Congenital heart defects (CHD) are the most frequent malformation in the human fetus and are the leading cause of mortality due to malformations in the first year of life. Despite its clinical importance screening performed by ultrasonographic examination during the second trimester of pregnancy has shown disappointingly low detection rates mainly due to the difficulties in obtaining an adequate examination of the fetal heart. Four-dimensional (4D) ultrasound of the fetal heart has been recently suggested as a tool to improve the detection rate of CHD by decreasing the dependency on operator skills required in two-dimensional ultrasound scans but up to now no practical manuals are available in describing its application in clinical practice for the study of fetal heart. The objective of this Ebook is to explain the role of 4D during second trimester examination and in fetuses with CHD. T

Historically, patients with advanced structural heart disease have required major surgery to correct the defect. This includes, for example, patients with atrial septal defect, aortic valve disease and mitral valve disease. In recent years there have been major advances in the treatment of patients with structural heart disease using minimally invasive, percutaneous treatments. This field continues to evolve quite quickly. This e-book outlines the current situation with respect to minimally invasive treatment of a wide range of structural cardiac defects. Each chapter covers details of a structural defect and outlines various technologies available for treating the condition. Indications for procedures as well as details of the procedures are also provided wherever possible. This e-book should be a useful reference for readers interested in minimally invasive cardiovascular surgery.

This book provides a comprehensive overview of current knowledge about research in oral infections and their association with cardiovascular diseases. Several epidemiological, clinical and other scientific aspects are covered in this book through the work of medical experts. The detailed accounts in this book are of great value to readers in the scientific community, practitioners, teachers and students in relevant fields, and health-care planners.

In recent decades, the prevalence of heart failure has steadily increased and can be considered a contemporary cardiovascular epidemic. Therefore, treatment of heart failure is a primary focus of cardiovascular disease management strategies. Cardiac resynchronization therapy: an established pacing therapy for heart failure and mechanical dyssynchrony provides basic knowledge about congestive heart failure and also covers the evolution of cardiac resynchronization therapy. State-of-the-art information and future directions of this therapeutic tool are explained. As cardiac resynchronization therapy (CRT) is a new therapy which still undergoes rapid advancement, it is imperative to provide updates on key issues. These include technological advances, the unique role of imaging to assess mechanical dyssynchrony, troubleshooting, recent key clinical trials, and the incorporation of monitoring capabilities into CRT or CRT plus defibrillation devices. Cardiac resynchronization therapy is an exciting new option for a growing number of heart failure patients, but CRT systems present special challenges to clinicians, even those accustomed to working with pacemakers.

This comprehensive ebook covers all the aspects of ADME/PK modeling including solubility, absorption, formulation, metabolic stability, drug-drug interaction potential and a special delivery tool of drug candidates. The book provides an integrated view of fundamental ADME issues and challenges in early drug development from the aspect of practicing drug researchers. It also provides valuable help for the medicinal chemist in the process of multiple optimization.

Thermodynamics and kinetics (i.e., chemical interactions) are extremely important concepts for pharmaceutical scientists to understand since the “drug selection process”, that is, the process used by pharmaceutical companies to discover and develop marketable drugs, is totally dependent upon these theories. While both theories are important, kinetic models describing complex chemical and biological processes provide a unifying theory for all phases of the discovery and development of drugs. Unfortunately, in most textbooks the mathematical descriptions necessary to develop a deeper understanding of kinetic models are omitted. This is primarily done such that the underlying chemistry and biochemistry principles are not obscured by the “mathematical maze” that is generated from these models. As a result many chemists and biologists veer rapidly away from thermodynamics and kinetics. For some scientists, this can lead to confusion on how to apply these models to real-life situations. For example, many enzyme kinetic models are formulated as rate equations. Since experimentally measurements typically determine concentrations and rarely determines rates directly, confusion arises on how to apply kinetic models. In this case, either the model is integrated to give a description of the concentration course of the enzyme reaction or the data is differentiated (i.e., the process of determining rates) by measuring tangents to the reaction curves at zero time. The level of mathematical skills required to solve kinetic models is minimal for anyone who has studied college level algebra and calculus. Thus, the objective of this book is to present a brief review of thermodynamics and kinetics followed by a detailed step-by-step approach in developing and solving kinetic models for complex chemical and biological processes. The book focuses on building a solid mathematical foundation of enzyme kinetic models by systematically evolving simple uni- and bi-molecular models to enzyme models. Applications for some of these kinetic models are generated from pharmaceutical examples and a selection of problems is presented at the end of each chapter. This elementary approach has been intentionally selected to keep the book at a self-explanatory level. It is anticipated that the reader will be able to follow the mathematical operations and in the process develop a deeper understanding of kinetic models and an improved ability to interpret kinetic parameters. The book is restricted to solution chemical kinetics and does not deal with the theories of chemical reactions, gas-phase reactions, experimental kinetic methods and so on. There are many excellent chemical kinetic textbooks available for those interested in these topics. The solution chemical kinetics materials for the book were obtained from literature papers and several books on physical chemistry and enzyme kinetics. The ideas from these sources have been hopefully reinterpreted in a style that is well matched to those pharmaceutical scientists that do not have a comprehensive knowledge of kinetic models and the mathematical skills to solve them. Chapter 1 presents a general overview to thermodynamic and kinetic principals and theory. In Section i, an overview to the scope of the book is presented. A brief review of mathematical fundamentals used in the book (Section ii) and kinetic and thermodynamic principals are present (Section iii and iv). A glossary of symbols and abbreviation used throughout the book is presented in Section v. Chapter 2 describes the basic theory of first-order kinetic models. These types of mathematical models are used for irreversible (Section I) and reversible (Section II) rearrangement reactions and some examples are presented to illustrate their applications to drug discovery. Chapter 3 describes second-order irreversible (Section III) and reversible (Section IV) dimerization reactions while Chapter 4 describes second-order irreversible (Section V) and reversible (Section VI) binding reactions. Chapter 5 describes partially and fully coupled reversible completive binding reactions (Section VII). Chapter 6 describes second-order kinetic models that are used to analyze consecutive irreversible (Section VIII) and reversible (Section IX) substrate suicide enzyme reactions. Chapter 7 describes kinetic models that are used to analyze consecutive irreversible (Section X) and reversible (Sections XI and XII) enzyme reactions. Chapter 8 describes kinetic models that are used to analyze consecutive reversible inhibition enzyme reactions (Section XIII - XVI). Chapter 9 describes kinetic models that are used to analyze substrate (Section XVII) and product inhibition (Section XVIII) enzyme reactions. The Appendix contains the answers to the problems.

