Landmark Papers in Cardiovascular Medicine

520 Pages·2012·3.913 MB·English

by  Aung Myat, Tony Gerschlick

Landmark Papers in
Cardiovascular Medicine

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Landmark Papers in . . . series
Titles in the series
Landmark Papers in Neurosurgery
Edited by Reuben Johnson and Alexander Green
Landmark Papers in Anaesthesia
Edited by Nigel Webster and Helen Galley
Landmark Papers in Cardiovascular Medicine
Edited by Aung Myat and Tony Gershlick
Landmark Papers in Nephrology
Edited by John Feehally, Christopher McIntyre, and J. Stewart Cameron
L andmark Papers in General Surgery
Edited by Graham Mackay, Richard Molloy, and Patrick O’Dwyer
Landmark Papers in Allergy
Edited by Professor Aziz Sheikh, Professor Estelle Simons, Professor Thomas Platts-Mills,
Dr Allison Worth, and Professor Stephen Holgate
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Landmark Papers in
Cardiovascular Medicine
Edited by
Dr Aung Myat BSc(Hons) MB BS MRCP
Specialist Registrar in Cardiology and
BHF Clinical Research Training Fellow
West Midlands Deanery and
BHF Centre of Research Excellence
The Rayne Institute, St Thomas’ Hospital,
King’s College London, UK
Professor Anthony H. Gershlick BSc(Hons) MB BS MD FRCP
Professor of Interventional Cardiology
University of Leicester, UK

