J. Baan – författare

Based on a number of collaborative efforts between basic researchers and clinicians from different institutions in Leiden, this book covers the initial and promising results of these efforts. The role of the endothelium, especially of the coronary intravascular species is a relatively new and fascinating development in the diagnosis and treatment of cardiac disease. Three major aspects of endothelial function receive attention in this volume: its regulatory role in myocardial function, evidence for which is gradually forthcoming, with possible great implications for disease states such as volume overload and failure its role in the calcium metabolism of vascular smooth muscle cells and the effects of calcium antagonists and the endothelial dysfunction generated by coronary angioplasty and its possible restoration by cholesterol reduction. The topic of imaging atherosclerotic lesions in the coronary arteries is discussed with the emphasis on advanced methods: single photon emission computed tomography (SPECT), positron emission tomography (PET), and magnetic resonance imaging techniques. A wholly new development is the characterization of the atherosclerotic lesion by Raman spectroscopy using a laser beam to illuminate the vascular wall. Various aspects of inflammation related to the pathogenesis of acute coronary syndromes, in particular unstable angina, are illuminated, as well as the role of blood-borne substances as risk factors for atherosclerosis. Transgenic mice carrying the gene for human APOE*3 Leiden are being used successfully to study the environmental and genetic factors that influence the remnant lipoprotein metabolism. Possibilities for gene therapy to treat atherosclerosis in the clinic are being investigated in animal models. Finally, as the book is based on 50 years of Cardiology in Leiden, the history of its development up to the present day is the topic of a separate chapter. This book is intended for cardiologists, internal medicine specialists, nuclear medicine specialists, thoracic surgeons, cardiovascular radiologists and basic scientists in the field of the cardiovascular system.

Cardiac Dynamics is the name of a relatively young field of study, born from the fruitful interaction between branches of two different disciplines: medicine and physics. "Dynamics" is the branch of physics which deals with the action of forces on bodies or particles in motion or at rest. "Cardiac" relates to the clinical field of cardiology but also to cardiophysiology, both of which are specialized branches of medicine. Narrower than the well­ established field of Hemodynamics, Cardiac Dynamics is restricted to dynamic phenomena occurring in and around the heart. The mathematical treatment of such phenomena, however, is vastly more complex because of the intricate nature of the mechanisms involved in the cardiac action. Thus, whereas hemodynamics is concerned with predominantly passive (visco-) elastic structures - vessels - containing time-variant flow of viscous flui- blood -, the mechanical study of the heart requires additional con­ siderations such as: active elastic components representing the contractile mechanism of cardiac muscle, complex geometry and fiber structure in the myocardial wall, autoregulatory mechanisms, and intricate flow patterns associated with valve motion. Viewed in this light it is not surprising that attempts to describe ventricular pump function and to quantify contractile performance have not reached the level of sophistication which is common in e. g. arterial hemodynamics. For the same reason, many of the often simplified approaches to describe ventricular mechanics failed to stand up to more rigorous theoretical, experimental or clinical testing.

Cardiac Dynamics is the name of a relatively young field of study, born from the fruitful interaction between branches of two different disciplines: medicine and physics. "Dynamics" is the branch of physics which deals with the action of forces on bodies or particles in motion or at rest. "Cardiac" relates to the clinical field of cardiology but also to cardiophysiology, both of which are specialized branches of medicine. Narrower than the well­ established field of Hemodynamics, Cardiac Dynamics is restricted to dynamic phenomena occurring in and around the heart. The mathematical treatment of such phenomena, however, is vastly more complex because of the intricate nature of the mechanisms involved in the cardiac action. Thus, whereas hemodynamics is concerned with predominantly passive (visco-) elastic structures - vessels - containing time-variant flow of viscous flui- blood -, the mechanical study of the heart requires additional con­ siderations such as: active elastic components representing the contractile mechanism of cardiac muscle, complex geometry and fiber structure in the myocardial wall, autoregulatory mechanisms, and intricate flow patterns associated with valve motion. Viewed in this light it is not surprising that attempts to describe ventricular pump function and to quantify contractile performance have not reached the level of sophistication which is common in e. g. arterial hemodynamics. For the same reason, many of the often simplified approaches to describe ventricular mechanics failed to stand up to more rigorous theoretical, experimental or clinical testing.