Use and Approval of Antihypertensive Agents and Surrogate Endpoints for the Approval of Drugs Affecting Antiarrhythmic Heart Failure and Hypolipidemia PDF Download
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Author: J. Morganroth
Publisher: Springer Science & Business Media
ISBN: 1461315050
Category : Medical
Languages : en
Pages : 230
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Book Description
The Symposium on New Drugs provides for an annual forum for academic investigators, research and development personnel from the pharmaceutical and related health care industries, and members of the Food and Drug Administration to discuss important clinical research issues. The Tenth Annual Symposium on New Drugs addressed the problem of whether it was still appropriate to approve antihypertensive agents soley on the endpoint of lowering cuff blood pressure. The initial discussions at this symposium related to the approaches and methods to studying antihypertensive agents. Dr. William Frishman provided a detailed list of the new approaches to the treatment of hypertension and pointed out the many new concepts that are currently active in the development of many new antihypertensive agents. Dr. William White detailed the growing importance of ambulatory blood pressure monitoring to define hypertension and to determine the change in blood pressure due to pharmacologically active agents. Dr. Jay Cohn pointed out the flaws in using cuff blood pressure and detailed the potential virtues of using vascular compliance to identify patients requiring treatment for hypertension. Dr. Thomas Pickering also discussed the potential value of evaluating changes in left ventricular hypertrophy a finding which identifies high risk patients who need to be included in clinical trials. Dr. Michael Weber detailed the issues and suggested refinements in the approaches to clinical trial designs for antihypertensive agents and Dr. Raymond Lipicky discussed the definition of dose-duration and the role of non-Mem and Peak/Through measurements in defining an antihypertensive drug effect.
Author: J. Morganroth
Publisher: Springer Science & Business Media
ISBN: 1461315050
Category : Medical
Languages : en
Pages : 230
Get Book Here
Book Description
The Symposium on New Drugs provides for an annual forum for academic investigators, research and development personnel from the pharmaceutical and related health care industries, and members of the Food and Drug Administration to discuss important clinical research issues. The Tenth Annual Symposium on New Drugs addressed the problem of whether it was still appropriate to approve antihypertensive agents soley on the endpoint of lowering cuff blood pressure. The initial discussions at this symposium related to the approaches and methods to studying antihypertensive agents. Dr. William Frishman provided a detailed list of the new approaches to the treatment of hypertension and pointed out the many new concepts that are currently active in the development of many new antihypertensive agents. Dr. William White detailed the growing importance of ambulatory blood pressure monitoring to define hypertension and to determine the change in blood pressure due to pharmacologically active agents. Dr. Jay Cohn pointed out the flaws in using cuff blood pressure and detailed the potential virtues of using vascular compliance to identify patients requiring treatment for hypertension. Dr. Thomas Pickering also discussed the potential value of evaluating changes in left ventricular hypertrophy a finding which identifies high risk patients who need to be included in clinical trials. Dr. Michael Weber detailed the issues and suggested refinements in the approaches to clinical trial designs for antihypertensive agents and Dr. Raymond Lipicky discussed the definition of dose-duration and the role of non-Mem and Peak/Through measurements in defining an antihypertensive drug effect.
Author: A.V. Bruschke
Publisher: Springer Science & Business Media
ISBN: 9400901437
Category : Medical
Languages : en
Pages : 230
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Book Description
A unique overview of all major angiographic lipid intervention trials, presented by their principal investigators. Basic mechanisms and methodological aspects, including biochemical as well as angiographic aspects, are discussed by experts in these fields. A careful comparison of all available data permits an analysis to be made of what may currently be considered proved, which aspects merit further investigation, and which hypotheses should be rejected. Audience: Clinicians involved in the practice of lipid lowering and investigators involved in lipid-lowering clinical trials. Scientists involved in other areas of lipid research and investigators conducting coronary angiographic trials designed to study the influence of different interventions will find a wealth of information and practical guidelines in this book.
Author: R. Vos
Publisher: Springer Science & Business Media
ISBN: 940113796X
Category : Medical
Languages : en
Pages : 398
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Book Description
We all know how much time, effort and money it takes to develop a new drug. Hundreds of chemical compounds have to be synthesized and thousands of different activities in biology, physiology, pharmacology, clinical investigation, management and marketing have to be initiated and coordinated. Each new drug starts a voyage of discovery through an unmapped terrain which is shrouded in mist and beset by pitfalls, as Dr. Rein Vos puts it in his absorbing inside story of the development of the beta-adrenoceptor blocking agents and the calcium antagonists. Indeed we know, for example, how long it took before the theory of Ahlquist of the alpha and beta adrenergic receptors was widely accepted. Similarly, it suffices to memorize shortly the difficulty of expanding the new concept of calcium antagonism through the national German boundaries into the world. This shows how laborious and complex pharmaceutical progress is, and we all will benefit from a deeper understanding of the process of innovative drug research.
