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Computed tomography myocardial perfusion 计算机断层扫描心肌灌注
ESC CardioMed Pub Date : 2018-07-01 DOI: 10.1093/MED/9780198784906.003.0116
Amita Singh, Noreen T. Nazir, V. Mor-Avi, Amit R. Patel
{"title":"Computed tomography myocardial perfusion","authors":"Amita Singh, Noreen T. Nazir, V. Mor-Avi, Amit R. Patel","doi":"10.1093/MED/9780198784906.003.0116","DOIUrl":"https://doi.org/10.1093/MED/9780198784906.003.0116","url":null,"abstract":"Coronary computed tomography angiography (CTA) has been widely adopted as a non-invasive tool for the evaluation of coronary artery disease. Given its high negative predictive value, it is an accurate modality to rule out obstructive coronary artery disease in the setting of chest pain. While the sensitivity and derived negative predictive value of coronary CTA are excellent, the specificity and positive predictive value are lower due to the difficult image interpretation in the presence of heavy coronary calcification, stents, coronary bypass grafts, motion artefacts, and arrhythmias. Vasodilator computed tomography myocardial perfusion (CTP) is an emerging technique with the ability to identify myocardial segments perfused by haemodynamically significant coronary stenoses. A growing number of studies have demonstrated the feasibility and diagnostic accuracy of CTP in comparison to a number of reference standards, including single-photon emission computed tomography, cardiovascular magnetic resonance imaging, and invasive coronary angiography with and without fractional flow reserve testing. This chapter summarizes the current state of CTP.","PeriodicalId":339880,"journal":{"name":"ESC CardioMed","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125748993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Hypoplastic left heart syndrome 左心发育不良综合征
ESC CardioMed Pub Date : 2018-07-01 DOI: 10.1093/MED/9780198784906.003.0194
A. Giardini
{"title":"Hypoplastic left heart syndrome","authors":"A. Giardini","doi":"10.1093/MED/9780198784906.003.0194","DOIUrl":"https://doi.org/10.1093/MED/9780198784906.003.0194","url":null,"abstract":"Hypoplastic left heart syndrome surgery in neonates has revolutionized survival in childhood. A new population with complex univentricular circulations has been created. Complex management problems can be anticipated for the adult survivors.","PeriodicalId":339880,"journal":{"name":"ESC CardioMed","volume":"238 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124616392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pacemakers in children and adolescents 儿童和青少年的起搏器
ESC CardioMed Pub Date : 2018-07-01 DOI: 10.1093/MED/9780198784906.003.0464
J. Sperzel
{"title":"Pacemakers in children and adolescents","authors":"J. Sperzel","doi":"10.1093/MED/9780198784906.003.0464","DOIUrl":"https://doi.org/10.1093/MED/9780198784906.003.0464","url":null,"abstract":"Children have been the beneficiaries of pacing therapies since the pioneering days of the technology. Yet, despite the fact that paediatric pacemaker implants represent around 1% of all pacemaker implantations, there are no guidelines at present dedicated to pacing in this population. This chapter discusses the challenges and needs specific to pacing therapy in children, such as the small stature and the continual somatic growth of paediatric patients; the prevalence of intracardiac shunting; and the often complex anatomical heart structures in children with an indication for pacing. Such differences from adult pacemaker recipients are reflected in the decisions on, for example, implantation route (epicardial versus endocardial), on choice of single-chamber versus dual-chamber devices, selection of pacing sites, or programming. The chapter also highlights questions about lead removal, which is particularly important given the sheer number of replacements expected in paediatric patients, and provides an outlook towards the future of pacing in children and the role of leadless devices and future therapeutic advances.","PeriodicalId":339880,"journal":{"name":"ESC CardioMed","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124696000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Preoperative evaluation: surgical risk for cardiac events and functional capacity risk indices 术前评价:手术风险的心脏事件和功能能力风险指标
ESC CardioMed Pub Date : 2018-07-01 DOI: 10.1093/med/9780198784906.003.0633
J. Juanatey
