Coronary Microvascular Obstruction in Acute Myocardial Infarction: From Mechanisms to Treatment provides a comprehensive understanding of the phenomenon of coronary microvascular obstruction (CMVO) that is the main limitation of reperfusion therapies in ST-elevation myocardial infarction. It provides in-depth coverage of the phenomenon of CMVO which heavily affects prognosis by increasing the risk of death and heart failure at follow-up. A first of its kind reference dedicated solely to this topic, it is appropriate for a wide audience, from researchers, to those who aid in the management, prevention and treatment of CMVO. Provides in-depth coverage of coronary microvascular obstruction (CMVO), spanning research, management, prevention and treatment Includes the most up-to-date information on CMVO as presented from top experts around the word Provides access to a companion website with extra material, including tables, additional references and instructional videos Gives extensive coverage on how to measure CMVO, including in-depth indexes that can be used to detect and quantify the phenomenon

In the past two decades a number of studies have shown that abnormalities in the function and structure of coronary microcirculation can be detected in several cardiovascular diseases. On the basis of the clinical setting in which it occurs, coronary microvascular dysfunction (CMD) can be classified into four types: CMD in the absence of any other cardiac disease; CMD in myocardial diseases; CMD in obstructive epicardial coronary artery disease; and iatrogenic CMD. In some instances CMD represents an epiphenomenon, whereas in others it represents an important marker of risk or may contribute to the pathogenesis of myocardial ischemia, thus becoming a possible therapeutic target. This book provides an update on coronary physiology and a systematic assessment of microvascular abnormalities in cardiovascular diseases, in the hope that it will assist clinicians in prevention, detection and management of CMD in their everyday activity.

The increasing awareness of coronary microvascular dysfunction through the broad spectrum of car-diovascular disease makes this pathophysiological feature an important aspect to study in clinical practice. A multimodality approach, including echocardiography, cardiovascular magnetic resonance, PET and cardiac catheterization, allows a holistic view into microcirculation in each entity, and contri-butes for a better understanding of the pathophysiology.The search for coronary microvascular dysfunction may potentially change the management of the patient and treatment approach, with recognized prognostic impact. This book aims to review the principal aspects of coronary microvascu-lar dysfunction, from the pathophysiology, to imaging, clinical relevance and treatment.

Research centering on blood flow in the heart continues to hold an important position, especially since a better understanding of the subject may help reduce the incidence of coronary arterial disease and heart attacks. This book summarizes recent advances in the field; it is the product of fruitful cooperation among international scientists who met in Japan in May, 1990 to discuss the regulation of coronary blood flow.

This book is open access under a CC BY 4.0 license. This quick-reference handbook offers a concise and practical review of key aspects of the treatment of ST-segment elevation myocardial infarction (STEMI) in the era of primary percutaneous coronary intervention (PPCI). In the context of STEMI, PPCI is the preferred mode of emergency revascularization. Access to PPCI is rapidly increasing and is now routinely practiced in both general and specialist hospitals and there has been a recent emphasis on developing STEMI networks to enhance and expedite the referral pathway. This coupled with concurrent developments to enhance the safety and efficacy of the PPCI procedure has heralded an era where STEMI interventions are increasingly considered an important subspecialty within interventional cardiology. Written by leading cardiologists who have been instrumental in the adoption of PPCI in their respective institutions, the book provides junior and senior cardiologists alike with insightful and thought-provoking tips and tricks to enhance the success of PPCI procedures, which may in turn translate into direct improvements in outcomes. The book is also relevant for healthcare providers and emergency department physicians.

