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CONTRIBUTORS
Jonathan Abrams, MD
Professor of Medicine, University of New Mexico School of
Medicine; Cardiology Division, University Hospital,
Albuquerque, New Mexico
Pharmacologic Options for Treatment of Ischemic Disease
Arnold B. Alper, MD
Hypertension Fellow, Vascular Biology and Hypertension
Program, University of Alabama at Birmingham,
Birmingham, Alabama
Hypertensive Emergencies
Elliott M. Antman, MD
Associate Professor of Medicine, Harvard Medical School;
Director, Samuel A. Levine Cardiac Unit, Brigham and
Women's Hospital, Boston, Massachusetts
Tools for Assessment of Cardiovascular Tests and Therapies
Lawrence J. Appel, MD
Associate Professor of Medicine, Johns Hopkins University
School of Medicine, Baltimore, Maryland
Lifestyle Modification in the Treatment of Hypertension
Phyllis August, MD
Professor of Medicine and Chief, Hypertension Division,
Weill Medical College of Cornell University; Attending
Physician, New York Presbyterian Hospital, Cornell
Campus, New York, New York
Hypertension in Pregnancy and in Children
George L. Bakris, MD
Professor of Preventive Medicine and Internal Medicine,
Rush Medical College of Rush University; Vice-chairman,
Department of Preventive Medicine, Director, Hypertension/
Clinical Research Center, Rush-Presbyterian-St. Luke's
Medical Center, Chicago, Illinois
Treatment of Hypertension in Patients with Renal Disease
Michael K. Banbury, MD
Staff Physician, Cleveland Clinic Foundation, Cleveland,
Ohio
Surgical Therapy for Valvular Heart Disease
Shannon M. Bates, MD, CM
Assistant Professor, Department of Medicine, McMaster
University, Hamilton, Ontario, Canada
Pharmacologic Options for Treatment of Ischemic Disease;
Treatment of Venous Thromboembolism
Richard C. Becker, MD
Professor of Medicine, University of Massachusetts Medical
School; Director, Cardiovascular Thrombosis Research
Center, Coronary Care Unit, and Anticoagulation Services,
University of Massachusetts Memorial Medical Center,
Worcester, Massachusetts
Bedside Assays in Cardiovascular Therapeutics
Jacques 1. Benisty, MD
Research Fellow, Department of Surgery, Harvard Medical
School; Fellow in Cardiology, Children's Hospital, Boston,
Massachusetts
Treatment of Primary Pulmonary Hypertension
Scott D. Berkowitz, MD
Adjunct Associate Professor of Medicine, Duke University
School of Medicine, Durham, North Carolina; Medical
Director, Clinical Research, Thrombosis and Hemostasis,
Astra Zeneca L.P., Wayne, Pennsylvania
Bedside Assays in Cardiovascular Therapeutics
John A. Bittl, MD
Interventional Cardiologist, Ocala Heart Institute, Munroe
Regional Medical Center, Ocala, Florida
Interventional Procedures in the Peripheral Circulation
Michael R. Bristow, MD, PhD
Professor of Medicine and Chief, Division of Cardiology,
University of Colorado School of Medicine, Denver,
Colorado
Principles of Pharmacologic Management of Chronic Heart
Failure
David A. Calhoun, MD
Medical Director, Vascular Biology and Hypertension
Program, University of Alabama at Birmingham,
Birmingham, Alabama
Hypertensive Emergencies
Robert M. Califf, MD
Professor of Medicine, Duke University School of
Medicine; Associate Vice-Chancellor for Clinical Research
and Director, Duke Clinical Research Institute, Duke
University Medical Center, Durham, North Carolina
Tools for Assessment of Cardiovascular Tests and
Therapies; Acute Myocardial Infarction
David J. Callans, MD
Associate Professor of Medicine, University of Pennsylvania
School of Medicine; Director, Electrophysiology Laboratory,
Hospital of the University of Pennsylvania, Philadelphia,
Pennsylvania
Nonpharmacologic Treatment of Tachyarrhythmias;
Malignant Ventricular Arrhythmias
A. John Camm, MD, FRCP
Professor of Clinical Cardiology, St. George's Hospital
Medical School, Department of Cardiological Sciences;
Consultant Cardiologist, St. George's Hospital, London
Atrial Fibrillation: A Comprehensive Approach
Charles R. Cannan, MB, ChB
Assistant Professor of Medicine, Oregon Health Sciences
University School of Medicine; Director, Cardiac
Catheterization Laboratory, Oregon Health Sciences
University, Portland, Oregon
Percutaneous Coronary intervention: Indications and Patient
Selection
Christopher P Cannon, MD
Assistant Professor of Medicine, Harvard Medical School;
Associate Physician, Cardiovascular Division, Brigham and
Women's Hospital, Boston, Massachusetts
Antiplatelet Therapy; Anticoagulant and Fibrinolytic
Therapy for Acute Coronary Syndromes
Blase A. Carabello, MD
Professor of Medicine and Vice Chairman, Department of
Medicine, Baylor College of Medicine; Medical Care Line
Executive, Houston Veterans Affairs Medical Center,
Houston, Texas
The Timing of Valve Surgery
George S. Chrysant, MD
Fellow, Division of Cardiovascular Diseases, Washington
University School of Medicine, St. Louis, Missouri
Treatment of Hypertension in the Patient with
Cardiovascular Disease
David J. Cohen, MD, MSc
Assistant Professor of Medicine, Harvard Medical School;
Associate Director of Interventional Cardiology, Beth Israel
Deaconess Medical Center, Boston, Massachusetts
Cost-Effectiveness of Percutaneous Coronary Intervention
Jay N. Cohn, MD Professor of Medicine, Cardiovascular
Division, University of Minnesota Medical School; Director,
Rasmussen Center for Cardiovascular Disease Prevention,
University of Minnesota, Minneapolis, Minnesota
Ambulatory Management of Heart Failure
Lawrence H. Cohn, MD
Virginia and James Hubbard Professor of Cardiac Surgery,
Harvard Medical School; Chief, Division of Cardiac
Surgery, Brigham and Women's Hospital, Boston,
Massachusetts
Surgical Therapy for Valvular Heart Disease
Wilson S. Colucci, MD
Professor of Medicine and Physiology, Boston University
School of Medicine; Chief, Cardiovascular Medicine,
Boston University Medical Center, Boston, Massachusetts
Pathophysiologlc and Clinical Considerations in the
Treatment of Heart Failure: An Overview; Hospital
Management of Heart Failure
Delos M. Cosgrove III, MD
Chairman, Thoracic and Cardiovascular Surgery, Cleveland
Clinic Foundation, Cleveland, Ohio
Surgical Therapy for Valvular Heart Disease
Gregory S. Couper, MD
Assistant Professor of Surgery, Harvard Medical School;
Surgical Director, Cardiac Transplant Program, and Surgical
Director, Circulatory Assist Program, Brigham and Women's
Hospital, Boston, Massachusetts
Circulatory Support Devices
George Dangas, MD, PhD
Associate Director, Interventional Cardiology Fellowship
Program, Cardiovascular Research Foundation, Lenox Hill
Heart and Vascular Institute, New York, New York
Interventlonal Revascularlzation Procedures in Acute
Myocardial Infarction; Intracardlac Devices and Catheters
Vincent S. DeCeare, MD, FACC, FACP
Clinical Instructor of Medicine/Cardiology, University of
Texas Medical School at San Antonio; Clinical Assistant
Professor of Medicine, Uniformed Services University of the
