and it is widely used for this purpose. Two modalities for intravascular coronary imaging are available in clinical practice: intravascular ultrasound (IVUS) and optical coherence tomography (OCT). For coronary physiology, the pressure wire-derived fractional flow reserve (FFR) provides information on the functional status of coronary trees. This technique and its clinical applications receive particular attention in the book, which also looks beyond FFR to FFR-CT, a method using computational fluid dynamics, and to invasive assessment of the microcirculation.

In non-fatal cases, cardiovascular diseases are associated with a decreased quality of life as well as a substantial economic burden to society. Most sudden cardiac events are related to the complications of a non-stenosing marginal plaque. For this reason, the ability to properly identify the atherosclerotic plaque with rapid, non-invasive techniques is of utmost clinical interest in diagnostic workup and therapeutic planning of symptomatic patient. Nowadays CT produces high-quality images of the coronary arteries, in addition to defining their location and the extent of the atherosclerotic involvement. This new edition is enriched with two important additions. Firstly, dedicated chapters on intravascular ultrasound (IVUS), catheter angiography, and nuclear imaging have been included, with some discussions on theoretical techniques such as optical coherence tomography (OCT) and magnetic resonance imaging (MRI). Secondly, a completely new section comprising more than 70 clinical cases remarkably expands the horizons reached by the previous edition. This volume provides general practitioners and cardiologists with a basic understanding of the imaging techniques. For radiologists with no direct experience in cardiac imaging, the book serves as an important source of information on coronary pathophysiology and anatomy.

The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.

Research centering on blood flow in the heart continues to hold an important position, especially since a better understanding of the subject may help reduce the incidence of coronary arterial disease and heart attacks. This book summarizes recent advances in the field; it is the product of fruitful cooperation among international scientists who met in Japan in May, 1990 to discuss the regulation of coronary blood flow.

This is the seventh edition of a long-selling book (first edition 1991) that was translated into Italian, French, Chinese, Portuguese, Spanish, English. In the last ten years, stress echocardiography has exploded in its breadth and variety of applications. From a one-fits-all approach (wall motion by 2D-echo in the patient with known or suspected coronary artery disease), the field has progressed to an omnivorous, next-generation laboratory employing a variety of technologies (from M-Mode to 2D, from pulsed, continuous, color and tissue Doppler to lung ultrasound) on patients covering the entire spectrum of severity (from elite athletes to patients with end-stage heart failure) and ages (from children with congenital heart disease to the elderly with aortic stenosis). This new edition is enriched with over 300 figures, 150 tables and video-clips. In a societal and economic climate of increasing pressure for appropriate, justified and optimized imaging, stress echocardiography offers the great advantages of being radiation-free, relatively low cost, with minimal environmental impact, and with a staggering versatility: we can get more (information) with less (cost and risk). The volume will be a tremendous aid to current best practices for all health operators who intend to use stress echocardiography and ultrasound for diagnosis and guidance of optimal management in their patients.

In recent years, there has been increasing interest in the clinical applications of coronary angiography techniques. Coronary MRA can be instrumental in the evaluation of congenital coronary artery anomalies, however, the complexity of advanced MR pulse sequences and strategies may be overwhelming to many. Coronary MR Angiography demystifies the art of coronary MRA by providing a text in plain language with clearly illustrated imaging steps and protocols. Designed to bridge the gap between radiology and cardiology, it is written for physicians and scientists planning to incorporate this technique into their research or practice.