This sixth edition is enriched by over 300 figures, 150 tables and a video-companion collecting more than 100 cases also presented in the format of short movies and teaching cartoons. This extensively revised and enlarged edition of this long-seller documents the very significant advances made since the fifth (2009) edition and is entirely written by Eugenio Picano, a pioneer in the field sharing his lifetime experience with the help of an international panel of 50 contributors from 22 countries representing some of the best available knowledge and expertise in their respective field. 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, and with a staggering versatility: we can get more (information) with less (cost and risk). For a long time, the scope and application of stress echo remained focused on coronary artery disease. In the last ten years, it has exploded in its breadth and variety of applications. From a black-and-white, one-fits-all approach (wall motion by 2D-echo in the patient with known or suspected coronary artery disease) now we have moved on to a omnivorous, next-generation laboratory employing a variety of technologies (from M-Mode to 2D and pulsed, continuous, color and tissue Doppler, to lung ultrasound and real time 3D echo, 2D speckle tracking and myocardial contrast echo) 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 low-flow, low-gradient aortic stenosis).
Over the past twenty years, under the impetus of technological innovations and the drive for cost-effectiveness, stress echocardiography has developed into a well-established technique that is versatile, patient friendly, and relatively inexpensive. This growth has been reflected in the increasing size of past editions of Stress Echocardiography, all of which have been praised for their clarity and scope. This fifth edition of the book has been extensively revised and updated to reflect the further progress achieved over the past few years. The early chapters place the technique within a historical context and describe its pathophysiological basis. Thereafter, all aspects of stress echocardiography are discussed, clearly and in detail, by the distinguished pioneer, Eugenio Picano, and other contributors carefully selected for their expertise in the topic under consideration. Both mainstream and emerging applications are explained, and systematic comparisons with competing and complementary cardiac imaging techniques are provided from a clinically oriented perspective. The text is supported by a large number of high-quality illustrations. This book will be invaluable not only to cardiologists but also to non-experts such as technicians and students.
After ten years of life restricted to the scientific world of research, stress echocardiography today appears on the clinical stage as a clean and efficient option for diagnostic imaging of myocardial ischemia. At the Institute of Clinical Physiology of Pisa, stress echocardiography has successfully moved from the status of fancy pathophysiological toy to one of practical diagnostic weapon - in spite of the availability of a strong and sophisticated nuclear cardiology department. This textbook stems from a long-standing experience and describes in a systematic fashion the new diagnostic entity of stress echocardiography: the pathophysiological and experimental roots, the methodology, the clinical fruits and the new branches of possible future development. Only time will tell whether the new plant of the diagnostic forest will grow tall; but certainly its place is no longer in the academic greenhouse with exotic entities, but rather in the open air of the real world, where this baedeker might be of help to the clinician and the researcher interested in ischemic heart disease.
For this 3rd edition several international authors contributed to the work of Dr.Picano, the well-known pioneer in stress echocardiography. This edition has also been enlarged by 8 new chapters, covering new techniques and describing the diagnostic help of stress echo examinations under certain conditions, such as hypertension and during severe heart diseases.
From reviews of the previous editions: "Dr. Picano, one of the pioneers of stress echo, describes the pathophysiological basis of the technique extremely well. In addition, both the advantages and the limitations of the method are covered in a clear and comprehensive way. The book will be useful to cardiologists and even "non-experts" such as echo technicians and students". (Jos Roelandt, Cardiov Res; 1994; 28: 1: 143) "A narrative and enjoyable style ... An extremely valuable and important book for those who practise stress echo and are interested in clinical and scientific aspects of the method". (H.P. Kuhl, Der Internist, 1999; 9: 958) "An extremely well written, unique Picano-style. This beautiful book is an essential part of every good cardiological library". (A. Boccanelli, G Ital Cardiol; 1998; 28:81)
Stress echocardiography today appears on the clinical stage as a clean and efficient option for diagnostic imaging of myocardial ischemia. This concise and therefore successful textbook stems from a long-standing experience and describes in a systematic fashion the recent diagnostic entity of stress echocardiography: the pathophysiological and experimental roots, the methodology, the clinical fruits and the new branches of possible future development. But first of all it tries to help the cardiologist in clinical practice to know why, how and when to perform stress echocardiography.
