Left Ventricular Hypertrophy [antikvár]

Preface Understanding the mechanisms involved in patho- physiological processes may not always lead imme- diately to direct therapeutic benefit and often the desire to investigate is triggered as much by curios- ity as benevolent goals. Research in the field of left ventricular hypertrophy (LVH) is a very good example of how careful, patient and persistent work can transform our understanding of a condi- tion and galvanise efforts to develop more effective treatments for it. Epidemiological research unmasked the adverse prognosis of LVH in man and thereby initiated a raft of experimental and clinical investigations into its causes, consequences and treatment. Recognition of the proarrhythmic effects of hypertrophy prompted studies of the underlying electrophysiological mechanisms as did the transition to heart failure in many patients lead to a better understanding of the associated contrac- tile dysfunction. The occurrence of myocardial ischaemia in the abscence of epicardial coronary disease is something of a conundrum to cardiolo- gists who deal with the current epidemic of athero- matous disease; however the underlying mecha- nisms for this are now well understood in cardiac hypertrophy. The molecular triggers, signals and messengers involved in the hypertrophic process have important links to normal growth and devel- opment and have attracted intense interest in recent years. Recognition of hypertrophic car- diomyopathy as a genetic disease was a major advance as is the evolving understanding of the role of genetic factors in determining the hyper- trophic response to hypertension. Regression of LVH is now recognised as an important and achievable therapeutic objective and this seemed an appropriate time to bring together a group of workers involved in all aspects of research in this field from epidemiology to molecular genetics to document their experience in a book. The aim has been to provide an account of the multi-discipli- nary advances in understanding LVH which have been achieved in the past two decades. Research is an ongoing process to extend the boundaries of knowledge, often fuelled by ques- tions arising from past experiments. The aim here is to inform, but also to engage the reader in the research process and thereby to generate questions which may influence future research. DJS July 1998