Coronary Heart Disease: Clinical, Pathological, Imaging, and Molecular Profiles

557 Pages·2012·41.78 MB·English

by  Zeev Vlodaver MD

Coronary Heart Disease

Zeev Vlodaver Robert F. Wilson Daniel J. Garry
● ●
Editors
Coronary Heart Disease
Clinical, Pathological, Imaging, and Molecular Profiles
Editors
Zeev Vlodaver Robert F. Wilson
Division of Cardiovascular Medicine Division of Cardiovascular Medicine
University of Minnesota University of Minnesota
Minneapolis, MN, USA Minneapolis, MN, USA
[email protected] [email protected]
Daniel J. Garry
Division of Cardiovascular Medicine
University of Minnesota
Minneapolis, MN, USA
[email protected]
ISBN 978-1-4614-1474-2 e-ISBN 978-1-4614-1475-9
DOI 10.1007/978-1-4614-1475-9
Springer New York Dordrecht Heidelberg London
Library of Congress Control Number: 2011943085
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This book is dedicated to our wives
Dalia P. Viodaver
Betsy Wilson
Mary G. Garry
For their encouragement, devotion and support.

Preface
Coronary Heart Disease
Clinical, Pathological, Imaging, and Molecular Profiles
This book will present a comprehensive picture of ischemic heart disease to those who, either as practitioners, students or
investigators, deal with the varied facets of this complex subject. It has meaning to the fields of clinical cardiology, thoracic
surgery, pathology, and cardiovascular molecular research.
After introductory chapters on the anatomy of the coronary blood vessels and cardiac development, several chapters
will consider stress echo and nuclear diagnostics tests, noninvasive imaging and coronary angiography in ischemic heart
disease, with techniques, indications, and examples of normal and abnormal patterns. In most instances, angiograms are
paired with labeled line drawings, which help the initiated in the reading of films. Specific chapters will deal with congeni-
tal anomalies of the coronary arteries, which may engender states of ischemic heart disease.
The principal thrust of the work concerns the main arena of ischemic heart disease, namely, coronary atherosclerosis.
The pathology of coronary atherosclerosis will be presented in conjunction with the results of anatomic, noninvasive imag-
ing and angiographic studies. Related chapters on atherogenesis will present new insights into the pathophysiology of the
vulnerable plaque, role of progenitor cells in vascular injury, inflammation and atherogenesis, and genomics of vascular
remodeling.
Major chapters will discuss the subject of angina pectoris, acute coronary syndromes, healed myocardial infarction and
congestive heart failure, catheter-based and surgical revascularization, and surgical treatment of myocardial infarction and
its sequelae. Final chapters will present therapies for refractory angina; metabolic syndromes and coronary heart disease;
coronary heart disease in women; and prevention and regression of atherosclerosis.
What is unique in this book is that many of the chapters will be case material from which profiles of the various mani-
festations are obtained through correlation of clinical, imaging, and pathological studies. The quality of the authors’ con-
tribution to this book will provide an immense depth to the book as they have hands on experience and are national leaders
in their field of cardiac pathology, clinical cardiology, and cardiovascular molecular research. This book will present a
comprehensive and real picture of the complexities of ischemic heart disease, both to the practitioners, who deal with it in
day-to-day practice with its problems, and to the students, residents, and investigators who try to develop firm concepts
regarding the varied states observed in this common condition and preparing them to the future advances in coronary heart
disease.
Minneapolis, MN, USA Zeev Vlodaver, M.D.
Minneapolis, MN, USA Robert F. Wilson, M.D.
Minneapolis, MN, USA Daniel J. Garry, M.D., Ph.D.
vii

Acknowledgments
We wish to recognize four pillars of medical science whose important contributions to cardiovascular medicine are
reflected in our book.
To Jesse E. Edwards, MD, a world-renowned, pioneering, and leading cardiac pathologist who had an extraordinary
passion for teaching. He was professor of pathology at the Mayo Clinic in Rochester, Minn., and at the University of
Minnesota, Minneapolis. He taught many medical students, pathologists, cardiologists, cardiac surgeons, and visiting
medical experts from around the world. Dr. Edwards housed an enormous collection of autopsied hearts at United Hospital,
81. Paul, Minn., known as the Dr. Edwards' Cardiovascular Registry that became a principal resource for his illustrated
reference books: "An Atlas of Acquired Diseases of the Heart and Great Vessels" (1961), and "Congenital Heart Disease"
(1965). He also co-authored nearly 800 journal articles and 14 books. Dr. Vlodaver pays special acknowledgment to Dr.
Edwards who was his teacher, mentor and "inspirational force in his medical life." He died in 2008 at the age of 96.
C. Walton Lillehei, MD, world-renowned as the "Father of Open-Heart Surgery," was professor of surgery at the
University of Minnesota. In 1952, he participated in the world's first successful open-heart operation using hypothermia,
performed at the University of Minnesota, and in1954, he performed the world's first open-heart surgery using cross-cir-
culation. In 1958, Dr. Lillehei was responsible for the world's first use of a small, portable, battery-powered pacemaker;
he also developed and implanted the world's first prosthetic valve in1966. Thousands of cardiac surgeons over the world
are indebted to Dr. Lillehei for his monumental contributions. Dr. Lillehei died in 1999 at the age of 80.
Kurt Amplatz, MD, professor of radiology for more than 40 years at the University of Minnesota, retired in 1999.
A pioneer in cardiovascular interventional radiology, he is well known for his many inventions which bridged medical
disciplines and included devices such as high-resolution x-ray equipment, heparin-coated wires, specially shaped cardiac
catheters, and vascular occlusive devices. Although retired, he continues to improve patients' lives through the development
of new technologies.
Howard B. Burchell, MD, cardiologist, professor of medicine at the Mayo Clinic in Rochester and chief of cardiology
at the University of Minnesota. He was editor-in-chief of the journal Circulation from 1965-1970, a tenure marked by rapid
advances in cardiac pacing and electrophysiology. Teaching and writing with a central theme of sound scientific evidence
were hallmarks of Dr. Burchell's career. He passed We also extendour gratitude to the manyspecialists who have contrib-
uted generously to this bookwith considerable experience in their specialty areas.
We acknowledge and thankJane Hutchins-Peterson, Stephanie Esperson and Andrea Silverman for their outstanding
help and for handling the flow of material from the writers to the publisher.
We recognize with deepappreciation Barb Umbergerfor her dedication in the editing of the manuscript in the minutest-
detail to ensurethe high quality of this project.
Our sincere thanks to Howard Gillbert for his invaluable illustrations and other artwork.
Our gratitude to Michael Griffin, developmental editor, Springer Publishing, for his tireless and utmost attention to all
details needed for the production of the book.
We wish to acknowledge the supportof and encouragement by Andrew Moyer, Senior Editor of Clinical Medicine, at
Springer, and his predecessors Melissa Ramondetta and Frances Louie, for their enthusiasm for this projectin bringing it
to reality.
Minneapolis, MN, USA Zeev Vlodaver, M.D.
Minneapolis, MN, USA Robert F. Wilson, M.D.
Minneapolis, MN, USA Daniel J. Garry, M.D., Ph.D
ix