Cardiovascular Therapeutics: A Companion to Braunwald's Heart Disease

Inside cover
Copyright page
Dedication
Contributors
Foreword
Preface
Acknowledgments
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Part I: Decision Making and Therapeutic Strategies in Cardiovascular Medicine
	Chapter 1: Tools for Assessment of Cardiovascular Tests and Therapies
		Interpretation of Diagnostic Tests
		Clinical Trials
			Need for Clinical Trials
			Clinical Trial Design
				Randomized Controlled Trials
				Nonrandomized Concurrent Control Studies
				Historic Controls
				Crossover Design
				Withdrawal Studies
				Factorial Design
				Trials that Test Equivalence of Therapies
				Selection of Endpoint
				Sample Size Estimations and Sequential Stopping Boundaries
				False-Positive and False-Negative Error Rates and Power of Clinical Trials
		How to Read and Interpret  a Clinical Trial
			Missing Data
			Measures of Treatment Effect
			Detection of Treatment Effects in Clinical Trials
		Meta-Analysis
			Principles of Pooling Studies
			Cumulative Meta-Analysis
			Meta-Regression
			Future Trends in Meta-Analysis
			How to Read and Interpret a Meta-Analysis
		Comparative Effectiveness Research
			Methods for Comparative  Effectiveness Research
			Balancing Risks and Benefits
		Cost-Effectiveness Analysis
			Types of Economic Evaluation
			Methods for Performing  a Cost-Effectiveness Analysis
				Trial-Based Analyses
				Modeling Approaches
				Hybrid Approaches
			Other Methodologic Considerations
				Sensitivity Analysis
				Perspective
				Discounting
				Time Horizon
			Defining When a Therapy Is Cost Effective
			How to Read an Economic Evaluation
		References
	Chapter 2: New Drug Development
		Overview of the Drug  Development Process
			Phase I to IV Paradigm
			Cycle of New Therapeutic Development
			Regulation of New Drugs: Prototypical Interface with the Food and  Drug Administration
				Before the Investigational  New Drug Application
				Types of Investigational New Drug Application
			Advisory Panels
			Labeling
			Postmarketing Surveillance
			Exemptions from Investigational New Drug Application and Practice of Medicine
				Investigator-Initiated Investigational  New Drug Application
			CDER Versus CBER: Key Differences  for Biologics
		International Drug Development Overview
			Ethics of Drug Development  in Developing Countries
		Anatomy of a Clinical Trial: Operations
			Protocol Development
			Site Management
			Data Management
			Statistics
			Safety Surveillance
			Clinical Events Adjudication
		Economics of New Drug Development
			Prescription Drug User Fee Act
			National Institutes of Health  Roadmap Program
			Patent Considerations
		Summary
		References
	Chapter 3: Device Development for Cardiovascular Therapeutics:
		Overview
		Medical Device Development and Differences from Drugs
			Development and Implementation of Cardiovascular Medical Devices: An Overview
			Differences Between Devices and Drugs and Associated Regulatory Implications
		Regulatory Fundamentals
			History of Device Regulation and the Medical Device Classification System
			Pathways for Regulatory Review of Cardiovascular Devices
				510k Premarket Notification
				Premarket Approval Application
				Investigational Device Exemption
				Humanitarian Device Exemption
		Contemporary Regulatory Issues
			Randomized Versus Nonrandomized Studies  in Medical Device Evaluation
			Endpoints and Surrogate Endpoints  in Cardiovascular Device Trials
			Study Blinding in Cardiovascular Device Trials
			Use of Foreign Data for U.S. Product Approval
			Independent Oversight of Cardiovascular  Device Trials
			Labeling and Off-Label Use of  Cardiovascular Devices
		Risk, Benefit, and the Product Life Cycle
			Total Product Life Cycle Approach
			Device Safety and Failure Concepts
		Ensuring the Safety of Marketed Devices
			Postmarket Safety Assessment Tools
			Cardiologists’ Role in Ensuring Device Safety and Performance
			Product Recall and Center for Devices  and Radiological Health
		Other Key Regulatory Topics
			Combination Products
			Role of the Advisory Panel
			CDRH Interactions with External Stakeholders and Government Partners
		References
	Chapter 4: Pharmacogenetics
		Clopidogrel
			Drug, Indications, Mechanism  of Action, and Pharmacology
			Drug Interactions
			Pharmacogenetics of Clopidogrel Therapy
				CYP2C19
				ABCB1
				PON1
			Therapeutic Implications
				Pharmacogenetic Testing in  Clopidogrel Therapy
				Therapeutic modifications
				Cost Effectiveness of Clopidogrel Pharmacogenetics Testing
			Future Directions
		Warfarin
			Drug, Indications, Mechanism of Action,  and Pharmacology
			Drug Interactions
			Pharmacogenetics of Warfarin Therapy
				VKORC1
				CYP2C9
				CYP4F2
			Therapeutic Implications
				Pharmacogenetic Testing in Warfarin Therapy
				Cost Effectiveness of Warfarin Pharmacogenetics Testing
				Therapeutic Modifications
			Future Directions
		Statins
			Drug, Indications, Mechanism of Action,  and Pharmacology
			Drug Interactions
			Pharmacogenetics of Statin Therapy
				Key Genetic Variants Affecting Statin Efficacy
					APOE
					PCSK9
					HMGCR
					CETP
					LDLR
					KIF6
				Genome-Wide Association Studies  of Statin Response
				Key Genetic Variants Affecting Statin  Adverse Effects
					SLCO1B1
			Therapeutic Implications
			Future Directions
		References
	Chapter 5: Systems of Health Care
		Systems Theory
		Why Systems of Care Are Needed
		Experience to Date with Cardiovascular Systems of Care
			ST-Segment Elevation Myocardial Infarction
				Prehospital Diagnosis, Catheterization Laboratory Activation, and Transport  to Primary Percutaneous Coronary Intervention Centers
				Regional Transfer Protocols
				State Systems for ST-Segment Elevation Myocardial Infarction CARE
				Mission: Lifeline Program to Improve ST-Segment Elevation Myocardial Infarction CARE
			Heart Failure
			Cardiac Arrest
		Quality Improvement Theory
		Experience to Date with Cardiovascular Quality Improvement
			ST-Segment Elevation Myocardial Infarction
				American College of Cardiology Door-to-Balloon Alliance
				CRUSADE Initiative
				Get with the Guidelines?Coronary Artery Disease Program
				Acute Coronary Treatment and Intervention Outcomes Network
			Heart Failure
			Out-of-Hospital Cardiac Arrest
		Lessons Learned
		References
	Chapter 6: Global Cardiovascular Therapy
		Introduction to Global Challenges in Cardiovascular Disease Therapy
		Burden of Cardiovascular Disease
		Current Trends and Challenges
			Acute Management and Secondary Prevention
				Acute Coronary Syndrome
				Secondary Prevention
			Challenges to Therapeutic Usage
				Current State of cardiovascular disease Drug Availability and Affordability in Low- and Middle-Income Countries
				Role of the World Health Organization Essential Drug List
				Human Resources Shortages
			Primary Prevention
			Polypill
		Population Strategies
			Risk Factors for Cardiovascular Disease
				Tobacco
				Blood Pressure
				Lipids
				Obesity
		Summary
		References
Part II: Ischemic Heart Disease
	Chapter 7: Pharmacologic Options for Treatment of Ischemic Disease
		Organic Nitrates
			Overview
			Mechanisms of Action
			Pharmacokinetics
			Pharmacodynamic Effects
			Side Effects of Organic Nitrates
			Clinical Efficacy of Organic Nitrates
				Sublingual Nitrates
				Long-Acting Nitrates
				Congestive Heart Failure
				Other Nitrate Indications
