Coronary flow reserve - measurement and application: Focus on transthoracic Doppler echocardiography

Coronary flow reserve - measurement and application: Focus on transthoracic Doppler echocardiography

Author: Pawel Petkow-Dimitrow

Publisher: Springer Science & Business Media

Published: 2012-12-06

Total Pages: 112

ISBN-13: 1461511259

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Coronary flow reserve is an important functional parameter to understand the pathophysiology of coronary circulation. Coronary flow reserve measurement is used to assess epicardial coronary stenoses or to examine the integrity of microvascular circulation. An appreciation of coronary physiology is an integral part of clinical decision-making for cardiologists treating patients with coronary artery disease. The pioneering research efforts of Dr Lance Gould, who explored the relationship between the anatomic severity of a stenosis and its flow resistance (59;60) , have been transferred to clinical practice (94; 194). In the absence of stenosis in epicardial coronary artery, the coronary flow reserve may be decreased when coronary microvascular circulation is compromised by arterial hypertension with or without left ventricular hypertrophy, diabetes mellitus, hypercholesterolemia, or other diseases. Several techniques have been established for measuring coronary flow reserve. However, these techniques are either invasive (intracoronary Doppler flow wire), highly expensive and scarcely available (Positron Emission Tomography - PET) or semi-invasive and causing patient discomfort (transesophageal Doppler echocardiography), thus their clinical use is limited. Because of the clinical importance of coronary flow reserve there is a need for a simple, noninvasive, repeatable and inexpensive tool capable of this functional evaluation. This monograph focuses on the assessment of coronary flow reserve using transthoracic Doppler echocardiography - the technique fulfilling the above-mentioned criteria. Transthoracic Doppler echocardiography has become a popular tool evolving from a research to diagnostic technique applied in everyday practice.


Book Synopsis Coronary flow reserve - measurement and application: Focus on transthoracic Doppler echocardiography by : Pawel Petkow-Dimitrow

Download or read book Coronary flow reserve - measurement and application: Focus on transthoracic Doppler echocardiography written by Pawel Petkow-Dimitrow and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 112 pages. Available in PDF, EPUB and Kindle. Book excerpt: Coronary flow reserve is an important functional parameter to understand the pathophysiology of coronary circulation. Coronary flow reserve measurement is used to assess epicardial coronary stenoses or to examine the integrity of microvascular circulation. An appreciation of coronary physiology is an integral part of clinical decision-making for cardiologists treating patients with coronary artery disease. The pioneering research efforts of Dr Lance Gould, who explored the relationship between the anatomic severity of a stenosis and its flow resistance (59;60) , have been transferred to clinical practice (94; 194). In the absence of stenosis in epicardial coronary artery, the coronary flow reserve may be decreased when coronary microvascular circulation is compromised by arterial hypertension with or without left ventricular hypertrophy, diabetes mellitus, hypercholesterolemia, or other diseases. Several techniques have been established for measuring coronary flow reserve. However, these techniques are either invasive (intracoronary Doppler flow wire), highly expensive and scarcely available (Positron Emission Tomography - PET) or semi-invasive and causing patient discomfort (transesophageal Doppler echocardiography), thus their clinical use is limited. Because of the clinical importance of coronary flow reserve there is a need for a simple, noninvasive, repeatable and inexpensive tool capable of this functional evaluation. This monograph focuses on the assessment of coronary flow reserve using transthoracic Doppler echocardiography - the technique fulfilling the above-mentioned criteria. Transthoracic Doppler echocardiography has become a popular tool evolving from a research to diagnostic technique applied in everyday practice.

The Heart in Systemic Autoimmune Diseases

The Heart in Systemic Autoimmune Diseases

Author: Fabiola Atzeni

Publisher: Elsevier

Published: 2017-02-11

Total Pages: 566

ISBN-13: 0444636692

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The Heart in Systemic Autoimmune Diseases, Second Edition, provides an overview on our current understanding of major complications relating to the heart and autoimmune diseases. It includes the latest information on the new pathogenetic mechanisms involved, along with clinical manifestations of these important comortbidities. Mortality in autoimmune diseases, in particular, rheumatoid arthritis and SLE, has increased when compared with the general population. This excess mortality is largely due to cardiovascular diseases (CVDs)-particularly those of atherosclerotic origin, such as ischemic heart disease-and is gaining recognition in all branches of medicine, from cardiology, to internal medicine, and from rheumatologists to orthopedics. Presents an impressive body of well ordered information on the topic of cardiovascular diseases and their relationship to autoimmune illness Highlights key references Summarizes the experience of a selected panel of distinguished physician-scientists who are actively involved in the field of cardiovascular disease and systemic autoimmunity


