Heart Hypertrophy And Failure

One of the most time-consuming tasks in clinical medicine is seeking the opinions of specialist colleagues. There is a pressure not only to make referrals appropriate but also to summarize the case in the language of the specialist. This book explains basic physiologic and pathophysiologic mechanisms of cardiovascular disease in a straightforward manner, gives guidelines as to when referral is appropriate, and, uniquely, explains what the specialist is likely to do. It is ideal for any hospital doctor, generalist, or even senior medical student who may need a cardiology opinion, or for that ma.

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.

In the past two decades a number of studies have shown that abnormalities in the function and structure of coronary microcirculation can be detected in several cardiovascular diseases. On the basis of the clinical setting in which it occurs, coronary microvascular dysfunction (CMD) can be classified into four types: CMD in the absence of any other cardiac disease; CMD in myocardial diseases; CMD in obstructive epicardial coronary artery disease; and iatrogenic CMD. In some instances CMD represents an epiphenomenon, whereas in others it represents an important marker of risk or may contribute to the pathogenesis of myocardial ischemia, thus becoming a possible therapeutic target. This book provides an update on coronary physiology and a systematic assessment of microvascular abnormalities in cardiovascular diseases, in the hope that it will assist clinicians in prevention, detection and management of CMD in their everyday activity.

Heart Hypertrophy and Failure brings together leading basic scientists and clinicians, presenting improved knowledge of the pathophysiology and treatment of the condition. The result is a synthesis of state-of-the-art information on molecular biology, cellular physiology and structure-function relationships in the cardiovascular system in health and disease. The papers presented describe fundamental mechanisms underlying changes in the cellular machinery during the development of cardiac hypertrophy and heart failure. Audience: Students, scientists, clinical and experimental cardiologists who seek to understand and manage the perplexing problems of hypertrophy and heart failure.

The book "From Hypertension to Heart Failure" will cover new aspects of the treatment of hypertension, arrhythmias, heart failure and coronary artery diseases. The topics will include new pathophysiological findings, the theoretical background of pharmacological treatment, results of the latest studies, and practical guidelines for treatment. Case reports will make the book applicable for a broad readership of general internists. The therapy of heart failure with betablockers is one of the most controversially discussed topics in cardiovascular medicine. Therefore, the book will critically deal with this new form of therapy for this disabling condition.

Contractility describes the relative ability of the heart to eject a stroke volume (SV) at a given prevailing afterload (arterial pressure) and preload (end-diastolic volume; EDV). Various measures of contractility are related to the fraction as the SV/EDV or the ejection fraction, and the dynamics of ejection as determined from maximum pressure rise in the ventricles or arteries or from aortic flow velocities determined by echocardiography. At the cellular level, the ultimate determinant of contractility is the relative tension generation and shortening capability of the molecular motors (myosin cross-bridges) of the sarcomeres as determined by the rates and extent of Ca activation, the turnover kinetics of the cross-bridges, and the relative Ca responsiveness of the sarcomeres. Engagement of the regulatory signaling cascades controlling contractility occurs with occupancy and signal transduction by receptors for neurohumors of the autonomic nervous system as well as growth and stress signaling pathways. Contractility is also determined by the prevailing conditions of pH, temperature, and redox state. Short-term control of contractility is fully expressed during exercise. In long-term responses to stresses on the heart, contractility is modified by cellular remodeling and altered signaling that may compensate for a time but which ultimately may fail, leading to disorders.

This book systematically focuses on central sleep apneas, analyzing their relationship especially with heart failure and discussing recent research results and emerging treatment strategies based on feedback modulation. The opening chapters present historical background information on Cheyne-Stokes respiration (CSR), clarify terminology, and explain the mechanics and chemistry of respiration. Following a description of the physiology of respiration, the pathophysiology underlying central apneas in different disorders and particularly in heart failure is discussed. The similarities and differences of obstructive and central apneas are then considered. The book looks beyond the concept of sleep apnea to daytime CSR and periodic breathing during effort and contrasts the opposing views of CSR as a compensatory phenomenon or as detrimental to the failing heart. The diagnostic tools currently in use for the detection of CSR are thoroughly reviewed, with guidance on interpretation of findings. The book concludes by describing the various forms of treatment that are available for CSR and by explaining how to select patients for treatment.