			Nitrate Tolerance
				Biotransformation Hypothesis
				Neurohormonal Hypothesis
				Free Radical Hypothesis
			Nonhemodynamic Effects of Organic Nitrates
			Current Perspectives on Therapy  with Organic Nitrates
		Calcium Channel Blockers
			Fundamental Mechanisms of  Calcium Channel Blockers
				Calcium Channel as Site of Action
					Molecular Structure
					Drug Binding Sites
			Calcium Channels: L and T Types
			Pharmacologic Properties of  Calcium Channel Blockers
				Pharmacodynamic Effects
				Major Cardiovascular Actions of Calcium Channel Blockers
			Classification of Calcium Channel Blockers
			Vascular Selectivity
			Noncardiovascular Effects
			Pharmacokinetics
			Major Indications for  Calcium Channel Blockers
				Systemic Hypertension
				Angina Pectoris
				Supraventricular Tachycardia
				Postinfarct Protection
			Specific Calcium Channel Blockers
				Verapamil
					Pharmacokinetics
					Dose
						Oral Preparations
						Intravenous Use
					Side Effects
					Contraindications
						Pregnancy
				Diltiazem
					Pharmacokinetics
					Dose
					Side Effects
					Contraindications
						Pregnancy
				Dihydropyridines
					First-Generation Dihydropyridines
					Contraindications and Cautions
					Side Effects
						Pregnancy
				Second-Generation Calcium Channel Blockers
			Drug Interactions of Calcium Channel Blockers
				β-Blockers
				Digoxin
				Diltiazem
				Dihydropyridines
			Calcium Channel Blockers:  The “Safety? Controversy
		β-Adrenergic Blockers
			β-Adrenergic Receptors
			Effects in Angina Pectoris
			Comparison with Other Antianginal Therapies
			Angina at Rest and Vasospastic Angina
			Combined Use of β-Blockers with Other Antianginal Therapies in Angina Pectoris
				Nitrates
				Calcium Channel Blockers
				Ranolazine
			Conditions Associated with Angina Pectoris
				Arrhythmias
				Hypertension
				Survivors of Acute Myocardial Infarction
				“Silent? Myocardial Ischemia
			Other Cardiovascular Conditions Associated with Angina Pectoris
				Hypertrophic Cardiomyopathy
				Congestive Cardiomyopathy
				Mitral Valve Prolapse
				Dissecting Aneurysms
				Ehlers-Danlos Syndrome
				Syndrome X
			Perioperative Therapy in High-Risk Patients with Ischemic Heart Disease
			Pharmacologic Differences Among β-Adrenergic Receptor–Blocking Drugs
				Potency
				β1 Selectivity
				Intrinsic Sympathomimetic Activity  Partial Agonist Activity
				α-Adrenergic Activity
				Nitric Oxide Potentiating Effect
				Pharmacokinetics
			Adverse Effects of β-Adrenergic  Receptor Blockers
			Contraindications to β-Adrenergic  Receptor Blockers
			Overdosage
			β-Adrenergic Receptor Blocker Withdrawal
			Drug-Drug Interactions
		Newer Options for Treatment  of Chronic Angina
			Nicorandil
			Ivabradine
			Ranolazine
				Mechanism of Action
				Other Potential Uses of Ranolazine
			Trimetazidine
		Thrombosis and Ischemic Cardiovascular Heart Disease
			Antiplatelet Therapy
				Aspirin
					Mechanisms of Action
					Indication
					Dosages
					Side Effects and Contraindications
				P2Y12 Receptor Antagonists
					Mechanisms of Action
					Indication
					Dosages
					Side Effects and Contraindications
				Glycoprotein IIb/IIIa Receptor Antagonists
					Mechanisms of Action
					Indications
					Dosages
					Side Effects and Contraindications
			Novel Antiplatelet Agents
			Anticoagulant Therapy
				Unfractionated Heparin
					Mechanisms of Action
					Indications
					Dosages
					Side Effects and Contraindications
				Low-Molecular-Weight Heparin
					Mechanisms of Action
					Indications
					Dosages
					Side Effects and Contraindications
				Direct Thrombin Inhibitors
				Hirudin Lepirudin
					Mechanisms of Action
					Indications and Dosages
					Side Effects and Contraindications
				Argatroban
					Mechanisms of Action
					Indications
					Dosages
					Side Effects and Contraindications
				Bivalirudin Hirulog
					Mechanisms of Action
				Indications and Dosage
			Factor Xa Inhibitors
				Fondaparinux
					Mechanisms of Action
					Indications and Dosages
			Oral Anticoagulants
				Warfarin
					Mechanisms of Action
					Indications
					Dosages
					Side Effects and Contraindications
				Novel Anticoagulant Agents
				Fibrinolytics
					Mechanisms of Action
					Indications
					Dosages
					Side Effects and Contraindications
		References
	Chapter 8: Stable Ischemic Heart Disease/Chronic Stable Angina
		Epidemiology
		Natural History
		Assessment and Investigation
			Clinical Assessment
			Risk Stratification
				Clinical Indicators
				Noninvasive Evaluation
					Electrocardiogram
					Echocardiography
					Cardiac Magnetic Resonance Imaging
					Myocardial Perfusion Scintigraphy
					Computed Tomography
						Coronary Calcium Score
						Computed Tomography Coronary Angiography
					Selection and Frequency of Noninvasive Stress Testing
				Invasive Evaluation
				Overall Assessment of Risk
		Therapeutic Interventions
			Lifestyle and Risk Factor Modifications
				Smoking
				Dietary Intervention
				Obesity
				Diabetes Mellitus
			Symptomatic Therapy
				Cardiac Rehabilitation
				Pharmacologic Therapy
					β-Blockers
					Calcium Channel Blockers
					Nitrates
						Acute Relief of Angina
						Prevention of Anginal Episodes
					Potassium Channel Agonists
					Miscellaneous Medical Therapies
				Coronary Revascularization
					Percutaneous Coronary Intervention
						Indications: Percutaneous Coronary Intervention Versus  Medical Treatment
						Percutanous Coronary Intervention Versus Coronary Artery Bypass Grafting
						Culprit Lesion Percutaneous Coronary Intervention
						Percutaneous Coronary Intervention After Coronary Artery Bypass Grafting
						Stents
						Antiplatelet Therapy
						Complications
					Coronary Artery Bypass Graft Surgery
						Indications: Coronary Artery Bypass Grafting Versus  Medical Treatment
						Complications
						Arterial Conduits
			Prevention of Coronary Events
				Cardiac Rehabilitation
				Antiplatelet Therapy
				Lipid-Lowering Therapy
				β-Blockers
				Angiotensin-Converting Enzyme Inhibition
				Coronary Revascularization
					Coronary Artery Bypass Graft Surgery
		Potential Future Therapies
			Cholesteryl Ester Transfer Protein Inhibitors
			Novel Antiplatelet Therapies
		References
	Chapter 9: Non–ST-Segment Elevation Acute Coronary Syndromes
		Antiischemic Medications
			Nitrates
			β-Adrenergic Receptor Blockers
			Calcium Channel Antagonists
			Ranolazine
		Antiplatelet Agents
			Aspirin
			P2Y12 Antagonists
			Clopidogrel
			Prasugrel
			Ticagrelor
			Duration of Therapy
		Platelet Function Testing and Genetics
			Intravenous Platelet Inhibitors
			Conclusions
		Anticoagulants
			Unfractionated Heparin and  Low-Molecular-Weight Heparin
			Direct Thrombin Inhibitors
			Factor Xa Inhibitors
			Other Anticoagulants
			Summary on Anticoagulant Selection
		Invasive Versus Conservative Strategy  for Cardiac Catheterization
		Hospital Discharge and  Postdischarge Care
			Antiplatelet Therapy, Anticoagulation, Angiotensin-Converting Enzyme Inhibitors,  and Angiotensin Receptor Blockade
			β-Blockade and Blood Pressure Control
			Cholesterol Treatment and Cigarette  Smoking Cessation
			Diabetes Management and Diet
			Exercise
			Influenza Vaccine
			Cardiac Syndrome X
			Cocaine and Methamphetamines
			Diabetes Mellitus
			The Elderly
			Women
			Chronic Kidney Disease
		References
	Chapter 10: ST-Segment Elevation Myocardial Infarction