Although the technology required for the successful application of contrast echo cardiography has evolved rapidly over the past few years, the technique has not yet gained widespread clinical acceptance. One important reason for the lack of clinical acceptance is the relative complexity of the technique, particularly in respect to myocardial perfusion imaging. The interaction between micro bubbles and ultrasound is an entire field by itsel£ as is the coronary microvasculature. It is in this regard that practicing echocardiographers, cardiologists in training, radiologists, so no graphers, and students will find 'A Handbook of Contrast Echocardiography' particularly useful. Written by two leaders in the field who have presented illustrative cases not only from their own laboratories but also from others around the world, this volume is a lucid, concise, and practical guide for the day-to-day use of contrast echocardiography. Dr Peter Burns has been involved in almost all the technical advances in the imaging methods that have made it possible to detect opacification of the left ventricular cavity and myocardium from a venous injection of microbubbles. He has been responsible to a large degree for advancing our understanding of the interaction between micro bubbles and ultrasound, which he describes in clear and easy to understand terms in this book. Dr Harald Becher has been active in the clincal application of contrast echocardiography for several years and has gained considerable experience with many imaging techniques and microbubbles, which he describes in this volume in some detail.
In una statistica comparsa qualche anno fa su un autorevole giornale di cardiologia sperimentale, il numero di errori di ortografia e sintassi nei manoscritti sottomessi per pubblicazione veniva messo a confronto per i vari paesi. Chi c’era in testa alla classifica per frequenza di errori (e in coda alla classifica della frequenza di accettazione)? C’eravamo noi, i cardiologi italiani. Modestia a parte, ci riconoscono ovunque per il nostro marchio di fabbrica lessicale, lo “spaghetti-English”. Un buon inglese non aiuta forse a farsi accettare il lavoro, ma un cattivo inglese di certo aiuta a farselo rifiutare. Il libro ci aiuta a cancellare qualche macchia di pomodoro nel nostro spaghetti-Cardio-English, e già questo sarà un ottimo risultato per il lettore." (dalla presentazione di Eugenio Picano)
During last two decades, stress echocardiography has progressed from a promising idea to a crucial diagnostic and prognostic tool in various cardiac conditions, particularly in ischemic heart diseases. Written by world recognized experts in the field, Stress Echocardiography: Essential Guide and DVD is an all-inclusive source of key information related to the principles and practice of stress echocardiography. Both the stress echocardiography trainee and those in practice seek to benefit from this text and DVD set.
Important features include:user-friendly accompanying DVD over 500 color and black-and-white illustrations and tables to assist the reader in correctly identifying various disease states detailed list of 50 landmark papers with commentary presentation of difficult case studies from everyday practice exploration of the practical aspects of imaging during stress and the science of reading of stress echo studies detailed explanations of the quantification of echocardiographic response and stress echo interpretation descriptions of the use of different stress echocardiographic modalities in specific clinical situations, as well as the advantages, drawbacks, pitfalls, and implications of results on patient management
W. F. ARMSTRONG While stress echocardiography is not the first technique to be applied to patients for the diagnosis of coronary artery disease, it represents an impor tant clinical tool, likely to become of increasing pertinence in today's era of cost containment and mandated cost-effectiveness of diagnosis. It may be the most rapidly expanding area of clinical echocardiography today. Stress echocardiography as we know it today represents the natural con clusion and merger of observations made over fifty years ago. In 1935 Tenn ant and Wiggers demonstrated that the immediate result of a coronary oc clusion, was an instantaneous abnormality of wall motion . As viewed from the surface of the heart in an open chest dog preparation, cyanosis and obvious paradoxical bulging of the left ventricular wall was noted. At a similar time Masters and co-workers, using fairly rudimentary exercise de vices, described the response of the human cardiovascular system to sustained exercise (Figure 1) . These two observations diverged for four decades while clinical investigation was pursued along the two parallel lines.
Vorwort Die nachfolgenden TabeBen und Schemata sallen die leichte Auffindung und schnelle Entnahme der in der Elektrokardio, graphie gebrauchlichen MeBwerte unter Vermeidung irgendwelcher Berechnungen ermoglich'en. Sie sind ausschlieBlich filr die tagliche elektrokardioƯ graphische Praxis bestimmt, enthalten daher nichts ProƯ blematisches, sondern steBen vielmehr eine Sammlung der in der Literatur verstreuten und heute bereits anƯ erkannten Durchschnittswerte auf engstem Raume dar. Dazu werden noch einige eigene Ergebnisse (beziiglich der Minuten-QT -Dauer und der Ekg-Typen) hinzugeƯ filgt und.