Health Sciences, San Antonio, Texas; Interventional
Cardiologist, Keesler Air Force Medical Center, Keesler
AFB, Mississippi
Interventional Revascularization Procedures in Acute
Myocardial Infarction
Margo A. Denke, MD
Professor of Medicine, University of Texas Southwestern
Medical Center at Dallas; Director of Endocrine Clinic,
Veterans Affairs Health Administration, Dallas, Texas
DyslipoproteinemiaslAtherosclerosis: Dietary Therapy
John P DiMarco, MD, PhD
Professor of Medicine and Director, Cardiac
Electrophysiology Laboratory, University of Virginia Health
Sciences Center, Charlottesville, Virginia
Acute and Chronic Pharmacologic Management of
Supraventricular Tachyarrhythmias
Elazer R. Edelman, MD, PhD
Thomas D. and Virginia W. Cabot Professor, Health
Sciences and Technology, Massachusetts Institute of
Technology, Cambridge; Associate Professor of Medicine,
Harvard Medical School; Associate Physician, Brigham and
Women's Hospital, Boston, Massachusetts
Intracardiac Devices and Catheters
Kenneth A. Ellenbogen, MD
Professor of Medicine and Director, Cardiac
Electrophysiology and Pacing, Medical College of Virginia,
Virginia Commonwealth University, Richmond, Virginia
Implantable Devices for the Electrical Management of Heart
Disease: Overview of Indications for Therapy and Selected
Advances
Stephen C. Ellis, MD
Professor of Medicine, Cleveland Clinic Health Sciences
Center of the Ohio State University, Cleveland, Ohio
Mechanical Approaches to Percutaneous Coronary
Intervention
Bonita Falkner, MD
Professor of Medicine and Pediatrics, Jefferson Medical
College of Thomas Jefferson University, Philadelphia,
Pennsylvania
Hypertension in Pregnancy and in Children
James C. Fang, MD
Assistant Professor of Medicine, Harvard Medical School;
Attending Physician Cardiovascular Division, Brigham and
Women's Hospital, Boston, Massachusetts
Circulatory Support Devices
John A. Farmer, MD
Associate Professor of Medicine, Divisions of Cardiology
and Atherosclerosis, Department of Medicine, Baylor
College of Medicine; Chief of Cardiology, Ben Taub
General Hospital, Houston, Texas
DyslipoproteinemiaslAtherosclerosis: Overview of
Pathology and Management Strategies;
DyslipoproteinemiaslAtherosclerosis: Pharmacologic
Therapy
Keith A. A. Fox, MB ChB, FRCP, FESC
Professor of Cardiology, University of Edinburgh;
Department of Cardiology, Royal Infirmary, Edinburgh,
Scotland, United Kingdom
Chronic Stable Angina
Jane E. Freedman, MD
Assistant Professor of Pharmacology and Medicine,
Georgetown University School of Medicine, Washington,
D.C.
Fibrinolytic and Antithrombotic Therapy of Peripheral
Vascular, Cerebrovascular, and Intracardiac Disorders
William H. Frishman, MD
Barbara and William Rosenthal Professor and Chairman of
Medicine and Professor of Pharmacology, New York
Medical College; Chief of Medicine, Westchester Medical
Center, Valhalla, New York
Pharmacologic Options for Treatment of Ischemic Disease
Victor F Froelicher, MD
Professor of Medicine, Stanford University School of
Medicine, Stanford; Director, Exercise and ECG
Laboratories, Palo Alto Veterans Administration Health
Care System, Palo Alto, California
Rehabilitation of the Patient with Cardiovascular Disease
Valentin Fuster, MD, PhD
Richard Gorlin, MD/Heart Research Foundation Professor
of Cardiology, Mt. Sinai School of Medicine; Director, the
Zena and Michael A. Wiener Cardiovascular Institute, Mt.
Sinai Medical Center, New York, New York
Anticoagulant and Fibrinolytic Therapy for Acute Coronary
Syndromes
J. Michael Gaziano, MD, MPH
Associate Professor of Medicine, Harvard Medical School;
Co-Director, Cardiovascular Epidemiology, Brigham and
Women's Hospital, Boston; Director, Massachusetts
Veterans Epidemiology Research and Information Center
(MAVERIC), Boston Veterans Administration Healthcare
System, Jamaica Plain, Massachusetts
Primary Prevention of Ischemic Heart Disease
Todd W B. Cehr, MD
Professor of Medicine, Division of Nephrology, Virginia
Commonwealth University; Medical College of Virginia
Hospitals, Richmond, Virginia
Pharmacologic Treatment of Hypertension
Bernard J. Gersh, MB ChB, DPhil, FRCP
Professor of Medicine, Mayo Medical School; Consultant,
Cardiovascular Diseases, Mayo Clinic, Rochester,
Minnesota
Ischemic Heart Disease: Surgical Options -A Cardiology
Perspective
Gary Gibbons, MD
Director, Cardiovascular Research Institute and Associate
Professor of Medicine, Morehouse School of Medicine,
Atlanta, Georgia
Gene Therapy for Cardiovascular Disease
Satyendra Girl, MD, MPH
Interventional Cardiology Fellow, Brigham and Women's
Hospital, Boston, Massachusetts
High-Risk Patient Subsets for Percutaneous Coronary
Interventions: Mechanisms and Management
Robert P Ciugliano, MD, SM
Instructor in Medicine, Harvard Medical School; Associate
Physician, Cardiovascular Division, Brigham and Women's
Hospital, Boston, Massachusetts
Antiplatelet Therapy
Michael M. Civertz, MD
Assistant Professor of Medicine, Boston University School
of Medicine; Clinical Director, Cardiomyopathy Program,
Boston University Medical Center, Boston, Massachusetts
Ambulatory Management of Heart Failure; Hospital
Management of Heart Failure
Britta U. Coldmann, MD
Fellow in Cardiology, Division of Cardiology, University
Hospital Eppendorf, Hamburg, Germany
Bedside Assays in Cardiovascular Therapeutics
Bruce R. Gordon, MD
Associate Professor of Clinical Medicine and Surgery, Weill
Medical College of Cornell University; Senior Member, The
Rogosin Institute, New York, New York
The Steps Beyond Diet and Drug Therapy for Severe
Hypercholesterolemia
Antonio M. Gotto, Jr., MD, DPhil
The Stephen and Suzanne Weiss Dean, Professor of
Medicine, Weill Medical College of Cornell University,
New York, New York
DyslipoproteinemiaslAtherosclerosis: Overview of
Pathology and Management Strategies;
DyslipoproteinemiaslAtherosclerosis: Pharmacologic
Therapy
Cindy L. Grines, MD
Director, Cardiac Catheterization Laboratories and
Interventional Cardiology Fellowship Program, William
Beaumont Hospital, Royal Oak, Michigan
Interventional Revasculartzation Procedures in Acute
Myocardial Infarction
Christian Hamm, MD
Professor of Internal Medicine and Cardiology, University of
Hamburg, Hamburg; Director, Department of Cardiology,
Kenckhoff Heart Center, Bad Nauheim, Germany Bedside
Assays in Cardiovascular Therapeutics
Jack Hirsh, MD
Professor Emeritus, McMaster University; Director,
Hamilton Civic Hospitals Research Centre, Hamilton,
Ontario, Canada
Treatment of Venous Thromboembolism
Reginald T. Ho, MD
Clinical Assistant Professor of Medicine, Thomas Jefferson
University Hospital, Philadelphia, Pennsylvania
Malignant Ventricular Arrhythmlas
Judith S. Hochman, MD
Professor of Medicine, Columbia University, College of
Physicians and Surgeons, New York; Director, Cardiac Care
and Cardiac Stepdown Units, Director, Cardiac Research, St.
