Physiological Assessment Of Coronary Stenoses And The Microcirculation

Author : Javier Escaned,Justin Davies
Publisher : Springer
Page : 313 pages
File Size : 47,5 Mb
Release : 2017-08-10
Category : Medical
ISBN : 9781447152453

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Physiological Assessment of Coronary Stenoses and the Microcirculation by Javier Escaned,Justin Davies Pdf

​Since the introduction of coronary angiography, a key technique in understanding coronary artery disease, a number of paradigms regarding its study and interpretation have taken place. Following an emphasis on improved angiographic and subsequent intracoronary imaging techniques, functional assessment of coronary circulation has demonstrated to have major implications for diagnosis and treatment of coronary artery disease. Fractional flow reserve, a pressure derived index of stenosis severity, constitutes the best example of the current importance of physiological assessment in clinical practice. However, the acceptance of FFR by cardiologists contrasts with important voids in knowledge on the basic principles of coronary physiology and of other available techniques that, as an alternative to FFR, allow a more comprehensive assessment of coronary circulation. This is particularly noticeable in the assessment of microcirculation, an unavoidable compartment of coronary circulation that is frequently affected in acute coronary syndromes of in the presence of cardiovascular risk factors or non-coronary heart disease. A deeper understanding of the relationship between epicardial vessel and microcirculatory involvement has started with the advent of newer imaging techniques like invasive optical coherence tomography, and non-invasive CT and NMR techniques. This book aims to be an indispensable tool for clinicians and researches in the field of coronary artery disease. It provides a balanced, comprehensive review of anatomy, physiology and available techniques, discusses both the diagnosis of epicardial vessel and microcirculatory disease, the impact of different diseases at different levels of coronary circulation, and the best way to address a separate or combined assessment of different levels of coronary circulation. ​

Author : Timothy J Watson,Paul JL Ong,James E Tcheng
Publisher : Springer
Page : 338 pages
File Size : 49,9 Mb
Release : 2018-07-13
Category : Medical
ISBN : 9789811311147

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Primary Angioplasty by Timothy J Watson,Paul JL Ong,James E Tcheng Pdf

This book is open access under a CC BY 4.0 license. This quick-reference handbook offers a concise and practical review of key aspects of the treatment of ST-segment elevation myocardial infarction (STEMI) in the era of primary percutaneous coronary intervention (PPCI). In the context of STEMI, PPCI is the preferred mode of emergency revascularization. Access to PPCI is rapidly increasing and is now routinely practiced in both general and specialist hospitals and there has been a recent emphasis on developing STEMI networks to enhance and expedite the referral pathway. This coupled with concurrent developments to enhance the safety and efficacy of the PPCI procedure has heralded an era where STEMI interventions are increasingly considered an important subspecialty within interventional cardiology. Written by leading cardiologists who have been instrumental in the adoption of PPCI in their respective institutions, the book provides junior and senior cardiologists alike with insightful and thought-provoking tips and tricks to enhance the success of PPCI procedures, which may in turn translate into direct improvements in outcomes. The book is also relevant for healthcare providers and emergency department physicians.

Author : Filippo Crea,Gaetano A. Lanza,Paolo G. Camici
Publisher : Springer Science & Business Media
Page : 257 pages
File Size : 50,9 Mb
Release : 2013-08-15
Category : Medical
ISBN : 9788847053670

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Coronary Microvascular Dysfunction by Filippo Crea,Gaetano A. Lanza,Paolo G. Camici Pdf

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.

Author : N.H. Pijls,B. de Bruyne
Publisher : Springer Science & Business Media
Page : 348 pages
File Size : 51,6 Mb
Release : 2013-06-29
Category : Medical
ISBN : 9789401588348

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Coronary Pressure by N.H. Pijls,B. de Bruyne Pdf

Cardiologists must answer three important questions when evaluating and treating patients with a coronary artery stenosis. As a physiologist: "What is the effect of this stenosis on coronary blood flow and myocardial function?"; as a clinician: " Is this lesion responsible for the patient's symptoms?"; and finally as an interventionalist: "Will revascularization of this artery improve the patient?" Fundamentally, the answer to these questions can be given to a large extent by measuring coronary pressure. That is the rationale of writing this book. 1. 1 Historical overview. Andreas Gruentzig and most interventional cardiologists in the early days of PTCA, had the intuitive feeling that pressure measurements could help to establish the severity of a coronary stenosis and to monitor the progress and result of a coronary intervention. At that time, measuring coronary pressure by the balloon catheter was part of a standard procedure. A residual transstenotic gradient of less than 15 mmHg was generally considered as a good result. Later, however, it turned out that measuring these (resting) gradients with balloon catheters was inaccurate an only had a limited prognostic value. Moreover, because there was no consistent theory to correlate pressure measurements to blood flow, the interest in measuring coronary pressures faded and disappeared almost completely with the introduction of new balloon catheters not intended for pressure measurement.