		Overview
		Pre?ST-Segment Elevation Myocardial Infarction Management
		Prehospital Management
			Symptom Recognition
			Out-of-Hospital Arrest
			Emergency Medical Services and  Systems of Care
			Prehospital Fibrinolysis
			Prehospital Destination Protocols
		Emergency Department Management
			Patient Triage
			Patient Evaluation
		Early Risk Assessment
			Medications Used in the Acute Phase
				Oxygen
				Nitroglycerin
				Analgesia
				Antiplatelet Agents
					Aspirin
					Clopidogrel
					Prasugrel
					Ticagrelor
					Glycoprotein IIb/IIIa Inhibitors
				Anticoagulant Agents
					Antithrombins
					Direct Thrombin Inhibitors
					Fondaparinux
				β-Blockers
			Reperfusion Therapy
				General Concepts
					Time from Symptom Onset
					Risk Stratification in ST-Segment Elevation  Myocardial Infarction
					Risk of Bleeding
					Predicted Transfer and Door-to-Balloon Time
				Fibrinolytic Therapy
					Indications and Contraindications
					Mortality Benefit
					Effect on Left Ventricular Function
					Complications
					Comparison of Fibrinolytic Agents
				Percutaneous Coronary Intervention
					Primary
					Use of Stents
					Thrombus Aspiration
					Pharmacoinvasive Management
					Hospitals Without on-Site Cardiac Surgery
		Hospital Management
			Location
			Routine Measures
			Medications
				Nitroglycerin
				Antithrombotic Agents
				β-Blockers
				Inhibition of the Renin-Angiotensin-Aldosterone System
				Glycemic Control
				Calcium Channel Blockers
			Hemodynamic Disturbances
				Hemodynamic Assessment
				Hypotension
				Low-Output State
				Pulmonary Congestion
				Cardiogenic Shock
				Right Ventricular Infarction
			Mechanical Complications
				Mitral Regurgitation
				Ventricular Septal Rupture
				Left Ventricular Free Wall Rupture
				Left Ventricular Aneurysm and Left Ventricular Thrombus
				Mechanical Support Devices
			Arrhythmias
				Bradyarrhythmias
				Supraventricular Arrhythmia
				Ventricular Arrhythmias
			Recurrent Chest Pain
				Recurrent Ischemia or Infarction
				Pericarditis
			Other Complications
				Ischemic Stroke
				Deep Venous Thrombosis and  Pulmonary Embolism
			Hemorrhagic Complications
			Coronary Artery Bypass Surgery
			Risk Stratification
				Exercise Testing
				Echocardiography
				Myocardial Perfusion Imaging
				Left Ventricular Function
				Myocardial Viability
				Invasive Evaluation
				Assessment of Electrical Substrate
		Long-Term Management
			Risk Factor Control
				Weight Management
				Smoking Cessation
				Lipid Management
				Blood Pressure Control
				Diabetes Management
			Medications
				Antiplatelet Agents
				β-Blockers
				Statins
				Inhibition of the Renin-Angiotensin-Aldosterone System
				Warfarin
				Hormone Replacement Therapy
			Functional Status
				Physical Activity
				Cardiac Rehabilitation
				Psychosocial Impact
				Follow-Up Visit
				Return to Work and Disability
		References
	Chapter 11: Advances in Coronary Revascularization
		Overview
		Advances in Coronary Stenting
			Pre-Stent Era
			Bare-Metal Stents
			Drug-Eluting Stents
				Development of Drug-Eluting Stents
				Drug-Eluting Stents Currently Available in the United States
					Sirolimus-Eluting Stents
					Paclitaxel-Eluting Stents
					Zotarolimus-Eluting Stents and Everolimus-Eluting Stents
				Efficacy and Safety of Drug-Eluting Stents
					Efficacy of Drug-Eluting Stents
					Safety of Drug-Eluting Stents
				When to Use Drug-Eluting Stents
				New Drug-Eluting Stents Available Outside the United States or Undergoing Investigation
					Products Involving Changes to the Stent Platform
						Traditional Stent Platforms
						Biodegradable Stents
					Products Involving Changes to Drug Coatings
					Products Involving Changes to the Polymer Structure
						Stents with Durable Polymers
						Stents with Biodegradable Polymers
							Biolimus A9?based Stents.
							Myolimus-Based Stents.
							Paclitaxel-Based Stents.
							Everolimus-Based Stents.
							Sirolimus-Based Stents.
						Polymer-Free Stents
					Drug-Coated Balloons
		Advances in Revascularization  in Specific Conditions
			Saphenous Vein Graft Interventions
			Chronic Total Occlusion Intervention
			Bifurcation Lesion Treatment
		Advances in Catheterization Techniques
			Transradial Access
			Mechanical Support for High-Risk Percutaneous Coronary Intervention
			Intravascular Assessment of Lesion Severity
		Advances in Surgical Coronary Revascularization
			Minimally Invasive Surgical Coronary Revascularization
				Off-Pump Coronary Artery Bypass Grafting
				Small-Access Coronary Revascularization
					Minimally Invasive Direct Coronary Artery Bypass
					Thoracoscopic Minimally Invasive Direct Coronary Bypass
					Multivessel Minimally Invasive Procedures
					Robotically Assisted Revascularization
			Non?Left Internal Mammary Arterial Conduits in Surgical Revascularization
				Background and Introduction
				Right Internal Mammary Artery for Use in Bilateral Mammary Artery Grafting
				Radial Artery Grafts
				Gastroepiploic Artery Grafts
			Hybrid Coronary Revascularization
				Introduction and Definition
				Rationale and Background
				Technical and Timing Issues of Hybrid Interventions
					Percutaneous Intervention Before Surgical Intervention
					Surgical Intervention Before Percutaneous Intervention
					Simultaneous Procedures
				Current State of Hybrid Revascularization  and Recent Information
			Future Directions
		References
Part III: Heart Failure
	Chapter 12: Pharmacologic Management of Heart Failure in the  Ambulatory Setting
		Pathophysiology and Staging System: Targets of Therapy
			Diuretics and Sodium Restriction
				Pathophysiologic Mechanisms
				Sodium Restriction
				Diuretics
					Mechanisms of Action
					Adverse Effects
					Practical Considerations
			Renin-Angiotensin System Inhibitors
				Pathophysiologic Mechanisms
				Clinical Efficacy
					Angiotensin-Converting Enzyme Inhibitors
						Cooperative North Scandinavian Enalapril Survival  Study CONSENSUS
						Vasodilator Heart Failure Trial V-HeFT II
						Studies of Left Ventricular Dysfunction SOLVD
						Assessment of Treatment with Lisinopril and Survival ATLAS
					Angiotensin Receptor Blockers
				Practical Considerations
					Angiotensin-Converting Enzyme Inhibitors
					Angiotensin Receptor Blockers
			β-Blockers
				Pathophysiologic Rationale
				Pharmacology
				Clinical Efficacy
					Cardiac Insufficiency Bisoprolol Studies CIBIS I and II
					U.S. Carvedilol Heart Failure Trials
					Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure MERIT-HF
					β-Blocker Evaluation and Survival Trial
					Carvedilol Prospective Randomized Cumulative  Survival Trial COPERNICUS
					Carvedilol and Metoprolol European Trial COMET
					Carvedilol Post-Infarct Survival Control in Left Ventricular Dysfunction CAPRICORN
					Study of the Effects of Nebivolol Intervention on Outcomes and Rehospitalization in Seniors with Heart Failure SENIORS
				Practical Considerations
				Choice of β-Blocker
			Aldosterone Antagonists
				Pathophysiology
				Clinical Efficacy
				Practical Considerations
				Options for Patients who Remain Symptomatic Despite Standard Therapy
			Hydralazine and Isosorbide Dinitrate
				Practical Considerations
			Digoxin
				Pharmacologic and Clinical Effects
				Practical Considerations
			Calcium Channel Blockers
			Positive Inotropic Agents
