|Year : 2015 | Volume
| Issue : 6 | Page : 700-701
Pathophysiology, pharmacotherapy, cardiovascular disease
Kamal H Sharma
Depatment of Cardiology, U. N. Mehta Institute of Cardiology, B. J. Medical College, Civil Hospital, Ahmedabad, Gujarat, India
|Date of Web Publication||17-Nov-2015|
Dr. Kamal H Sharma
A/406, Shivalik Yas, 132 Feet Ring Road, Opp. Sahashtrinagar BRTS Bus Stand, Naranpura, Ahmedabad - 380 013, Gujarat
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sharma KH. Pathophysiology, pharmacotherapy, cardiovascular disease. Indian J Pharmacol 2015;47:700-1
Gowraganahalli Jagadeesh, Pitchai Balakumar, Khin Maung-U
Publisher: Springer International
Medical science is not rigid enough to be compartmentalized into water-tight subspecialties. There is an overlap among subspecialties such as physiology, medical pharmacology, and the practice of medical therapy and medicinal drug discovery.
One of the recent books by Adis, a brand of Springer titled, “Pathophysiology and Pharmacotherapy of Cardiovascular disease” with G. Jagdeesh, P. Balakumar, and Khin Maung-U as editors, is a classic illustration of how pathophysiology and pharmacotherapy of cardiovascular system can be the basis of understanding cardiovascular therapy. It reviews disorders of cardiovascular system such as heart failure, cardiomyopathies, coronary artery disease, atherosclerosis and dyslipidemia, hypertension, arrhythmias, valvular heart disease, and disorders in childhood and pregnancy.
The book is divided into 8 parts with each part dedicated to separate disorders. Part 1 deals with heart failure with chapters outlining guidelines and basic pathophysiology, autonomic regulation and its dysregulation, and then focuses on managing the same with drug and device therapy. However, evolving therapies in the form of “Vagus nerve stimulation” and other novel therapies that are being developed outlining the same principle could have been included too. It also discusses how various biomarkers may facilitate in diagnosis and finally it touches upon gene therapy in cardiovascular diseases. Similarly, part 2 dwells into cardiac hypertrophy and how it is different from genetic cardiomyopathies and hence their molecular targets in therapy. Part 3 deals with coronary artery disease with its classification, pathophysiology of acute coronary syndrome, medical management of chronic stable angina, acute coronary syndrome, and finally, drug-eluting stents. Evolving and available science of bioabsorbable scaffolds could be discussed. Part 4 is dedicated to atherosclerosis and hyperlipidemia touching upon vascular endothelial dysfunction and roles of nitric oxide, omega-3 fatty acids, and other hypolipidemic drugs. Finally, it touches upon the concept of polypill. There was a scope for adding newer treatment modalities such as PCSK9 inhibitors and targeted therapies.
Hypertension is well described in part 5 from pathophysiology to genomics, and role of Gi proteins, renin-angiotensin-aldosterone system, and various drug modalities are well covered. However, some recent guidelines such as JNC-8 and NICE guidelines could have been discussed in details, particularly the science behind these guidelines. Part 6 discusses cardiac arrhythmias including arrhythmogenesis, proarrhythmic effects of antiarrhythmic drugs, drug-induced Qt prolongation, and treatment of atrial fibrillation. Mechanical devices to reduce stroke and antiarrhythmic drugs for ventricular arrhythmias are well discussed. Part 7 deals with valvular heart disease with chapters dedicated to mitral, tricuspid regurgitation, and aortic valve disease. Part 8 deals with cardiovascular disease of childhood and pregnancy with an equally well-written chapter on miRNA in cardiovascular development.
The book is an extensive “link” between “How” cardiovascular system works at molecular and signaling pathway levels; “what” can potentially go wrong triggering the cardiovascular disorders, and “Where” and “how” can potentially we fix these abnormalities or “fine tune” them if not modify them completely. It is, indeed, a welcome way of analyzing and pursuing a cardiologists' goal of conquering the disorders in “basics to finale” approach. However, the book could potentially have touched into novel therapies and pharmacophysiology of “bioabsorbable scaffolds,” novel cardiovascular imaging, disorders of pericardium, recent drug therapy in pulmonary hypertension, and some other untouched arenas. Overall, it is a fantastic attempt to demystify cardiovascular diseases at cellular and molecular levels and utilize the knowledge to potentially change the way cardiology is practiced and learned. It also pitches itself as the Bible for a “cardiovascular researcher” as the launch pad from where the “investigative” cardiology can take off! In totality, it is a book worth a read for those involved in cardiovascular research and to comprehend these basics that guide the therapeutic choices in practice!