Luke's-Roosevelt Hospital Center, New York, New York
Acute Myocardial Infarction
Brian D. Hoit, MD
Professor of Medicine and Director of Cardiovascular
Physiology, Case Western Reserve University School of
Medicine; Co-Director, Echocardiographic Laboratory,
University Hospitals of Cleveland, Cleveland, Ohio
Treatment of Pericardial Disease
Lisa Cooper Hudgins, MD
Assistant Professor of Pediatrics, Weill Medical College of
Cornell University; Member, The Rogosin Institute, New
York, New York
The Steps Beyond Diet and Drug Therapy for Severe
Hypercholesterolemia
Munawar Izhar, MD
Senior Fellow, Rush Medical School of Rush University;
Senior Fellow, Rush-Presbyterian-St. Luke's Medical
Center, Chicago, Illinois
Treatment of Hypertension in Patients with Renal Disease
Alice K. Jacobs, MD
Professor of Medicine, Boston University School of
Medicine; Director, Cardiac Catheterization Laboratory and
Interventional Cardiology, Boston Medical Center, Boston,
Massachusetts
Percutaneous Coronary Intervention: Indications and Patient
Selection
Mark E. Josephson, MD
Professor of Medicine, Harvard Medical School; Director,
Howard Thorndike Electrophysiology Institute and
Arrhythmia Service and Associate Chief of Cardiology for
Academic Affairs, Beth Israel Deaconess Medical Center,
Boston, Massachusetts
Evaluation of the Patient with Disturbances of the Cardiac
Rhythm
Adolf W Karchmer, MD
Professor of Medicine, Harvard Medical School; Chief,
Division of Infectious Diseases, Beth Israel Deaconess
Medical Center, Boston, Massachusetts
Prevention and Treatment of Infective Endocardltls
Ralph A. Kelly, MD
Associate Professor of Medicine, Harvard Medical School;
Associate Physician, Brigham and Women's Hospital,
Cardiology Division, Boston, Massachusetts
Principles of Pharmacologic Management of Chronic Heart
Failure
Dean J. Kereiakes, MD, FACC
Professor of Clinical Medicine, University of Cincinnati
College of Medicine, Cincinnati; Professor of Clinical
Medicine, Ohio State University, Columbus; Medical
Director, The Lindner Center for Research and Education,
and Chief Executive Officer, Ohio Heart Health Center,
Cincinnati, Ohio
Adjunctive Pharmacology During Percutaneous Coronary
Intervention
Lawrence R. Krakoff, MD
Professor of Medicine, Mount Sinai School of Medicine of
the City University of New York, New York; Chief of
Medicine, Englewood Hospital and Medical Center,
Englewood, New Jersey
Antihypertensive Therapy
Joel Kupersmith, MD
Professor of Internal Medicine, Texas Tech University
Health Sciences Center, School of Medicine; Dean, School
of Medicine and Graduate School of Biomedical Sciences,
Vice President for Clinical Affairs, and Member of the
University Medical Center Board of Managers, Texas Tech
University Health Sciences Center, Lubbock, Texas
Tools for Assessment of Cardiovascular Tests and Therapies
Michael J. Landzberg, MD
Assistant Professor of Medicine, Harvard Medical School;
Director, Boston Adult Congenital Heart (BACH) Service,
Brigham and Women's and Children's Hospitals, Boston,
Massachusetts
Care for Adults with Congenital Heart Disease; Treatment
of Primary Pulmonary Hypertension
Martin B. Leon, MD
Director, Cardiovascular Research Foundation, Lenox Hill
Heart and Vascular Institute, New York, New York
Intracardiac Devices and Catheters
A. Michael Lincoff, MD
Associate Professor of Medicine, Cleveland Clinic Health
Sciences Center of the Ohio State University; Staff,
Cleveland Clinic Foundation, Cleveland, Ohio
Mechanical Approaches to Percutaneous Coronary
Intervention
Joseph Loscalzo, MD, PhD
Wade Professor and Chairman, Department of Medicine,
Boston University School of Medicine; Director, Whitaker
Cardiovascular Institute, and Physician-in-Chief, Boston
University Medical Center, Boston, Massachusetts
Fibrinolytlc and Antithrombotic Therapy of Peripheral
Vascular, Cerebrovascular, and Intracardiac Disorders
Donna Mancini, MD
Associate Professor of Medicine, Columbia University
College of Physicians and Surgeons, Columbia Presbyterian
Medical Center, New York, New York
Cardiac Transplantation and Circulatory Support Devices
J. Michael Mangrum, MD
Assistant Professor of Medicine, University of Virginia
School of Medicine, Charlottesville, Virginia
Acute and Chronic Pharmacologic Management of
Supraventricular Tachyarrhythmias
Roxana Mehran, MD
Director, Clinical Research and Data Coordinating Center,
Cardiovascular Research Foundation, Lenox Hill Heart and
Vascular Institute, New York, New York
Intracardiac Devices and Catheters
Stephen Monroe, MD
Assistant Professor of Medicine, Division of Cardiovascular
Medicine, University of Florida College of Medicine,
Gainesville, Florida
Management of Unstable Angina
Mary P Mullen, MD, PhD
Instructor in Pediatrics, Harvard Medical School; Assistant
in Cardiology, Department of Cardiology, Children's
Hospital, Boston, Massachusetts
Care for Adults with Congenital Heart Disease
Jonathan N. Myers, PhD
Clinical Assistant Professor of Medicine, Stanford
University School of Medicine, Stanford; Palo Alto
Veterans Administration Health Care System, Palo Alto,
California
Rehabilitation of the Patient with Cardiovascular Disease
Stanley Nattel, MD
Professor of Medicine, University of Montreal; Director of
Research Center and Staff Cardiologist, Montreal Heart
Institute, Montreal, Quebec
Cardiovascular Drugs
David E. Newby, PhD, DM, MRCP
Senior Lecturer in Cardiology, University of Edinburgh,
Department of Cardiology, Royal Infirmary, Edinburgh,
Scotland, United Kingdom
Chronic Stable Angina
Suzanne Oparil, MD
Professor of Medicine and Physiology and Biophysics,
University of Alabama at Birmingham, School of Medicine;
Director, Vascular Biology and Hypertension Program,
Division of Cardiovascular Disease, Department of
Medicine, University of Alabama at Birmingham,