{"title":"Preoperative evaluation: surgical risk for cardiac events and functional capacity risk indices","authors":"J. Juanatey","doi":"10.1093/med/9780198784906.003.0633","DOIUrl":"https://doi.org/10.1093/med/9780198784906.003.0633","url":null,"abstract":"Functional capacity assessment and key clinical elements included in risk indices are cornerstones for preoperative evaluation of cardiac patients submitted for non-cardiac surgery. Poor functional capacity and high-risk surgeries identify a subgroup of patients where is it necessary to carry out a more intensive cardiac evaluation prior to surgery.","PeriodicalId":339880,"journal":{"name":"ESC CardioMed","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125012801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Epidemiological relationships between respiratory and cardiovascular diseases 呼吸系统疾病和心血管疾病之间的流行病学关系
ESC CardioMed Pub Date : 2018-07-01 DOI: 10.1093/med/9780198784906.003.0251
J. Quint, K. Rothnie
{"title":"Epidemiological relationships between respiratory and cardiovascular diseases","authors":"J. Quint, K. Rothnie","doi":"10.1093/med/9780198784906.003.0251","DOIUrl":"https://doi.org/10.1093/med/9780198784906.003.0251","url":null,"abstract":"Cardiovascular and respiratory diseases are common and becoming increasingly more so due to improved availability worldwide of diagnostics and an ageing population. While the true coexistence of both sets of diseases is probably underestimated, multimorbidity is increasingly recognized as a problem with over 70% of people over the age of 65 years having at least two conditions and a correlation between increasing age and one of the diseases being cardiovascular. Multimorbidity increases healthcare costs due to a combination of multiple medications, and longer and more frequent hospital stays, and is also associated with increased mortality. Identifying multiple diagnoses in an individual is important as management of individual diseases can impact both morbidity and mortality.","PeriodicalId":339880,"journal":{"name":"ESC CardioMed","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125023997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Indications for surgery: guidelines 手术指征:指南
ESC CardioMed Pub Date : 2018-07-01 DOI: 10.1093/MED/9780198784906.003.0397
G. Habib
{"title":"Indications for surgery: guidelines","authors":"G. Habib","doi":"10.1093/MED/9780198784906.003.0397","DOIUrl":"https://doi.org/10.1093/MED/9780198784906.003.0397","url":null,"abstract":"Surgery is a major part of treatment of infective endocarditis and is used in approximately half of patients to avoid, or because of, severe complications. Recently published European Society of Cardiology guidelines underlined the crucial importance of the optimal selection of candidates for surgery and in addition, they proposed new important features that are discussed in this chapter.","PeriodicalId":339880,"journal":{"name":"ESC CardioMed","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129508593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cardiovascular effects of non-cardiovascular drugs 非心血管药物对心血管的影响
ESC CardioMed Pub Date : 2018-07-01 DOI: 10.1093/MED/9780198784906.003.0043
P. Bosco-Lévy, J. Bezin, F. Salvo, N. Moore
{"title":"Cardiovascular effects of non-cardiovascular drugs","authors":"P. Bosco-Lévy, J. Bezin, F. Salvo, N. Moore","doi":"10.1093/MED/9780198784906.003.0043","DOIUrl":"https://doi.org/10.1093/MED/9780198784906.003.0043","url":null,"abstract":"Many drugs that were not designed to treat cardiovascular diseases may affect the cardiovascular system, causing adverse reactions. The objective of this chapter is to review in a systematic manner these adverse effects of non-cardiovascular drugs. The heart consists of four main entities that may be affected by non-cardiovascular drugs and lead to very different types of events: (1) the conduction tissue, that governs heart rate and rhythm, associated with arrhythmia and sudden death; (2) the endocardium and valves, associated with valvular disease and endocardial fibrosis; (3) the myocardium, which can directly or indirectly lead to heart failure; and (4) the coronary arteries, and in general the vascular bed, with myocardial ischaemia and infarction as main adverse events. These different elements may be affected by different drugs with different mechanisms of action, though some drugs may affect several components (e.g. myocardial infarction may result in heart failure). The objective of this chapter is not to provide exhaustive listings of all drugs ever associated with any of these events, which can be found online and will be obsolete the moment they are published, but an understanding of the typology of these events and their mechanism.","PeriodicalId":339880,"journal":{"name":"ESC CardioMed","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128331045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Complex cardiovascular diseases: the genetics of arterial hypertension 复杂心血管疾病:动脉高血压的遗传学
