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Book
Coronary syndrome : clinical treatment, prevention and management for better outcomes
Authors: ---
Year: 2023 Publisher: [Place of publication not identified] : Multidisciplinary Digital Publishing Institute,

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Abstract

This book focuses on recent advances in the clinical care of patients with acute and chronic coronary syndromes. We must accumulate novel scientific and clinical knowledge in this field to develop seamless treatments and preventive strategies for this patient population. Furthermore, accumulated data have implicated that there are some residual risk factors for coronary syndromes, and the clinical management of cardiovascular/non-cardiovascular complications associated with coronary syndromes is also a critical concern. We hope that this book will facilitate the management of future patients with coronary syndromes; however, further research is still required. It is also our hope that this book will promote future research to enable a better understanding of the clinical practice of coronary syndromes.


Book
Remodeling of cardiac passive electrical properties and susceptibility to ventricular and atrial arrhythmias
Author:
Year: 2015 Publisher: Frontiers Media SA

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Abstract

The effective management of cardiac arrhythmias, either of atrial or of ventricular origin, remains a major challenge. Sudden cardiac death due to ventricular tachyarrhythmias remains the leading cause of death in industrialized countries while atrial fibrillation is the most common rhythm disorder; an arrhythmia that’s prevalence is increasing and accounts for nearly one quarter of ischemic stokes the elderly population. Yet, despite the enormity of the problem, effective therapeutic interventions remain elusive. In fact, several initially promising antiarrhythmic agents were found to increase rather than decrease mortality in patients recovering from myocardial infarction. The question then is what went wrong, why have these interventions proven to be so ineffective? An obvious answer is the drugs were designed to attack the wrong therapeutic target. Clearly, targeting single ion channels (using either isolated ion channels or single myocytes preparations) has proven to be less than effective. What then is the appropriate target? It is well established that cardiac electrical properties can vary substantially between single cells and intact preparations. One obvious example is the observation that action potential duration is much longer in isolated cells as compared to multi-cellular preparations or intact hearts. Due to the low electrical resistance between adjacent myocytes, the cells act in coordinated fashion producing “electrotonic interdependence” between neighboring cells. Myocardial infarction and/or acute ischemia provoke profound changes in the passive electrical properties of cardiac muscle. In particular, electrotonic uncoupling of the myocytes disrupts the coordinated activation and repolarization of cardiac tissue. The resulting compensatory changes in ionic currents decrease cardiac electrical stability increasing the risk for life-threatening changes in the cardiac rhythm. Thus, the electrical properties of myocardial cells must be considered as a unit rather than in isolation. It is the purpose of this Research Topic to evaluate the largely neglected relationship between changes in passive electrical properties of cardiac muscle and arrhythmia formation.


Book
Sudden arrhythmic death : from basic science to clinical practice
Authors: --- --- ---
ISBN: 9782889192694 Year: 2014 Publisher: Frontiers Media SA

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Abstract

With upwards of 4.5 million deaths worldwide each year, and more than one tenth of these occurring in those with no previously documented heart disease, sudden arrhythmic death (SAD) is both a major public health burden and a highly emotive issue for society at large. Recent years have witnessed a marked expansion in our knowledge of the physiology underlying SAD, both in the context of hereditary and acquired cardiac disorders. Thanks largely to work in genetically modified animals, the growth in our understanding of mechanisms underlying arrhythmia in the hereditary channelopathies has been particularly marked. Our growing knowledge of the fundamental mechanisms underlying SAD has so far failed to spur substantial developments in clinical practice. Despite a large body of work in both humans and animals, it remains impossible to confidently identify those at high risk of SAD, making pre-emptive therapy a challenge. What is more, with the thankful exception of the implantable cardioverter-defibrillators and pharmacological agents in very specific situations, there has been depressingly little progress in finding new and effective therapies. This Research Topic aims to go some way towards bridging the gap between advances in basic science and the development and delivery of new therapies. It brings together original research contributions and review articles from key opinion leaders in the field, focusing on the direct clinical implications of the basic science research now and in the future.

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