Book Synopsis The Heart in Systemic Autoimmune Diseases by : Fabiola Atzeni

Download or read book The Heart in Systemic Autoimmune Diseases written by Fabiola Atzeni and published by Elsevier. This book was released on 2017-02-11 with total page 566 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Heart in Systemic Autoimmune Diseases, Second Edition, provides an overview on our current understanding of major complications relating to the heart and autoimmune diseases. It includes the latest information on the new pathogenetic mechanisms involved, along with clinical manifestations of these important comortbidities. Mortality in autoimmune diseases, in particular, rheumatoid arthritis and SLE, has increased when compared with the general population. This excess mortality is largely due to cardiovascular diseases (CVDs)-particularly those of atherosclerotic origin, such as ischemic heart disease-and is gaining recognition in all branches of medicine, from cardiology, to internal medicine, and from rheumatologists to orthopedics. Presents an impressive body of well ordered information on the topic of cardiovascular diseases and their relationship to autoimmune illness Highlights key references Summarizes the experience of a selected panel of distinguished physician-scientists who are actively involved in the field of cardiovascular disease and systemic autoimmunity

What Should We Know About Prevented, Diagnostic, and Interventional Therapy in Coronary Artery Disease

What Should We Know About Prevented, Diagnostic, and Interventional Therapy in Coronary Artery Disease

Author: Baskot Branislav

Publisher: BoD – Books on Demand

Published: 2013-03-20

Total Pages: 486

ISBN-13: 9535110438

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The mortality from ischemic heart disease has decreased in recent years. The better understanding of risk factors associated with development of coronary artery disease has significantly contributed to this decline. Improvements in medical and interventional therapy have reduced the complications associated with acute myocardial infarction as well as revascularization. After the introduction of imaging modalities, the noninvasive characterization of regional function, perfusion and metabolism allowed for more sophisticated tissue characterization to identify reversible dysfunction with high diagnostic and prognostic accuracy. We now can legitimately claim that computed tomography angiography (CTA) of the coronary arteries is available. In the evaluation of patients with suspected coronary artery disease, many guidelines today consider CTA an alternative to stress testing. However the nuclear technique most frequently used by cardiologists is myocardial perfusion imaging (MPI). The combination of a nuclear camera with CTA allows for the attainment of coronary anatomic, cardiac function and MPI from one piece of equipment. Assessing cardiac viability is now fairly routine with these enhancements to cardiac imaging. Traditional coronary angiography presents a variety of limitations related to image acquisition, content, interpretation, and patient safety. Barriers to such improvements include the paucity of clinical outcomes studies related to new imaging technology, the need for physician and staff member training, and the costs associated with acquiring and effectively using these advances in coronary angiography. This issue is full of important information that every cardiologist needs to now.


Book Synopsis What Should We Know About Prevented, Diagnostic, and Interventional Therapy in Coronary Artery Disease by : Baskot Branislav

Download or read book What Should We Know About Prevented, Diagnostic, and Interventional Therapy in Coronary Artery Disease written by Baskot Branislav and published by BoD – Books on Demand. This book was released on 2013-03-20 with total page 486 pages. Available in PDF, EPUB and Kindle. Book excerpt: The mortality from ischemic heart disease has decreased in recent years. The better understanding of risk factors associated with development of coronary artery disease has significantly contributed to this decline. Improvements in medical and interventional therapy have reduced the complications associated with acute myocardial infarction as well as revascularization. After the introduction of imaging modalities, the noninvasive characterization of regional function, perfusion and metabolism allowed for more sophisticated tissue characterization to identify reversible dysfunction with high diagnostic and prognostic accuracy. We now can legitimately claim that computed tomography angiography (CTA) of the coronary arteries is available. In the evaluation of patients with suspected coronary artery disease, many guidelines today consider CTA an alternative to stress testing. However the nuclear technique most frequently used by cardiologists is myocardial perfusion imaging (MPI). The combination of a nuclear camera with CTA allows for the attainment of coronary anatomic, cardiac function and MPI from one piece of equipment. Assessing cardiac viability is now fairly routine with these enhancements to cardiac imaging. Traditional coronary angiography presents a variety of limitations related to image acquisition, content, interpretation, and patient safety. Barriers to such improvements include the paucity of clinical outcomes studies related to new imaging technology, the need for physician and staff member training, and the costs associated with acquiring and effectively using these advances in coronary angiography. This issue is full of important information that every cardiologist needs to now.