				Oral Positive Inotropes
				Intravenous Positive Inotropes
					Bridge to Transplantation
					Bridge to End of Life
			Antithrombotic Therapy
			Antiarrhythmic Therapy
			Special Considerations
				Heart Failure Patients with Preserved  Ejection Fraction
					Clinical Efficacy
					Practical Considerations
				Patients with Ischemic Heart Disease
				Patients with Valvular Heart Disease
				Patients with Diabetes
				Gender, Race, and Ethnic Considerations
				Patients with Myocarditis
		Future Directions in  Pharmacologic Therapy
			Pharmacotherapy
			Comorbidities
		References
	Chapter 13: Implantable Devices for the Management of Heart Failure
		Implantable Cardioverter-Defibrillators in the Management of Heart Failure
			MADIT II
			DEFINITE
			SCD-HeFT
		Implantable Cardioverter-Defibrillators Early After Myocardial Infarction
			DINAMIT
			IRIS
		Indications for Prophylactic Cardioverter-Defibrillator Implantation in Heart Failure Patients
		Practical Considerations in Implantable Cardioverter-Defibrillator Therapy
		Conduction Abnormalities  in Heart Failure
		Landmark Cardiac Resynchronization Therapy Clinical Trials
			MUSTIC
			MIRACLE
			MIRACLE ICD
			CONTAK CD
			COMPANION
			CARE-HF
		Cardiac Resynchronization Therapy  in Mild Heart Failure
			REVERSE
			MADIT-CRT
			RAFT
		Cardiac Resynchronization Therapy
			Cardiac Resynchronization Therapy  in Long-Term Right Ventricle Pacing
			Cardiac Resynchronization Therapy  in Atrial Fibrillation
			Indications for Cardiac Resynchronization Therapy in Heart Failure Patients
			Future Directions of Cardiac  Resynchronization Therapy
		Monitoring Heart Failure Through Implantable Devices
		Future Directions in Implantable Devices for the Management of Heart Failure
		Summary
		References
	Chapter 14: Strategies for Management of Acute Decompensated Heart Failure
		Terminology
		Epidemiology
		Pathophysiology
			Heart Failure with Reduced Versus Preserved Ejection Fraction
			Acute Compensatory Mechanisms
			Myocardial Injury
			Common Precipitating Factors of Heart Failure
		General Management
			Initial Patient Evaluation
			Risk Stratification
			Clinical Assessment of Intracardiac  Filling Pressures
			Clinical Assessment of Systemic Perfusion
			Laboratory Assessment
				B-Type Natriuretic Peptide
			Noninvasive Versus Invasive Management
			Hemodynamic Profiles
			Hemodynamic Goals of Therapy
		Fluid Management
			Parenteral Diuretic Therapy
			Ultrafiltration
		Vasoactive Therapy
			Nitroglycerin
			Nesiritide
			Nitroprusside
			Dobutamine
			Milrinone
			Dopamine
			Epinephrine and Norepinephrine
			Digoxin
		Adjustment of Oral Medications
			Renin-Angiotensin-Aldosterone  System Inhibitors
			Nitrates and Hydralazine
			β-Blockers
			Oral Diuretics
		Other Management Issues
			Sodium and Fluid Restriction
			Oxygen Supplementation
			Ventricular Arrhythmias
			Anticoagulation
			Comorbidities
			Discharge Planning and Immediate Postdischarge Care
		Special Considerations
			Mechanical Circulatory Support
			Acute Pulmonary Edema
			Heart Failure with Preserved Ejection Fraction
		Unfulfilled Promises and  Future Directions
		References
	Chapter 15: Cardiac Transplantation and Circulatory Support Devices
		Overview
		Patient Selection for Advanced Heart Failure Therapies
		Cardiac Transplantation
			Patient Selection
				Assessment of Cardiac Disease Severity
				Assessment of the Pulmonary Vasculature
				Other Cardiac Transplantation  Candidacy Issues
					Age
					Comorbidities
					Immunologic Sensitization
					Listing for Cardiac Transplantation
			Pretransplantation Patient Management
			Cardiac Transplantation Surgical Technique
			Management of the Patient After  Cardiac Transplantation
				Prevention and Treatment of Cardiac Rejection
				Drug Interactions
			Prevention and Treatment of  Posttransplant Complications
				Infections
				Hypertension
				Diabetes
				Dyslipidemia
				Cardiac Allograft Vasculopathy
				Renal Insufficiency
				Malignancy
			Future Directions
		Mechanical Circulatory Support
			Benefits of Mechanical Circulatory Support
				Hemodynamic
				Biologic
			Configuration of Mechanical  Circulatory Support
				Pulsatile Flow
				Continuous Flow
				Cannulation
			Indications for Mechanical Circulatory Support
				Univentricular Versus Biventricular Support
			Timing of Support
			Considerations Prior to Long-Term Mechanical Circulatory Support
				Cardiac Considerations
					Right Ventricular Function
					Valvular Disease
					Arrhythmias
					Other Cardiac Abnormalities
				Noncardiac Considerations
				Surgical Considerations
				Other Considerations
					Adverse Events
		References
	Chapter 16: Regenerative Therapy for Heart Failure
		Circulating Progenitor Cells and Myocardial Regeneration
		Hematopoietic Stem Cell Transdifferentiation
		Bone Marrow Cells and Clinical Studies
		Endogenous Cardiac Progenitors
		Age, Cardiac Disease, and Human Cardiac Stem Cell Function
		References
	Chapter 17: Hypertrophic, Restrictive, and Infiltrative Cardiomyopathies
		Hypertrophic Cardiomyopathy
			Management of Left Ventricular Outflow  Tract Obstruction
			Therapies for Nonobstructive  Hypertrophic Cardiomyopathy
			Prevention of Sudden Cardiac Death  in Hypertrophic Cardiomyopathy
			Management of Atrial Fibrillation  in Hypertrophic Cardiomyopathy
			Screening at-Risk Family Members for Hypertrophic Cardiomyopathy
		Restrictive and Infiltrative Cardiomyopathies
			Idiopathic Restrictive Cardiomyopathy
			Cardiac Amyloidosis
			Cardiac Sarcoidosis
				Treatment
			Cardiac Hemochromatosis
				Treatment
			Storage Diseases of the Myocardium
				Fabry Disease
				Cardiomyopathy Associated with Mutations  in LAMP2 Danon Disease, PRKAG2, or Mitochondrial Genes
			Endomyocardial Disorders
				Endomyocardial Fibrosis
				Löffler Hypereosinophilic Syndrome
		References
Part IV: Arrhythmias and Conduction Disturbances
	Chapter 18: Clinical Pharmacology of Antiarrhythmic Drugs
		Classification of Antiarrhythmic Drugs
		Drugs
			Lidocaine
				Clinical Applications
				Mechanism of Action
				Clinical Pharmacology
				Dosage and Administration
				Modification of Dosage in Disease States
				Adverse Reactions
				Drug Interactions
			Mexiletine
				Clinical Applications
				Mechanism of Action
				Clinical Pharmacology
				Dosage and Administration
				Modification of Dosage in Disease States
				Adverse Reactions
				Drug Interactions
			Procainamide
				Clinical Applications
				Mechanism of Action
				Clinical Pharmacology
				Dosage and Administration
				Modification of Dosage in Disease States
				Adverse Reactions
				Drug Interactions
			Disopyramide
				Clinical Applications
				Mechanisms of Action
				Clinical Pharmacology
				Dosage and Administration
				Modification of Dosage in Disease States
				Adverse Reactions
				Drug Interactions
			Quinidine
				Clinical Applications
				Mechanism of Action
				Clinical Pharmacology
				Dosage and Administration
				Modification of Dosage in Disease States
				Adverse Reactions
				Drug Interactions
			Propafenone
				Clinical Applications
				Clinical Pharmacology
				Dosage and Administration
				Modification of Dosage in Disease States
				Drug Interactions
			Flecainide
				Clinical Applications
				Mechanism of Action
				Clinical Pharmacology
				Dosage and Administration
				Modification of Dosage in Disease States
				Adverse Reactions
				Drug Interactions
