Oxidative Stress and Vascular Disease

Developments in Cardiovascular Medicine

Book 224
Springer Science & Business Media
Free sample

One of the major biomedical triumphs of the post-World War II era was the defmitive demonstration that hypercholesterolemia is a key causative factor in atherosclerosis; that hypercholesterolemia can be effectively treated; and that treatment significantly reduces not only coronary disease mortality but also all cause mortality. Treatment to lower plasma levels of cholesterol - primarily low density lipoprotein (LDL) cholesterol - is now accepted as best medical practice and both physicians and patients are being educated to take aggressive measures to lower LDL. We can confidently look forward to important decreases in the toll of coronary artery disease over the coming decades. However, there is still uncertainty as to the exact mechanisms by which elevated plasma cholesterol and LDL levels initiate and favor the progression of lesions. There is general consensus that one of the earliest responses to hypercholesterolemia is the adhesion of monocytes to aortic endothelial cells followed by their penetration into the subendothelial space, where they differentiate into macrophages. These cells, and also medial smooth muscle cells that have migrated into the subendothelial space, then become loaded with mUltiple, large droplets of cholesterol esters . . . the hallmark of the earliest visible atherosclerotic lesion, the so-called fatty streak. This lesion is the precursor of the more advanced lesions, both in animal models and in humans. Thus the centrality of hypercholesterolemia cannot be overstated. Still, the atherogenic process is complex and evolves over a long period of time.
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Additional Information

