Vascular Manifestations of Systemic Autoimmune Diseases,
Автор: Gregory Dendramis Название: Brugada Syndrome: Diagnosis, Clinical Manifestations, Risk Stratification & Treatment ISBN: 163483948X ISBN-13(EAN): 9781634839488 Издательство: Nova Science Рейтинг: Цена: 83410.00 T Наличие на складе: Невозможна поставка. Описание: Electrocardiographically characterised by a distinct ST-segment elevation in the right precordial leads, Brugada syndrome (BrS) is an arrhythmogenic disease reported to be responsible for at least 4% of all sudden deaths (at least 20% of sudden deaths in those without structural heart disease), and is a leading cause of death in subjects under the age of forty years. Global prevalence of the BrS varies from 5% to 20% in every 10,000 inhabitants worldwide, and it is considered endemic in Asian and Southeast Asian countries. The diagnosis is mainly based on electrocardiographic features and may be hampered by incomplete penetrance, particularly because of dynamic ECG manifestations. As far as we know, inheritance occurs via an autosomal dominant mode of transmission, and about eighteen genes have been associated with BrS; thus far, genetic abnormalities are found in 30-50% of genotyped BrS patients. Mutations in the cardiac sodium channel gene SCN5A are identified in 1128% of patients with BrS, with over 300 different mutations of SCN5A having been identified as the list still grows. Because a genotype remains lacking for at least half of BrS probands, a negative genetic test does not rule out BrS. Febrile states, dysionia and many drugs such as vagotonic agents, sodium channel blockers, α-adrenergic agonists, β-adrenergic blockers, antidepressants, and alcohol and cocaine toxicity may unmask the electrocardiographic concealed ECG manifestations of BrS. Identifying patients with BrS at risk of malignant arrhythmias and sudden cardiac death remains the most important objective and therefore the fundamental question remains on the best strategy for assessing the real disease-associated arrhythmic risk, especially in asymptomatic patients. The therapeutic approach for patients with BrS is centered on the prevention of cardiac arrest and syncopal events due to ventricular arrhythmias. Lifestyle changes, such as never using drugs that may potentially induce ventricular arrhythmias and an immediate treatment of fever, should be recommended in all patients with diagnosis of BrS. Some drugs have been tested in BrS patients, but controlled data and/or randomised studies proving their real effective have not been performed. Currently, the cornerstone of therapy for the prevention of sudden cardiac death (SCD) is an implantable cardioverter defibrillator (ICD). An accurate individual risk stratification to select patients for ICD implantation should be accurately performed, particularly in asymptomatic patients. Lastly, catheter ablation of the substrate located in the anterior epicardial region of the right ventricular outflow tract may be considered in patients with a history of arrhythmic storms or repeated appropriate ICD shocks. The study of the areas of delayed depolarisation in patients with BrS and the procedure of catheter ablation of the substrate located in the anterior epicardial region therefore opens new horizons in regards to the management of patients with extremely frequent ventricular tachycardia/ventricular fibrillation (VT/VF), for patients at high risk who refuse the implantation of an ICD, and for a better prognostic stratification of patients with BrS not classified as high risk for SCD.
Автор: Atzeni, Fabiola Название: The Heart in Systemic Autoimmune Diseases,14 ISBN: 0128039973 ISBN-13(EAN): 9780128039977 Издательство: Elsevier Science Рейтинг: Цена: 143730.00 T Наличие на складе: Есть у поставщика Поставка под заказ. Описание:
The Heart in Systemic Autoimmune Diseases, Second Edition, provides an overview on our current understanding of major complications relating to the heart and autoimmune diseases. It includes the latest information on the new pathogenetic mechanisms involved, along with clinical manifestations of these important comortbidities. Mortality in autoimmune diseases, in particular, rheumatoid arthritis and SLE, has increased when compared with the general population. This excess mortality is largely due to cardiovascular diseases (CVDs)-particularly those of atherosclerotic origin, such as ischemic heart disease-and is gaining recognition in all branches of medicine, from cardiology, to internal medicine, and from rheumatologists to orthopedics.
Автор: Nussinovitch, Udi Название: The Heart in Rheumatic, Autoimmune and Inflammatory Diseases ISBN: 0128032677 ISBN-13(EAN): 9780128032671 Издательство: Elsevier Science Рейтинг: Цена: 140360.00 T Наличие на складе: Есть у поставщика Поставка под заказ. Описание:
The prevalence of autoimmune diseases and rheumatic conditions is constantly increasing. Autoimmune diseases affect approximately 7-10% of the population of the United States, while more than 50,000,000 American adults suffer from some type of arthritis. The Heart in Rheumatic, Autoimmune and Inflammatory Diseases examines the complex mechanisms relating to cardiac diseases from a pathophysiological and clinical point of view. Autoimmune rheumatic diseases can affect the coronary vessels, myocardium, pericardium, heart valves and the conduction system. The diagnosis of these unique cardiac complications necessitates medical awareness and a high index of suspicion. Increased risk of advanced atherosclerosis plays a pivotal role in the development of cardiac diseases in systemic, rheumatic and autoimmune illnesses. Yet, other complex immune medicated mechanisms may contribute to the pathogenesis. Patients' optimal care requires coordination between the primary caregiver, the rheumatologist, immunologist and cardiologist. Screening for cardiovascular risk factors, recognition of high-risk patients and identification of subclinical cardiac conditions are of great importance. Moreover, regulation of inflammation, as well as abnormal immune responses and the initiation of early treatments should be the focus of patient management. A continuous attempt to identify novel therapeutic targets and change the natural history of the underlying disease and its cardiac manifestations is in progress. The book aims at providing the readers with a state of the art collection of up to date information regarding clinically important topics based on experts' perspectives.
This book was a result of an extended coordinated collaboration of one-hundred and fifty-four distinguished scientists from thirty-one countries around the globe.
A review of common, as well as unusual (yet clinically significant) medical cardiac complications of prevalent rheumatic, autoimmune and inflammatory diseases.
Focuses on aspects of pathophysiological processes, clinical presentations, screening tests, prognostic implications and novel therapeutic approaches.
Presents an up-to-date "level of evidence" and "strengths of recommendations" for suggested therapies and reviews all randomized clinical trials, meta-analyses and other supporting published clinical findings.
Автор: Saksena Название: Color Atlas of Local and Systemic Manifestations of Cardiovascular Disease ISBN: 1405159766 ISBN-13(EAN): 9781405159760 Издательство: Wiley Рейтинг: Цена: 79150.00 T Наличие на складе: Поставка под заказ. Описание: This brief guide to visual diagnosis helps the novice develop -- and the veteran refresh -- crucial skills that can spare the patient unnecessary testing and bring the physician one step closer to an accurate diagnosis.
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