Myocardial Ischemia

Myocardial Ischemia

Author: Dennis V. P. Cokkinos

Publisher: Springer Science & Business Media

Published: 2006-03-08

Total Pages: 212

ISBN-13: 0387286586

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Effective new treatments of heart disease are based on a refined understanding of cellular function and the heart's response to environmental stresses. Not surprisingly therefore, the field of experimental cardiology has experienced a phase of rapid expo nential growth during the last decade. The acquisition of new knowledge has been so fast that textbooks of cardiology or textbooks of cardiovascular physiology are often hard-pressed to keep up with the most important conceptual advances. Witness the explosive increase in knowledge about signaling pathways of cardiac growth, transcrip tional regulation of cardiac metabolism, hormonal signaling, and the complex responses of the heart to ischemia, reperfusion, or ischemic preconditioning. This book is meant to bridge the gap between original literature and textbook reviews. It brings together inves tigators of various backgrounds who share their expertise in the biology of myocardial ischemia. Each chapter is a self-contained mini-review, but it will soon become apparent to the reader that there is also a common thread: Molecular and cellular cardiology has never been more exciting than now, but ever more exciting times are yet to come. The Editors ACKNOWLEDGEMENTS - Publication of this book was generously supported by Sanofi-Aventis Hellas. - Eikon creative team provided the technical assistance in preparing the manuscripts. - We thank Dr. Bernard Swynghedauw for all his scientific support.


Book Synopsis Myocardial Ischemia by : Dennis V. P. Cokkinos

Download or read book Myocardial Ischemia written by Dennis V. P. Cokkinos and published by Springer Science & Business Media. This book was released on 2006-03-08 with total page 212 pages. Available in PDF, EPUB and Kindle. Book excerpt: Effective new treatments of heart disease are based on a refined understanding of cellular function and the heart's response to environmental stresses. Not surprisingly therefore, the field of experimental cardiology has experienced a phase of rapid expo nential growth during the last decade. The acquisition of new knowledge has been so fast that textbooks of cardiology or textbooks of cardiovascular physiology are often hard-pressed to keep up with the most important conceptual advances. Witness the explosive increase in knowledge about signaling pathways of cardiac growth, transcrip tional regulation of cardiac metabolism, hormonal signaling, and the complex responses of the heart to ischemia, reperfusion, or ischemic preconditioning. This book is meant to bridge the gap between original literature and textbook reviews. It brings together inves tigators of various backgrounds who share their expertise in the biology of myocardial ischemia. Each chapter is a self-contained mini-review, but it will soon become apparent to the reader that there is also a common thread: Molecular and cellular cardiology has never been more exciting than now, but ever more exciting times are yet to come. The Editors ACKNOWLEDGEMENTS - Publication of this book was generously supported by Sanofi-Aventis Hellas. - Eikon creative team provided the technical assistance in preparing the manuscripts. - We thank Dr. Bernard Swynghedauw for all his scientific support.

The Local Cardiac Renin-Angiotensin Aldosterone System

The Local Cardiac Renin-Angiotensin Aldosterone System

Author: Edward D. Frohlich

Publisher: Springer Science & Business Media

Published: 2006

Total Pages: 248

ISBN-13: 9780387278254

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Until recently, the renin-angiotensin-aldosterone system has been considered a systemic endocrine hormonal system exclusively. It is now known that each component of the renin-angiotensin system is produced, synthesized and indeed, present in many organisms including the heart and vessels. This volume presents the most recent clinical and laboratory experiences of the leading physicians and investigators in the field of the local cardiac renin-angiotensin aldosterone system.Cardiovascular, renal and hypertension oriented physicians, investigators and scientists would find this book of interest.Edward D. Frohlich, M.D., M.A.C.P, F.A.C.C., is the Alton Ochsner Distinguished Scientist at the Ochsner Clinic Foundation in New Orleans, Louisiana. He is also Professor of Medicine and of Physiology at Louisiana State University School of Medicine, New Orleans, and Clinical Professor of Medicine and Adjunct Professor of Pharmacology at Tulane University School of Medicine, New Orleans. He is past Editor-in-Chief of the American Heart Association journal HYPERTENSION.Richard N. Re, M.D., is the Section Head, Hypertension at the Ochsner Clinic Foundation in New Orleans, Louisiana. He is also Ochsner's Scientific Director of Research.


