A.V. Bruschke - Böcker

The importance of left ventricular hypertrophy (LVH) in cardiovascular disease has gained wide recognition. LVH is a highly important risk factor associated with major cardiovascular events, including symptomatic heart failure, particularly in patients with systemic hypertension. In recent years much has been learned about the genetics, molecular background, prevalence, incidence and prognosis of LVH. A variety of noninvasive methods has emerged for detecting LVH and the assessment of reversal of hypertrophy, yet a lot of controversy remains about the connotations and clinical implications of LVH. For instance, in the athlete's heart LVH may constitute a physiological adaptation to pressure overload, which normalizes following discontinuation of strenuous physical activity. On the other hand, in particular in patients with hypertension, LVH denotes a serious prognosis in the course of hypertension. In these patients LVH should be regarded as a grave prognostic sign rather than an innocent compensatory phenomenon. The distinction between physiologic and pathophysiologic LVH is the basis for this book.The text is a bibliographical reflection of a Boerhaave Symposium held on April 9, 1999, in Leiden, The Netherlands. At this symposium the major issues in dealing with LVH were discussed, including etiology, genetics, detection, and therapy. In particular, the book includes advances in detection methods for LVH such as magnetic resonance imaging and spectroscopy. Furthermore, much attention was paid to the molecular and genetic approach of LVH. This book should be useful to clinical cardiologists, fellows in cardiology, general internists, radiologists, cardiothoracic surgeons, biochemists, physiologists, pharmacologists, and basic research fellows in understanding the most recent insights in the background of physiologic versus pathologic LVH.

The importance of left ventricular hypertrophy in cardiovascular disease has gained wide recognition. Left ventricular hypertrophy is a highly important risk factor associated with major cardiovascular events, including symptomatic heart failure, particularly in patients with systemic hypertension. Over the past years much has been learned about the genetics, molecular background, prevalence, incidence and prognosis of left ventricular hypertrophy. A variety of noninvasive methods has emerged for detecting left ventricular hypertrophy and the assessment of reversal of hypertrophy. Yet, a lot of controversy remains about the connotations and clinical implications of left ventricular hypertrophy. For instance, in the athlete's heart left ventricular hypertrophy may constitute a physiological adaptation to pressure overload, which normalizes following discontinuation of strenuous physical activity. On the other hand, in particular in patients with hypertension, left ventricular hypertrophy denotes a serious prognosis in the course of hypertension. In these patients left ventricular hypertrophy should be regarded as a grave prognostic sign rather than an innocent compensatory phenomenon. The distinction between physiologic and pathophysiologic left ventricular hypertrophy has been the basis for this book.

A unique overview of all major angiographic lipid intervention trials, presented by their principal investigators. Basic mechanisms and methodological aspects, including biochemical as well as angiographic aspects, are discussed by experts in these fields. A careful comparison of all available data permits an analysis to be made of what may currently be considered proved, which aspects merit further investigation, and which hypotheses should be rejected. Audience: Clinicians involved in the practice of lipid lowering and investigators involved in lipid-lowering clinical trials. Scientists involved in other areas of lipid research and investigators conducting coronary angiographic trials designed to study the influence of different interventions will find a wealth of information and practical guidelines in this book.