Address for correspondence: Professor Rafael Beyar, MD, DSc, Director, Rambam Health Care Campus 8 Ha’Aliyah Street, Haifa 35254, Israel. Voice: +972 4854 2389; fax: +972 4854 2907. r_beyar{at}rambam.health.gov.il
Progress in cardiovascular disease understanding and management
continues at an exponential pace. Our understanding of the molecular
basis of disease is enhanced by newer molecular measurement
techniques, sophisticated models of physiological protein functions,
understanding of the genetic foundation for diseases, and the
incorporation of population genetic tools in our clinical analysis.
In this review, I discuss prevention and therapy of coronary
stenosis impeding coronary flows, prevention of acute and chronic
manifestation of coronary flow impairment, and interfering with
myocardial manifestation of acute or chronic deprivation of
coronary flow. Mechanical heart failure and arrhythmias are
common causes of myocardial dysfunction that originate, in part,
from the loss of myocardial tissue and function. Techniques
for interfering with cardiac function, in order to address the
molecular mechanisms associated with restenosis, range from
pharmacologic to mechanical procedures including mechanical
dilation and scaffolding of coronary stenosis. The use of stents
with and without drug coating is leading the clinical world
of revascularization side-by-side with cardiac bypass surgery.
Other topics that are discussed here include managing myocardial
damage and acute and chronic pump failure. Finally, population
genetics of cardiac health and the potential for genetic therapeutic
guidance in managing ischemic cardiovascular diseases are discussed.