Micro RNAs (miRNAs) are known to play an important role in gene expression regulation. Owing to their ever-increasing implications in the control of various biological and pathological processes, miRNAs have now been considered novel biomarkers of various human diseases including, cancer, viral disease, cardiovascular disorders, metabolic disturbances, etc. Unique expression profiles have been associated with specific pathological states. Cardiovascular disease is among the main causes of mortality in developed countries. The pathological process of the heart is associated with altered expression profile of genes that are important for cardiac function. The implications of miRNAs in the pathological process of the cardiovascular system have recently been recognized, and the research on miRNAs in relation to cardiovascular disease is now in rapid progress. The aim of this ebook is to present updated research on the subject with analyses from published reports. Micro RNAs and Cardiovascular Disease caters to the growing interest and information needs of cardiac clinicians and gene expression researchers.

The simple assessment of atherosclerotic risk factors is not an accurate tool to predict the risk of cardiovascular disease (CVD) in adults without past history of atherosclerotic disease. Preclinical atherosclerotic increases the global cardiovascular risk and should be evaluated for a better risk stratification. Intima-media thickness (IMT), reduced ankle-brachial pressure index (ABI) and impaired flow mediated dilatation (FMD) are independent markers of multifocal but subclinical atherosclerosis and result associated with an increased rate of cardiovascular events. Multidetector computed tomography (MDCT) may be a useful non-invasive technique to detect silent coronary disease (CAD) in patients with peripheral preclinical atherosclerosis. This ebook outlines “preclinical athersclerosis” and its markers in clinical practice. The ebook gives simple but clear information for a better stratification of global cardiovascular risk. The text serves as an important guide for medical professionals involved in the management of cardiovascular patients.

Congenital heart diseases are the most common neonatal malformations, ranging from 8 to 15/1000 live births in various communities. Improvement of knowledge in the genetic and etio-pathogenic aspects of these malformations as well as the technical advances of diagnostic and therapeutic tools have brought about a significant improvement in overall long-term patient outcome over the last few decades. This e-book is an update on the most recent genetic, diagnostic and therapeutic aspects of this pediatric cardiology. Specifically, the book explains, in detail, recent acquisitions in the field of interaction between the genome and heart development, advances in diagnostic non-invasive techniques and novel therapeutic applications of the percutaneous and “hybrid” cardiologic/surgical procedures. These developments in diagnostics and therapeutics will be extremely valuable for both pediatric and adult cardiologists treating patients with congenital heart defects.

"Degenerative aortic valve disease is the most prominent cardiac valve disease in Western societies. This volume describes some of the more important issues and problems for this condition: its progressive character and the underlying mechanisms of this progression diagnostic difficulties 1) ascertainment of valvular origin of symptoms in elderly; 2) the challenge of the low output – low gradient syndrome; 3) moderate aortic valve calcification during CABG; 4) prediction of the rate of progression (who will need surgery on short term and who not). the burden on the left ventricle and its consequences (danger of postponement of surgery) the effect and the modalities (access, types of valves) of surgical treatment on survival (and QoL) the mode of registering postoperative complications determining predictors for valve related, non-valve related cardiac and non-cardiac postoperative complications. The e-book is a unique presentation, specific to degenerative aortic valve disease and its treatment including information about ways to deal with the progressive character of the disease (autophagy as a mode of cell death). Cardiologists still avoid or delay referring patients to the surgeon for the sake of age, left ventricular function or co-morbidity. Therefore, the e-book benefits readers by addressing the above issue and providing critical information for changing referral policy, which would ultimately enhance postoperative survival of patients suffering from heart valve disease."