Book Synopsis The Local Cardiac Renin-Angiotensin Aldosterone System by : Edward D. Frohlich

Download or read book The Local Cardiac Renin-Angiotensin Aldosterone System written by Edward D. Frohlich and published by Springer Science & Business Media. This book was released on 2006 with total page 248 pages. Available in PDF, EPUB and Kindle. Book excerpt: Until recently, the renin-angiotensin-aldosterone system has been considered a systemic endocrine hormonal system exclusively. It is now known that each component of the renin-angiotensin system is produced, synthesized and indeed, present in many organisms including the heart and vessels. This volume presents the most recent clinical and laboratory experiences of the leading physicians and investigators in the field of the local cardiac renin-angiotensin aldosterone system.Cardiovascular, renal and hypertension oriented physicians, investigators and scientists would find this book of interest.Edward D. Frohlich, M.D., M.A.C.P, F.A.C.C., is the Alton Ochsner Distinguished Scientist at the Ochsner Clinic Foundation in New Orleans, Louisiana. He is also Professor of Medicine and of Physiology at Louisiana State University School of Medicine, New Orleans, and Clinical Professor of Medicine and Adjunct Professor of Pharmacology at Tulane University School of Medicine, New Orleans. He is past Editor-in-Chief of the American Heart Association journal HYPERTENSION.Richard N. Re, M.D., is the Section Head, Hypertension at the Ochsner Clinic Foundation in New Orleans, Louisiana. He is also Ochsner's Scientific Director of Research.

Adrenomedullin in Cardiovascular Disease

Adrenomedullin in Cardiovascular Disease

Author: Toshio Nishikimi

Publisher: Springer Science & Business Media

Published: 2005-04-28

Total Pages: 240

ISBN-13: 9780387254043

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Adrenomedullin was discovered in 1993 in an extract of human pheochromocytoma while monitoring cAMP levels in rat platelets. Adrenomedullin has attracted considerable interest among cardiologists due to its impact on the cardiovascular system which includes a decrease in blood pressure in vivo; an impact on vascular smooth muscle cells; increases cAMP levels; indirectly reduces blood pressure and has a role in the pathogenesis of arteriosclerosis. Adrenomedullin in Cardiovascular Disease is an up-to-date review of the most relevant aspects of adrenomedullin. It encompasses a broad range of fields including biochemistry, molecular biology, physiology, pharmacology, pathophysiology of cardiovascular disease and clinical applications of adrenomedullin to cardiovascular disease. Toshio Nishikimi, MD, PhD, is an Associate Professor in the Department of Hypertension and Cardiorenal Medicine, Dokkyo University School of Medicine, Tochigi, Japan.


Book Synopsis Adrenomedullin in Cardiovascular Disease by : Toshio Nishikimi

Download or read book Adrenomedullin in Cardiovascular Disease written by Toshio Nishikimi and published by Springer Science & Business Media. This book was released on 2005-04-28 with total page 240 pages. Available in PDF, EPUB and Kindle. Book excerpt: Adrenomedullin was discovered in 1993 in an extract of human pheochromocytoma while monitoring cAMP levels in rat platelets. Adrenomedullin has attracted considerable interest among cardiologists due to its impact on the cardiovascular system which includes a decrease in blood pressure in vivo; an impact on vascular smooth muscle cells; increases cAMP levels; indirectly reduces blood pressure and has a role in the pathogenesis of arteriosclerosis. Adrenomedullin in Cardiovascular Disease is an up-to-date review of the most relevant aspects of adrenomedullin. It encompasses a broad range of fields including biochemistry, molecular biology, physiology, pharmacology, pathophysiology of cardiovascular disease and clinical applications of adrenomedullin to cardiovascular disease. Toshio Nishikimi, MD, PhD, is an Associate Professor in the Department of Hypertension and Cardiorenal Medicine, Dokkyo University School of Medicine, Tochigi, Japan.