			Sotalol
				Clinical Applications
				Mechanism of Action
				Clinical Pharmacology
				Dosage and Administration
				Modification of Dosage in Disease States
				Adverse Reactions
				Drug Interactions
			Amiodarone
				Clinical Applications
				Mechanism of Action
				Clinical Pharmacology
				Dosage and Administration
				Modification of Dosage in Disease States
				Adverse Reactions
				Drug Interactions
			Ibutilide
				Clinical Applications
				Mechanism of Action
				Clinical Pharmacology
				Dosage and Administration
				Modification of Dosage in Disease States
				Adverse Reactions
				Drug Interactions
			Dofetilide
				Clinical Applications
				Mechanism of Action
				Clinical Pharmacology
				Dosage and Administration
				Modification of Dosage in Disease States
				Adverse Drug Reactions
				Drug Interactions
			Adenosine
				Clinical Applications
				Mechanism of Action
				Clinical Pharmacology
				Dosage and Administration
				Modification of Dosage in Disease States
				Adverse Reactions
				Drug Interactions
			Dronedarone
				Clinical Applications
				Mechanism of Action
				Clinical Pharmacology
				Individualization of Dosage
				Modification of Dosage in Disease States
				Adverse Reactions
				Drug Interactions
		Appendix
		References
	Chapter 19: Pharmacologic Management of Supraventricular Tachycardias
		Pharmacology of Supraventricular Tachycardias
		Evaluation of Therapy
		Paroxysmal Supraventricular Tachycardia
		Mechanisms of Paroxysmal Supraventricular Tachycardia
			Management of Acute Episodes of Paroxysmal Supraventricular Tachycardia
			Long-Term Therapy of Premature Supraventricular Tachycardia
			Long-Term Pharmacologic Therapy
		Atrial Flutter
			Short-Term Management of Atrial Flutter
			Long-Term Management of Atrial Flutter
			Multifocal Atrial Tachycardia
			Inappropriate Sinus Tachycardia
		Junctional Ectopic Tachycardia
		References
	Chapter 20: Atrial Fibrillation
		Classification
		Decision for Rhythm or Rate Control
			Rate Control
				Pharmacologic Rate Control in Atrial Fibrillation: Optimal Ventricular Rate
				Nonpharmacologic Approach to Rate Control
			Rhythm Control
				Pharmacologic Cardioversion
				Electrical Cardioversion
		Maintenance of Sinus Rhythm
			Pharmacologic Approaches
				Choice of Drug
				Initiation and Monitoring  of Antiarrhythmic Drugs
			Adjunctive Therapy for the Maintenance of Sinus Rhythm
			Nonpharmacologic Approaches to  the Maintenance of Sinus Rhythm
			Pacing for the Maintenance of Sinus Rhythm
			Thromboembolic Prophylaxis
			Pericardioversion Anticoagulation
		Atrial Fibrillation Following  Cardiac Surgery
		Conclusions
		References
	Chapter 21: Nonpharmacologic Treatment of Tachyarrhythmias
		Catheter Ablation for the Treatment  of Tachyarrhythmias
		Practical Considerations
		Catheter Ablation by Specific Arrhythmia Syndrome
			Catheter Ablation for Supraventricular Tachyarrhythmias
				Accessory Pathway?mediated Tachycardias
				Atrioventricular Node Reentry
				Atrial Tachycardia
				Atrial Flutter
					Isthmus-Dependent Atrial Flutter
					Other Atrial Flutters
		Atrial Fibrillation
		Atrioventricular Junction Ablation for Ventricular Rate Control
			Catheter Ablation for Ventricular Tachyarrhythmias
				Idiopathic Ventricular Tachycardia
				Ventricular Tachycardia in Patients with Structural Heart Disease
				Ventricular Fibrillation and Polymorphic Ventricular Tachycardia
		Summary
		References
	Chapter 22: Role of Implantable Cardioverter-Defibrillators in Primary and Secondary Prevention of Sudden Cardiac Death
		Sudden Cardiac Death
		Implantable Cardioverter-Defibrillator Systems and Technology
			Implantable Cardioverter-Defibrillators  for Secondary Prevention of  Sudden Death
			Implantable Cardioverter-Defibrillators for Primary Prevention of Sudden Cardiac Death
				Clinical Trials
			Risk Stratification for Sudden Cardiac Death
				Ejection Fraction
				Electrophysiologic Studies
				Nonsustained Ventricular Arrhythmias
				Signal-Averaged Electrocardiogram
				T-Wave Alternans
				Autonomic Function
				Left Ventricular Scar Burden
				Genetic Testing
			Comorbidities and Implantable  Cardioverter-Defibrillator Benefit
				Age
				Kidney Disease
				Heart Failure
				Effects of Multiple Comorbid Conditions
			Cardiac Resynchronization Implantable Cardioverter-Defibrillators
			Guidelines for Cardioverter-Defibrillator Implantation
				Class I Indications
				Class II Indications
				Class III Indications
			Special Patient Groups
				After Coronary Artery Bypass  Graft/Revascularization
				Immediately after Myocardial Infarction
				Long QT Syndrome
				Hypertrophic Cardiomyopathy
				Arrhythmogenic Right Ventricular Dysplasia
				Brugada Syndrome
				CARdioverter-defibrillator therapy
			Clinical Issues
				Follow-Up
				Implantable Cardioverter-Defibrillator Shocks
				Electrical Storm
				Electromagnetic Interference and Perioperative Care
				Driving
		References
	Chapter 23: Treatment of Ventricular Tachycardia and Cardiac Arrest
		Ventricular Tachycardia:  Acute Management
			Sustained Monomorphic Ventricular Tachycardia with a Pulse
				Lidocaine
				Procainamide
				Sotalol
				Amiodarone
				Magnesium
				Overdrive Ventricular Pacing
				Cardioversion
				Evaluation to Exclude Potentially Reversible Causes of Ventricular Tachycardia
			Polymorphic Ventricular Tachycardia
		Management of Cardiac Arrest
			Epidemiology and General Principles
			Cardiopulmonary Resuscitation and Advanced Cardiac Life Support
				Chest Compressions
				Defibrillation
				Rescue Breathing
				Advanced Cardiac Life Support
			Post?Cardiac Arrest Care
				General Approach
				Critical Care Support
				Therapeutic Hypothermia
				Neurologic Prognostication
		References
Part V: Dyslipoproteinemias and Atherosclerosis
	Chapter 24: Drugs for Elevated Low-Density Lipoprotein Cholesterol
		Effects on Lipids and Lipoproteins
		Pharmacokinetic Properties
			Drug Interactions
			Efficacy
				Angiographic Trials
				Large-Scale Clinical Trials
		Mechanism of Benefit of Statins
			Safety
				Liver
				Muscle
				Bile Acid Sequestrants
					Effects on Lipids and Lipoproteins
					Efficacy
					Safety/Compliance Issues
				Ezetimibe and Cholesterol  Absorption Inhibitors
					Effect on Lipids/Lipoproteins
					Efficacy
					Safety
				Plant Stanol Esters
					Effect on Lipids/Lipoproteins
					Efficacy Against Coronary Heart Disease
					Safety
		References
	Chapter 25: Therapy to Manage Low  High-Density Lipoprotein Cholesterol and Elevated Triglycerides
		Rationale for Combination Therapy
			Lack of Achievement of Non?High-Density Lipoprotein Goals
			Residual Risk for Statin Therapy
		Combined Dyslipidemia
			Non?High-Density Lipoprotein  Cholesterol Reduction
			Therapy to Modify High-Density Lipoprotein
			Statin-Fibrate Combination
			Statin-Niacin Combination
			Statin?Omega-3 Fatty Acids Combination
		Cholesteryl Ester Transfer  Protein Inhibition
		Conclusion
		References
	Chapter 26: Cardiovascular Disease and Lifestyle Modification
		Dietary Fats and Blood Lipids
			High-Carbohydrate, Low-Fat Diets to  Reduce Low-Density Lipoprotein  Cholesterol and Blood Pressure
			The DASH Diet
			Low-Fat Diets, Low Saturated Fat,  and Cardiovascular Disease:  Clinical Trials and Epidemiology
			Moderate Unsaturated Fat Diets
			Reduced-Carbohydrate, Higher Unsaturated Fat, and Protein Diets: A New Twist to the DASH Dietary Approach