Birmingham, Alabama
Treatment of Hypertension in the Patient with
Cardiovascular Disease
Lionel H. Opie, MD, PhD
Professor, Department of Medicine, and Director, Cape
Heart Center, University of Capetown Medical School;
Senior Consultant, Groote Schuur Hospital, Capetown,
South Africa
Pharmacologic Options for Treatment of Ischemic Disease
Mehmet Oz, MD
Associate Professor of Surgery, Columbia University
College of Physicians and Surgeons; Director,
Cardiovascular Institute, New York Presbyterian Hospital,
New York, New York
Cardiac Transplantation and Circulatory Support Devices
Carl J. Pepine, MD
Professor of Medicine, Division of Cardiovascular
Medicine, University of Florida College of Medicine,
Gainesville, Florida
Management of Unstable Angina
Matthew Pollman, MD
Assistant Professor of Medicine, Morehouse School of
Medicine; Director, Functional Genomics Research,
Cardiovascular Research Institute, Atlanta, Georgia
Gene Therapy for Cardiovascular Disease
Jeffrey J. Popma, MD
Associate Professor of Medicine, Harvard Medical School;
Director, Interventional Cardiology, Cardiac Catheterization
Laboratory, Brigham and Women's Hospital, Boston,
Massachusetts
Intracardiac Devices and Catheters
J. David Port, PhD
Associate Professor of Medicine/Cardiology and
Pharmacology, University of Colorado Health Sciences
Center, Denver, Colorado
Principles of Pharmacologic Management of Chronic Heart
Failure
Sharon C. Reimold, MD
Assistant Professor of Medicine, University of Texas
Southwestern Medical School, Dallas, Texas
Pharmacologic Options for Treating Cardiovascular Disease
During Pregnancy
Ira W. Reiser, MD
Assistant Professor of Medicine, State University of New
York Health Science Center at Brooklyn; Attending
Physician, Division of Nephrology and Hypertension, The
Brookdale University Hospital and Medical Center,
Brooklyn, New York
Secondary Hypertension: Renovascular Causes
Allison W. Richardson, MD
Cardiology Fellow, Beth Israel Deaconess Medical Center,
Boston, Massachusetts
Evaluation of the Patient with Disturbances of the Cardiac
Rhythm
Paul M. Ridker, MD, MPH
Associate Professor of Medicine, Harvard Medical School;
Director, Center for Cardiovascular Disease Prevention,
Brigham and Women's Hospital, Boston, Massachusetts
Primary Prevention of Ischemic Heart Disease
Campbell D. K. Rogers, MD
Associate Professor of Medicine, Harvard Medical School;
Director, Cardiac Catheterization Laboratory, Brigham and
Women's Hospital, Boston, Massachusetts
High-Risk Patient Subsets for Percutaneous Coronary
Interventions: Mechanisms and Management
Frank M. Sacks, MD
Professor of Cardiovascular Disease Prevention, Harvard
School of Public Health, Harvard Medical School; Brigham
and Women's Hospital, Boston, Massachusetts
Lifestyle Modification in the Treatment of Hypertension
Richard Jay Shemin, MD
Professor and Chairman of Cardiothoracic Surgery, Boston
University School of Medicine; Chief, Cardiothoracic
Surgery, Boston Medical Center, Boston, Massachusetts
Coronary Artery Bypass Craft Surgery: A Surgical
Perspective
Thomas M. Shimshak, MD, FACC
Professor of Clinical Medicine, Ohio State University,
Columbus; Director, Interventional Fellowships and
Educational Programs, The Lindner Center for Research ani
Education, Cincinnati, Ohio
Adjunctive Pharmacology During Percutaneous Coronary
Intervention
Domenic A. Sica, MD
Professor of Medicine and Pharmacology, Virginia
Commonwealth University; Chief, Division of Clinical
Pharmacology and Hypertension, Medical College of
Virginia Hospitals, Richmond, Virginia
Pharmacologic Treatment of Hypertension
Daniel I. Simon, MD
Associate Professor of Medicine, Harvard Medical School;
Associate Director, Interventional Cardiology, Brigham and
Women's Hospital, Boston, Massachusetts
High-Risk Patient Subsets for Percutaneous Coronary
Interventions: Mechanisms and Management
P. J. Skerrett, MA
Senior Medical Editor, Brigham and Women's Hospital,
Boston, Massachusetts
Primary Prevention of Ischemic Heart Disease
Allen J. Solomon, MD
Director, Cardiac Arrhythmia Service and Cardiovascular
Fellowship Program, Georgetown University Hospital,
Washington, D.C.
Ischemic Heart Disease: Surgical Options -A Cardiology
Perspective
Samuel Spitalewitz, MD
Associate Professor of Clinical Medicine, State University
of New York Health Science Center at Brooklyn; Attending
Physician, Division of Nephrology and Hypertension and
Physician-in-Charge of the Renal and Hypertension Clinics,
The Brookdale University Hospital and Medical Center,
Brooklyn, New York
Secondary Hypertension: Renovascular Causes
Lynne Warner Stevenson, MD
Associate Professor of Medicine, Harvard Medical School;
Director, Cardiomyopathy and Heart Failure Program,
Brigham and Women's Hospital, Boston, Massachusetts
Hospital Management of Heart Failure
Gregg W. Stone, MD
Director of Cardiovascular Research and Education,
Cardiovascular Research Foundation, Lenox Hill Heart and
Vascular Institute, New York, New York
Interventional Revascularization Procedures in Acute
Myocardial Infarction
Michael O. Sweeney, MD
Assistant Professor, Harvard Medical School; Cardiac
Arrhythmia Service, Brigham and Women's Hospital,
Boston, Massachusetts
Implantable Devices for the Electrical Management of Heart
Disease: Overview of Indications for Therapy and Selected
Advances; Intracardlac Devices and Catheters
Steven G. Terra, PharmD
Cardiovascular Pharmacotherapy Fellow, University of
Florida, College of Pharmacy, Gainesville, Florida
Cardiovascular Drugs
Donald G. Vidt, MD, MSc
Professor of Medicine, Ohio State University, Columbus;
Consultant, Department of Hypertension and Nephrology,
The Cleveland Clinic Foundation, Cleveland, Ohio
Refractory Hypertension
Johan E. P Waktare, MB, MRCP
Honorary Research Fellow, Cardiological Sciences, St.
