(Circulation. 1998;97:2579.)
© 1998 American Heart Association, Inc.
Book Reviews
Marcus Cardiac Imaging: A Companion to Braunwald's Heart
Disease, Volume 1 and Volume 2
David J. Skorton, MD. 1218 pp. Philadelphia, Pa: WB Saunders; 1996.
$195.00 (2-volume set). ISBN 0–7216-4687–5.
Although there are a number of cardiac imaging
textbooks, this one must be the "mother of all books." All imaging
modalities are included: radiography, angiography, MRI,
cine CT, radionuclide imaging, two-dimensional
echocardiography, and PET. This book in its second
edition is a companion to the 5th edition of Braunwald's Heart
Disease: A Textbook of Cardiovascular Medicine.
This book, more than 1200 pages long, is organized in 8 parts and 73
chapters; 13 of these chapters are new in the 2nd edition. There are
hundreds of contributors from around the world, who are experts in
their respective fields.
Part I deals with physiological and
pathophysiological concepts that are important to
imaging, part II is an integrated clinical approach, part III is
conventional radiography and angiography, part IV is
echocardiography, part V is MRI, part VI is cine
CT, part VII is radionuclide imaging, and part VIII is positron
emission tomography. The indexing is quite useful, and the liberal uses
of subheadings, illustrations, and extensive bibliography constitute
major strengths of this book. Most of the images are black and white
and are of good quality; some are of exceptionally good quality (those
in chapters 17, 34, 40, 47, and 56). Some chapters have provided very
useful summaries of relevant data from the literature (for example,
chapters 36, 63, 70, and 71). There are colored plates that are of high
quality, but unfortunately they are (like colored plates in other
books) misplaced and often cumbersome to relate to the text, which
detracts from the ease of reading.
As in any multiauthor book, there is some repetition, which is
unavoidable, but since this book is unlikely to be read from cover to
cover, such repetition may in fact be a necessity. There is some
inequality in the length and depth of the chapters. For example,
chapter 30 has 30 pages and 322 references, whereas chapter 45 has 5
pages and no references. The authors have attempted, with some success,
to provide an integrated clinical approach in part II of the textbook.
The section about which test, for whom, when, and why is of paramount
interest to the clinician who has no vested interest in the technology.
I particularly like chapter 8, which is written from the clinician's
viewpoint. This chapter probably would have been better placed at the
end of part II rather than at the end of part I, and I wish it had been
much longer.
The authors are uniquely qualified to offer a critical appraisal of the
pros and cons of each technique, but this did not come out as a clear
message. In today's environment, duplication of tests is discouraged,
and therefore the clinician would like to know what is the most
cost-effective test if all tests were available and of good quality.
The lack of cost-effectiveness analysis is not the fault of the
authors but rather probably reflects the lack of such data in the
scientific literature. It would have been helpful, however, to
synthesize a concept and couple it with a Bayesian analysis in
a number of important clinical scenarios.
The slightly critical overtone of this review should not in any way
detract from the valuable contribution of the authors for taking on the
extraordinary task of putting together a comprehensive textbook on
cardiac imaging. This book is a must for the bookshelf of imaging
specialists and their trainees. It should be a valuable addition to
university, hospital, and personal libraries.
Ami E. Iskandrian, MD
Allegheny University of the Health Sciences
Philadelphia, Pa