Author: Johan H. C. Reiber
Publisher: Springer Science & Business Media
ISBN: 9401126666
Category : Medical
Languages : en
Pages : 409
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Book Description
In recent years there have been major advances in the fields of cardiovascular nuclear medicine and cardiac magnetic resonance imaging. In nuclear cardiology more adequate tomographic systems have been designed for routine cardiac use, as well as new or improved quantitative analytic software packages both for planar and tomographic studies implemented on modern state-of-the-art workstations. In addition, artificial intelligence techniques are being applied to these images in attempts to interpret the nuclear studies in a more objective and reproducible manner. Various new radiotracers have been developed, such as antimyosin, labeled isonitriles, metabolic compounds, etc. Furthermore, alternative stress testing with dipyridamole and dobutamine has received much attention in clinical cardiac practice. Magnetic resonance imaging is a relative newcomer in cardiology and has already shown its merits, not only for anatomical information but increasingly for the functional aspects of cardiac performance. This book covers almost every aspect of quantitative cardiovascular nuclear medicine and magnetic resonance imaging. It will assist the nuclear medicine physician, the radiologist, the physicist/image processing specialist and the clinical cardiologist in understanding the nuclear medicine techniques used in cardiovascular medicine, and in increasing our knowledge of cardiac magnetic resonance imaging.
Author: Ernst E. van der Wall
Publisher: Springer Science & Business Media
ISBN: 9401100233
Category : Medical
Languages : en
Pages : 262
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Book Description
Myocardial viability has become one of the most important issues in clinical cardiology. In particular, absence or presence of viability may be decisive in patient management, and the decision to perform angioplasty (PTCA) or bypass surgery (CABG) is frequently based on the accurate assessment of viability. Although echocardiography and conventional nuclear medicine techniques may provide valuable information on viability, positron emission tomography (PET) is currently considered to be the gold standard for the assessment of myocardial viability. The simultaneous evaluation of myocardial metabolism and perfusion allows precise delineation and accurate quantification of residual myocardial viability in affected regions. In addition, accurate quantification of myocardial perfusion alone may provide insight into the basic mechanisms of syndrome X and may assist in the appropriate clarification of this clinically complicated, but frequently occurring phenomenon. Besides that, cardiac PET may deepen our insight into metabolism and perfusion of cardiac muscle disease, particularly in hypertrophic cardiomyopathy. Furthermore, receptor imaging studies with PET will become important as the study of cardiac neurohumoral regulation in heart failure has gained in interest. Cardiac Positron Emission Tomography: Viability, Perfusion, Receptors and Cardiomyopathy describes the most recent developments in cardiac PET as these are related to myocardial viability and myocardial perfusion studies of syndrome X. The value of PET for receptor imaging and cardiac muscle disease is also discussed. For cardiologists, nuclear medicine physicians, radiochemists, physiologists, technicians and basic researchers interested in understanding the most recent achievements in cardiovascular PET.
Author: P.E. Vardas
Publisher: Springer Science & Business Media
ISBN: 9401152543
Category : Medical
Languages : en
Pages : 461
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Book Description
Europace '97 was held in Athens, Greece, on 8-11 June Leads were, as usual, an important topic, with the earl 1997 in the city of classical civilisation and learning. iest mention of the then-new polyurethane leads. Future Though now held in modem surroundings and meeting conferences elaborated on these basic topics while pro facilities, the influence of the ancient city-state was un gressively adding sensors and sensor function, dual mistakable, with the architecture and learning of antiquity chamber pacing, and recognising the development of looming over the city, by its influence over the intellectual clinical cardiac electrophysiology. activities of the symposium. The ancient magnificence of Clinical cardiac electrophysiology and compre the site was matched by the novelty of modem art and hension of arrhythmias has been largely a development science, Europace is a European symposium, begun in of the twentieth century. With the description and 1979, and has occurred every second year since. Con recording of the bundle of His depolarisation, by direct sistent with its importance and continental reach the actual access and by catheter, modem clinical investigation of symposium has moved to different cities throughout arrhythmias and cardiac electrophysiology began. The Western Europe. The first symposium was held in London disciplines of cardiac stimulation and of investigation of and subsequent symposia have been held in Torremolinos, arrhythmias, impulse formation and A V conduction Ostend, Florence, Istanbul and other cities. Because of the were essentially separate for many years.