			Type of Carbohydrate
			Fish Oil to Prevent Coronary Heart Disease
		Obesity
			Clinical Assessment of Obesity
			Goals for Weight Loss and Management
			Determination of Calorie Levels for  Weight Loss
			2010 Dietary Guidelines
			Healthy Eating Patterns
				The Mediterranean Diet
			Physical Activity
			Overall Effect of Diet and Lifestyle
		References
	Chapter 27: Steps Beyond Diet and Drug Therapy for Severe Hypercholesterolemia
		Definition of the Target Population
		Description of the Patient Population
			Homozygous Familial Hypercholesterolemia
			Patients with Low-Density Lipoprotein Cholesterol Concentrations of More than 200 mg/dL and Coronary Artery Disease
			Patients with Low-Density Lipoprotein Cholesterol Concentrations of More than 300 mg/dL Without Coronary Artery Disease
		Extracorporeal Therapies for  the Treatment of Severe Hypercholesterolemia
			Technical Aspects
				Low-Density Lipoprotein Apheresis Using Dextran Sulfate Cellulose Columns
				Low-Density Lipoprotein Apheresis Using Immunoadsorption Columns
				Low-Density Lipoprotein Apheresis Using Heparin-Induced Extracorporeal Low-Density Lipoprotein Precipitation
				Low-Density Lipoprotein Apheresis Using Whole Blood?compatible Systems
			Risks of Low-Density Lipoprotein Apheresis
			Benefits of Low-Density Lipoprotein Apheresis
			Benefits of Low-Density Lipoprotein Apheresis Beyond Reducing Low-Density  Lipoprotein Concentrations
		Low-Density Lipoprotein Apheresis: Failure to Treat Individuals  Who May Benefit
		Surgical Procedures
			Portacaval Shunt
				Technique
				Cholesterol Lowering
				Risks and Benefits
				Treatment Guidelines
			Liver Transplantation
				Cholesterol Lowering
				Risks and Benefits
				Treatment Guidelines
			Partial Ileal Bypass
				Technique
				Cholesterol Lowering
				Risks and Benefits
			Gene Therapy
		Conclusions and Recommendations  for Therapy
		References
Part VI: Hypertension
	Chapter 28: Initial Evaluation and Approach to the Patient with Hypertension
		Overview and Definitions
		Evaluation of the Patient
			History
			Present Illness
			Family History
			Past Medical History
			Review of Systems
			Personal History
			Physical Examination
			Blood Pressure Measurement
			Laboratory Evaluation
			Overview of Treatment of  the Hypertensive Patient
			Resistant Hypertension
		Adherence to Antihypertensive Medications
		Lifestyle Modifications: Overview
			Practical Approaches to Encouraging  Lifestyle Modifications
				Barriers to Lifestyle Modifications
				Approaches to Increasing the Adoption of Lifestyle Modifications
					Readiness for Change
				Tips for Success in Adopting Healthier  Dietary Practices
				Tips for Success in Increasing Physical Activity
				General Tips for Adopting Healthier Lifestyles
		Conclusion
		References
	Chapter 29: Pharmacologic Management of Hypertension
		Overview
		Principles of Treatment
			Evidence-Based Treatment
			Blood Pressure Goals
		Selecting Drug Therapy
			Uncomplicated Hypertension
			Patients with Compelling Indications
				Diabetes
				Chronic Kidney Disease
				Coronary Artery Disease
				Left Ventricular Dysfunction
				Previous Ischemic Stroke
		Overview of Drug Classes
			Angiotensin-Converting Enzyme Inhibitors
			Angiotensin Receptor Blockers
			Calcium Channel Blockers
			Diuretics: Thiazides
			β-Blockers
			Aldosterone Antagonists
			Other Agents
				α-Blockers
				Arterial Vasodilators
				Central α-Agonists
				Direct Renin Inhibitor
				Rauwolfia Alkaloids
		Implementing Drug Therapy
			Need for 24-Hour Coverage
			Monotherapy Versus Combination Therapy
				Monotherapy
				Combination Therapy
			Effects of Patient Characteristics on Blood Pressure Lowering
			Monitoring
			Adherence
			Step-Down Therapy
		Special Populations
			Elderly Patients
				Isolated Systolic Hypertension
				Blood Pressure Goals
				Orthostatic Hypotension
				Selecting Drug Therapy
			African-American Patients
		References
	Chapter 30: Endocrine Causes of Hypertension
		Pheochromocytoma
			Presentation
				Syndromic Pheochromocytoma
			Diagnosis
			Principles of Treatment
				Preoperative Management
					α-Adrenergic Blockade
					β-Adrenergic Blockade
					Catecholamine Synthesis Inhibitor
					Calcium Channel Blockers
				Acute Hypertensive Crises
				Anesthesia and Surgery
				Long-Term Postoperative Follow-Up
				Malignant Pheochromocytoma
				Pheochromocytoma in Pregnancy
		Primary Aldosteronism
			Diagnosis
				Case Detection
				Confirming the Diagnosis
				Subtype Evaluation
			Principles of Treatment
				Surgical Treatment of Aldosterone-Producing Adenoma and Unilateral Hyperplasia
			Pharmacologic Treatment
				Pharmacologic Treatment of Glucocorticoid-Remediable Aldosteronism
		Other Forms of Mineralocorticoid Excess
			Hyperdeoxycorticosteronism
				Congenital Adrenal Hyperplasia
					11-β-Hydroxylase Deficiency
					17-α-Hydroxylase Deficiency
				Deoxycorticosterone-Producing Tumor
				Primary Cortisol Resistance
			Apparent Mineralocorticoid Excess Syndromes
				Cushing Syndrome
					Presentation
					Diagnosis
				Principles of Treatment
		Thyroid and Parathyroid Disease
			Thyroid Dysfunction
				Presentation and Diagnosis
				Principles of Treatment
			Primary Hyperparathyroidism
				Presentation and Diagnosis
				Principles of Treatment
			Acromegaly
				Presentation and Diagnosis
				Principles of Treatment
		References
	Chapter 31: Resistant Hypertension
		Pseudoresistance
		Diagnosis
			Ambulatory Blood Pressure Monitoring
		Cardiovascular Risk
		Secondary Causes of Hypertension
			Obstructive Sleep Apnea and  Resistant Hypertension
			Primary Aldosteronism and  Resistant Hypertension
		Interfering Substances
			Dietary Sodium
		Pharmacologic Treatment
			Diuretics
			Mineralocorticoid Receptor Antagonists
			Other Antihypertensive Agents
			Other Treatment Modalities
				Renal Sympathetic Denervation
				Baroreflex Activation Therapy
		Role of the Hypertension Specialist
		References
	Chapter 32: Hypertensive Crisis
		Overview
		Definitions
			Hypertensive Urgency
			Hypertensive Emergency
			Hypertensive Crisis
			Malignant and Accelerated Hypertension
		Epidemiology and Etiology
		Pathophysiology
			Patient Evaluation
				History, Physical Examination,  and Ancillary Testing
		Management of Hypertensive Emergency
			Cardiovascular Presentations
				Acute Coronary Syndromes
				Left Ventricular Failure and  Acute Pulmonary Edema
				Aortic Dissection
			Neurologic Presentations
				Ischemic Cerebrovascular Syndromes
				Hemorrhagic Cerebrovascular Syndromes
				Intracerebral Hemorrhage
				Subarachnoid Hemorrhage
				Hypertensive Encephalopathy
			Renal Presentations
			Catecholaminergic Presentations
				Acute Withdrawal of Antihypertensive Therapy
				Pheochromocytoma
				Sympathomimetic Drugs
				Autonomic Dysfunction
			Pediatric Hypertensive Emergencies
			Obstetric Presentations:  Preeclampsia and Eclampsia
			Hemorrhage and Post?Vascular  Surgery Presentations
		Follow-up and Prognosis
		Caveats to Therapy in Hypertensive Emergency Care
		References
	Chapter 33: Hypertension in Pregnancy
		Overview
		Epidemiology and Risk Factors
		Pathophysiology
			Preeclampsia
			Chronic Hypertension
			Gestational Hypertension
		Diagnosis
		Treatment
			Prevention
			Treatment of Hypertension in Pregnancy
			Acute Management of Severe Hypertension  in Pregnancy
			Prevention and Management of Eclampsia
