AMI E. ISKANDRIAN & ERNST E. VAN DER WALL The first edition of this book was published in 1994. Since then important advances have occurred in the field of myocardial viability. This, coupled with increasing interest by the scientific community in the broader issues of its relevance to patient care, suggested to us the need to write the second edition. We are most fortunate to have the help of a distinguished group of experts who have helped shape the field; we appreciate their commitments and contributions. Almost all chapters have been radically modified. Chapter 1 deals with pathophysiology of myocardial hibernation and stunning; Chapter 2 with apoptosis; Chapter 3 with the role of positron emission tomography; Chapters 4 and 5 with the role of single photon emission computed tomography with thallium-201 and technetium agents, respectively; Chapter 6 with the role of SPECT fatty acid imaging; Chapter 7 with the role of SPECT FDG imaging; Chapter 8 with the role of cardiac catheterization angiography; Chapter 9 with the role of echocardiography; Chapter 10 with the role of magnetic resonance imaging; and Chapter 11 with clinical applications. Finally, Chapter 12 provides a short summary.

In the past few years it has become clear that left ventricular dysfunction, even of severe degree, may be reversible after coronary revascularization in some patients. As a result, myocardial viability has captured the imagination of researchers and clinicians seeking to unravel the cellular and subcellular mechanisms and define appropriate diagnostic modalities. These diagnostic modalities include: cardiac catheterization, positron-emission tomography, magnetic resonance imaging, two-dimensional echocardiography and single-photon imaging. This book, for the first time, brings together a diverse array of information in a comprehensive and concise fashion using a template of ten chapters written by experts in the field. It will be required reading for cardiologists, radiologists, nuclear medicine specialists, cardiac surgeons, anesthesiologists, internists and basic researchers and their trainees who are involved in the management of patients with coronary artery disease in whom myocardial viability is a clinically relevant issue.

This book presents the most up-to-date information on the practice of cardiac PET and hybrid PET/CT. Each chapter takes a step-by-step approach, from basic principles of instrumentation, imaging, and protocols to advanced discussions of current and future clinical applications. Coverage also includes a perspective on other emerging imaging modalities, such as MRI, and the relative role of each. In addition, the volume details the technical aspects of cardiac PET and PET/CT imaging. A library of original cases completes the text by illustrating interpretation and technical challenges in cardiac PET and hybrid PET/CT.

Recent research has identified the assessment of myocardial perfusion and viability as another promising CT application for the comprehensive diagnosis of coronary heart disease. In this book, the first to be devoted to this novel application of CT, leading experts from across the world present up-to-date information and consider future directions. After short sections outlining the state of the art in the traditional applications of CT to image structure and function, the full range of CT techniques that may be employed to evaluate the myocardial blood supply are discussed in detail. Similarly, diverse CT approaches for the assessment of myocardial viability are described, with careful consideration of the available experimental and clinical evidence and the role of quantitative imaging. Protocol recommendations that will be of invaluable practical assistance are also provided.

Computed tomography of the heart and cardiovascular system continues to show an impressive and tremendously successful development. Technical improvements translate into new applications and enhanced diagnostic accuracy and the new diagnostic opportunities may potentially be beneficial for many individuals with known or suspected cardiovascular dis

The clinical use of nuclear cardiology for the assessment of myocardial ischemia continues to grow at an unprecedented rate. Part of the reason for this growth is the technical advances in single photon emission computerized tomography (SPECT). SPECT has been shown to provide high contrast images superior to planar imaging techniques. An important and recent technical advancement in SPECT has been ECG-gated myocardial perfusion SPECT to generate simultaneous myocardial perfusion and function information from a single study. Automated, quantitative techniques have facilitated the widespread application of this breakthrough. Another recent advancement has been the use of attenuation correction techniques to help remove the effects of the physical phenomena that degrades the visual and quantitative accuracy of SPECT images. Another reason for the growth of the clinical use of nuclear cardiology is the large body of published evidence documenting the effectiveness of SPECT techniques for assessing myocardial ischemia, myocardium at risk, viable myocardium and stunned or hibernating myocardium. These assessments have been shown to be important not only in diagnosis but also in prognosis. This book is divided into three major sections, each addressing the important topics of nuclear cardiology. The first section is a that have led to the clinical success description of the technical aspects of state-of-the-art myocardial perfusion SPECT imaging. This section deals with the radionuclides, instrumentation, image acquisition and analysis, interpretation and quantification techniques used in the most progressive nuclear cardiology clinics.

