Open Access Medical Books



Edited by Richard M. Fleming .

274 pages .
Open Access .

In 1986, I graduated from the University of Iowa College of Medicine. On the day, I entered Medical School, the Dean told us that 90% of what we would be taught was wrong, he simply did not know what that 90% was. He encouraged us to strive to determine what was wrong and what was right, allowing us to take better care of our patients. To do that would require a lifetime commitment to research, education, reading and building upon our clinical experiences. For that reason, we can never stop learning, growing or questioning what we know or think we know. When I was a Medical Student, Color Flow Doppler echocardiography had not even hit the clinical setting and when I was first introduced to it as a Cardiology Fellow, it made little sense to me as the “doppler shift” phenomena, something I knew well from my days as a physics student, meant, “red is moving away” from you, while “blue is moving toward you.” (Actually, I knew this in Junior High.) Unfortunately, for Doppler echocardiography, this is the opposite as “red” is toward and “blue” is away from the transducer. This presents the classic example of mistakes in the field and the need to learn the terminology. Medicine does not stand still; however, improvements, corrections in misunderstandings and breakthroughs are constantly fighting their way to the surface of science where they can be discussed at meetings, conferences, journals and eventually books, such as this one. To that end, we present this book to the reader as s/he continues to learn and acquire new knowledge on this lifelong quest for improvement.
Recent changes in the fields of Doppler Echocardiography, Computed Tomography and Nuclear Cardiology have improved the detection and treatment of countless individuals over the last decade. This book introduces the reader to some of those improvements and provides an informative and useful framework, upon which both clinician and researcher alike can use to improve the quality of care provided to patients and their work. Hence, it establishes better standards of care and understanding in these non‐invasive areas of Cardiology. We have broken this book into six main sections, with the first four sections looking at Doppler Echocardiography including (1) the right heart and its special considerations, (2) the influence of pulmonary factors which will influence doppler evaluations, (3) evaluation of left heart function, and (4) a special considerations section which will address the use of contrast agents in addition to factors which influence Doppler studies, the effects of timing and aging as seen with Doppler, evaluation of hepatic transplants and even the effects of rheumatoid arthritis. The remaining two sections include (5) Nuclear Cardiology, where dramatic shifts in understanding have significantly improved the detection of ischemic heart disease, including the detection of Vulnerable Inflammatory Plaques (VIPs), building upon the “Inflammation and Heart Disease” theory proposed by the Editor in 1995 and finally (6) the impact that Coronary CT may play in the detection of coronary artery disease. After reading this book, we believe the reader will not only have a better understanding of how to go about utilizing these unique tools in the treatment and diagnosis of individuals with heart disease; but, also be encouraged to participate in the process of constantly striving to improve patient care and management and to actively seek answers to questions yet unanswered....

Richard M. Fleming
Critical Care and Cardiology, Department of Internal Medicine,
Sierra Nevada Veterans Affairs Health Care System, Reno, Nevada,



Part 1 Right Heart Doppler .

 1 Superior Vena Cava Doppler Flow Changes in 
Superior Vena Cava Syndrome 3 
Yun You Duan and Li Jun Yuan

 2 The use of Tricuspid Annular Plane Systolic Excursion and Tissue Doppler Imaging Velocities for the Estimation of Pulmonary Hypertension and Right Ventricular Function in Mechanically Ventilated Patients 17 Vasilios Papaioannou and Ioannis Pneumatikos

 3 Endomyocardial Biopsy Guided by Echocardiography 31 Alfredo Inácio Fiorelli, Wilson Mathias Junior and Noedir Antonio Groppo Stolf

Part 2 Pulmonary Factors Influencing Doppler .

 4 Doppler Echocardiographic Changes in Respiratory Diseases 59 Mohammed Al-Biltagi and Adel Salah Bediwy

Part 3 Left Ventricular Doppler .

 5 Tissue Doppler in Ischemic Heart Disease 83 Ola Gjesdal and Thor Edvardsen

 6 Evaluation of Left Ventricular Diastolic Function by Echocardiography 99 Juan Lacalzada, Amelia Duque, Alejandro de la Rosa, Antonio Barragan, María Manuela Izquierdo, Eduardo Arroyo, Ana Laynez and Ignacio Laynez

 7 Left Ventricle Postinfarction Aneurism: Comparison Between Diagnostic Value of Different Methods of Visualization 123 Maryna N. Dolzhenko, Sergey V. Potashev and Natalia N. Nosenko

Part 4 Special Considerations .

 8 Doppler Contrast Echocardiography 135 Vincent L. Sorrell and Sachin Kumar

 9 Factors Influencing Doppler Blood Flow and its Measurements 147 Tie-Sheng Cao and Li-Jun Yuan

 10 The Importance of Doppler-echocardiography in the Assessment of the Athlete’s Heart 167 Gábor Pavlik and Zsuzsanna Kneffel

 11 Cardiopulmonary Disease in the Liver Transplant Patient: The Role of Doppler Echocardiography 179 Michael Ramsay

 12 Echocardiography in Rheumatoid Arthritis (RA) 187 Małgorzata Wisłowska

Part 5 Nuclear Cardiology .

 13 Fleming-Harrington Redistribution Wash-in Washout (FHRWW): The Platinum Standard for
Nuclear Cardiology 207 Richard M. Fleming and Gordon M. Harrington

Part 6 Computed Tomography .

 14 Diagnostic Value of Multisliced Computed Tomography in Coronary Arteries Atherosclerotic Lesions Detection in the Patients with Coronary Heart Disease – a Comparative Study 253 Maryna N. Dolzhenko, Sergey V. Potashev and Natalia N. Nosenko

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Published by: younes younes - Tuesday, May 14, 2013


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