Publisher
Springer Science & Business Media
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Published on
Dec 6, 2012
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Pages
373
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ISBN
9781461546498
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Language
English
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Genres
Medical / Cardiology
Medical / Clinical Medicine
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Content Protection
This content is DRM protected.
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Despite the significant decline in heart disease mortaht>' rates over the last 25 years, heart failure has remained a significant problem. We are now confronted with large numbers of terminally ill patients for whom conventional therapies for heart failure have been exhausted and for whom repeated hospital visits are necessary. There now is a major thrust towards a management strategy which embraces a comprehensive approach including vigorous preventive measures and earlier surgical interventions. This book outlines the major surgical options for the treatment of heart failure and brings together a very broad base of opinions with contributions from several outstanding individuals. With the improved knowledge and techniques to control rejection, transplantation has become the central pillar in the surgical management of this group of patients. Unfortunately, because of limited donor supply the teclmique cannot be applied to large numbers of patients. A great deal of excitement, however, exists in the potential for xenotransplantation as a supplement to homotransplantation. The use of cardiac assist devices has become a reality with several hundred LVADS and BiVADS implanted throughout the world and cardiac replacement with total artificial hearts continues to be used successfully as a bridge to transplantation. We are on the thieshold of the broad application of assist devices to provide prolonged relief of heart failure and restore patients to an ambulatoiy home environment and hopefully return to the work force in significant numbers.
On 29 February 1964, a group of European scientists met in Paris to discuss a subject of common interest, namely atherosclerosis research, with particular reference to international communication and collaboration. After a second meeting on 15 May 1964, they founded the European Atherosclerosis Group which was to com prise individuals engaged in the various disciplines of atherosclero sis research in Eastern and Western Europe. Since then this group has initiated multidisciplinary discussion and scientific collabora tion across Europe, in accordance with the objects and aims written in its statutes: 1. To hold colloquia and symposia dealing with research in the field of atherosclerosis and allied sciences 2. To encourage meetings and exchanges between scientists in the group engaged in the investigation of atherosclerosis 3. To encourage collaborative work between national and interna tional centers engaged in atherosclerosis research 4. To encourage the publication of reviews, etc. , on atherosclerosis research which may be considered of value 5. To promote research fellowships, particularly for younger research workers, for studies within the field of atherosclerosis and allied sciences 6. To accept dues, endowments, grants, funds, and bequests to be used for the above purposes The European Atherosclerosis Group has helped to bring together what was separated during the second world war and the postwar period in Europe and to reestablish ties with the leading American teams.
Despite the significant decline in heart disease mortaht>' rates over the last 25 years, heart failure has remained a significant problem. We are now confronted with large numbers of terminally ill patients for whom conventional therapies for heart failure have been exhausted and for whom repeated hospital visits are necessary. There now is a major thrust towards a management strategy which embraces a comprehensive approach including vigorous preventive measures and earlier surgical interventions. This book outlines the major surgical options for the treatment of heart failure and brings together a very broad base of opinions with contributions from several outstanding individuals. With the improved knowledge and techniques to control rejection, transplantation has become the central pillar in the surgical management of this group of patients. Unfortunately, because of limited donor supply the teclmique cannot be applied to large numbers of patients. A great deal of excitement, however, exists in the potential for xenotransplantation as a supplement to homotransplantation. The use of cardiac assist devices has become a reality with several hundred LVADS and BiVADS implanted throughout the world and cardiac replacement with total artificial hearts continues to be used successfully as a bridge to transplantation. We are on the thieshold of the broad application of assist devices to provide prolonged relief of heart failure and restore patients to an ambulatoiy home environment and hopefully return to the work force in significant numbers.
This Symposium is the third of a series of scientific meetings in the field of echocardiology, held at the Erasmus University Rotterdam. * The series was initiated by Klaas Born, who organized the first two meetings with great success. These followed the procedure of two days of parallel sessions with invited speakers only. This time, we decided to broaden the basis of the meeting and have a three-day program of parallel sessions, combining invited papers, free com munications and posters. We decided, however, to maintain one of the most striking features of the last meeting- having the complete proceedings available at the time of the meeting. We confronted the authors-to-be with a very tight schedule in order to make the book a true reflection of the state of the art in echocardiology. As a 'result, editing time was also very limited and neither terminology nor units have been completely standardized. This book has three main parts. The first, and largest, part consists of contributions on echocardiology in adults, and is divided into four sections. The first section is a general survey of various applications, whereas the remaining three centre round specific applications, i.e. ischemic disease, left ventricular function and cardiac valves, respectively. The second part con tains applications in pediatric cardiology; due to the wide variety of topics covered, no particular subdivision has been made. The last part of the book is devoted to instrumentation, methods and new developments.
This handy reference puts essential information at your fingertips! Pocket Reference for the 12-Lead ECG in Acute Coronary Syndromes, 3rd Edition helps you recognize ST segment elevation myocardial infarction (STEMI) by introducing the 5-step approach to 12-lead analysis, making it faster and easier to learn 12-lead interpretation. Clear and concise, this book provides a simple, step-by-step approach along with tables, illustrations, and practice 12-lead ECGs to help you determine the likelihood of the presence of STEMI versus imposters or other causes of ST elevation. Written by two well-known educators, Tim Phalen, a paramedic, and Barbara J. Aehlert, a nurse, this pocket reference is available separately or as a package with its corresponding textbook, The 12-Lead ECG in Acute Coronary Syndromes Text, 3rd Edition.A clear, succinct, pocket-sized approach makes it easy to identify possible ST segment elevation myocardial infarction, determine the likelihood of the top STEMI imposters, and confidently categorize the ECG.Streamlined explanation of STEMI recognition includes an emphasis on STEMI imposters (non-infarct causes of ST elevation).Full-color illustrations clearly depict concepts and skills. Updated approach to ECG interpretation helps you determine STEMI versus other causes of ST elevation.NEW 5-step approach simplifies how to determine non-infarct causes of ST elevation, whether STEMI or STEMI imposter(s).NEW content in Suspecting STEMI chapter includes identifying the J-Point, determining ST elevation, Lead "Views," suspecting STEMI, and additional STEMI ECG changes.NEW content in STEMI Imposters chapter includes the top 5 STEMI imposters, ruling out the top STEMI imposters, and a 5-step analysis.NEW content in STEMI Imposters chapter includes the coronary artery anatomy, right ventricular infarction, posterior infarction, and obtaining additional leads.NEW Practice ECGs chapter is devoted to practicing the 5-step approach.NEW Practice ECGs chapter and 23 new 12-lead practice ECGs help you develop skills in 12-lead ECG recognition.NEW Key Point! boxes call attention to essential information.
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