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Essential Cardiology: Principles and Practice

Clive Rosendorff (eds.)

Second Edition.

Resumen/Descripción – provisto por la editorial

No disponible.

Palabras clave – provistas por la editorial

Cardiology

Disponibilidad
Institución detectada Año de publicación Navegá Descargá Solicitá
No detectada 2006 SpringerLink

Información

Tipo de recurso:

libros

ISBN impreso

978-1-58829-370-1

ISBN electrónico

978-1-59259-918-9

Editor responsable

Springer Nature

País de edición

Reino Unido

Fecha de publicación

Información sobre derechos de publicación

© Humana Press Inc. 2006

Tabla de contenidos

Assessment of Patients With Heart Disease for Fitness for Noncardiac Surgery

Joseph Savino; Lee A. Fleisher

The tendency in medicine over the past decade is to decrease preoperative testing, as the evidence for improved outcomes for these often expensive procedures is lacking. Population-based management decisions are often steered by clinical trials, cost-effectiveness analysis, and resource allocation. However, few doctors take care of populations. Most of us care for individuals. Evidence-based paradigms based on “population medicine” define the most effective management scheme for the vast majority of patients, but not for every patient. Individual patient decisions by attending physicians are not consistently based on evidence but are often made in the context of “what would I do if it was my mother?” with the premise that more information is better. Should every patient undergoing repair of an abdominal aortic aneurysm undergo dipyridamole or dobut-amine stress testing? The evidence supports not. Nonetheless, the practice in many centers is to obtain a dipyridamole or adenosine thallium stress test even if the patient is asymptomatic. Despite the reassurances provided by large clinical trials, practitioners do not consistently adhere to their recommendations and often rely on tradition, anecdote, and impression in their decision-making. If physicians are to remain the dispensers of medical care and resources, then we need to be cognizant of the effects of our decisions on all patients, not just the one sitting in the examination room. Exorbitant sums spent on unnecessary testing exhausts valuable resources that could be diverted to the more needy. Unfortunately, the risk of uncertainty and medicolegal liability results in more testing than is often indicated.

XI - Additional Topics | Pp. 747-761

Cardiovascular Gene and Cell Therapy

Eddy Kizana; Federica del Monte; Sian E. Harding; Roger J. Hajjar

Cardiovascular disease is a major cause of morbidity and mortality in contemporary societies. Although progress in conventional treatment modalities is making steady and incremental gains to reduce this disease burden, there remains a need to explore new and potentially therapeutic approaches. Gene therapy, for example, was initially envisioned as a treatment strategy for inherited monogenic disorders. It is now apparent that gene therapy has broader potential that also includes acquired polygenic diseases, such as atherosclerosis and heart failure. Advances in the understanding of the molecular basis of conditions such as these, together with the evolution of increasingly efficient gene transfer technology, has placed some cardiovascular pathophysiolo-gies within reach of gene-based therapy.

XI - Additional Topics | Pp. 763-788

Preventive Cardiology

Michael Miller

Since the inaugural edition of this book, an increased awareness in preventing and treating heart disease has been spawned by revisions of cholesterol, hypertension and diabetes guidelines. As national guidelines have recently dictated, there is a trend in the direction of “the lower the better” for each of these risk factors. However, the past several years have also witnessed the emergence of diagnostic biomarkers of atherothrombosis that include C-reactive protein and noninvasive surrogates of atherosclerosis, such as carotid intima-media thickness and coronary calcification. In contrast, therapies that were previously deemed to have an important role in offsetting coronary heart disease (CHD) risk (e.g., antioxidant vitamins and hormone replacement therapy) have been shown to exert no beneficial impact. As our understanding of cardiovascular preventive measures continues to evolve, the goal of this chapter is to focus on the most important advances in this relatively new field with an emphasizes on clinical endpoint data influencing both initial and secondary cardiovascular events.

XI - Additional Topics | Pp. 789-806

Peripheral Arterial Disease

James J. Jang; Jonathan L. Halperin

The most widely recognized peripheral vascular disease in adults . The traditional term “arteriosclerosis obliterans” distinguishes the development of obstructive lesions from normal aging by which the arteries increase in diameter, rigidity, and calcium content (). The disease was defined in 1958 by the World Health Organization as a “variable combination of changes of the intima or arteries (as distinguished from arterioles) consisting of the focal accumulation of lipids, complex carbohydrates, blood and blood products, fibrous tissue and calcium deposits, and associated with medial changes” ().

XI - Additional Topics | Pp. 807-828