viewed as rolling downhili from an uphill or This book represents an edited compilation of the scientific presentations given at an Interna high-energy state. This transition results from tional Symposium on the Physiology of Diastole the opening of membrane pores that allow in Health and Disease, September 11 to 14, calcium to rush into the cytosol, triggering 1986, in Cambridge, Massachusetts. Numerous excitation-contraction coupling. If the energy studies have documented the importance of available to sarcoplasmic reticular and sarcolem diastolic dysfunction in clinical heart disease. In mal calcium pumps was insufficient to remove recent years clinicians have become increasingly this calcium from the cytosol and res tore the aware that many patients with congestive heart 1O, OOO-fold calcium gradient, characteristic of failure have completely normal myocardial con the "resting" myocyte, we would live for one tractile function. In these patients, inotropic glorious systole and die in cardiac rigor. The agents provide no clinical benefit and may in well-known phenomenon of rigor mortis re fact exacerbate clinical manifestations of heart minds us that for skeletal muscles as weIl relaxation is the high-energy state and per failure. These patients, who may be regarded as having diastolic heart failure, represent a major manent contraction is the inevitable downhili therapeutic challenge today. It has also become state for muscle that can no longer produce increasingly apparent that a variety of patho adenosine triphosphate."

Numerous studies have documented the importance of diastolic dysfunction in heart disease. Now, providing cardiologists with the most current information available on the subject, the editors have pulled together contributions from an impressive array of top researchers and compiled them into one comprehensive, carefully edited source, Diastolic Relaxation of the Heart, Second Edition: The Biology of Diastole in Health and Disease. This brand new Second Edition, based on a recent meeting, includes such topics as: molecular biology of relaxation; consequences of altered gene expression; impaired relaxation in experimental models (ischemia and hypoxia, and hypertrophy and failure); diastolic dysfunction in the diseased human heart. Diastolic Relaxation of the Heart, Second Edition: The Biology of Diastole in Health and Disease, the successor to the editors' bestselling work on the same subject, published in 1987 - belongs on the shelf of every practising cardiologist. It will also be an invaluable addition to the library of scientists researching the effects of diastole on heart function.

Heart failure is the biggest killer in the western world, and the prevalence is expected to increase due to aging of the population. Over the past decade there has been an increasing awareness of left ventricular (LV) diastolic dysfunction as a mechanism of congestive heart failure. This book provides the clinician with essential insights into the epidemiology and aetiology of diastolic heart failure, and will enable them to understand how the condition can be diagnosed. Furthermore, the book will provide insights in cardiac function that are needed to perform and interpret the diagnostic tests, and to provide some guides to treatment choices.

Chapter 22: Crossbridge and Muscle Properties, Energetics, and Pressure-Volume Area -- Chapter 23: Constancy and Variability of Oxygen Costs of Mechanical Energy (PVA) and Contractility (Emax) -- Chapter 24: Tight Coupling between Regional Myocardial Oxygen Consumption and Contractile Function -- Chapter 25: Force-Frequency Relation, Force-Interval Relation, and Mechanical Restitution -- Chapter 26: Elastance-Based Mechanical Restitution Provides Data from the Intact Heart Not Available from Any Other Technique -- Chapter 27: Contractility Indices -- Chapter 28: Searching for Indices of Contractility Is Counterproductive -- Chapter 29: Rapid Contractile Upregulation Rematches Stroke Work to Increased Afterload Independent of Ventricular Geometry, Afterload-Related Coronary Perfusion Pressure Fluctuations and Baseline Contractile State -- Chapter 30: Wall Thickening, Shears, and Cleavage Planes -- Chapter 31: Mechanisms of Large Ventricular Wall Shortening and Thickening -- Chapter 32: Twisting, Torsion, and Other Shears -- Chapter 33: Ventricular Twist and Its Relationship to Pressure Volume and Shortening -- Chapter 34: Differences in Systolic and Diastolic Torsional Deformation of the Left Ventricle -- Chapter 35: Coronary Flow, Systolic Perfusion, and the "Gregg Phenomenon -- Chapter 36: Intramyocardial Hydraulic Regulation of Cardiac Mechanics and Energetics -- Chapter 37: Left Ventricular Afterload and Arterial Coupling -- Indexes -- Author Index -- Affiliation Index -- Subject Index

