American Heart Association Monograph Series – serie

Obesity is becoming increasingly prevalent in a worldwide context, and has been recognised as a major contributing factor in heart disease. This volume was authored by the participants in a 1998 AHA sponsored conference on the impact of obesity on cardiovascular disease. The three main sections of the book set out to evaluate current research pertaining to causation and cardiovascular sequela of obesity. Part I defines obesity, exploring its epidemiology, its genetic and non-genetic influences and its contribution to the problem of cardiovascular disease. Special attention is given to the primary prevention of obesity as a means of avoiding specific sequelae as well as the difficulties experienced by those who try to lose weight. Part II deals with the relatively new and much heralded discovery of obesity related genes the current state of diet drugs and valvular heart disease, and the interaction of obesity and metabolism, hormonal regulation and various other biological systems. Recent basic advances in the biological understanding of obesity are introduced. Part III suggests the most accurate ways of assessing BMI, of defining helpful dietary strategies and of managing the issues involved in the implementation of physical activity and pharmacological intervention as a means to decrease and maintain weight. Quality of life, economic issues and managed care settings are also discussed.

Birth is a sudden, traumatic transition of environments. Once the placental oxygen supply ceases, the foetus has only minutes to establish pulmonary oxygen transport, which requires not only inflation of the lungs, but also sudden and sustained changes in the lung circulation. Not long ago, research in this field was largely restricted to morphology and physiology. Now the powerful new tools of cellular and molecular biology have begun toshed light on the physiological processes in the developing lung and its supporting vasculature. In 22 chapters, three main sections explore lung growth and development, vascular cell growth and differentiation, and the mechanisms of hemodynamic control in the neonate; extensive illustrations give a comprehensive picture of pulmonary circulatory development. Factors controlling vasculogenesis and angiogenesis are described by the scientists who pioneered the field. Similarly, the intracellular signaling cascades that determine proliferation or growth inhibition of fibroblasts, smooth muscle cells, and endothelial cells are also presented in an understandable manner. Finally, the role ofsubstances, such as nitric oxide and endothelin, that control the hemodynamics of the fetal and neonatal circulations are discussed in detail, particularly in relation to the changes occurring at birth.This book will inform basic scientists as well as the clinician and student, and should be of particular interest to pediatric cardiologists, pulmonary medicine physicians, and vascular biologists.

Diagnostic accuracy is critical for the identification and treatment of patients with potential cardiac disease. There is now an ever-increasing reliance on the measured levels of diverse proteins (i.e. markers) whose presence in varying amounts can suggest certain cardiovascular pathologies and help to identify optimal therapeutic alternatives. Cardiac Markers: Current and Future Applications is designed to familiarize the reader with these concepts, and to facilitate the application of these concepts to patients with cardiac disease. The chapters in this monograph detail the past, present, and potential future of markers used for the detection of myocardial injury and for risk assessment as part of a cardiovascular disease work-up strategy. The strengths of this extensive overview, written by many of the current leaders in the field, lie in the evidence presented in addressing analytical/technical, clinical, and outcome-assessments of each biomarker currently used in clinical practice, and for those being investigated as potential cutting-edge tools. Clinical cardiologists, pathologists, researchers, and critical and primary care physicians interested in the clinical application of blood-based assays in cardiac patients will all learn from this monograph.

Edited by Valentin Fuster, former Chairman of the American Heart Association's Committee on Vascular Lesions, Assessing and Modifying the Vulnerable Atherosclerotic Plaque explores the cutting-edge developments in a steadily advancing field.This monograph is a valuable multidisciplinary resource, written by experts in the fields of mechanical and electrical engineering, pathology, neurology, imaging, clinical and vascular biology, physics, radiology and surgery. The book's nineteen chapters and five transcribed Panel Discussions provides a wealth of information on the identification and treatment of atherosclerotic plaques, including the latest diagnostic applications of numerous imaging techniques, the reasons for selecting a particular method, and what can be learned from the imaging results. Important insights into the structural and cellular components of vulnerable plaque are presented, as well as an examination of factors/activities that trigger thrombosis.

Exercise testing has become an integral component of the management of patients with chronic heart failure. Exercise and heart failure can be seen to have a dynamic interrelationship, in which exercise can provide important diagnostic information, yet can also be used to assess the effectiveness of treatment regimes, and as a therapeutic intervention in itself. This is the first book that directly and comprehensively addresses the issues involving exercise patients with heart failure and heart transplants. It presents a unique and comprehensive overview of epidemiological, physiological and clinical aspects of this relationship. The text covers the physiology of myocardial dysfunction, the transplanted heart, and ventricular assist devices as they affect exercise capacity and responses during exercise and exertion. It goes on to discuss in more depth the exercise testing of patients, including the methods and utility of ventilatory gas analysis, the physiologic and clinical effects of exercise training on these patients, and ecommended exercise training programsThis text, part of the American Heart Association Monograph Series, provides a cogent and comprehensive overview of its topic that should be of practical value to a broad range of physicians, exercise physiologists and consultants working in this field.

A thorough exploration of the interaction between erythrocytes, leukocytes, platelets, and the pulmonary vasculature in a variety of disease states-an important topic not addressed by other books. The lungs accommodate the entire cardiac output, and the pulmonary vessels are well known for their metabolic and endocrine functions, as well as gas exchange. The interaction of the pulmonary circulation with the cellular elements of blood has received less attention. Interactions of Blood and the Pulmonary Circulation covers many topics of interest to the clinician. In particular, chapters on sickle cell anemia provide a wealth of information on mechanisms of vascular occlusion, suggesting new approaches to treatment for the cardiologist and the pulmonary and intensive care physician. Intensivists will also enjoy the chapters on the role of leukocytes and inflammation in lung injury, and those on the contribution of platelets and thrombosis in pulmonary hypertension. The long-term management of chronic thromboembolic pulmonary hypertension is covered in detail. This book will be of special interest to pulmonary and intensive care physicians, cardiologists, hematologists, and vascular biologists.

In this book, an international group of investigators from a broad array of clinical and basic disciplines present the ideas and concepts in the foreground of cerebrovascular disease. Included in their discussion are perspectives on topics that continue to guide current investigations, such as white matter injury, newer imaging approaches, delayed neuronal death, and recovery after stroke, as well as continuing disagreements on the value of heparin or MRI endpoints in the management of stroke patients. Further topics include a proposal for a major multicenter re-study of the utility of extracranial-intracranial bypass surgery in light of additional diagnostic information available through PET scanning; examination of how processes such as apoptosis, inflammation, free radicals, poly (ADP-ribose) polymerase activation, and alterations in glutamate receptor function contribute to the pathogenesis of ischemic brain injury; and finally an exploration of how estrogens or cholesterol-lowering agents might be used therapeutically.