		Implications for Later  Cardiovascular Disease
		Conclusions
		References
	Chapter 34: Management of Hypertension in Children and Adolescents
		Overview
		Definitions of High Blood Pressure  in Children
		Confirmation of Elevated Blood Pressure
		Primary Versus Secondary Hypertension in Childhood
			Approach to Therapy
				Nonpharmacologic Approaches
				Use of Antihypertensive Medications
		Summary
		References
Part VII: Other Vascular Conditions
	Chapter 35: Peripheral Artery Disease
		Overview
		Medical Therapy of Peripheral  Artery Disease
		Cardiovascular Risk Reduction
			Antiplatelet Therapy
			Anticoagulant Therapy
			Lipid-Lowering Drugs
				HMG-CoA Reductase Inhibitor Statin Therapy
				Nonstatin Lipid-Lowering Therapy
			Antihypertensive Therapy
			Angiotensin-Converting Enzyme  Inhibitor Therapy
			β-Blocker Therapy
			Smoking Cessation Therapy
		Diabetes
		Intermittent Claudication
			Pentoxifylline
			Cilostazol
		Perioperative Medical Therapy for Noncardiac Vascular Surgery
			β-Blockers
			Statin Therapy
			Antiplatelet Therapy
		Interventional Management of Peripheral Artery Disease
			Indications for Revascularization
			Procedural Considerations
		Aortoiliac Disease
		Femoral-Popliteal Disease
		Infrapopliteal Disease
		Therapeutic Angiogenesis
		Conclusions
		References
	Chapter 36: Cerebrovascular Disease
		Atherosclerotic Carotid Artery Disease and Stroke
			Risk of Stroke
			Prevalence of Carotid Artery Disease
		Medical Therapy of Atherosclerotic Carotid Artery Disease
			Smoking Cessation
			Antihypertensive Therapy
			Lipid-Lowering Therapy
			Antiplatelet Therapy
		Revascularization for Carotid  Artery Disease
			Surgical Revascularization
				Carotid Endarterectomy for Symptomatic Carotid Artery Stenosis
				Carotid Endarterectomy for Asymptomatic Carotid Artery Stenosis
			Endovascular Therapy for  Carotid Artery Stenosis
				Carotid Artery Stenting in Symptomatic and Asymptomatic Patients at HIGH Surgical Risk: Data From Large Registries
				Carotid Artery Stenting in Patients at HIGH Surgical Risk: Data From Randomized Trials
				Carotid Artery Stenting in Normal-Risk Symptomatic Patients
				Carotid Artery Stenting in Normal-Risk Symptomatic and Asymptomatic Patients:  CREST
			Should Asymptomatic Carotid Artery Stenosis Be Revascularized?
			Carotid Artery Disease and Coronary Artery Bypass Graft Surgery
		References
	Chapter 37: Renal Artery Stenosis
		Overview
		Clinical Manifestations
		Natural History of Renal Artery Stenosis
		Diagnosis of Renal Artery Stenosis
		Treatment of Atherosclerotic Renal Artery Stenosis
			Medical Therapy
			Which Patients Should Be Revascularized?
			Catheter-Based Intervention
			Surveillance of Renovascular Disease
			Catheter-Based Renal Artery  Sympathetic Denervation
		Conclusion
		References
	Chapter 38: Pulmonary Embolism and Deep Vein Thrombosis
		Epidemiology and Risk Factors
		Pathophysiology and Natural History
		Diagnosis
			Deep Vein Thrombosis
				Clinical Presentation
					Clinical Likelihood Assessment
					Laboratory Testing
					Imaging
					Overall Diagnostic Algorithm
			Pulmonary Embolism
				Clinical Presentation
					Laboratory Testing
					Electrocardiogram
					Chest Radiography
					Chest Computed Tomography for  Diagnosis and Risk Stratification
					Echocardiography for Diagnosis and Risk Stratification
					Lung Scanning
					Magnetic Resonance Imaging
					Overall Diagnostic Algorithm
				Overall Risk Stratification  of Pulmonary Embolism
		Management
			Spectrum of Disease: Superficial Venous Thrombosis, Deep Vein Thrombosis, and Pulmonary Embolism
			Anticoagulation
				Unfractionated Heparin
					Heparin-Induced Thrombocytopenia
				Low-Molecular-Weight Heparin
				Fondaparinux
				Warfarin
				Direct Factor XA and Factor IIA Inhibitors
			Basic Versus Advanced Therapy  for Venous Thromboembolism
				Deep Vein Thrombosis
				Advanced Therapy for Pulmonary Embolism
				Duration of Anticoagulation
				Inferior Vena Cava Filters
		Prevention
			Prevention of Venous Thromboembolism in Patients with Cancer
			Implementation of in-Hospital Prophylaxis
			Hip Replacement, Knee Replacement,  and Hip Fracture
			Mechanical Prophylaxis
				Unconventional Prophylaxis
					Vitamin E
					Statins
				Duration of Prophylaxis and Extension of Prophylaxis after Hospital Discharge
		Conclusions
		References
	Chapter 39: Treatment of Pulmonary Arterial Hypertension
		Current State of Diagnosis
		Epidemiologic Associations
		Current Pathobiologic Paradigm of Pulmonary Arterial Hypertension
		Diagnosis and Risk Stratification
		Current State of Therapy
			Prostanoids
			Endothelin Receptor Antagonism
			Phosphodiesterase Inhibition
			Atrial Septostomy
			Transplantation for Idiopathic Pulmonary Arterial Hypertension
		Medical Therapy Algorithms
		New Pathobiologic and Care Paradigms
		Pregnancy and Contraception
		References
	Chapter 40: Aortic Disease
		Abdominal Aortic Aneurysms
			Surgical Management
			Medical Management
		Thoracic Aortic Aneurysms
			Surgical Management
			Medical Management
		Aortic Dissection
			Definitive Therapy
			Long-Term Therapy and Late Follow-up
		Intramural Hematoma
		Penetrating Atherosclerotic Ulcer
		Thoracic Aortic Atheroembolism
		References
Part VIII: Other Cardiovascular Conditions
	Chapter 41: Pharmacologic Options for Treating Cardiovascular Disease During Pregnancy
		Hypertension
		Edema
		Valvular Heart Disease
		Thromboembolic Disease  During Pregnancy
			Fibrinolysis
		Ischemic Heart Disease
		Lipid Disorders
		Heart Failure
		Cardiac Arrhythmias
		Marfan Syndrome
		Pulmonary Hypertension
		Antibiotic Prophylaxis
		References
	Chapter 42: Care for Adults with Congenital Heart Disease
		Issues for the Care Provider
			Endocarditis
		Left-to-Right Shunting:  General Principles
		Cyanosis
			Major Cyanotic Organ Complications
				Musculoskeletal Changes
				Hematologic Changes
				Renal Changes
			Cardiopulmonary Exercise
			Neurologic Effects
			Recommendations for Management  of the Cyanotic Patient
		Pregnancy
			Recommendations
		Noncardiac Surgery
			Recommendations
		Arrhythmia Management
			Exercise and Athletic Participation
			Transplantation
		Guidelines for Management of Patients with Specific Congenital Cardiac Lesions
			Atrial Septal Defects
				Recommendations
			Patent Foramen Ovale
				Patent Foramen Ovale and Hypoxemia
				Patent Foramen Ovale and Migraine
				Recommendations
			Bicuspid Aortic Valve
				Recommendations
			Pulmonary Stenosis
				Recommendations
			Aortic Coarctation
				Recommendations
			Tetralogy of Fallot
				Recommendations
			Patent Ductus Arteriosus
				Recommendations
			Ventricular Septal Defects
			Post?Myocardial Infarction Ventricular  Septal Rupture
			Perimembranous Ventral Septal Defect Closure
				Recommendations
			Postoperative Residual Defects,  Collaterals, and Fenestrations
		References
	Chapter 43: Prevention and Treatment of Infective Endocarditis
		Overview
		Diagnosis
			Echocardiography in the Diagnosis and Management of Endocarditis
		Antibiotic Therapy
		Identifying Patients at Risk of Poor Clinical Outcomes
		Surgical Therapy and Complicated Infective Endocarditis
			Heart Failure
			Abscess
			Embolic Events
			Prosthetic Valve Infections
			Cardiac Device Infections
		Long-Term Outcomes and Management
		Prevention
		Future Directions
		Conclusions
		References
	Chapter 44: Treatment of Pericardial Disease