George's Hospital Medical School; Specialist Registrar in
Cardiology, St. George's Hospital, London, United Kingdom
Atrial Fibrillation: A Comprehensive Approach
Jeffrey I. Weitz, MD
Professor of Medicine, McMaster University; Director,
Experimental Thrombosis and Atherosclerosis Group, .
Hamilton Civic Hospitals Research Center, Hamilton,
Ontario, Canada
Pharmacologic Options for Treatment of Ischemic Disease
David O. Williams, MD
Professor of Medicine, Brown University School of
Medicine; Director, Cardiac Catheterization Laboratory and
Interventional Cardiology, Rhode Island Hospital,
Providence, Rhode Island
Percutaneous Coronary intervention: Indications and Patient
Selection
Mathew Williams, MD
Cardiothoracic Surgery Research Fellow, College of
Physicians and Surgeons of Columbia University, New
York, New York
Cardiac Transplantation and Circulatory Support Devices
Raymond L. Woosley, MD, PhD
Professor of Medicine and Associate Dean for Clinical
Research, Georgetown University Medical Center,
Washington, D.C.
Clinical Pharmacology of Antiarrhythmic Drugs
Neil Worrall, MD
Staff Surgeon, The Heart Institute of Spokane, Spokane,
Washington
Surgical Therapy for Valvular Heart Disease
William F. Young, Jr., MD
Professor of Medicine, Mayo Medical School; Consultant,
Divisions of Endocrinology, Hypertension, and Internal
Medicine, Mayo Clinic, Rochester, Minnesota
Secondary Hypertension: Endocrine Causes
Peter J. Zimetbaum, MD
Assistant Professor of Medicine, Harvard Medical School;
Director of Atrial Fibrillation Clinic, Beth Israel Deaconess
Medical Center, Boston, Massachusetts
Evaluation of the Patient with Disturbances of the Cardiac
Rhythm
CONTENTS
Color Plates follow page xxiv.
SECTION I: DECISION-MAKING TOOLS
Edited by Elliott M. Antman, MD
1. TOOLS FOR ASSESSMENT OF CARDIOVASCULAR
TESTS AND THERAPIES 1
Elliott M. Antman, MD, Robert M. Califf, MD, and
Joel Kupersmith, MD
Interpretation of Diagnostic Tests 1
Clinical Trials 2
How To Read and Interpret a Clinical Trial 11
Meta-Analysis 13
Cost- Effectiveness Analysls 19
2. BEDSIDE ASSAYS IN CARDIOVASCULAR
THERAPEUTICS 35
Richard C. Becker, MD, Scott D. Berkowitz, MD,
Britta U. Goldmann, MD, and Christian Hamm, MD
Important Features of Bedside Assays 35
Assessing Platelet Function 35
Impedance Platelet Aggregometry 36
Flow Cytometry 36
Coagulation Assays 37
Coagulation Assays in Development for
Point-of-Care Testing 42
Combined Coagulation and Platelet Function
Assays 42
Clinical Implementation of Bedside Assays 43
Markers of Myocardial Injury 43
Point-of-Care Testing in Acute Coronary
Syndromes 45
Conclusions 48
SECTION II: ISCHEMIC DISEASE
Edited by Elliott M. Antman, MD
3. PRIMARY PREVENTION OF ISCHEMIC HEART
DISEASE 53
Paul M. Ridker, MD, MPH, P. J. Skerrett, MA, and
J. Michael Gaziano, MD, MPH
Epidemiology of Primary Prevention 53
Assessment of Risk 56
Evolving Concepts In Atherogenesis: Relevance
for Primary Prevention 61
Therapeutic Approaches 62
Novel Risk Factors 77
The Public Health Impact of Coronary Heart
Disease Prevention 83
Screening for Coronary Heart Disease Risk
Factors 83
Clinical Profiles In Primary Prevention 87
4. PHARMACOLOGIC OPTIONS FOR TREATMENT OF
ISCHEMIC DISEASE 97
Jonathan Abrams, MD, William H. Frishman, MD,
Shannon M. Bates, MD CM, Jeffrey I. Weitz, MD,
and Lionel H. Opie, MD, PhD
Nitrates 97
Calcium Channel Blockers 102
p-Adrenergic Blockers 112
Role of Thrombosis in Ischemlc Heart Disease 122
Future Prospects 141
5. ISCHEMIC HEART DISEASE: SURGICAL
OPTIONS-A CARDIOLOGY PERSPECTIVE 155
Allen J. Solomon, MD, and
Bernard J. Gersh, MB ChB, DPhil, FRCP
Comparison with Medical Therapy 155
Comparison with Percutaneous Transluminal
Coronary Angioplasty 157
Indications for Coronary Artery Bypass Graft
Surgery 159
Special Considerations 164
Preoperative Evaluation 170
Postoperative Management 171
Alternative Surgical Strategies 173
6. CHRONIC STABLE ANGINA 179
David E. Newby, PhD, DM, MRCP, and
Keith A. A. Fox, MB ChB, FRCP, FESC
Chronic Stable Angina Not Attributable to
obstructive Atheroma 179
Epidemiology 179
Natural History 179
Assessment and Investigation 182
Therapeutic Interventions 186
Potential Future Therapies 198
7. MANAGEMENT OF UNSTABLE ANGINA 205
Stephen Monroe, MD, and Carl J. Pepine, MD
Pathogenesis 205
Clinical Presentation and Assessment 207
Diagnostic Tools 208
Prevention of Ischemia, Myocardial Infarction,
and Death 212
Ongoing Risk Stratification and Noninvasive
Testing 223
Coronary Anglography and Intervention 225
Conclusion 228
8. ACUTE MYOCARDIAL INFARCTION 233
Judith S. Hochman, MD, and Robert M. Califf, MD
Pathophysiology 233
Clinical Epidemiology 233
Prehospital Phase 234
Emergency Department Phase 235
Chest Pain Unit 262
Cardiac Care Unit Phase 263
Recurrent Symptoms 274
Risk Stratification 277
Secondary Prevention 280
SECTION III: HEART FAILURE
Edited by Wilson S. Colucci, MD
9. PATHOPHYSIOLOGIC AND CLINICAL
CONSIDERATIONS IN THE TREATMENT OF HEART
FAILURE: AN OVERVIEW 293
Wilson S. Colucci, MD
Goals of Therapy 293
Pathophysiolo9Y 294
Clinical Manifestations 296
10. PRINCIPLES OF PHARMACOLOGIC
MANAGEMENT OF CHRONIC HEART FAILURE 300
Michael R. Bristow, MD, PhD, J. David Port, PhD,
and Ralph A. Kelly, MD
Diuretics 300
Vasodilators 305
Positive Inotropic Agents 308
