Asymptomatic Atherosclerosis (eBook)

Pathophysiology, Detection and Treatment

Morteza Naghavi (Herausgeber)

eBook Download: PDF

2010 | 2011
XXII, 737 Seiten
Humana Press (Verlag)
978-1-60327-179-0 (ISBN)

Infos

Despite recent advances in the diagnosis and treatment of symptomatic atherosclerosis, available traditional screening methods for early detection and treatment of asymptomatic coronary artery disease are grossly insufficient and fail to identify the majority of victims prior to the onset of a life-threatening event. In Asymptomatic Atherosclerosis: Pathophysiology, Detection and Treatment, Dr. Morteza Naghavi and leading authorities from the Society for Heart Attack Prevention and Eradication (SHAPE) present a new paradigm for the screening and primary prevention of asymptomatic atherosclerosis. The text focuses on accurate, yet underutilized, measures of subclinical atherosclerosis, notably coronary artery calcium scanning and carotid intima-media thickness measurement. The authors introduce a comprehensive approach to identifying the vulnerable patients (asymptomatic individuals at risk of a near future adverse event). Additional chapters discuss future directions towards containing the epidemic of atherosclerotic cardiovascular disease using innovative solutions such as preemptive interventional therapies (bioabsorbable stents) for stabilization of vulnerable atherosclerotic plaques, mass unconditional Polypill therapy for population-based risk reduction, and ultimately vaccination strategies to prevent the development of atherosclerosis. Up-to-date and authoritative, Asymptomatic Atherosclerosis: Pathophysiology, Detection, and Treatment is a must-have for any cardiologist or primary care physician who wishes to practice modern preventive cardiology and manage the increasing number of asymptomatic atherosclerotic patients. Outlines more accurate measures of risk (coronary artery calcium and carotid intima-media thickness) than traditional risk factors (total cholesterol, LDL cholesterol, HDL cholesterol) Presents new multipronged strategies to aid in the early detection and treatment of high risk asymptomatic patients