ESC CardioMed Pub Date : 2018-07-01 DOI: 10.1093/MED/9780198784906.003.0166
G. Ehret
{"title":"Complex cardiovascular diseases: the genetics of arterial hypertension","authors":"G. Ehret","doi":"10.1093/MED/9780198784906.003.0166","DOIUrl":"https://doi.org/10.1093/MED/9780198784906.003.0166","url":null,"abstract":"Arterial hypertension appears as two genetic types: primary hypertension is to a substantial extent determined by a large number of genetic risk variants, whereas rare patients with a familial hypertensive syndrome have a single gene defect that drives the elevated blood pressure. The familial hypertensive syndromes have been instrumental in highlighting blood pressure-regulating pathways that almost exclusively cluster in the kidney and in the mineralocorticoid pathways. Conversely, hundreds or more genetic variants cause the genetic component of primary hypertension and each risk variant causes a small blood pressure increase. The blood vessels appear to be one tissue in which these variants principally act and surprisingly there is little overlap with pathways of kidney and hormone pathways. Genetic testing is useful for the rare familial hypertensive syndrome, but in primary hypertension cardiovascular risk prediction can currently not be improved by genotyping.","PeriodicalId":339880,"journal":{"name":"ESC CardioMed","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128333339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sexual function and dysfunction in women (and the effect for the couple) 女性的性功能和功能障碍(以及对夫妻的影响)
ESC CardioMed Pub Date : 2018-07-01 DOI: 10.1093/MED/9780198784906.003.0247
K. Wylie
{"title":"Sexual function and dysfunction in women (and the effect for the couple)","authors":"K. Wylie","doi":"10.1093/MED/9780198784906.003.0247","DOIUrl":"https://doi.org/10.1093/MED/9780198784906.003.0247","url":null,"abstract":"Sexual function is dependent on relatively intact physiological and psychological mechanisms that are extensive and varied in both influence and impact for any individual woman and her partner. Problems of sexual arousal in women are now recognized to mirror erectile dysfunction in men in many ways and assessment of cardiovascular disease should form part of the routine assessment of women presenting with sexual problems of lack of vaginal arousal (including lubrication) or clitoral arousal. However, psychosocial issues can predominate and perpetuate sexual problems for women and often require concurrent assessment. The sexual difficulties may be concurrent to erectile dysfunction or another sexual problem in the man. An offer of multiple interventions should be recommended where indicated.","PeriodicalId":339880,"journal":{"name":"ESC CardioMed","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128522157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Personalized therapies for cardiac channelopathies 心脏通道病变的个体化治疗
ESC CardioMed Pub Date : 2018-07-01 DOI: 10.1093/med/9780198784906.003.0729
A. Mazzanti, S. Priori
{"title":"Personalized therapies for cardiac channelopathies","authors":"A. Mazzanti, S. Priori","doi":"10.1093/med/9780198784906.003.0729","DOIUrl":"https://doi.org/10.1093/med/9780198784906.003.0729","url":null,"abstract":"The new target for treatment of patients with long QT syndrome (LQTS) and catecholaminergic polymorphic ventricular tachycardia (CPVT) is represented by the correction of the arrhythmogenic substrate underlying the disorders, in order to restore a physiological duration of ventricular repolarization in LQTS and a normal intracellular calcium handling in CPVT. This chapter reviews how conventional drugs, such as sodium channel blockers, may be suitable to treat the type 3 LQTS, both reverting the prolongation of QT interval and reducing arrhythmic events caused by abnormalities in the cardiac sodium inward current. Beside conventional drugs, advanced therapy medicinal products have been tested in preclinical studies: these therapies represent nowadays the frontier of medical research and are being tested in thousands of clinical trials in a large variety of indications. The chapter also provides a review of how different gene therapy strategies have been used to rescue the wild-type phenotype in LQTS and CPVT models. Finally, it reports the current limits of gene therapy, reviewing the case of Brugada syndrome that, despite being one of the most prevalent cardiac channelopathies, remains far from the possibility to have a ‘personalized’ therapy.","PeriodicalId":339880,"journal":{"name":"ESC CardioMed","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128635099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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