Author: Donald Bers
Publisher: Springer Science & Business Media
ISBN: 9401715122
Category : Medical
Languages : en
Pages : 278
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Book Description
The main aim of this monograph is to provide an overview of calcium regulation in cardiac muscle cells, particularly with respect to excitation-contraction coupling and the control of cardiac contractile force. It is my hope that this book will be useful to students of the cardiovascular system and muscle at all different levels and in different disciplines (such as physiology, biochemistry, pharmacology and pathophysiology). I also hope that it will find use for those studying developmental, comparative and disease processes as well as more integrative phenomenon. I kept several goals in mind in writing this monograph. First, it should be easily readable. Second, I chose to include numerous illustrations and tables to help integrate results from numerous investigators in practical formats and also present key figures from important papers. Thus, this monograph may serve as a resource of information for people working in the areas described herein. Third, the presentation is a very personal one, and I have necessarily drawn extensively on my personal experience in this field over the past 15 years. This, I think, helps maintain a certain continuity of thought from chapter to chapter. Fourth, I have made serious attempts to make each chapter "up to date", despite the breadth of topics covered. I have also tried to be equitable in choosing references while not intending to be comprehensive or exhaustive. Neither of these aims can be perfectly matched, and I apologize to the many investigators whose papers I have not cited, but should have.
Author: M. Morad
Publisher: Springer Science & Business Media
ISBN: 9401139903
Category : Medical
Languages : en
Pages : 586
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Book Description
Knowledge of cardiac ion channels and transporters has advanced remarkably in the last two decades with the development of patch-clamp and molecular biological techniques. This textbook offers a comprehensive overview of structures and functions of ion channels and transporters in the heart. Readers are first introduced to the molecular biology and electrophysiology of all the important ion channels. After discussing their developmental changes, the pharmacology and pathophysiology of clinically-relevant ion channels are reviewed. Molecular aspects of the cardiac excitation-contraction coupling and intracellular Ca2+ regulation by ion transporters are also described. The book will be useful to electrophysiologists, cardiac physiologists and pharmacologists, and molecular biologists interested in ion channels at all levels. For research specialists, the book will provide a perspective of the field. The book can be used as a reference source for working scientists in the fields of ion channels, biophysics, cardiac electrophysiology, and pharmacology. It is aimed at graduate and medical students, designed for use as a textbook for graduate and medical courses.
Author: Johan H. C. Reiber
Publisher: Springer Science & Business Media
ISBN: 9400902913
Category : Medical
Languages : en
Pages : 579
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Book Description
In the past, coronary arteriography was the only modality available to provide high quality images of the coronary anatomy. Quantitative coronary arteriography (QCA) was developed, implemented, validated and extensively applied to obtain accurate and reproducible data about coronary morphology and the functional significance of coronary obstructions. Over the last few years extensive basic technological research supported by clinical investigations has created competing modalities to visualize coronary morphology and the associated perfusion of the myocardial muscle. Currently, the following modalities are available: X-ray coronary arteriography, intracoronary ultrasound, contrast- and stress-echocardiography, angioscopy, nuclear cardiology, magnetic resonance imaging, and cine and spiral CT imaging. For all these imaging modalities, the application of dedicated quantitative analytical software packages enables the evaluation of the imaging studies in a more accurate, reliable, and reproducible manner. These extensions and achievements have resulted in improved diagnostics and subsequently in improved patient care. Particularly in patients with ischaemic heart disease, major progress has been made to detect coronary artery disease in an early phase of the disease process, to follow the atherosclerotic changes in the coronary arteries, to establish the functional and metabolic consequences of the luminal obstructions, and accurately to assess the results of interventional therapy. Aside from all these high-tech developments in cardiac imaging techniques, the transition from the analogue to the digital world has been going on for some time now. For the future, it has been predicted that the CD-R will be the exchange medium for cardiac images and DICOM-3 the standard file format. This has been a major achievement in the field of standardization activities. Since these developments will have a major impact on the way images will be stored, reviewed and exchanged in the near future, an important part of this book has been dedicated to DICOM and the filmless catheterization laboratory. Cardiovascular Imaging will assist cardiologists, radiologists, nuclear medicine physicians, image processing specialists, physicists, basic scientists, and fellows in training for these specialties to understand the most recent achievements in cardiac imaging techniques and their impact on cardiovascular medicine.
Author: Peter Hanrath
Publisher: Springer Science & Business Media
ISBN: 9401124906
Category : Medical
Languages : en
Pages : 472
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Book Description
An international meeting of experts on Cardiovascular Imaging by Ultrasound was held in Aachen from 26-27 April, 1991. It provided new and interesting insights into what has already been achieved in ultrasound-based cardiovascular diagnosis and therapy and what will be introduced in clinical practice in the near future. Since the introduction of ultrasound in clinical practice in 1984 there has been no other physical principle that has added and will continue to add so much to clinical diagnosis and therapy. Echocardiography, once established as a non-invasive diagnostic tool, is increasingly becoming an invasive technique for cardiovascular imaging. This book contains the edited contributions from 38 scientists and engineers from all over the world who presented the most up-to-date findings on 2-dimensional echocardiography, different Doppler modalities, contrast and stress echocardiography and the different modalities of transesophageal echocardiography, including mono-, bi- and multiplane TEE, as well as pulsed and CW-Doppler application via TEE. Exciting and promising developments are discussed in the field of intravascular ultrasound, tissue characterization, ultrasound ablation, ultrasound-based 3-dimensional reconstruction of the heart, and high frequency Doppler analysis.
