Heart Failure [antikvár]

ForewordThe past decade has seen dramatic advances in our understanding of the basic mechanisms of cardiac contraction and relaxation. These advances have led to a growing appreciation of cellular and molecular causes of heart disease. However, this rapid growth of knowledge has also created a widening gap in communication between physicians responsible for managing patients with heart disease and scientists working to advance the frontiers of knowledge.Health care practitioners commonly view the heart as an organ that pumps blood and understand heart failure as a deficiency in cardiac pumping. Although the intricacy of the heart's machinery is appreciated by the clinician, the vast and growing body of new molecular understanding has become overwhelming in both volume and complexity. Basic scientists, on the other hand, while able to relate specific aspects of the heart's performance to precisely characterized features of specific molecules within myocardial cells, are often not well trained to understand the clinical challenges posed by the patient with heart failure. This book, which focuses on what is becoming the most important cause of heart disease in our aging population, seeks to bridge this gap by juxtaposing the latest knowledge of the mechanism and control of cardiac contraction with discussions of the pathophysiology and therapy of heart failure.One consequence of our new understanding of the pathophysiology of heart failure is a blurring of the definition of this condition. At the beginning of this century, clinicians had no difficulty in defining heart failure simply as impaired pumping by a diseased heart. C. J. Wiggers, in his 1915 book Circulation in Health and Disease, stated that cardiac insufficiency occurs "when the heart fails to discharge as much blood as it receives." This definition was echoed in 1933 by Sir Thomas Lewis, who wrote in his Diseases of the Heart: "There is but one meaning to the term cardiac failureit signifies inability of the heart to discharge its contents adequately." Sir James MacKenzie, in the third (1915) edition of his Diseasesvii