Snapshots of Hemodynamics

Snapshots of Hemodynamics

Author: Nico Westerhof

Publisher: Springer Science & Business Media

Published: 2006-01-12

Total Pages: 182

ISBN-13: 0387233466

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Hemodynamics makes it possible to characterize in a quantitative way, the function of the heart and arterial system, thereby producing information about what genetic and molecular processes are of importance for cardiovascular function. Snapshots of Hemodynamics: An Aid for Clinical Research and Graduate Education by Nico Westerhof, Nikos Stergiopulos and Mark I. M. Noble is a quick reference guide designed to help basic and clinical researchers as well as graduate students to understand hemodynamics. The layout of the book provides short and independent chapters that provide teaching diagrams as well as clear descriptions of the essentials of basic and applied principles of hemodynamics. References are provided at the end of each chapter for further reading and reference.


Book Synopsis Snapshots of Hemodynamics by : Nico Westerhof

Download or read book Snapshots of Hemodynamics written by Nico Westerhof and published by Springer Science & Business Media. This book was released on 2006-01-12 with total page 182 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hemodynamics makes it possible to characterize in a quantitative way, the function of the heart and arterial system, thereby producing information about what genetic and molecular processes are of importance for cardiovascular function. Snapshots of Hemodynamics: An Aid for Clinical Research and Graduate Education by Nico Westerhof, Nikos Stergiopulos and Mark I. M. Noble is a quick reference guide designed to help basic and clinical researchers as well as graduate students to understand hemodynamics. The layout of the book provides short and independent chapters that provide teaching diagrams as well as clear descriptions of the essentials of basic and applied principles of hemodynamics. References are provided at the end of each chapter for further reading and reference.

Genetics and Genomics for the Cardiologist

Genetics and Genomics for the Cardiologist

Author: Gian Antonio Danieli

Publisher: Springer Science & Business Media

Published: 2012-12-06

Total Pages: 254

ISBN-13: 1461510252

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Genetics and Genomics for the Cardiologist is a concise, but comprehensive volume for the clinical cardiologist or medical student interested in learning how molecular genetics is now being applied to prevention and treatment of heart diseases, from DNA tests to pharmacogenomics and gene-based therapeutics. The volume, written in a plain language, contains detailed figures. A rich glossary, three appendices, many references and several URLs provide additional sources of information.


Book Synopsis Genetics and Genomics for the Cardiologist by : Gian Antonio Danieli

Download or read book Genetics and Genomics for the Cardiologist written by Gian Antonio Danieli and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 254 pages. Available in PDF, EPUB and Kindle. Book excerpt: Genetics and Genomics for the Cardiologist is a concise, but comprehensive volume for the clinical cardiologist or medical student interested in learning how molecular genetics is now being applied to prevention and treatment of heart diseases, from DNA tests to pharmacogenomics and gene-based therapeutics. The volume, written in a plain language, contains detailed figures. A rich glossary, three appendices, many references and several URLs provide additional sources of information.

Contrast Echocardiography

Contrast Echocardiography

Author: Harald Becher

Publisher: Springer

Published: 2019-07-03

Total Pages: 333

ISBN-13: 3030159620

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This book provides a comprehensive overview of the practical aspects of contrast echocardiography. It also covers all the material in the guidelines published by the American Society of Echocardiography (ASE) in 2018 and the recommendations set out by the European Association of Cardiovascular Imaging (EACVI) in 2017. Contrast echocardiography at present is only used in 5-10% of cases, but this is expected to grow rapidly following the recommendations of the ASE and EACVI. The chapters cover the approved indications and provide practical advice on how to administer the contrast agents and how to optimize the recordings as well as how to deal with the pitfalls. The reader will find all the information on how to use contrast agents for assessment of shunts, LV volumes and function as well as myocardial diseases and masses. Detailed protocols are included for stress echocardiography and myocardial perfusion imaging. Other topics covered include the use of contrast agents for coronary sonography and transesophageal echocardiography. Contrast Echocardiography: Compendium for Clinical Practice comprehensively covers all aspects of the clinical use of contrast echocardiography and has been written by two cardiologists who share their experience from their high volume echo laboratories. One of the authors has been a member of both the ASE guidelines and EACVI recommendation writing groups. It is therefore, a critical text for echocardiographers and sonographers who perform echocardiography.