Signaling Molecule Inhibitors 311
11. AMBULATORY MANAGEMENT OF HEART
FAILURE 325
Michael M. Givertz, MD, and Jay N. Cohn, MD
Background Pathophysiology 325
Dietary Sodium Restriction 326
Diuretics 327
Angiotensin-Converting Enzyme Inhibitors and
Vasodilators 330
-Blockers 337
Digoxin 341
Options for Patients with Persistent Signs and
Symptoms 343
Positive Inotropic Agents 343
Adjunctive Therapy 344
Future Directions 346
Special Considerations 347
12. HOSPITAL MANAGEMENT OF HEART FAILURE
356
Michael M. Givertz, MD,
Lynne Warner Stevenson, MD,
and Wilson S. Colucci, MD
Pathophysiology 356
General management 358
Invasive Hemodynamic Monitoring: General
Principles and Initial Therapy 360
Other Management Issues 368
Special Considerations 369
Future Directions 370
13. CARDIAC TRANSPLANTATION AND
CIRCULATORY SUPPORT DEVICES 374
Donna Mancini, MD, Mehmet Oz, MD, and
Mathew Williams, MD
Cardiac Transplantation 374
Posttransplantation Management 376
Quality of Life after Transplantation 382
Circulatory Assist Devices 383
Other Surgical Modalities 387
Conclusion 387
SECTION IV: ARRHYTHMIAS/CONDUCTION
DISTURBANCES
Edited by Mark E. Josephson, MD
14. EVALUATION OF THE PATIENT WITH
DISTURBANCES OF THE CARDIAC RHYTHM 391
Allison W. Richardson, MD, Peter J. Zimetbaum, MD,
and Mark E. Josephson, MD
Ambulatory Monitoring 391
Exercise Testing 393
Tilt Table Testing 393
Techniques for Risk Stratification 393
Evaluation of the Symptomatic Patient 395
Noninvasive Risk Stratification and Surveillance
for Asymptomatic Arrhythmias 398
Patients with Primary Electrophysiologic
Abnormalities 400
Ambulatory Monitoring to Assess Safety and
Efficacy of Antiarrhythmic Medications 401
The Electrophysiology Study 401
Future Strategies 402
15. CLINICAL PHARMACOLOGY OF
ANTIARRHYTHMIC DRUGS 407
Raymond L. Woosley, MD, PhD
Quinidine 407
Procainamide 410
Disopyramide 411
Lidocaine 411
Mexiletine 413
Propafenone 413
Flecainide 414
Bretylium 415
Sotalol 415
Amiodarone 416
Ibutilide 416
Dofetilide 417
Adenosine 417
16. ACUTE AND CHRONIC PHARMACOLOGIC
MANAGEMENT OF SUPRAVENTRICULAR
TACHYARRHYTHMIAS 423
J. Michael Mangrum, MD, and
John P. DiMarco, MD, PhD
Pharmacology of Supraventricular Arrhythmlas 423
Evaluation of Therapy 423
Atria[ Fibrillation 425
Atrial Flutter 434
Paroxysmal Supraventricular Tachycardia 434
Atrial Tachycardias 438
17. NONPHARMACOLOCIC TREATMENT OF
TACHYARRHYTHMIAS 445
David J. Callans, MD
Catheter Ablation for the Treatment of
Tachyarrhythmias 445
Practical Considerations 445
Review of the Success of Catheter Ablation by
Specific Arrhythmia Syndrome 446
Summary 454
18. ATRIAL FIBRILLATION: A COMPREHENSIVE
APPROACH 458
Johan E. P. Waktare, MB, MRCP,
and A. John Camm, MD, FRCP
Nomenclature-A Rational Framework for
Management 458
Antiarrhythmic Drugs 461
Nonpharmacologic Strategies for Treatment
of AF 468
Thromboembolic Prophylaxis 470
Conclusion 471
19. MALIGNANT VENTRICULAR ARRHYTHMIAS 477
Reginald T. Ho, MD, and David J. Callans, MD
Treatment Options 478
Short-term Therapy 479
Long-term Therapy 479
Monomorphic Ventricular Tachycardia 484
Polymorphic Ventricular Tachycardla 496
Role of Electrophyslologic Testing 498
Future Directions 499
20. IMPLANTABLE DEVICES FOR THE ELECTRICAL
MANAGEMENT OF HEART DISEASE: OVERVIEW OF
INDICATIONS FOR THERAPY AND SELECTED
ADVANCES 503
Michael O. Sweeney, MD, and
Kenneth A. Ellenbogen, MD
Advances in Pacemaker Therapy 503
Advances in Implantable Card ioverter-Defibrillator
Therapy 520
Indications for Implantable Cardioverter
Defibrfllator Therapy 523
Summary 526
SECTION V: DYSLIPOPROTEINEMIAS/
ATHEROSCLEROSIS
Edited by Antonio M. Gotto, Jr., MD, DPhil
21. DYSLIPOPROTEINEMIAS/ATHEROSCLEROSIS:
OVERVIEW OF PATHOLOGY AND MANAGEMENT
STRATEGIES 529
Antonio M. Gotto, Jr., MD, DPhil, and
John A. Farmer, MD
Theories of Pathogenesis 529
Morphologic Stages of Atherosclerosis 532
Plaque Vulnerability 535
Overview of Management 535
Summary 541
22. DYSLIPOPROTEINEMIAS/ATHEROSCLEROSIS:
DIETARY THERAPY 543
Margo A. Denke, MD
Definition of a Therapeutic Diet 543
Diet and Lipoprotein metabolism 544
Quantitative Relationships Between Nutrient
Intake and Lipid/Lipoprotein Levels 550
Efficacy of a Cholesterol-Lowering Diet 556
A Stepwise Approach to the Dietary Management
of Patients with Specific Lipid and
Lipoprotein Patterns 560
23. DYSLIPOPROTEINEMIAS/ATHEROSCLEROSIS:
PHARMACOLOGIC THERAPY 567
Antonio M. Gotto, Jr., MD, DPhil, and
John A. Farmer, MD
Indications for Drug Therapy 567
Drug Therapy 569
Drug Interactions 584
Summary 585
24. THE STEPS BEYOND DIET AND DRUG THERAPY
FOR SEVERE HYPERCHOLESTEROLEMIA 589
Bruce R. Gordon, MD, and Lisa Cooper Hudgins, MD
Definition of the Target Population 589
Description of the Patient Population 589
Extracorporeal Therapies for the Treatment of
Severe Hypercholesterolemia 590
Surgical Procedures 594
Conclusions and Recommendations for Therapy 598
SECTION VI: THROMBOSIS/THROMBOLYSIS
Edited by Joseph Loscalzo, MD, PhD
25. ANTIPLATELET THERAPY 601
Robert P. Giugliano, MD, SM, and
Christopher P. Cannon, MD
Arachidonic Acid Inhibitors 602
Non-Cyclooxygenase Inhibition of
Arachidonic Acid 609
Phosphodiesterase Inhibitors 611
ThienopYridines 616
Thromboxane Inhibitors 619
Serotonin Antagonists 620
Inhibitors of Platelet Adhesion 621
Platelet Glycoprotein lib/üia Receptor Blockers 622