This presentation describes various aspects of the regulation of tissue oxygenation, including the roles of the circulatory system, respiratory system, and blood, the carrier of oxygen within these components of the cardiorespiratory system. The respiratory system takes oxygen from the atmosphere and transports it by diffusion from the air in the alveoli to the blood flowing through the pulmonary capillaries. The cardiovascular system then moves the oxygenated blood from the heart to the microcirculation of the various organs by convection, where oxygen is released from hemoglobin in the red blood cells and moves to the parenchymal cells of each tissue by diffusion. Oxygen that has diffused into cells is then utilized in the mitochondria to produce adenosine triphosphate (ATP), the energy currency of all cells. The mitochondria are able to produce ATP until the oxygen tension or PO2 on the cell surface falls to a critical level of about 4–5 mm Hg. Thus, in order to meet the energetic needs of cells, it is important to maintain a continuous supply of oxygen to the mitochondria at or above the critical PO2 . In order to accomplish this desired outcome, the cardiorespiratory system, including the blood, must be capable of regulation to ensure survival of all tissues under a wide range of circumstances. The purpose of this presentation is to provide basic information about the operation and regulation of the cardiovascular and respiratory systems, as well as the properties of the blood and parenchymal cells, so that a fundamental understanding of the regulation of tissue oxygenation is achieved.

This report considers the biological and behavioral mechanisms that may underlie the pathogenicity of tobacco smoke. Many Surgeon General's reports have considered research findings on mechanisms in assessing the biological plausibility of associations observed in epidemiologic studies. Mechanisms of disease are important because they may provide plausibility, which is one of the guideline criteria for assessing evidence on causation. This report specifically reviews the evidence on the potential mechanisms by which smoking causes diseases and considers whether a mechanism is likely to be operative in the production of human disease by tobacco smoke. This evidence is relevant to understanding how smoking causes disease, to identifying those who may be particularly susceptible, and to assessing the potential risks of tobacco products.

This reference is a volume in the Handbook of Physiology, co-published with The American Physiological Society. Growth in knowledge about the microcirculation has been explosive with the field becoming fragmented into numerous subdisciplines and subspecialties. This volume pulls all of the critical information into one volume. - Meticulously edited and reviewed. Benefit: Provides investigators a unique tool to explore the significance of their findings in the context of other aspects of the microcirculation. In this way, the updated edition has a direct role in helping to develop new pathways of research and scholarship - Highlights the explosive growth in knowledge about the microcirculation including the biology of nitric oxide synthase (NOS), endothelial cell signaling, angiogenesis, cell adhesion molecules, lymphocyte trafficking, ion channels and receptors, and propagated vasomotor responses. Benefit: Microcirculatory biology has become fragmented into numerous sub-disciplines and subspecialties, and these reference reintegrates the information in one volume

Cardiologists must answer three important questions when evaluating and treating patients with a coronary artery stenosis. As a physiologist: "What is the effect of this stenosis on coronary blood flow and myocardial function?"; as a clinician: " Is this lesion responsible for the patient's symptoms?"; and finally as an interventionalist: "Will revascularization of this artery improve the patient?" Fundamentally, the answer to these questions can be given to a large extent by measuring coronary pressure. That is the rationale of writing this book. 1. 1 Historical overview. Andreas Gruentzig and most interventional cardiologists in the early days of PTCA, had the intuitive feeling that pressure measurements could help to establish the severity of a coronary stenosis and to monitor the progress and result of a coronary intervention. At that time, measuring coronary pressure by the balloon catheter was part of a standard procedure. A residual transstenotic gradient of less than 15 mmHg was generally considered as a good result. Later, however, it turned out that measuring these (resting) gradients with balloon catheters was inaccurate an only had a limited prognostic value. Moreover, because there was no consistent theory to correlate pressure measurements to blood flow, the interest in measuring coronary pressures faded and disappeared almost completely with the introduction of new balloon catheters not intended for pressure measurement.

This comprehensive reference book of coronary microcirculation broadly covers theoretical aspects, clinical cases and therapeutic considerations from an innovative perspective. Topics covered include: ischemic heart disease, silent cerebral damage, heart failure, left ventricular hypertrophy arrhythmias, and cerebral and renal microcirculation. Microcirculation: From Bench to Bedside underlines the clinical importance of addressing coronary microcirculation with relevant clinical examples that are often encountered by practitioners. It therefore provides a critical resource on microcirculation for both specialist and non-specialist practitioners.