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This comprehensive manual reviews the management of cardiorenal syndrome in heart failure. Chapters are structured in a practically applicable and easy-to-follow format with realistic case vignettes and key clinical management questions and answers, followed by a brief discussion of underlying pathophysiological mechanisms of a patient with cardiorenal syndrome. Building from this case, key questions are posed that are relevant to the clinical management and then potential evidence-based treatment strategies are proposed. Topics covered include loop diuretic resistance in acute and chronic heart failure, abdominal congestion, low output failure and potential diuretic complications due to hyponatremia. Cardiorenal Syndrome in Heart Failure thoroughly reviews cardiorenal syndrome from the perspective of both the cardiologist and nephrologist. Its case-based approach makes it an ideal resource for both practising and trainee cardiology and nephrology practitioners.
This comprehensive manual reviews the management of cardiorenal syndrome in heart failure. Chapters are structured in a practically applicable and easy-to-follow format with realistic case vignettes and key clinical management questions and answers, followed by a brief discussion of underlying pathophysiological mechanisms of a patient with cardiorenal syndrome. Building from this case, key questions are posed that are relevant to the clinical management and then potential evidence-based treatment strategies are proposed. Topics covered include loop diuretic resistance in acute and chronic heart failure, abdominal congestion, low output failure and potential diuretic complications due to hyponatremia. Cardiorenal Syndrome in Heart Failure thoroughly reviews cardiorenal syndrome from the perspective of both the cardiologist and nephrologist. Its case-based approach makes it an ideal resource for both practising and trainee cardiology and nephrology practitioners.
For many years, there has been a great deal of work done on chronic congestive heart failure while acute heart failure has been considered a difficult to handle and hopeless syndrome. However, in recent years acute heart failure has become a growing area of study and this is the first book to cover extensively the diagnosis and management of this complex condition. The book reflects the considerable amounts of new data reported and many new concepts which have been proposed in the last 3-4 years looking at the epidemiology, diagnostic and treatment of acute heart failure.
This textbook provides a practical and board-driven resource to describe and define the emerging field of cardiorenal medicine. Covering all aspects of the topic with depth and relevance, this groundbreaking reference brings together experts at the nexus between cardiovascular and renal medicine to provide an exception reference to educate in this critical area of modern medicine. It describes how the heart and kidneys are inextricably linked via hemodynamic, neural, hormonal and cellular signaling systems and, concentrating on disease-based coverage, goes on to review emerging concepts in epidemiology, pathogenesis, screening, diagnosis and the management of cardiorenal syndromes, all extensively illustrated and containing features to support scholarship in the field. Textbook of Cardiorenal Medicine provides consistent chapter organization, clear design and engaging text to define the diagnosis, treatment, intervention and surgical aspects of the full range of conditions encountered within this area of medicine. It is therefore an essential resource to all involved in the management of cardiorenal disease.
Chronic kidney disease with a worldwide prevalence of 10% in the general population is emerging as a major public health priority. Renal dysfunction is associated with a high risk for cardiovascular complications. The relationship between renal insufficiency and cardiovascular disease, termed the cardiorenal syndrome exists whether impairment of renal function is a consequence of primary renal parenchymal disease or primary heart disease. Several pathophysiologic mechanisms have been postulated to explain the relationship between renal dysfunction and cardiovascular disease. Recent studies indicate an integrated response of the vascular smooth muscles and glomerular mesangial cells to traditional and uremia related cardiovascular risk factors. Traditional risk factors can incite renal impairment and cardiac damage. As renal function deteriorates, uremia-related risk factors play an increasing role both in reduction in glomerular filtration rate and cardiovascular damage. Several uremia related factors such as uncontrolled hypertension, disturbed glucose insulin metabolism, microalbuminuria, phosphate retention, secondary hyperparathyroidism, myocardial and vascular calcification, hypertensive-uremic cardiomyopathy, inflammation, oxidant injury, and neurohormonal dysregulation have been implicated in the pathogenesis of the cardiorenal syndrome. Recent data suggest that management of the cardiorenal syndrome requires aggressive control of traditional risk factors as well novel approaches to prevent or reverse uremia –related processes. This book provides a comprehensive update analysis of our current understanding of the cardiorenal syndrome including epidemiology, pathophysiologic mechanisms, and therapeutic approaches.
Associated with both acute kidney injury (AKI) and cardio-renal syndromes (CRS), new biomarkers represent both a popular area of investigation and a new opportunity for advancement of therapy. This book contains the resolutions of the most recent ADQI conferences on biomarkers in AKI (Dublin) and on cardio-renal syndromes (Venice). The first part answers specific questions about new biomarkers and their use and utility in AKI: What are the most suitable candidate molecules and physiologic measures, how solid and evidence based is the discovery phase? How can we incorporate the new biomarkers in the AKI conceptual model describing the evolution from susceptibility to insult, decreased GFR and organ death? Even if we have a positive biomarker pattern and we can identify patients at risk or patients with early or even subclinical AKI, how is this information affecting our clinical behavior and practice? The second part is dedicated to the appraisal of the current knowledge about the pathophysiological mechanisms involved in different forms of CRS: it contains contributions on the state-of-the-art knowledge and practice of CRS, particularly focusing on the pathophysiology of the five subtypes. Acute and chronic mechanisms of damage are explored in depth, with particular attention to the primacy of organ involvement and the subsequent pathways of organ crosstalk.Presenting the most recent research in the field of biomarkers, AKI and CRS, this publication is an important educational tool for advanced investigators and clinical experts, but also for students and fellows.