Unclassified Antiplatelet Agents 635
Drugs with Secondary Antiplatelet Activity 636
Summary 636
26. TREATMENT OF VENOUS THROMBOEMBOLISM
655
Jack Hirsh, MD, and Shannon M. Bates, MD CM
Initial Treatment of Venous Thromboembolism 655
Long-Term Treatment of Venous
Thromboembolism 661
Duration of Anticoagulant Therapy 663
Special Circumstances 664
Conclusions 664
27. ANTICOAGULANT AND FIBRINOLYTIC
THERAPY FOR ACUTE CORONARY SYNDROMES
669
Christopher P. Cannon, MD, and
Valentin Fuster, MD, PhD
Antithrombotic Drugs 669
Fibrinolytic Drugs 678
Conclusion 688
28. FIBRINOLYTIC AND ANTITHROMBOTIC
THERAPY OF PERIPHERAL VASCULAR,
CEREBROVASCULAR, AND INTRACARDIAC
DISORDERS 695
Jane E. Freedman, MD, and
Joseph Loscalzo, MD, PhD
Thrombolytic and Antithrombotic Treatment of
Arterial Thrombotic Disease 695
Thrombolytic and Antithrombotic Treatment of
Venous Thrombotlc Disease 699
Thrombolytic and AntlthromboticTreatment of
Valvular and Intraventricular Thrombotic
Disease 700
SECTION VII: HYPERTENSION
Edited by Suzanne Oparil, MD
29. ANTIHYPERTENSIVE THERAPY 705
Lawrence R. Krakoff, MD
Overall or Absolute Risk as the Basis for
Treatment 706
Hypertension-Changing Definitions 709
Goals for Treatment of Hypertension: Surrogates
and Outcomes 710
Preventing Hypertension 710
Work-Up or Evaluation Before and During
Treatment 711
Summary 713
30. LIFESTYLE MODIFICATION IN THE TREATMENT
OF HYPERTENSION 715
Frank M. Sacks, MD, and Lawrence J. Appel, MD
Weight Loss 715
The Dash Diet 716
Sodium Reduction 718
Limited Alcohol intake 719
Combinations of Lifestyle Interventions 720
31. PHARMACOLOGIC TREATMENT OF
HYPERTENSION 722
Domenic A. Sica, MD, and Todd W. B. Gehr, MD
General Guidelines 722
Blood Pressure Goals and the J-Curve 724
Special Considerations in Therapy 734
Step-Down Therapy 735
Choice of Drugs: First, Second, and Beyond 737
32. SECONDARY HYPERTENSION: ENDOCRINE
CAUSES 741
William F. Young, Jr., MD
Pheochromocytoma 741
Primary Aldosteronism 745
Other Forms of Mineralocorticoid Excess 748
Cushing's Syndrome 749
Thyroid and Parathyroid Disease 751
Acromegaly 752
33. SECONDARY HYPERTENSION: RENOVASCULAR
CAUSES 754
Ira W. Reiser, MD, and Samuel Spitalewitz, MD
Incidence And Etiology 754
Screening Tests 754
Angiography 756
Physiologic Significance 756
Management of Renovascular Hypertension 756
Preservation of Renal Function 763
34. TREATMENT OF HYPERTENSION IN THE
PATIENT WITH CARDIOVASCULAR DISEASE 768
George S. Chrysant, MD, and Suzanne Oparil, MD
Systolic Blood Pressure, Pulse Pressure, and
Cardiovascular Disease Risk 771
Treatment of Isolated Systolic Hypertension 772
Diastolic Blood Pressure and Cardiovascular
Disease Risk 774
Treatment of Diastolic Hypertension 774
Left Ventricular Hypertrophy 778
Chronobiology and Coronary Heart Disease 779
Coronary Heart Disease: Angina and Silent
Ischemia 780
Coronary Heart Disease: Acute Myocardial
infarction 780
Heart Failure 784
Hypertension and Cerebrovascular Disease 789
Hypertension and Peripheral Vascular Disease 791
35. TREATMENT OF HYPERTENSION IN PATIENTS
WITH RENAL DISEASE 797
Munavvar Izhar, MD, and George L. Bakris, MD
Nondiabetic Renal Parenchymal Disease 798
Diabetes and Chronic Renal Disease 799
Therapeutic Approaches to Hypertension 800
Treatment Recommendations and Caveats 806
36. REFRACTORY HYPERTENSION 810
Donald G. Vidt, MD, MSc
Consider Pseudoresistance 810
Look for Signs of Nonadherence to Therapy 810
Is the Treatment Regimen Adequate and
Appropriate? 811
Is There a Potential for Drug-Drug Interactions? 812
Identify the Impact of Associated Conditions 812
Do Not Overlook Plasma Volume Expansion 813
Secondary Hypertension 813
A Time for Revisions in Therapy 814
Hemodynamic and Neurohumoral Evaluation 814
Individualized and Targeted Therapy 815
37. HYPERTENSIVE EMERGENCIES 817
Arnold B. Alper, MD, and David A. Calhoun, MD
Definitions 817
Incidence, Prevalence, and Natural History 817
PathophyslologY 819
Evaluation and Treatment of Hypertensive
Emergencies 819
Specific Hypertensive Emergencies 824
38. HYPERTENSION IN PREGNANCY AND IN
CHILDREN 832
Phyllis August, MD, and Bonita Falkner, MD
Hypertension in Pregnancy 832
Hypertension in Children 842
Summary 851
SECTION VIII: INTERVENTIONAL CARDIOLOGY/
CARDIAC SURGERY
Edited by Jeffrey J. Popma, MD
39. PERCUTANEOUS CORONARY INTERVENTION:
INDICATIONS AND PATIENT SELECTION 855
Charles R. Carman, MB ChB, Alice K. Jacobs, MD, and
David O. Williams, MD
Indications 855
Assessment of Patients for Coronary Intervention859
40. MECHANICAL APPROACHES TO
PERCUTANEOUS CORONARY INTERVENTION 865
A. Michael Lincoff, MD, and Stephen G. Ellis, MD
Coronary Balloon Angioplasty 865
Stents 868
Atherectomy and Other Ablative Devices 872
Endovascular Radiation 877
Intravascular Imaging Techniques 878
Summary 879
41. ADJUNCTIVE PHARMACOLOGY DURING
PERCUTANEOUS CORONARY INTERVENTION 885
Dean J. Kereiakes, MD, FACC,
and Thomas M. Shimshak, MD, FACC
Basic Considerations 885
Conventional Therapy with Aspirin and
Unfractionated Heparin 885
Low-Molecular-Weight Heparin 888
Adjunctive Antithrombin Therapy 890
Adjunctive Antiplatelet Therapy 890
Platelet Glycoprotein Ilb/iiia Blockade 891
Unplanned or Provisional Coronary Stenting 892
Complex Coronary Stenting 893
Elective Stent Deployment 894
Directional Coronary Atherectomy 895