Cardiovascular dynamics is a field in which modelling and systems analysis have formed an extremely important discipline. For example, understanding of even such a fundamental function of the circulation as the relationship between central venous pressure apd cardiac output has required evolution of a pertinent model based on years of exhaustive ex perimental investigations by Starling, Starr, and Guyton. Hemodynamic analyses of pulsatile pressures and flows in the arteries and veins have been a continuing challenge taken up by champions of fluid dynamics such as Frank, Wetterer, Taylor, and Wormersley, just to mention a few names, and some kind of model was always proposed as a conceptual framework. An even greater challenge to cardiovascular dynamicists was how to analyze the intermittent coupling of the ventricle and the arterial or venous vasculature through the valve. The availability of numerical solutions by computer and the recently evolved ventricular model with a time-varying elastance and a pressure-dependent internal resistance opened the way to analysis of this coupling. The ever increasing speed of computers has also facilitated trips between the fre quency and the time domain, even on-line for some experimental studies. This book contains many analyses dedicated to the interactions between the heart and the vasculature, providing the reader with findings at the cutting edge of current research in this field.

This reference thoroughly equips you to successfully diagnose and manage even the most complex incidences of diastolic heart failure and their comorbidities. It examines the basic mechanisms of this condition through discussions of both cellular and anatomic causes; guides you through non-invasive techniques for diagnosis, including echocardiography, cardiac CT, and MRI; and provides expert advice on pharmacologic management. Covers the basic mechanisms of diastolic heart problems from both cellular and anatomic perspectives. Chapters covering modalities helpful in assessment of diastolic function such as: echocardiography, cardiac MRI, radionuclide ventriculography, and invasive hemodynamic measurements. Features in-depth assessments of all diagnostic methods for diastolic heart failure, including rationales for their use. Examines contributing conditions that play a role in diastolic heart failure and offers guidance on their management. Offers pharmacologic strategies for multiple problem management.

This issue of Heart Failure Clinics examines Heart Failure with Preserved Ejection Fraction (HFPEF). The followings aspects of HFPEF are addressed: epidemiology, etiologic factors and pathophysiology, diagnosis, clinical spectrum, imaging, invasive hemodynamic characterization, exercise physiology, natriuretic peptides, novel biomarkers, differential diagnoses and comorbidities, outcomes, clinical trials, current therapeutic approach, and novel therapeutic targets.

The new edition of the acclaimed reference text on the most critical tool in pediatric cardiology practice Echocardiography in Pediatric and Congenital Heart Disease provides comprehensive guidance on the use of non-invasive ultrasound imaging in the diagnosis and treatment of pediatric cardiac conditions. Written by a team of experts from the world’s leading pediatric cardiology centers, this highly-illustrated, full-color reference covers anatomy, pathophysiology, ultrasound physics, laboratory setup, patient preparation and safety, pediatric echocardiogram protocols, quantitative methods of echocardiographic evaluation, and more. Offering a wealth of additional material on state-of-the-art techniques and technologies in echocardiography, the thoroughly revised third edition features entirely new chapters on examination guidelines and standards, quality improvement in the laboratory, perioperative echocardiography, hemodynamic assessment of the neonate, early fetal echocardiography, and multimodality imaging. This edition offers updated and expanded discussion of the latest advances in echocardiography, particularly those related to speckle tracking and 3D echocardiography. An essential resource for all practitioners, instructors, and trainees in the field, Echocardiography in Pediatric and Congenital Heart Disease: Provides up-to-date reference to ultrasound imaging of the hearts of fetuses, children, and adults with both acquired and congenital heart disease Covers the echocardiographic examination of congenital cardiovascular abnormalities before, during, and after treatment Describes quantitative methods of echocardiographic evaluation, including assessment of diastolic function, right ventricular function and assessment of the post-Fontan patient Discusses intraoperative echocardiography, heart disease in pregnancy, and other special techniques and topics Includes more than 1200 high-quality color images as well as a companion website with over 600 video clips Echocardiography in Pediatric and Congenital Heart Disease, Third Edition, remains an essential textbook for cardiac sonographers, pediatric and adult cardiologists, echocardiography nurses and technicians, and adult cardiologists with interest in congenital heart disease.