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Databases for Cardiology
A database is in principle just a large collection of related or separate data, systematically stored in a computer. It should be possible for the data to be easily entered into the database-structure and afterwards also easily read, corrected and processed. The later analysis of data from such a database is greatly enhanced by the availability of special query languages and statistical analysis programs, not only for serial items but also for large combinations of data. Query languages, such as SQL (Structured Query Language) developed especially for these purposes, make databases easily accessible, also to researchers who may not be very well versed in computer programming. The cardiologic...
Coronary Angioplasty: A Controlled Model for Ischemia
Since the introduction of coronary angioplasty in 1977, this procedure has gained a steadily increasing position in the treatment of coronary artery obstmction. From the available evidence it can be estimated, that this thera peutic tool will get even more additional momentum of many ten-thousands of patients to be treated in the next few years, due to a growing fraction of patients who are candidates for this intervention. Information about the indications, benefits and risks of coronary angioplasty is accumulating rapidly in addition to publications about refinements of the technique itself. Recently, a number of investigators have realized that coronary angioplasty is not only a therapeut...
Quantitation in Cardiology
This book comprises the essential records from a Boerhaave course given in June 1971 for specialists in cardiology and other fields of internal medicine interested in the subject of quantitation in cardiology. It is evident that in the wide field of medicine, and particularly in cardiology, there is a growing need for exact and detailed information in conjunction with existing diag nostic methods. This is apparent in the greater precision in anatomical and haemodynamic details required by the thoracic surgeon as the number of available heart operations gradually increases. In retrospect it is hardly surprising that the high initial mortality after the introduction of each operation depended ...
Cardiovascular Imaging
In the past, coronary arteriography was the only modality available to provide high quality images of the coronary anatomy. Quantitative coronary arteriography (QCA) was developed, implemented, validated and extensively applied to obtain accurate and reproducible data about coronary morphology and the functional significance of coronary obstructions. Over the last few years extensive basic technological research supported by clinical investigations has created competing modalities to visualize coronary morphology and the associated perfusion of the myocardial muscle. Currently, the following modalities are available: X-ray coronary arteriography, intracoronary ultrasound, contrast- and stres...
Coronary Bypass Surgery in the Elderly
Coronary artery bypass surgery in the elderly: Too often or too seldom? It is a testimony to scientific advances that raising a simple inquiry today, such as whether coronary artery bypass surgery is done too often or too seldom in elderlypatients, requiresanexplorationofwhatviewsonemightholdonseveral medical as well as non-medical issues. Unlike earlier years when doctors were clinically free to decide what should be done with a patient, health has become an expensive human right, decisions about which also involve the patient, the epidemiologist, the health policy administrator, politicians, the exchequer, and the philosopher. In its broadest definition health has come to mean the core of ...
Surgical Options for the Treatment of Heart Failure
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 ...
PTCA An Investigational Tool and a Non-Operative Treatment of Acute Ischemia
Obstruction of coronary blood flow and the resultant consequences are the center stage pathophysiologic events in cardiology today. The speculations of Jenner, Burns, Heberdin, McKenzie, Prinzmetal and many others had until now been left to observations of isolated tissue and intact animal experimentation. Only with the advent of Gruentzig's technique, which allowed us to 'work safely inside the coronary arteries' are we able to observe the effects of coronary occlusion in living conscious man. PTCA provides not only a therapeutic modality for non-operatively opening coronary obstructions, but has also provided the best model for studying the effects of acute ischemia on the heart. The proce...
Excitation-Contraction Coupling and Cardiac Contractile Force
The main aim of this monograph is to provide an overview of calcium regulation in cardiac muscle cells, particularly with respect to excitation-contraction coupling and the control of cardiac contractile force. It is my hope that this book will be useful to students of the cardiovascular system and muscle at all different levels and in different disciplines (such as physiology, biochemistry, pharmacology and pathophysiology). I also hope that it will find use for those studying developmental, comparative and disease processes as well as more integrative phenomenon. I kept several goals in mind in writing this monograph. First, it should be easily readable. Second, I chose to include numerous...
The Pacemaker Clinic of the 90’s
Since the first pacemaker implantation in October 1958 by Senning and Elmqvist in Sweden, cardiac pacing for bradycardia has become a well-established therapy. The impressive growth of clinical experience and the rapid development of pacemaker devices have greatly contributed to this situation. The electrical therapy appears to be so easy that insertion of the lead and its connection to the pacemaker generator requires little effort, skill or insight. However, after implantation a patient's condition seldom remains stable, which requires a flexible pacing program to cover all new cardiac events, and broad insight from clinician and technical colleagues. The Pacemaker Clinic of the 90's teaches anatomical and electrophysiological aspects of pacing, supports the prevention of complications, and points to new developments in the field. Apart from classical indications for cardiac pacing, the book discusses the validity of the latest indications, supporting the cardiologist and the associated professional in selecting the appropriate pacing mode and pacemaker follow-up in individual patients. The Pacemaker Clinic of the 90's will be a helpful companion for years to come.
Myocardial Damage
The spectrum of unstable coronary syndromes has been the object of steadily increasing research particularly in respect of novel diagnostic and treatment modalities. Although the WHO criteria for the diagnosis of acute myocardial infarction have been known for decades, there is still much debate as to the proper use of these, especially the handling of biochemical markers. Traditional enzymes have limitations in diagnostic power and new markers have unclarified applicability with regard to standardisation of assays and decision limits. Furthermore, the growing understanding of the conception of minimal myocardial damage in the borderzone between unstable angina pectoris and myocardial infarc...
