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First Edition: 2017

It gives me immense pleasure to write the foreword for the book Applied Echocardiography in Coronary Artery Disease. Having known Dr Kasliwal for over three decades now, I should say a work like this, with internationally renowned faculty and some of the best known Indian authors, was long overdue! This book fulfills a hiatus that existed in our practical understanding of patients of coronary artery disease: from the outpatient clinics to the emergency room and from the critically ill patients in the ICU to the cardiac operation theater.

As a cardiac surgeon, I have been witness, as well as a part, of the stupendous growth echocardiography has achieved during the past decades. I remember vividly the pioneering work of Drs Kronzon and Kasliwal in evaluation of protruding atheromas of the aortic arch not so far back and here we are, in an era wherein the use of 3D technology for mitral valve repair has become commonplace in the operation theaters across the globe.

As coronary artery disease constitutes the largest number of patients in any cardiac department, echocardiography has emerged as a key investigation, something that is truly indispensable. However, echocardiography needs to be viewed in clinical context and therein lies the true significance of this book—from scientific thinking to practical demonstration for clinical decision making for the patients.

I unhesitatingly recommend this text to everyone who is interested in learning the nuance of echocardiography. My colleague Ravi Kasliwal and the “who's-who” of the world of echocardiography who have contributed to this book, deserve my appreciation.

It is my pleasure and honor to write a few words about my Indian colleagues and the current edition of the Applied Echocardiography in Coronary Artery Disease. Indian cardiologists have always been an example for the rest of the world in the field of echocardiography, with dynamic pioneers and innovative specialists of this fantastic technique. More important, facing such an important clinical problem as ischemic heart disease, we need to be not only echocardiographists, but also clinicians, that means doctors able to integrate the echocardiographic results in their clinical context, and to use these results to give the best therapy to the patient. Several echocardiographic techniques, including 2D, 3D echocardiography, stress echocardiography, contrast echocardiography and other more recent techniques such as tissue Doppler imaging and deformation imaging, are perfectly described in this book, and their use in ischemic heart disease is clearly depicted.

In that way, Applied Echocardiography in Coronary Artery Disease is the perfect example of what we can expect from a medical book: to be complete, exhaustive, comprehensive, but also easy to use in clinical practice by all practicing physicians. The result is here: this book will be an easy and fantastic tool for all Indian cardiologists, and probably around the world.

This foreword is also the opportunity for me to underline the strong and friendly relationship between Indian and European echocardiographists. As a specialist of echocardiography, but also President of the European Association of Cardiovascular Imaging, I am happy to see that in this book, the patient is at the center, and all the efforts are done to use echocardiography to find the best way to treat him/her.

The next step will be multimodality imaging. Other imaging techniques are also useful for the assessment of coronary artery disease. I am sure that the next objective of the authors will be to teach us how and when to use echocardiography and other imaging techniques in different clinical scenarios.

At the moment, we are learning echocardiography. Enjoy the Applied Echocardiography in Coronary Artery Disease!

Coronary artery disease (CAD) is one of the leading causes of death worldwide, and its prevalence continues to increase in many parts of the world. The patients of CAD thus constitute a major chunk of the patients seen by cardiologists today. For optimal management of these patients, the cardiologists rely on a thorough clinical evaluation supplemented by appropriate investigations. Echocardiography is one of the most useful imaging modalities available for this purpose in these patients.

Echocardiography is noninvasive, versatile, and safe and provides a vast amount of information about cardiac structure and function almost instantly. With its various modalities encompassing the entire spectrum of CAD—from visualization of early evidence of atherosclerosis to assessment of myocardial ischemia and viability to guiding therapeutic interventions—echocardiography assists at every step in critical decision making in these patients. For example, in a patient with CAD slated to undergo percutaneous coronary intervention, detection of significant mitral regurgitation will alter the entire course of treatment. Hence, a clinician dealing with the patients of CAD today cannot afford to be ignorant of the various aspects of echocardiography and the implications thereof.

Elaborate texts have been written and a huge amount of information is available about various aspects of echocardiography, both in the print form and on the internet. These are mainly textbooks of echocardiography describing the techniques and the role of echocardiography in all forms of cardiovascular diseases. However, the vastness of the available literature means that very often the interested reader has to sift through volumes of material on the subject and is left bewildered at the end of it all. This is the very need that the book aims to fulfill by compiling the state-of-the-art and updated knowledge about the role of echocardiography in the evaluation and management of patients with the various facets of CAD. When confronted with a patient of CAD and assailed with doubts regarding any aspect, the practicing physician needs to just pick-up this book and find the solution!

The book is divided into two sections—the first section deals with the technical aspects of the commonly used echocardiographic modalities while the second section discusses the clinical application of these modalities in the evaluation of patients with CAD. The contributors are the respected and renowned names in the field of echocardiography with years of experience behind them. They have graciously spent time and energy to give their best for this book. My grateful thanks to all of them for having responded to my numerous emails and conceding to my demands elegantly.

I hope the book will be widely read and will satisfy the needs of the discerning physicians!

I am extremely thankful to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President), Mr Tarun Duneja (Director-Publishing), Mr KK Raman (Production Manager), as well as the editorial team of Mr Sarvesh Singh, Mr Mohit Bhargava, Mr Pramod Rout (Typesetter), Mr Amit Mathur (Graphic Designer) and Ms Monika Arora of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for all their efforts and support in bringing out our ideas in print form.18