Myocardial ischemic syndromes pose a major medical problem and a significant economic health care concern. Reperfusion, although used in the clinical arena as essential to the survival of acutely ischemic heart muscle carries with it the risk of reperfusion injury. Therefore the salvage of additional myocardium is highly desirable.

A critical review of the most up-to-date research on purines and myocardial protection. The role of purines in reversible `myocardial stunning' and irreversible (myocardial infarction) ischemic injury, ventricular arrhythmias, and ischemic preconditioning is discussed in detail, by experts. All reviews address recent and rather controversial issues on purines and myocardial protection. Mechanisms of cardioprotection of exogenous versus endogenous purines are discussed in detail. The contribution of internationally recognized experts in the field of purines and cardiovascular physiology and in myocardial protection makes this a unique and interesting book for clinicians, basic scientists and students.

Myocardial ischemia and subsequent reperfusion of the ischemic myocardium represent complex phenomena encompassing numerous physiological processes. This book aims at enhancing our understanding of these processes and stresses recent important developments in this very active area of research. The concise, state-of-the-art reviews cover recent advances in many fields important to the area of myocardial ischemia and reperfusion including physiology, pathology, pharmacology, biochemistry and molecular biology with reference to clinical relevance and applicability of these findings. Major areas which are highlighted include vascular mechanisms resulting in myocardial ischemia, cellular events in the ischemic, postinfarcted and reperfused myocardium as well as new exciting developments in cardiac protection that involve both novel pharmacological approaches as well as endogenous cardioprotective mechanisms such as preconditioning. Aimed at both the basic and clinical cardiovascular investigator, the book comprehensively reviews the rapid progress made in recent years in understanding the etiology of myocardial ischemia and reperfusion. It will further serve as an authoritative reference for all those interested in learning about the important developments in the treatment of myocardial ischemic and reperfusion disorders.

Heat shock proteins (HSP) were originally described in heat-shocked drosophila by Ritossa in the early 1960's. In the last 5 years it has become apparent that these heat shock proteins have important functions both in the normal cell and in the stressed cell. These proteins constitute an endogenous protective system; mutations in the heat shock proteins can be lethal, and there are no known organisms without heat shock proteins. The first observations on heat shock proteins and the heart were made in the 1980's and interest in these proteins increased over the decade. In the last few years there has been an exponential growth in number of papers published on heat shock proteins and the heart. Heat shock proteins have been implicated in a number of cardiovascular research areas including ischemia, hypertrophy, aging, and atherosclerosis, and this list is growmg. The purpose of this volume is to give an overview of our current understanding of the heat shock proteins in the cardiovascular system, and to summarize the approaches to the study of heat shock proteins in the heart. This volume assembles results from a number of different cardiovascular fields. and provides a comprehensive review of heat shock proteins in the cardiovascular system.

This book gives a comprehensive survey of the current knowledge of the expression and function of small stress proteins (sHsps) in different organisms, from prokaryotes to humans. It provides an overview of the diversity and complex evolutionary history of sHsps and describes their function and expression in different eukaryote models. Additional chapters discuss the role of sHsps in pathological conditions and gene therapy approaches towards a control of sHsp expression levels.

Myocardial protection is regarded as one of the most important, yet also most controversial aspects of cardiac surgery. There has been considerable improvement in myocardial protection strategies over recent years, utilising a variety of new approaches to treat cardiac diseases, and this text is intended to embrace the state of the art in this field. The book summarises the state of knowledge on all aspects of myocardial protection, including the latest in the treatment of cardiac diseases, robotics, pediatric surgery and the treatment of cardiac failure. Robotic surgery, valvular surgery, pediatric surgery and coronary surgery are all covered by renowned experts, producing a comprehensive, forward-looking view of the field of myocardial protection. This book should function to update physicians and surgeons interested in the field of cardiac surgery on the current state of knowledge on myocardial protection.

This book is about the unique ability of the heart to protect itself against the serious consequences of an abrupt reduction in blood flow to the myocardium - a phenomenon which is switched on by stress and termed myocardial preconditioning. This volume describes the main features and characteristics of preconditioning, with respect to the time-course of the protective effect of the phenomenon (first and second windows) and the different sequelae of myocardial ischaemia against which it protects, such as myocardial injury, arrhythmias and contractile dysfunction. The proposed mechanisms underlying the fascinating form of cardioprotection are discussed. Among these are the role of endogenous labile mediators, receptor-linked G proteins, ATP-sensitive potassium channels and protein kinase C activation.

This work is concerned with a group of proteins which were originally consid ered to be an esoteric phenomenon but which have now been shown to play critical roles both in normal and stressed cells as well as being involved in a variety of human diseases. It is the purpose of this work to give a comprehen sive view of these proteins and their various aspects. After an introductory chapter providing an overview of these proteins, the work is divided into four main sections each of which deals with one important aspect of these proteins. Thus, the first section contains a series of chapters which describe individual stress proteins and their roles in particular biological phenomena. Evidently, the induction of these proteins by elevated tempera ture or other stresses is their defining feature and the second section of this book therefore considers the regulation of stress protein gene expression both by stressful stimuli such as elevated temperature or ischaemia and by non stressful stimuli such as cytokines.

Effective new treatments of heart disease are based on a refined understanding of cellular function and the heart's response to environmental stresses. Not surprisingly therefore, the field of experimental cardiology has experienced a phase of rapid expo nential growth during the last decade. The acquisition of new knowledge has been so fast that textbooks of cardiology or textbooks of cardiovascular physiology are often hard-pressed to keep up with the most important conceptual advances. Witness the explosive increase in knowledge about signaling pathways of cardiac growth, transcrip tional regulation of cardiac metabolism, hormonal signaling, and the complex responses of the heart to ischemia, reperfusion, or ischemic preconditioning. This book is meant to bridge the gap between original literature and textbook reviews. It brings together inves tigators of various backgrounds who share their expertise in the biology of myocardial ischemia. Each chapter is a self-contained mini-review, but it will soon become apparent to the reader that there is also a common thread: Molecular and cellular cardiology has never been more exciting than now, but ever more exciting times are yet to come. The Editors ACKNOWLEDGEMENTS - Publication of this book was generously supported by Sanofi-Aventis Hellas. - Eikon creative team provided the technical assistance in preparing the manuscripts. - We thank Dr. Bernard Swynghedauw for all his scientific support.