This volume is the product of a February 1982 conference, cosponsored by the American Heart Association, the National Institutes of Health, and the Bowman Gray School of Medicine, which examined techniques for delineating quantitatively the natural history of atherosclerosis. Against the background of current pathologic and clinical knowledge of atherosclerosis, invasive and noninvasive evaluative methods now in use and under development are surveyed in depth. Correlative clinicopathologic studies of atherosclerosis pose special questions with respect to both luminal and plaque characteristics that are addressed in this volume. An old observa tion, based on the examination of arterial casts, suggested that the so-called nodose lesion of atherosclerosis may be at first flattened into the wall of a weakened, dilated artery, rather than raised into the lumen. This is now fully confirmed in vivo by ultrasonic and other imaging techniques. The morbid anatomist is challenged anew to describe lesions as they are likely to occur in vivo. To achieve closer correlation with natural conditions, perfu sion fixation of arteries under arterial pressure is becoming more widely used and has already demonstrated more valid quantita tion of the composition and configuration of lesions. While the noninvasive methods of B-mode and Doppler ultrasound are suitable only for the clinical study of superficial arteries, such as the carotid or femoral, the new and relatively noninvasive procedure of intravenous digital subtraction angio graphy can be effectively used for the examination of deep systems, such as cerebral vessels.

Atherosclerosis is a degenerative process affecting blood vessels, which determines narrowing of the lumen, plaque growth, and hardening of the walls. It is a risk factor for cardiovascular diseases. The focus of this book is on the management of the atherosclerotic disease. The coverage of this book spans from histological presentation of the various stages of atherosclerotic lesions to the earliest studies in atherosclerosis therapy, from advanced clinical diagnosis to monitoring, follow-up, and home-care of the atherosclerotic patient. The book shows well-established diagnostic techniques covering several medical imaging modalities such as Ultrasounds, IVUS, MRI, Computer Tomography, along with new trends in early and advanced atherosclerosis diagnosis (innovative drugs and tissue characterization procedures). Surgical standards will be presented along with innovative experimental trials for the treatment of the atherosclerotic patient. The book will also cover emerging techniques based on molecular imaging and vibro-acoustics.

The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.

Stroke is a major cause of death and the major cause of adult neurological disability in most of the world. Despite its importance on a population basis, research into the genetics of stroke has lagged behind that of many other disorders. However, the situation is now changing. An increasing number of single gene disorders causing stroke are being described, and there is growing evidence that polygenic factors are important in the risk of apparently "sporadic" stroke. Stroke Genetics provides an up-to-date review of the area, suitable for clinicians treating stroke patients, and both clinical and non-clinical researchers in the field of cerebrovascular disease. The full range of monogenic stroke disorders causing cerebrovascular disease, including ischaemic stroke, intracerebral haemorrhage, aneurysms and arteriovenous malformations, are covered. For each, clinical features, diagnosis, and genetics are described. Increasing evidence suggest that genetic factors are also important for the much more common multifactorial stroke; this evidence is reviewed along with the results of genetic studies in this area. Optimal and novel strategies for investigating multifactorial stroke, including the use of intermediate phenotypes such as intima-media thickness and MRI detected small vessel disease are reviewed. The book concludes by describing a practical approach to investigating patients with stroke for underlying genetic disorders. Also included is a list of useful websites.

Despite recent advances in the diagnosis and treatment of symptomatic atherosclerosis, available traditional screening methods for early detection and treatment of asymptomatic coronary artery disease are grossly insufficient and fail to identify the majority of victims prior to the onset of a life-threatening event. In Asymptomatic Atherosclerosis: Pathophysiology, Detection and Treatment, Dr. Morteza Naghavi and leading authorities from the Society for Heart Attack Prevention and Eradication (SHAPE) present a new paradigm for the screening and primary prevention of asymptomatic atherosclerosis. The text focuses on accurate, yet underutilized, measures of subclinical atherosclerosis, notably coronary artery calcium scanning and carotid intima-media thickness measurement. The authors introduce a comprehensive approach to identifying the vulnerable patients (asymptomatic individuals at risk of a near future adverse event). Additional chapters discuss future directions towards containing the epidemic of atherosclerotic cardiovascular disease using innovative solutions such as preemptive interventional therapies (bioabsorbable stents) for stabilization of vulnerable atherosclerotic plaques, mass unconditional Polypill therapy for population-based risk reduction, and ultimately vaccination strategies to prevent the development of atherosclerosis. Up-to-date and authoritative, Asymptomatic Atherosclerosis: Pathophysiology, Detection, and Treatment is a must-have for any cardiologist or primary care physician who wishes to practice modern preventive cardiology and manage the increasing number of asymptomatic atherosclerotic patients. Outlines more accurate measures of risk (coronary artery calcium and carotid intima-media thickness) than traditional risk factors (total cholesterol, LDL cholesterol, HDL cholesterol) Presents new multipronged strategies to aid in the early detection and treatment of high risk asymptomatic patients

This textbook focuses on the vascular biology and physiology that underlie vascular disorders in clinical medicine. Vascular biomedicine is a rapidly growing field as new molecular mechanisms of vascular health and disease are unraveled. Many of the major cardiovascular diseases including coronary artery disease, heart failure, stroke and vascular dementia are diseases of the vasculature. In addition vascular injury underpins conditions like kidney failure and cardiovascular complications of diabetes. This field is truly multidisciplinary involving scientists in many domains such as molecular and vascular biology, cardiovascular physiology and pharmacology and immunology and inflammation. Clinically, specialists across multiple disciplines are involved in the management of patients with vascular disorders, including cardiologists, nephrologists, endocrinologists, neurologists and vascular surgeons. This book covers a wide range of topics and provides an overview of the discipline of vascular biomedicine without aiming at in-depth reviews, but rather offering up-to-date knowledge organized in concise and structured chapters, with key points and pertinent references. The structure of the content provides an integrative and translational approach from basic science (e.g. stem cells) to clinical medicine (e.g. cardiovascular disease). The content of this book is targeted to those who are new in the field of vascular biology and vascular medicine and is ideal for medical students, graduate and postgraduate students, clinical fellows and academic clinicians with an interest in the vascular biology and physiology of cardiovascular disease and related pathologies.

It has been known for over 150 years that hallmarks of inflammation can be observed in the wall of atherosclerotic vessels. It was, however, not clear if this inflammation is the cause or the consequence of atherogenesis. More recently, it has become evident that inflammation mediated both by innate and adaptive immunity is instrumental even in the earliest stages of the development of atherosclerotic lesions, i.e., that it plays an important pathogenetic role. In this volume, international experts in the field discuss the pathogenetic, diagnostic, preventive and possible therapeutic relevance of inflammation in atherogenesis. This book is intended for researchers and physicians in the fields of vascular biology, immunology and atherosclerosis.