G.T. Meester - Böcker

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 therapeutic tool, but can, during the procedure, be used as a source of diagnostic information. When the catheter is placed in a coronary artery obstruction, inflation of the balloon produces transient myocardial ischemia. Before, during, and after this period of severe ischemia, studies of the perfor­ mance of the myocardium at risk can be carried out. The fact that therapeutic coronary angioplasty is carried out in a cardiac catheterization laboratory which is by definition optimally equipped for the measurement of hemodynamic parameters, has probably also contributed to the effectuation of these investigations. The combination of hemodynamic and biochemical parameters with morphological information from the coronary angiogram can be utilized for the quantification of myocardial involvement and the success of coronary dilatation with angioplasty. Studies of interactions with pharmacological substances are also feasible and informative.

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 cardiological/medical clinician and researcher of today is of necessity confronted more and more with computer-based data storage. Interest is of course focused primarily on the clinical use of such databases more than on the technical design itself, except for some very specific, personalized applications. For the latter approach, there are at present many software packages commercially available, especially designed for use in the personal computer environment. This book is comprised out of a number of contributions by various authors with differing backgrounds and from many different countries. The editors, being a cardiologist and an information scientist, have strived to achieve an equilibrium between these two fields. The chapters in this book form a cross-section of the many approaches to database design and implementation in the area of cardiology.