1
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3
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Foreword
Landmark Papers in Cardiovascular Medicine by Dr Aung Myat and Professor Tony
Gershlick represents an outstanding collection of articles and associated commen-
tary. This book is part of the prestigious Oxford University Press series. Distinguished
authors from around the globe have been assembled and have successfully identified
key papers from the past four decades—papers that have informed clinical practice,
shaped professional society guidelines, and spawned further research.
The editors start off their book with a section on coronary heart disease, and then
cover electrophysiology, heart failure, hypertension, valvular heart disease, and car-
diac imaging—the major disciplines within cardiology. Within each of these sections,
authors present the seminal papers in the field. Beyond providing mere summaries of
these papers, the authors provide contextual background, as well as a critique of the
strengths and weaknesses of the papers. They also provide expert perspective on the
impact the papers have had on the field, as well as key learning points, and additional
references for those who want to pursue a specific topic in greater detail. Essentially,
the book summarizes the major papers that would have been covered in an academic
journal club conducted over the past forty years, with the added benefit of assessing
what is truly important and durable through the lens of time.
This book will be of great interest to those who practice or study cardiovascular
medicine. For the physician in training, this book provides the perfect preparation to
quote the relevant medical literature on rounds and appear erudite (and, in fact, be
erudite). I hope you find the book as stimulating, educational, and exciting as I did.
Deepak L. Bhatt, MD, MPH, FACC, FAHA, FSCAI, FESC
Professor of Medicine, Harvard Medical School
Chief of Cardiology, VA Boston Healthcare System
Director, Integrated Interventional Cardiovascular Program,
Brigham and Women’s Hospital & VA Boston Healthcare System
Senior Investigator, TIMI Study Group
Boston, United States
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Preface
‘Why’ is always the question. Compiling a book entitled ‘ Landmark Papers in
Cardiovascular Medicine’ is no small undertaking. As with all such projects, it
requires the assistance and dedication of busy authors to produce high quality manu-
scripts against a backdrop of over-ambitious editors and publisher-driven deadlines.
In this instance the effort required has been that much greater since, for each cho-
sen discipline of cardiovascular medicine, all of the papers published over the past
40 years were to be considered for inclusion in the appropriate chapter, reviewed
where indicated, read forensically, then analysed, and a decision taken to select (or
not) the source for inclusion. If chosen, the papers had to be summarized, and then
came the difficult bit — considering their contemporary relevance and adjudicating on
their importance, and indicating the reasons why.
In completing this book we were privileged to draw upon the ability, enthusiasm,
and drive of junior colleagues who prepared the first summary drafts for each chapter.
Their contribution should not be underestimated and their efforts bode well for their
futures and for that of their chosen disciplines. We were also extremely fortunate to
be able to muster the support of the cognoscenti: senior researchers who have pub-
lished extensively in the field. These senior authors know and have used these data
(and those not selected) over many years, building on all publications to generate
new hypotheses and incrementally advanced research studies. They were handed the
difficult and unenviable job of finally selecting the papers to be included, reviewing
the junior doctors’ summary reviews, modifying and fine tuning the arguments where
needed, and then writing the all-important commentaries at the beginning and end of
each chapter. Clearly, the selection of a source as a ‘Landmark Paper’ is a decision based
on individual professional experience and some, may be many, will not agree with the
choices. There cannot be, however, a right or wrong choice, merely the opinion of
experienced senior researchers in the field. Unexpressed reader criticism, debate, and
controversy over the choices they have made may stimulate others to choose their own
personal list. The reader should not get confused by the differing order of the papers.
We gave the authors free rein on how they wished to present their chapters—some
chose a chronological order, others hierarchical, others interweaving papers to tell an
important historical story. The variance prevents conformity and makes the overall
text more interesting. We are lucky that all contributions are of the highest quality.
So ‘why’? Most importantly we feel that to have available an analytical understand-
ing of what went before will always foster robust thinking and hopefully evolve novel
concepts and research data of equally high quality. Contemporary research doesn’t
just appear out of thin air. Instead the evidence base that constitutes any discipline is
the bedrock for understanding the strengths and weaknesses of the medicine we prac-
tice. We hope and believe that such a book will educate beyond the boundaries of the
papers presented, inspire, and encourage readers to generate future robust data in or-
der to support current and future clinical practice. Moreover many training schemes
worldwide have entry, mid, or exit exams — it is all here, between these covers.
We hope this tome achieves its aims. If even one reader is inspired sufficiently by
what went before to begin to build new data and understandings for the future, then
our combined efforts have been worthwhile.
Tony Gershlick and Aung Myat
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Acknowledgements
First and foremost we owe a huge debt of gratitude to our panel of expert authors.
It is they that have selected the landmark papers we have included in this text. It is
their choices that will no doubt court some degree of controversy despite the justifi-
cation and detailed analysis. By virtue of their position, scientific track records, and
their standing in the wider cardiovascular community, these esteemed experts are
hugely busy people. We therefore thank each and every one of them wholeheartedly
for believing in the project and their willingness to devote their valuable time to its
success.
Second, we thank our junior colleagues for their energy and enthusiasm for the
project. They have worked tirelessly and challenged themselves without reproach to
extract every nuance from each of the papers they have summarized. We have been
exacting in what we required from the landmark paper appraisals and we have been
hugely impressed at what we have received.
Third, we must pay tribute to our colleagues at Oxford University Press, namely
Helen Liepman, Elizabeth Chadwick, Imogen Lowe, Susan Crowhurst, and Charles
Haynes for their trust, guidance, and ultimately patience, for a manuscript which has
taken the best part of two years to compile. Thanks too to Priya Sagayaraj at Cenveo
Publisher Services.
And last, but by no means least, we thank, unreservedly, our families, friends and
colleagues for their unerring support and understanding.
Aung Myat and Tony Gershlick
I also acknowledge financial support from the Department of Health via the National
Institute for Health Research (NIHR) comprehensive Biomedical Research Centre
award to Guy’s and St Thomas’ NHS Foundation Trust in partnership with King’s
College London and King’s College Hospital NHS Foundation Trust, alongside a
British Heart Foundation Clinical Research Training Fellowship.
And finally I would like to take this opportunity to thank, wholeheartedly, my
mentors: Professors Redwood, Marber, and Gershlick, for their belief, guidance and
unequivocal support.
Aung Myat
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Contents
Contributors xi
List of abbreviations xvii
Part I Coronary heart disease
1 Epidemiology, outcomes, and quality of care 3
2 Lipids and cardiovascular disease 30
3 Myocardial ischaemia 44
4 Thrombosis, haemostasis, and platelet biology 68
5 Medical versus invasive management of coronary heart disease 83
6 Percutaneous coronary intervention 102
7 Percutaneous coronary intervention versus coronary artery bypass
graft surgery 119
Part II Cardiac electrophysiology and heart rhythm
disturbances
8 Epidemiology and molecular foundation 133
9 Atrial fibrillation 150
1 0 Interventional electrophysiology 168
1 1 Anti-arrhythmic drug therapy 182
Part III Heart failure
1 2 Epidemiology 201
1 3 Medical management 216
14 Cardiac resynchronization therapy 241
1 5 Non-ischaemic cardiomyopathy 258
1 6 Cardiac failure and transplantation 268
Part IV Hypertension
1 7 Systemic arterial hypertension 281
1 8 Pulmonary arterial hypertension 302
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