Stress Doppler echocardiography

252 scientists have left the physiologists and clinicians in their dust, far behind”. Dr. Hondeghem expresses his confidence that “the great progress at the basic level will translate into better therapeutic agents for patients suffering from arrhythmias”. I share this hope, but feel that many more studies are needed in the area between channel and patient to close the gap. At this point in time, I do not think the practising clinician will alter his therapeutic behavior after reading this book. Nevertheless, the book provides an excellent summary for researchers in cardiac electrophysiology and pharmacology, and will serve as a stimulus for, much needed, further research.

involved with stress Doppler echocardiography, where it will provide a useful literature base and a valuable summary of the subject. It is probably too specialized to be of major practical value for clinicians or ultrasonographers who are not primarily involved in stress echocardiography. As with any rapidly changing field, the contents of this book will be fairly quickly outdated but this does not detract from the up-to-date information provided in the current text. This book is highly recommended. It will prove a valuable addition to the library of those persons actively involved in cardiac ultrasound research. Dept. of Cardiology St George’s Hospital London, U.K.

Experimental Cardiology Lab. Academic Medical Centre Amsterdam The Netherlands

Michiel J. Janse

Jkhavioural Editors:

Stress Doppler lkhocardiography Editor: Kluwer

ton/London, 1990; ISBN o-7923-0499-3

Publishers, 266 pp.;

Medicine in Cardiovascular

T. Elbert,

W. Langosche,

Disorders

A. Steptoe

and

D. Vaitl

Steve M. Teague Academic

Iain A. Simpson

John Dordrecht/ Dfl240,

$129,

Bosf85;

This is a multi-author textbook spanning many aspects of stress ‘echocardiography with chapters including: Effect of preload; afterload and inotropic state on Doppler ejection dynamics; Practical considerations in Doppler stress testing; Exercise Doppler in coronary arterial disease; Pharmacologic Doppler stress testing in coronary arterial disease; Evaluation of exercise performance in mitral stenosis using Doppler echocardiography; and the use of color Doppler ultrasound in exercise testing. As a multi-author textbook the standard of the individual chapters, of which there are twenty, is highly variable though the overall standard is generally high. The chapters mainly reflect the particular interests of individual authors and, as such, the topics are a little patchy rather than providing a comprehensive coverage of stress Doppler echocardiography. Nevertheless, this allows the authors to provide a more m-depth discussion of their individual subjects than might otherwise have been possible. There is considerable detail spent on the theoretical background of stress Doppler but the practicalities of the techniques are not overlooked. The chapter entitled “practical considerations in Doppler The stress testing” is particularly recommended. textbook is liberally illustrated and well referenced throughout. This is largely a book for those personally

Wiley

York/Brisbane, 471-91770-2

&

Sons 1988;

Ltd, 328 pp.;

Chichester/New 539.50;

ISBN

O-

As described in the preface, the purpose of this book is to outline basic psychophysiological mechanisms in the development of cardiovascular disorders and to discuss recent developments in the behavioural management of these conditions. This goal was reached perfectly. Contributors from six countries in Europe as well as overseas - though with the focal point being Germany stressed (in 4 sections and 19 articles) the necessity to take into account social, behavioural, emotional and personality factors as being crucial for prevention as well as treatment of cardiovascular illness. The four sections reflect four areas which provide new insight into the psychophysiological link between social condition and medical problems. The first section focusses on the psychophysiology of essential hypertension, for example, baroreceptor sensitivity and its influence on hypertension as well as its effects on the electrical activity of the brain and on the threshold for pain. The second section is engaged in showing implications for behavioural management of essential hypertension. The importance of the behavioural approach is emphasized in programmes for control of weight as well as in treatment aimed at the management of stress. It could be shown that blood pressures in patients with mild essential hypertension decreased after cognitive modification of behaviour together with relaxation therapy.