Rotational Atherectomy 895
Future Directions 896
42. HIGH-RISK PATIENT SUBSETS FOR
PERCUTANEOUS CORONARY INTERVENTIONS:
MECHANISMS AND MANAGEMENT 903
Satyendra Giri, MD, MPH,
Campbell D. K. Rogers, MD,
and Daniel I. Simon, MD
Patients with Diabetes Mellitus 903
Advanced Renal Failure and Dialysis 907
Elderly Patients 910
43. INTERVENTIONAL REVASCULARIZATION
PROCEDURES IN ACUTE MYOCARDIAL
INFARCTION 919
George Dangas, MD, PhD,
Vincent S. DeGeare, MD, FACC, FRCP,
Cindy L. Grines, MD, and Gregg W. Stone, MD
Limitations of Fibrlnolytic Therapy 919
Primary Angioplasty 920
Randomized Trials of Primary PTCH and
Fibrinolytic Therapy 920
Insights from Prospective Randomized
Acute Myocardial Infarction Trials 922
Adjunctive Pharmacotherapy and Advanced
Interventional Techniques 925
Primary Stenting Versus Primary Angioplasty
Randomized Trials 928
Cost-Effectiveness of Primary Mechanical
Reperfusion Compared with Thrombolytic
Therapy 931
Mechanical Revascularization after Fibrinolytic
Therapy 931
44. INTERVENTIONAL PROCEDURES IN THE
PERIPHERAL CIRCULATION 937
John A. Bittl, MD
Cerebrovascular Disease 937
Subclavian and Brachiocephalic Stenting 942
Renal Artery Stenting 943
Iliofemoral Obstructive Disease 947
Stent Grafts for Aortic Aneurysms 949
Dialysis Graft Interventions 951
Conclusions 952
45. CORONARY ARTERY BYPASS GRAFT SURGERY
A SURGICAL PERSPECTIVE 955
Richard Jay Shemin, MD
Coronary Artery Bypass Graft Surgery Versus
Medical Therapy 955
Coronary Artery Bypass Graft Surgery Versus
Percutaneous Coronary Intervention 961
Advances in Coronary Artery Bypass Graft Surgery
968
Transmyocardial Laser Revascularization 971
Future of Coronary Artery Bypass Craft Surgery 971
46. THE TIMING OF VALVE SURGERY 975
Blase A. Carabello, MD
Aortic Stenosis 975
Mltral Stenosis 981
Mitral Regurgitation 983
Aortic Regurgitation 987
Tricuspid Regurgitation 989
Tricuspid Stenosis 991
Pulmonic Stenosis in Adults 991
Prosthetic Valves 991
Conclusion 991
47. SURGICAL THERAPY FOR VALVULAR HEART
DISEASE 995
Lawrence H. Cohn, MD, Neil Worrall, MD,
Michael K. Banbury, MD, and
Delos M. Cosgrove III, MD
Mitral Valve Disease 995
Tricuspid Valve Disease 1000
Aortic valve 1001
48. COST-EFFECTIVENESS OF PERCUTANEOUS
CORONARY INTERVENTION 1007
David J. Cohen, MD, MSc
Medical Care Cost Concepts 1007
Medical Economic Studies 1008
Cost-Effectiveness Analysis 1008
Economic Evaluations of Coronary
Revascularization 1009
Conclusions 1020
SECTION IX: MISCELLANEOUS CONDITIONS
Edited by Elliott M. Antman, MD
49. GENE THERAPY FOR CARDIOVASCULAR
DISEASE 1023
Gary Gibbons, MD, and Matthew Pollman, MD
Genomic Technologies: Implications for
Cardiovascular Gene Therapy 1023
Gene Therapy of Cardiovascular Disease:
Therapeutic Strategies 1024
Challenges in Gene Therapy: Targeted Tissue
Delivery 1025
Gene Therapy: Tools of the Trade 1026
Cardiac Gene Therapy 1030
Vascular Gene Therapy 1032
Future Directions and Opportunities 1036
50. PHARMACOLOGIC OPTIONS FOR TREATING
CARDIOVASCULAR DISEASE DURING PREGNANCY
1039
Sharon C. Reimold, MD
Hypertension 1039
Valvular Heart Disease 1041
Deep Venous Thrombosis and Pulmonary
Embolism 1042
Prosthetic Heart Valves 1043
Edema 1043
Acute Coronary Syndromes 1043
Heart Failure 1044
Lipid Disorders 1044
Cardiac Arrhythmias 1044
Man`an's Syndrome 1046
Pulmonary Hypertension 1046
Antibiotic Prophylaxis 1046
51. CARE FOR ADULTS WITH CONGENITAL HEART
DISEASE 1048
Mary P. Mullen, MD, PhD, and
Michael J. Landzberg, MD
Issues for the Care Provider 1048
52. TREATMENT OF PRIMARY PULMONARY
HYPERTENSION 1075
Jacques I. Benisty, MD,
and Michael J. Landzberg, MD
Pathobiology of Primary Pulmonary
Hypertension 1075
Diagnosis 1075
Medical Therapy of Primary Pulmonary
Hypertension 1076
Atrial Septostomy for Primary Pulmonary
Hypertension 1080
Transplantation for Primary Pulmonary
Hypertension 1080
Summary 1080
53. PREVENTION AND TREATMENT OF INFECTIVE
ENDOCARDITIS 1082
Adolf W. Karchmer, MD
Infective Endocarditis Syndromes 1082
Diagnosis of Infective Endocarditis 1083
Antimicrobial Therapy for Specific Agents 1085
Timing the Initiation of Antimicrobial Therapy 1090
Monitoring Therapy for Endocarditis 1091
Outpatient Antimicrobial Therapy 1091
Surgical Treatment of Intracardiac Complications
1092
Treatment of Extracardiac Complications 1095
Anticoagulant Therapy 1095
Prevention of Endocarditis 1097
54. REHABILITATION OF THE PATIENT WITH
CARDIOVASCULAR DISEASE 1100
Jonathan N. Myers, PhD, and
Victor F. Froelicher, MD
Physiologic Responses to Exercise 1100
Physical Training 1102
Cardiovascular Effects of Immobility 1103
Cardiac Rehabilitation after a Myocardial
Infarction 1104
Medical Evaluation for Exercise 1106
Closing Comment 1111
55. TREATMENT OF PERICARDIAL DISEASE 1113
Brian D. Hoit, MD
Acute Pericarditis 1113
Recurrent Pericarditis 1114
Pericardial Effusion 1114
Constrictive Pericarditis 1117
Treatment of Specific Causes of Pericarditis 1118
APPENDICES
APPENDIX 1. CARDIOVASCULAR DRUGS 1123
Stanley Nattel, MD, and
Steven G. Terra, PharmD
APPENDIX 2. INTRACARDIAC DEVICES AND
CATHETERS 1165
Elazer R. Edelman, MD, PhD,
George Dangas, MD, PhD, Martin B. Leon, MD,
Roxana Mehran, MD, Jeffrey J. Popma, MD, and
Michael O. Sweeney, MD
APPENDIX 3. CIRCULATORY SUPPORT DEVICES1180
James C. Fang, MD, and
Gregory S. Couper, MD
