Summary :
We intend Heart Disease to constitute the “core curriculum,” an up-to-date, comprehensive, and authoritative ready reference for all practitioners. We strove to make this Eighth Edition an information source of practical clinical utility, grounded in the rapidly expanding evidence base that informs our practice. As in the previous editions of Heart Disease, we present the scientific underpinnings that govern cardiovascular pathophysiology and provide a rational basis for understanding therapeutics and management of cardiovascular diseases encountered in clinical practice. Since the preparation of the last edition of Heart Disease much has changed, a reflection of the rapid pace of progress in our specialty. The results of manifold new clinical trials have become available in ways that in many cases profoundly affect our management strategies and practice. Novel therapeutics, both pharmacological and device-based, provide new management options. In the last few years we have not only witnessed striking advances in therapeutics but encountered challenges in the application of drug therapies and cardiovascular devices ranging from drug-eluting stents to implantable devices. The constant change and complexities in therapeutics and management strategies render obsolete textbooks published only a few years ago. Other rapid shifts are under way in the prevalence of cardiovascular disease. In recent years cardiovascular specialists could congratulate themselves that the epidemic of cardiovascular disease had declined, based on the progress in our specialty. Current demographic trends suggest, however, that the scourge of cardiovascular disease, rather than waning, may indeed be increasing in the years to come. The aging of the population will increase the overall burden of cardiovascular disease in society, even as age-adjusted rates of cardiovascular mortality plateau or decline. We also need to confront a renewed upswing of cardiovascular risk linked to the worldwide epidemic of obesity, insulin resistance, and diabetes rooted in over-nutrition and declining physical activity. This gathering of cardiovascular risk increasingly threatens to extend the burden of cardiovascular disease to developing as well as Western societies. Thus, we cannot presume that the toll of cardiovascular disease will continue to ebb, highlighting the urgency of tools such as the Heart Disease Learning System that aim to help the clinician remain abreast of the constantly changing landscape of cardiovascular disease. We have thoroughly revised this new edition to reflect these multiple changes. Thirty of eighty-nine chapters are entirely new. Thus, more than one third of the Eighth Edition represents completely new material. There are 43 new authors, comparing the Eighth to the Seventh Edition of Heart Disease. All of the chapters carried over from the Seventh Edition have undergone extensive revision to update them and heighten their utility. A full description of the changes introduced in this Eighth Edition exceeds the scope of this Preface. Among the major changes, Douglas L. Mann, MD, has joined the editorial team and overseen a recasting of the entire section devoted to heart failure and chapters relating to myocardial disease. As heart failure represents the leading cause of admissions of patients covered by Medicare to hospitals, and comprises an ever-increasing fraction of our

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