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Functional Abnormalities of the Aorta
Book Review
Functional Abnormalities of the Aorta H. Boudoulas, P.K. Toutouzas, & C.F. Wooley, eds. Armonk, NY: Futura Publishing Co., 1995, Cloth, $85.00; pp 398. This book is dedicated to "the aorta: an unattended, unexplored, and unsung hero." It targets the concept of ventricular-aortic coupling, emphasizing aortic function as an important codeterminant of cardiovascular diseases, efficacy of treatment, and clinical outcome. Based on the affiliation of the individual authors and the majority of cited references, ventricular-aortic coupling is largely a domain of cardiology. Herein lie both the strength and the weakness of this text. It provides an instantaneous and thorough overview of knowledge in an important field of vascular pathology that may have been neglected by radiology, but fails to supply a bridge to noncardiology research. The book is divided into five parts. Boudoulas and Wooley give an excellent introductory overview of aortic function and conclude with a chapter on future directions. An international array of specialists, with some emphasis on contributors from the University of Athens and Ohio State University, assess aortic structure as it determines aortic function, and the role of the aorta in systemic disorders. The text addresses questions ranging from why taller people are at higher risk for coronary artery disease to the effects of endothelin, nitric oxide release, medication, nutrition, exercise, age, and heredity. A section on methodology gives valuable advice regarding instrumentation and experimental approach. Overall, the book is clearly written. Most contributions are thorough reviews and data presentations are substantiated by extensive lists of references, a generous number of line drawings, and high-quality illustrations. Only two contributions are of superficial "cut and paste" quality, in which the authors refer the
382
reader to other (including their own) "excellent" work rather than providing a self-sufficient discussion. Repetition in the 25 chapters is kept to a minimum, and reinforces rather than annoys where present. Surprising by their absence are the use and assessment of modern imaging methods such as DSA, CT, and sophisticated external and intravascular ultrasound applications. In particular, the chapter "Angiographic Evaluation of the Aorta: What Is Normal" appears archaic by limiting discussion to large x-ray film or cine images. Descriptions of aortic arch anatomy (eg, "aortic spindle") may be unfamiliar to radiologists, and even misleading in some cases (eg; "intercostal" arteries do not arise from the "aortic isthmus . . . where most of the injuries of the aorta occur in most of the automobile accidents." The quality of printing, paper, illustrations, and tables is excellent, although the typeface is small. An interesting surface treatment conveys an unusual soft, agreeable feel to the paper. The price is appropriate for the quality of presentation. The book fulfills its purpose of giving new respect to the aorta. It caters to the novice as well as the experienced laboratory researcher, providing introductory understanding, practical information, and advanced concepts. It should prove valuable for anyone seeking comprehensive information on aortic function and ventricular-aortic coupling, and for all involved in aortic stenting or endovascular therapy. The book is recommended for clinicians treating cardiovascular diseases medically and invasively, as well as for cardiovascular researchers. -Reviewed
Journal of Vascular and Interventional Radiology
by Elvira V. Lang, MD
MayJune 1997
Functional Abnormalities of the Aorta H. Boudoulas, P.K. Toutouzas, & C.F. Wooley, eds. Armonk, NY: Futura Publishing Co., 1995, Cloth, $85.00; pp 398. This book is dedicated to "the aorta: an unattended, unexplored, and unsung hero." It targets the concept of ventricular-aortic coupling, emphasizing aortic function as an important codeterminant of cardiovascular diseases, efficacy of treatment, and clinical outcome. Based on the affiliation of the individual authors and the majority of cited references, ventricular-aortic coupling is largely a domain of cardiology. Herein lie both the strength and the weakness of this text. It provides an instantaneous and thorough overview of knowledge in an important field of vascular pathology that may have been neglected by radiology, but fails to supply a bridge to noncardiology research. The book is divided into five parts. Boudoulas and Wooley give an excellent introductory overview of aortic function and conclude with a chapter on future directions. An international array of specialists, with some emphasis on contributors from the University of Athens and Ohio State University, assess aortic structure as it determines aortic function, and the role of the aorta in systemic disorders. The text addresses questions ranging from why taller people are at higher risk for coronary artery disease to the effects of endothelin, nitric oxide release, medication, nutrition, exercise, age, and heredity. A section on methodology gives valuable advice regarding instrumentation and experimental approach. Overall, the book is clearly written. Most contributions are thorough reviews and data presentations are substantiated by extensive lists of references, a generous number of line drawings, and high-quality illustrations. Only two contributions are of superficial "cut and paste" quality, in which the authors refer the
382
reader to other (including their own) "excellent" work rather than providing a self-sufficient discussion. Repetition in the 25 chapters is kept to a minimum, and reinforces rather than annoys where present. Surprising by their absence are the use and assessment of modern imaging methods such as DSA, CT, and sophisticated external and intravascular ultrasound applications. In particular, the chapter "Angiographic Evaluation of the Aorta: What Is Normal" appears archaic by limiting discussion to large x-ray film or cine images. Descriptions of aortic arch anatomy (eg, "aortic spindle") may be unfamiliar to radiologists, and even misleading in some cases (eg; "intercostal" arteries do not arise from the "aortic isthmus . . . where most of the injuries of the aorta occur in most of the automobile accidents." The quality of printing, paper, illustrations, and tables is excellent, although the typeface is small. An interesting surface treatment conveys an unusual soft, agreeable feel to the paper. The price is appropriate for the quality of presentation. The book fulfills its purpose of giving new respect to the aorta. It caters to the novice as well as the experienced laboratory researcher, providing introductory understanding, practical information, and advanced concepts. It should prove valuable for anyone seeking comprehensive information on aortic function and ventricular-aortic coupling, and for all involved in aortic stenting or endovascular therapy. The book is recommended for clinicians treating cardiovascular diseases medically and invasively, as well as for cardiovascular researchers. -Reviewed
Journal of Vascular and Interventional Radiology
by Elvira V. Lang, MD
MayJune 1997