		Acute Pericarditis
		Recurrent Pericarditis
		Pericardial Effusion and Tamponade
		Constrictive Pericarditis
		Treatment of Specific Causes  of Pericarditis
			Purulent Pericarditis
			Mycobacterial and Fungal Pericarditis
			Human Immunodeficiency Virus?Associated Pericarditis
			Neoplastic Pericarditis
			Pericarditis Complicating Myocardial Infarction and the Postpericardial Injury Syndrome
			Radiation-Induced Pericardial Disease
			Traumatic Pericardial Disease
			Chylopericardium
			Pericardial Disease in Patients  with Renal Failure
			Myxedema Pericardial Disease
			Connective Tissue Disease?Related  Pericardial Disease
			Pericardial Disease and Pregnancy
			Drug-Induced and Iatrogenic  Pericardial Disease
			Anticoagulation in Pericarditis
		Acknowledgment
		References
	Chapter 45: Optimal Timing of Surgical and Mechanical Intervention in Native Valvular Heart Disease
		Overview
		Aortic Stenosis
			Assessment of Severity
			Timing of Surgical Intervention
				Symptomatic Patients
				Low-Gradient Aortic Stenosis
				Elderly Patients
				Asymptomatic Patients
			Overall Approach
				Role of Percutaneous Intervention
		Mitral Stenosis
			Assessment of Severity
			Overall Approach
				Percutaneous Mitral Balloon Valvuloplasty
		Aortic Insufficiency
			Assessment of Severity
			Timing of Surgical Intervention
				Symptomatic Patients with Normal Left Ventricular Function
				Symptomatic Patients with Left  Ventricular Dysfunction
				Asymptomatic Patients
			Overall Approach
		Mitral Insufficiency
			Assessment of Severity
			Timing of Intervention
				Symptomatic Patients
				Asymptomatic Patients
			Overall Approach
				Functional Ischemic Mitral Regurgitation
		Right-Sided Valve Disease
			Tricuspid Valve Disease
			Pulmonary Valve Disease
		Future Directions
		References
	Chapter 46: Surgery for Valvular Heart Disease
		Overview
		General Considerations
			Epidemiology
			Indications
			Preoperative Evaluation and Optimization
				History and Physical examination
				Echocardiography
				Cardiac Catheterization
				Other Preoperative Testing
				Medical Therapy
			Surgical Approaches
				Median Sternotomy
				Minimally Invasive Approaches
			Prostheses
				Mechanical Valves
				Stented Xenografts
				Stentless Xenografts
				Homografts
			Postoperative Care
		Aortic Valve Surgery
			Overview
			Indications
				Aortic Stenosis/Mixed Aortic Valve Disease
				Aortic Regurgitation
			Aortic Valve Replacement
				Surgical Technique
				Choice of Prosthesis
				Patient-Prosthesis Mismatch
			Aortic Valve Repair
			Results
				Early
				Late
		Mitral Valve Surgery
			Overview
				Anatomy
				Carpentier’s Functional Classification
				Preoperative Evaluation
			Indications
				Mitral Regurgitation
				Mitral Stenosis
			Mitral Valve Repair
				Principles
				Annuloplasty
				Leaflet Prolapse Repair Techniques Type II
				Restricted Leaflet Techniques Type III
				Other Techniques
			Mitral Valve Replacement
				Chordal-Sparing Mitral Valve Replacement
				Choice of Prosthesis
			Results
				Early
				Late
		Tricuspid Valve Surgery
			Overview
			Indications
			Surgical Techniques
				Approach
				Valve Repair
				Valve Replacement
			Results
		Special Considerations
			Multiple Valves
				Mitral and Tricuspid Disease
				Aortic and Mitral Disease
			Reoperation
			Endocarditis
			Ischemic Heart Disease
				Incidental Coronary Disease in Valve  Surgery Patients
				Incidental Valve Disease in Coronary  Surgery Patients
				Aortic Stenosis in Coronary Artery Bypass Grafting Patients
				Mitral Regurgitation in Coronary Artery Bypass Grafting Patients
			Atrial Fibrillation
		References
	Chapter 47: Percutaneous Treatment for Valvular Heart Disease
		Overview
		Percutaneous Aortic Valve Implantation
		Current Percutaneous Aortic Valves
			Edwards Sapien Valve
			Medtronic CoreValve Revalving System
		Patient Evaluation and Imaging Prior to Transcatheter Aortic Valve Implantation
			Access Site Evaluation
			Measurement of Aortic Valve Annulus
		Transcatheter Aortic Valve  Implantation Procedure
			Patient Outcomes
			New Access Approaches
			New Applications
			Potential Complications
			Next-Generation Aortic Valve Therapy
				Transapical Valves
		Percutaneous Mitral Valve Therapy
			Approach to Leaflet Repair
			Chamber Remodeling
			Direct Annuloplasty
			Ventricular Remodeling
			Chordal Implantation
			Mitral Valve Replacement
		Summary
		References
	Chapter 48: Manifestations, Mechanisms, and Treatment of HIV-Associated Cardiovascular Disease
		Overview
		Antiretroviral Therapy
			Protease Inhibitors
			Nucleoside/Nucleotide Reverse  Transcriptase Inhibitors
			Nonnucleoside Reverse  Transcriptase Inhibitors
			Fusion Inhibitors
			Integrase Inhibitors
			Combination Medications
		Metabolic Effects of HIV Infection and Antiretroviral Therapy
			Hypertension
			Lipodystrophy and the Metabolic Syndrome
		Screening for Cardiovascular Disease in HIV-Positive Patients
		HIV Infection and Myocardial Infarction
		Clinical Features of Coronary Disease in HIV Patients
			Pathogenesis of Coronary Heart Disease  in HIV Infection
		Treatment of Coronary Risk Factors in HIV Patients
			Myocardial Involvement in HIV
			Pericardial Disease in Patients  with HIV Infection
		HIV-Related Pulmonary Hypertension
			Cerebrovascular Disease
			Endocarditis and Other Cardiac Disease
		Summary
		References
	Chapter 49: Rehabilitation of the Patient with Cardiovascular Disease
		Physiologic Effects of Immobility
		Physical Training
			Newer Concepts Regarding Physiologic Benefits of Exercise Training
		Cardiac Rehabilitation After  Myocardial Infarction
			Disability from Myocardial Infarction
			In-Hospital Exercise After a Coronary Event
				Patient Education
				Exercise Testing Before Hospital Discharge
			Outpatient Cardiac Rehabilitation
				Other Components of Outpatient Rehabilitation
					Safety of Cardiac Rehabilitation
					Monitoring in Outpatient Rehabilitation
					Maintenance Program
			Exercise Prescription for  Outpatient Rehabilitation
				Principles of Exercise Prescription
				Resistance Exercise
			Contraindications to Exercise Training
			Rehabilitation in Patients with Chronic  Heart Failure
			Meta-Analyses of Survival After  Cardiac Rehabilitation
			Evolving Landscape for Cardiac Rehabilitation
		Summary
		References
Part IX: Appendix
	Cardiovascular Devices
		Pulmonary Artery Catheters
			Indications
			Design
			Technical Aspects of Placement
			Interpretation of Waveforms
			Troubleshooting and Complications
		Intraaortic Balloon Pump Counterpulsation
			Indications
			Design
			Technical Aspects of Placement
			Timing and Waveforms
			Complications
		Pericardiocentesis
			Indications
			Technical Aspects
		Electrical Cardioversion  and Defibrillation
			Equipment
			Setup and Patient Preparation
			Technical Considerations
		Permanent Pacemakers
			Leads
			Basic Pacing Concepts
			Pacemaker Programming Considerations
				Mode
				Rate-Responsive Pacing
			Pseudo Pacemaker Malfunction
		Temporary Pacemakers
			Indications
			Placement
			Complications and Troubleshooting
		Implantable Cardioverter-Defibrillators
			Programmed Therapies for  Ventricular Arrhythmias
			Magnet Operation
			Inappropriate Shocks
			Routine Follow-up
		References
Index
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	D
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