The treatment of hypertension has become the most important intervention in the management of all forms of chronic kidney disease. Chronic Kidney Disease and Hypertension is a current, concise, and practical guide to the identification, treatment and management of hypertension in patients with chronic kidney disease. In depth chapters discuss many relevant clinical questions and the future of treatment through medications and or novel new devices. Written by expert authors, Chronic Kidney Disease and Hypertension provides an up-to-date perspective on management and treatment and how it may re-shape practice approaches tomorrow.
This book introduces pathophysiology and practical heart failure (HF) management at the acute, in-hospital stages during hospitalization and also in the end-stages of HF. Given its increasing incidence and prevalence, we live in a world that is essentially facing an HF pandemic. A country with an ageing population, Japan is unique in terms of the selection of medical treatment, diagnostic techniques, team managing and other approaches. This book sheds new light on the clinical challenges involved in reducing re-hospitalization and improving patients’ prognosis and ADL/QOL, while also reporting on the status quo in Japan. By highlighting these challenges and the methods used to address them, it will encourage experts around the globe to intensively discuss and accelerate research in this field. Including contributions by authors who have played central roles in managing HF in Japan, the book offers an indispensable guide not only for clinicians, technicians and nurses in this field, but also for general physicians, emergency physicians and all others who are involved in the management of acute and end-stage HF.
Arterial hypertension, coronary heart disease and heart fail ure are the commonest cardiovascular conditions to present in clinical practice. Over the past few years it has become in creasingly clear that they are closely and causally interrelated and that their relationship can have a significant bearing on prognosis. Epidemiological studies have shown that arterial hypertension is one of the most important risk factors for de veloping heart failure. Only one in four patients with hyper tension is adequately managed, and in 50% of cases, the hypertension has not been recognised or treated. Patients with pre-existing hypertension who go on to suffer an acute myocardial infarction have usually not previously had typi cal angina symptoms, the infarct territory is larger, life threatening arrhythmias are commoner and hence in-hospi tal mortality and long-term prognosis are markedly worse. The presence of raised blood pressure in the post-infarct phase doubles the risk of manifest heart failure. The close relationship between hypertension, coronary heart disease and heart failure makes the choice of therapeu tic strategy particularly important. Agents and classes of agents that have prognostic value in all three conditions should be considered first, as synergy might result in addi tional benefits. In such patients, this sort of therapeutic deci sion-making might have further advantages. The use of these agents may prevent complications which are not yet clinically obvious (such as heart failure).
The ESC Textbook of Intensive and Acute Cardiovascular Care is the official textbook of the Acute Cardiovascular Care Association (ACVC) of the ESC. Cardiovascular diseases (CVDs) are a major cause of premature death worldwide and a cause of loss of disability-adjusted life years. For most types of CVD early diagnosis and intervention are independent drivers of patient outcome. Clinicians must be properly trained and centres appropriately equipped in order to deal with these critically ill cardiac patients. This new updated edition of the textbook continues to comprehensively approach all the different issues relating to intensive and acute cardiovascular care and addresses all those involved in intensive and acute cardiac care, not only cardiologists but also critical care specialists, emergency physicians and healthcare professionals. The chapters cover the various acute cardiovascular diseases that need high quality intensive treatment as well as organisational issues, cooperation among professionals, and interaction with other specialities in medicine. SECTION 1 focusses on the definition, structure, organisation and function of ICCU's, ethical issues and quality of care. SECTION 2 addresses the pre-hospital and immediate in-hospital (ED) emergency cardiac care. SECTIONS 3-5 discuss patient monitoring, diagnosis and specific procedures. Acute coronary syndromes (ACS), acute decompensated heart failure (ADHF), and serious arrhythmias form SECTIONS 6-8. The main other cardiovascular acute conditions are grouped in SECTION 9. Finally SECTION 10 is dedicated to the many concomitant acute non-cardiovascular conditions that contribute to the patients' case mix in ICCU. This edition includes new chapters such as low cardiac output states and cardiogenic shock, and pacemaker and ICDs: troubleshooting and chapters have been extensively revised. Purchasers of the print edition will also receive an access code to access the online version of the textbook which includes additional figures, tables, and videos to better to better illustrate diagnostic and therapeutic techniques and procedures in IACC. The third edition of the ESC Textbook of Intensive and Acute Cardiovascular Care will establish a common basis of knowledge and a uniform and improved quality of care across the field.