Author : Michitoshi Inoue,Masatsugu Hori,Shoichi Imai,Robert M. Berne
Publisher : Springer Science & Business Media
Page : 330 pages
File Size : 53,5 Mb
Release : 2013-11-09
Category : Medical
ISBN : 9784431683674

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Regulation of Coronary Blood Flow by Michitoshi Inoue,Masatsugu Hori,Shoichi Imai,Robert M. Berne Pdf

Research centering on blood flow in the heart continues to hold an important position, especially since a better understanding of the subject may help reduce the incidence of coronary arterial disease and heart attacks. This book summarizes recent advances in the field; it is the product of fruitful cooperation among international scientists who met in Japan in May, 1990 to discuss the regulation of coronary blood flow.

Author : George D. Dangas,Carlo Di Mario,Nicholas N. Kipshidze,Peter Barlis,Tayo Addo
Publisher : John Wiley & Sons
Page : 2479 pages
File Size : 46,5 Mb
Release : 2016-11-28
Category : Medical
ISBN : 9781118975961

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Interventional Cardiology by George D. Dangas,Carlo Di Mario,Nicholas N. Kipshidze,Peter Barlis,Tayo Addo Pdf

Expert guidance from internationally recognized authorities, who provide clear and current updates on all aspects of interventional cardiology. This new edition; Contains a radically expanded chapter contents list presented in four clear sections; coronary interventions, interventional pharmacology, structural heart interventions, and endovascular therapy Includes 46 new chapters, including the latest advances in bioresorbable coronary stents, advanced transcatheter aortic valve replacement, MitraClip, new transcatheter mitral valve interventions, and more Chapters are templated for rapid referral, beginning with pathophysiological background and relevant pathology, moving to mechanisms of treatment, device description, procedural techniques, follow-up care, and ending with risks, contraindications and complications Multiple choice questions at the end of each chapter for self-assessment, a total of more than 400 MCQs in the book Features 19 procedural videos, hosted on a companion website

Author : Jos Spaan
Publisher : Springer Science & Business Media
Page : 434 pages
File Size : 54,6 Mb
Release : 1991-05-31
Category : Medical
ISBN : 0792312104

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Coronary Blood Flow by Jos Spaan Pdf

by JULIEN IE HOFFMAN One of the earliest coronary physiologists was Scaramucci who, in 1695, postu lated that during systole the contracting myocardium inhibited coronary blood flow. Since then, the many contributions that have been made to our knowledge of the coronary circulation can be arbitrarily divided into three phases based on advances in technical methods. The early phase of research into the coronary circulation, done with great difficulty with crude methods, may be regarded as ending in the 1940s, and it included major discoveries made by such well known investigators as Georg von Anrep, Ernest Starling, Carl Wiggers, and Louis Katz, who formulated much of our basic understanding of the field. After 1940, the field of coronary physiology entered a new phase when instruments for high fidelity registration of coronary flow and pressure became available. This era was domi nated by Donald Gregg who combined careful attention to the function of these instruments (some of which he helped to develop) with an extraordinary ability to discern mechanisms from apparently minor changes in coronary flow and pressure patterns. His book 'The Coronary Circulation in Health and Disease' set a new standard in the field. After 1960, techniques for measuring regional myocardial blood flow became available, and enabled a large group of eminent investigators to make major advances in understanding the physiology and pathophysiology of myocardial blood flow.

Author : Peter Lanzer
Publisher : Springer
Page : 1891 pages
File Size : 48,5 Mb
Release : 2018-04-30
Category : Medical
ISBN : 9783319559940

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Textbook of Catheter-Based Cardiovascular Interventions by Peter Lanzer Pdf

This book is a fully updated and revised second edition of a highly successful text in which a new concept of knowledge mining, based on explication and transfer of interventional knowledge of experts, has been implemented. The dedicated training program that is set out will serve the needs of all interventional operators, whether cardiologists, vascular surgeons, vascular specialists, or radiologists, enabling them to achieve a consistent expert level across the entire broad spectrum of catheter-based interventions. Operator skills – and in particular decision-making and strategic skills – are the most critical factors for the outcome of catheter-based cardiovascular interventions. Currently, such skills are commonly developed by the empirical trial and error method only. The explicit teaching, training, and learning approach adopted in this book permits the rapid transfer of interventional knowledge and enables individual operators to negotiate steep learning curves and acquire complex skills in a highly efficient manner. It will thereby offer invaluable assistance in meeting successfully the challenges of modern cardiovascular care.