Performing any diagnostic test in medicine is always a matter of trying to get the condition of the patient diagnosed properly with the least effort, exposure, discomfort and at the same time with the lowest possible error probability. Pre-test probability is helpful but often imprecise, effectively overestimating the patient's risk profile. In a broader prevention objective, the phases of a disease, its onset, progression, and complications must be taken into account. The negative predictive value, which is so important, has in turn its main limitation in identifying the healthy patient, that is, the one who does not belong to any cluster of patients in which we would act in terms of prevention. In coronary syndromes, the goal is instead to evaluate coronary heart disease, from mild to more extensive and significant forms. For this purpose, it is necessary to use parameters that investigate different and complementary aspects: stenosis, ischemia, the morphology of the atherosclerotic plaque, metabolic processes, in particular vitality and apoptosis, the presence of inflammatory processes. The possibility, already present thanks to Hybrid Imaging, of 'joining’ exams that study different aspects, will allow the patient to be increasingly characterized not only from a diagnostic point of view but also from a prognostic and personalized therapeutic choice.

This book is a comprehensive overview of heart failure and cardiac transplantation and integrates scientific and clinical information about the physiology, pathophysiology, diagnosis, and treatment of this disorder. Organized into five parts, it reviews the history and basic mechanisms of heart failure; etiology of heart failure; heart failure disease progression; advanced therapies for heart failure; and cardiac transplantation. The book presents basic concepts in the physiology, molecular biology, pathology, and epidemiology of the normal and failing heart; known causes of heart failure, such as right heart failure, valvular cardiomyopathy, molecular mechanisms of sarcomeric cardiomyopathies, and neuromuscular cardiomyopathy; cardiorenal syndrome; neurohormonal activation; cardiac resynchronization, ventricular assist devices; regenerative mechanisms; orthotopic heart transplantation; early and late management of the post-transplant patient; heart transplantation and antibody-mediated rejections; heart-lung transplantation; and cardiac xenotransplantation. Featuring contributions from leaders in the fields of heart failure, cardiac transplantation, cardiac pathology, and cardiovascular molecular research, Congestive Heart Failure and Cardiac Transplantation is a valuable compendium for cardiologists, cardiothoracic surgeons, researchers, trainees, and students.

Cardiac Magnetic Resonance Imaging (CMR) is a rapidly evolving tool. This book presents a state-of-the-art compilation of expert contributions to the field, each examining normal and pathologic anatomy of the cardiovascular system as assessed by magnetic resonance imaging. Functional techniques such as myocardial perfusion imaging and assessment of flow velocity are emphasized. The book represents a multi-disciplinary approach to the field.

This textbook provides a succinct overview of cardiac surgery, with key concepts being emphasized throughout. An abundance of illustrations, intra-operative photographs, tables as well as information boxes, aids the reader to visualise, grasp and retain difficult concepts. The inclusion of evidence-based approaches to the management of a range of cardiac surgical conditions equips the reader with an understanding of how to overcome a variety of potentially tough clinical challenges. Concise Cardiac Surgery: A Complete Guide comprehensively covers a range of techniques used in cardiac surgery. It is therefore, an ideal resource for the trainee and practising cardiac surgeon seeking a practically focused text detailing how to apply the latest techniques and evidence-based approaches in their day-to-day practice.