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Coronary Circulation - from Basic Mechanisms to Clinical Implications (Developments in Cardio- vascular Medicine Series) Editors: Jos A.E. Spaan, Alberg V.G. Bruschke, Adriana C. Gittenberger-de Groot Martinus Nijhoff Publishers, Dordrecht/Boston/ Lancaster, 1987; 239 pp; DFl 140, $66.50, E42.50; ISBN O-89838-978-X

In their foreword, the editors outline the main aim of the book, which is to bring together cardiological re- search and clinical investigation, two worlds which have sadly stayed too far apart in the past. This relatively small book, I think, achieves its aim. It is split into four main sections starting with coronary anatomy going on to myocardial perfusion, its clinical assessment and ending with myocardial reperfusion. Both abnormal and normal coronary microvasculature are dealt with skill- fully, with good histological photographs. For such a

small book, anatomy and pathology of large coronary arteries is presented very succinctly. Developmental abnormalities of the main coronary arteries are also briefly discussed.

In the section on myocardial perfusion, many aspects of local control of coronary flow are dealt with, but sadly the role of endothelium has been omitted. An interesting section on extravascular resistance is in- cluded, of which many clinicians are unaware. Mathe- matical models for local control of blood flow are given and this leads nicely to the relation of myocardial blood flow to function. In the chapters on clinical assessment of myocardial perfusion, state of the art accounts of digital angiography are given by pioneers in this field. Up-to-date metabolic consequences of myocardial hypo-perfusion are discussed. Myocardial blood flow evaluation by radionucleotide techniques, resonance imaging and Doppler probes are described in detail.

The fourth chapter on myocardial reperfusion is again up-to-date and excellent. One chapter, on the right ventricle and coronary arterial fistulas, in contrast, appears to be quite out of place. The book ends by discussing up-to-date data on coronary arterial surgery, thrombolysis and laser angiosurgery.

Overall the book reads well, each chapter leading on to the next very well, with few exceptions. The editors have done a good job as they appear to have achieved their aim by combining basic research knowledge and clinical investigation. I think this book would be ex- tremely helpful to anyone who is involved in research into the coronary circulation or anyone who is about to embark on such research. A book of this size cannot be

totally comprehensive, but it gives enough detail to be very informative on the topics that it deals with and gives up-to-date references, if further information is required. I would recommend this book to clinical cardiologists and basic scientists who are researching into the fascinating field of the coronary circulation.

Dept. of Cardiac Medicine National Heart & Lung Inst. London, U.K. Peter Collins

Cardiomyopathies: Clinical Presentation, Differen- tial Diagnosis and Management (Cardiovascular Clinics 19/ 1) Editor: James A. Shaver FA Davies Co., Philadelphia, 1988; 290 pp.; $93.75; ISBN o-8036-7821-5

This book attempts to review cardiac muscle disease in its entirety rather than cardiomyopathy according to a strict definition. In so doing, it has thrown its net too wide. Though the individual chapters by the many distinguished authors are, in their own right, interesting and readable, taken as a whole they give neither a comprehensive nor organised account of cardiomyopa- thy. Thus, it is not possible to dip into the book and easily dissect out an account of any particular aspect of the cardiomyopathies. The chapter dealing with restric- tive cardiomyopathy gives an account of its pathophysi- ology and differential diagnosis and is not comprehen- sive. Thus, it is not possible to get a good “handle” on this disease with the information available. The chapters dealing with hypertrophic cardiomyopathy and idio- pathic dilated cardiomyopathy are more extensive but most contributors have made little effort to present “state of the moment” information or perspectives on these disorders. The consideration of ischaemic heart disease as ischaemic cardiomyopathy, despite the clini- cal credibility that the term seems to have acquired, in the context of an authoritative view of cardiomyopathy clouds the waters.

In summary, this is an interesting collection of re- views, pitched at the level of the junior cardiologist, but too inconsistent in content to be a useful overview. It is inadequate as a definitive text on cardiomyopathy and the perspectives and depth of its reviews will fail to interest the more senior cardiologist. Thus, despite the impressive list of contributors, this book will be of educational help to some but necessary reading for none.

National Heart Hosp. London. U.K. John Morgan