Author : Javier Escaned,Patrick W. Serruys
Publisher : Unknown
Page : 535 pages
File Size : 45,8 Mb
Release : 2010
Category : Electronic
ISBN : 2913628567

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Coronary Stenosis Imaging, Structure and Physiology by Javier Escaned,Patrick W. Serruys Pdf

"Coronary stenosis. Imaging, structure and physiology" has been designed as a clinically and research orientated reference for all cardiologists, physicians, cardiovascular imagers, trainees and investigators working in the field of ischemic heart disease. In the scenario of facilitated access to the coronary arteries provided by new diagnostic techniques, this book cornes to fill an empty space in the medical literature: a textbook providing a comprehensive, multifaceted analysis of atherosclerotic and non-atherosclerotic coronary stenoses, addressing multiple issues that are of key importance in invasive and non-invasive diagnostic studies of the coronary vessels. Emphasis has been placed in integrating three separate aspects: imaging, structure and physiology. The chapters are written by top experts in invasive and non-invasive diagnostics, coronary anatomy, pathology and physiology, encouraged by the editors to adress each topic from a plural perspective to facilitate knowledge sharing between their respective disciplines. An associated website provides access to the electronic edition of the book, which includes moving images and updated material. This book is an indispensable companion for all those involved in the diagnosis and treatment of ischemic heart disease. With a foreword by Morton J. Kern, MD, PhD.

Author : Wolfgang Schaper
Publisher : Unknown
Page : 300 pages
File Size : 52,7 Mb
Release : 1971
Category : Medical
ISBN : UOM:39015000893266

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The Collateral Circulation of the Heart by Wolfgang Schaper Pdf

Author : Harald Becher,Peter N. Burns
Publisher : Springer Science & Business Media
Page : 184 pages
File Size : 51,5 Mb
Release : 2012-12-06
Category : Medical
ISBN : 9783642597480

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Handbook of Contrast Echocardiography by Harald Becher,Peter N. Burns Pdf

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.

Author : David Chambers,Christopher Huang,Gareth Matthews
Publisher : Cambridge University Press
Page : 469 pages
File Size : 53,8 Mb
Release : 2019-07-25
Category : Medical
ISBN : 9781108463997

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Basic Physiology for Anaesthetists by David Chambers,Christopher Huang,Gareth Matthews Pdf

Easily understood, up-to-date and clinically relevant, this book provides junior anaesthetists with an essential physiology resource.

Author : K. Lance Gould
Publisher : Elsevier Publishing Company
Page : 323 pages
File Size : 49,9 Mb
Release : 1991
Category : Artères coronaires - Sténose - Physiopathologie
ISBN : 0444015442

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Coronary Artery Stenosis by K. Lance Gould Pdf

Incorporating 20 years of clinical, physiologic and technological research, this book develops the scientific basis for new approaches to the diagnosis and management of symptomatic and asyptomatic coronary atherosclerosis.

Author : Myeong-Ki Hong
Publisher : Springer
Page : 331 pages
File Size : 41,5 Mb
Release : 2017-10-31
Category : Medical
ISBN : 9789811027871

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Coronary Imaging and Physiology by Myeong-Ki Hong Pdf

This book is intended as a guide for all cardiologists who are interested in coronary imaging and physiology, a sound understanding of which is vital for the optimal performance of appropriate coronary interventions. The basics of each relevant modality are presented, with clear explanation of clinical utility and evaluation of the evidence regarding clinical outcomes. All technical methods are described in detail, and the text is complemented by numerous helpful tables and illustrations. The effectiveness of intravascular coronary imaging in improving clinical outcomes is proven, and it is widely used for this purpose. Two modalities for intravascular coronary imaging are available in clinical practice: intravascular ultrasound (IVUS) and optical coherence tomography (OCT). For coronary physiology, the pressure wire-derived fractional flow reserve (FFR) provides information on the functional status of coronary trees. This technique and its clinical applications receive particular attention in the book, which also looks beyond FFR to FFR-CT, a method using computational fluid dynamics, and to invasive assessment of the microcirculation.

Author : Peter R. Seidensticker,Lars K. Hofmann
Publisher : Springer Science & Business Media
Page : 295 pages
File Size : 42,5 Mb
Release : 2008-05-24
Category : Medical
ISBN : 9783540776024

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Dual Source CT Imaging by Peter R. Seidensticker,Lars K. Hofmann Pdf

This book provides an introduction to Dual Source Computed Tomography (DSCT) technology and to the basics of contrast media administration. This is followed by 25 in-depth clinical scan and contrast media injection protocols.