Book Synopsis Contrast Echocardiography by : Harald Becher

Download or read book Contrast Echocardiography written by Harald Becher and published by Springer. This book was released on 2019-07-03 with total page 333 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides a comprehensive overview of the practical aspects of contrast echocardiography. It also covers all the material in the guidelines published by the American Society of Echocardiography (ASE) in 2018 and the recommendations set out by the European Association of Cardiovascular Imaging (EACVI) in 2017. Contrast echocardiography at present is only used in 5-10% of cases, but this is expected to grow rapidly following the recommendations of the ASE and EACVI. The chapters cover the approved indications and provide practical advice on how to administer the contrast agents and how to optimize the recordings as well as how to deal with the pitfalls. The reader will find all the information on how to use contrast agents for assessment of shunts, LV volumes and function as well as myocardial diseases and masses. Detailed protocols are included for stress echocardiography and myocardial perfusion imaging. Other topics covered include the use of contrast agents for coronary sonography and transesophageal echocardiography. Contrast Echocardiography: Compendium for Clinical Practice comprehensively covers all aspects of the clinical use of contrast echocardiography and has been written by two cardiologists who share their experience from their high volume echo laboratories. One of the authors has been a member of both the ASE guidelines and EACVI recommendation writing groups. It is therefore, a critical text for echocardiographers and sonographers who perform echocardiography.

Stress Doppler Echocardiography

Stress Doppler Echocardiography

Author: Steve M. Teague

Publisher: Springer Science & Business Media

Published: 2012-12-06

Total Pages: 270

ISBN-13: 9400904770

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For almost 40 years, a small but intense group of cardiovascular investigators have evaluated cardiac performance by measuring the mass, velocity, and acceleration of blood ejected from the left ventricle. These studies reveal that energy is transferred from ventricle to blood very early in systole, and that the left ventricle is charac terized as an impulse generator. Recent explosive developments in Doppler echocar diography have allowed study of the energetics of ventricular contraction through noninvasive acceleration, velocity, and volumetric flow measurements. Compared against reference standards of ejection fraction, dP/dt, and instantaneous pressure gradient across the aortic valve, Doppler acceleration and velocity measurements are highly sensitive to changes in ventricular performance. Most patients seeking cardiovascular care present with coronary artery disease as a chief concern. This book focuses upon identification of coronary disease presence and severity through the evaluation of left ventricular Doppler ejection responses to stress loading. Chapters I through 4 detail basic research on the dynamics of left ventricular ejection in ischemic and nonischemic animal models. Chapters 5 through 13 present clinical correlates of changes in the Doppler systolic ejection pulse during exercise and under pharmacologic stress loading. Angiographic anatomy, thallium perfusion defects, and radionuclear ejection fraction responses serve as reference standards. Chapters 14, 15 and 16 address applications of Doppler echocardiography during the stresses of brief coronary occlusion, myocar dial infarction and post infarction recovery, while chapters 17 and 20 illustrate applications of stress Doppler techniques in valvular heart disease.


Book Synopsis Stress Doppler Echocardiography by : Steve M. Teague

Download or read book Stress Doppler Echocardiography written by Steve M. Teague and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 270 pages. Available in PDF, EPUB and Kindle. Book excerpt: For almost 40 years, a small but intense group of cardiovascular investigators have evaluated cardiac performance by measuring the mass, velocity, and acceleration of blood ejected from the left ventricle. These studies reveal that energy is transferred from ventricle to blood very early in systole, and that the left ventricle is charac terized as an impulse generator. Recent explosive developments in Doppler echocar diography have allowed study of the energetics of ventricular contraction through noninvasive acceleration, velocity, and volumetric flow measurements. Compared against reference standards of ejection fraction, dP/dt, and instantaneous pressure gradient across the aortic valve, Doppler acceleration and velocity measurements are highly sensitive to changes in ventricular performance. Most patients seeking cardiovascular care present with coronary artery disease as a chief concern. This book focuses upon identification of coronary disease presence and severity through the evaluation of left ventricular Doppler ejection responses to stress loading. Chapters I through 4 detail basic research on the dynamics of left ventricular ejection in ischemic and nonischemic animal models. Chapters 5 through 13 present clinical correlates of changes in the Doppler systolic ejection pulse during exercise and under pharmacologic stress loading. Angiographic anatomy, thallium perfusion defects, and radionuclear ejection fraction responses serve as reference standards. Chapters 14, 15 and 16 address applications of Doppler echocardiography during the stresses of brief coronary occlusion, myocar dial infarction and post infarction recovery, while chapters 17 and 20 illustrate applications of stress Doppler techniques in valvular heart disease.