Inhalt

Dedications and Acknowledgments 5
Preface 6
Foreword 7
Contents 8
Contributors 13
Preventive Cardiology: The SHAPE of the Future 19
From Vulnerable Plaque to Vulnerable Patient 31
Pathology of Vulnerability Caused by High- Risk ( Vulnerable) Arteries and Plaques 57
Pathophysiology of Vulnerability Caused by Thrombogenic ( Vulnerable) Blood 70
Vulnerability Caused by Arrhythmogenic Vulnerable Myocardium 84
Approach to Atherosclerosis as a Disease: Primary Prevention Based on the Detection and Treatment of Asymptomatic Atherosclerosis 94
Risk Factors and Circulating Markers of Asymptomatic Atherosclerotic Cardiovascular Disease 103
History of the Evolution of Cardiovascular Risk Factors and the Predictive Value of Traditional Risk- Factor- Based Risk Assessment 104
Comprehensive Lipid Profiling Beyond LDL 121
New Blood Biomarkers of Inflammation and Atherosclerosis 133
Genomics and Proteomics: The Role of Contemporary Biomolecular Analysis in Advancing the Knowledge of Atherosclerotic Coronary Artery Disease 148
Circulating Endothelial Progenitor Cells: Mechanisms and Measurements 163
Family History: An Index of Genetic and Environmental Predisposition to Coronary Artery Disease 180
Endothelial Activation Markers in Sub- clinical Atherosclerosis: Insights from Mechanism- Based Paradigms 190
Non Invasive, Non Imaging, Assessment of Asymptomatic Atherosclerotic Cardiovascular Disease 206
Exercise Stress Testing in Asymptomatic Individuals and Its Relation to Subclinical Atherosclerotic Cardiovascular Disease 207
The Ankle Brachial Index 221
Arterial Elasticity/Stiffness 234
Assessment of Endothelial Function in Clinical Practice 245
Digital (Fingertip) Thermal Monitoring of Vascular Function: A Novel, Noninvasive, Nonimaging Test to Improve Traditional Cardiovascular Risk Assessment and Monitoring of Response to Treatments 254
Assessment of Macro- and Microvascular Function and Reactivity 271
Non Invasive Structural Imaging of Asymptomatic Atherosclerotic Cardiovascular Disease 282
Coronary Artery Calcium Imaging 283
Noninvasive Ultrasound Imaging of Carotid Intima Thickness 289
Carotid Intima-Media Thickness: Clinical Implementation in Individual Cardiovascular Risk Assessment 323
Computed Tomographic Angiography 327
Role of Noninvasive Imaging using CT for Detection and Quantitation of Coronary Atherosclerosis 338
Noninvasive Coronary Plaque Characterization: CT Versus MRI 353
Magnetic Resonance Imaging 358
The Role of MRI in Examining Subclinical Carotid Plaque 363
Comprehensive Non-contrast CT Imaging of the Vulnerable Patient 374
Non Invasive Functional Imaging of Asymptomatic Atherosclerotic Cardiovascular Disease 391
Ultrasound Assessment of Brachial Artery Reactivity 392
Cardiac Imaging for Ischemia in Asymptomatic Patients: Use of Coronary Artery Calcium Scanning to Improve Patient Selection: Lessons from the EISNER Study 408
Targeted MRI of Molecular Components in Atherosclerotic Plaque 425
Noninvasive Imaging of the Vulnerable Myocardium: Cardiac MRI and CT Based 429
Invasive (Intravascular) Risk Stratification for Detection of Vulnerable ( High- Risk) Asymptomatic Atherosclerotic Plaques 448
Angiography for Detection of Complex and Vulnerable Atherosclerotic Plaque 449
Intravascular Characterization of Vulnerable Coronary Plaque 454
Detecting Vulnerable Plaque Using Invasive Methods 467
Assessment of Plaque Burden and Plaque Composition Using Intravascular Ultrasound 474
Vulnerable Anatomy The Role of Coronary Anatomy and Endothelial Shear Stress in the Progression and Vulnerability of Coronary Artery Lesions: Is Anatomy Destiny?
Vasa Vasorum Imaging 497
VI Screening for Risk Assessment of Asymptomatic At- Risk Population and Identification of the Vulnerable Patient – The SHAPE Paradigm 507
From Vulnerable Plaque to Vulnerable Patient – Part III 507
Cost Effectiveness of Screening Atherosclerosis 526
Monitoring of Subclinical Atherosclerotic Disease 537
Implications of SHAPE Guideline for Improving Patient Compliance 556
The SHAPE Guideline: Why Primary Care Physicians Should Embrace It 563
Should We Treat According to the SHAPE Guidelines? 567
Duty-Bound: Rational Foundations of Clinical Strategies for Prevention of Cardiovascular Events 573
A Time to Live: Dynamic Changes in Risk as the Basis for Therapeutic Triage 583
Treatment of Asymptomatic Atherosclerotic Cardiovascular Disease and the Vulnerable Patients: Systemic Therapies 588
LDL Targeted Therapies 589
Antioxidants as Targeted Therapy: A Special Protective Role for Pomegranate and Paraoxonases ( PONs) 604
The Multiconstituent Cardiovascular Pill ( MCCP): Challenges and Promises of Population Based Prophylactic Drug Therapy for Heart Attack Prevention and Eradication 618
Vaccine for Atherosclerosis: An Emerging New Paradigm 631
Local and Focal Therapies for Stabilization of Vulnerable Arteries and Plaques 640
Drug-Eluting Stents: A Potential Preemptive Treatment Choice for Vulnerable Coronary Plaques 641
Intrapericardial Approach for Pancoronary Stabilization of the Vulnerable Arteries and Myocardium 650
Educations, Life Style Modifications and Non- Pharmacologic Treatments for Primary Prevention and Saving the Vulnerable 665
Dietary Management for Coronary Atherosclerosis Prevention and Treatment 666
Management of Preconditioning Physical Activity in a Vulnerable Patient: Getting in SHAPE 675
Last Chance for Prevention (Acute Prevention): Identification of Prodromal Symptoms and Early Heart Attack Care 682
Index 698

Produkt-Details

• Erscheint lt. Verlag: 1.7.2010
• Reihe/Serie: Contemporary Cardiology
• Reihe/Serie: Contemporary Cardiology
• Zusatzinfo: XXII, 737 p.
• Verlagsort: Totowa
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Allgemeinmedizin
• Themenwelt: Medizinische Fachgebiete ► Innere Medizin ► Kardiologie / Angiologie
• ISBN-10: 1-60327-179-1 / 1603271791
• ISBN-13: 978-1-60327-179-0 / 9781603271790