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MAN UAL OF

Cardiovascular Medicine
ii
MANUAL OF

Cardiovascular
Medicine
edited by

Thomas F. Lüscher, MD, FRCP, FESC

Professor of Cardiology
Royal Brompton & Harefield Hospitals GSST and Imperial
College
National Heart & Lung Institute
London, UK

1
iv

1
Great Clarendon Street, Oxford, OX2 6DP,
United Kingdom
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The moral rights of the authors have been asserted
First Edition published in 2021
Impression: 1
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above should be sent to the Rights Department, Oxford University Press, at the
address above
You must not circulate this work in any other form
and you must impose this same condition on any acquirer
Published in the United States of America by Oxford University Press
198 Madison Avenue, New York, NY 10016, United States of America
British Library Cataloguing in Publication Data
Data available
Library of Congress Control Number: 2020952970
ISBN 978–​0–​19–​885031–​1
DOI: 10.1093/​med/​9780198850311.001.0001
Printed in Great Britain by
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Oxford University Press makes no representation, express or implied, that the
drug dosages in this book are correct. Readers must therefore always check
the product information and clinical procedures with the most up-​to-​date
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contained in any third party website referenced in this work.
 Dear Colleagues,

Cardiovascular medicine has experienced an unforeseen and im-

pressive development over the last 50 years, particularly recently,
as we developed new diagnostics and innovative medications, as
well as interventional and surgical procedures to treat patients with
cardiac disease. Thus, the number of cardiovascular diagnoses and
the number of diagnostic modalities, as well as the number of
treatment options has expanded enormously and made cardiovas-
cular medicine one of the biggest specialties in medicine at large.
Cardiac patients are among the most important patient groups,
both for general practitioners and for physicians working in hospital
centres, and therefore it is of utmost importance to have infor-
mation about the management of such patients readily at hand.
This cardiovascular manual focusing on diagnostic algorithms and
therapeutic recommendations according to European Guidelines,
provides such a tool. Indeed, it encompasses all aspects of car-
diovascular medicine from hypertension to transplantation, from
imaging to intervention, and from pharmacotherapy to surgical
procedures. With therefore hope to provide an important guide
based on the current levels of evidence for surgery and for clinical
rounds whilst managing patients with cardiovascular problems.
We sincerely hope that you enjoy using this manual.

Yours sincerely
Thomas F. Lüscher
vi
 vii

Contents
Contributors xi
Abbreviations xv

1 Global Cardiovascular Risk 1

Thomas F. Lüscher and John E. Deanfield

2 Arterial Hypertension 7
Thomas F. Lüscher, Felix Beuschlein, and Isabella Sudano

3 Hypertensive Emergencies 23
Isabella Sudano and Matthias Hermann

4 Lipid Disorders 29
Thomas F. Lüscher and François Mach

5 Metabolic Syndrome 41
Roger Lehmann

6 Diabetes Mellitus 45
Roger Lehmann

7 Smoking and Cessation 63

Isabella Sudano and Thomas F. Lüscher

8 Nutrition and Dietary Recommendations 69

David Faeh

9 Cardiovascular Assessment in Athletes 77

Sanjay Sharma and Christian Schmied

10 Acute Chest Pain 85

Thomas F. Lüscher

11 Angina Pectoris 91
Oliver P. Guttmann, Oliver Gämperli, and Andreas Baumbach
 viii Contents

12 Ischaemia with Non-​Obstructive Coronary Artery

101 Disease (INOCA) –​Microvascular Angina
Juan-​Carlos Kaski, Jack Barton, and Hussein Al-​Rubaye

111 13 Acute Coronary Syndromes

Oliver P. Guttmann, Ronald Binder, and Andreas Baumbach

14 Antithrombotics for Acute and Chronic Coronary

117 Syndromes
Oliver P. Guttmann, Ronald Binder, Oliver Gämperli,
and Andreas Baumbach

125 15 Takotsubo Syndrome

Christian Templin, Jelena R. Templin-​Ghadri,
and Thomas F. Lüscher

135 16 Acute Aortic Syndrome

Christoph A. Nienaber and Hatem Alkadhi

141 17 Aortic Aneurysm

Christoph A. Nienaber and Mario Lachat

153 18 Carotid Artery Disease

Marco Roffi and Ronald Binder

159 19 Transient Ischaemic Attack and Stroke

Andreas Luft and Thomas F. Lüscher

169 20 Peripheral Arterial Disease

Nick Cheshire and Beatrice Amann-​Vesti

181 21 Raynaud’s Phenomenon

Beatrice Amann-​Vesti

185 22 Peripheral Oedema

Beatrice Amann-​Vesti

189 23 Acute Deep Venous Thrombosis

Beatrice Amann-​Vesti

195 24 Acute Pulmonary Embolism

Stavros V. Konstantinides
 Contents ix

25 Pulmonary Hypertension 205

Silvia Ulrich

26 Supraventricular Tachycardia 215

Silvia Guarguagli and Sabine Ernst

27 Atrial Tachycardia Including Atrial Flutter 221

Silvia Guarguagli and Sabine Ernst

28 Atrial Fibrillation 229

Silvia Guarguagli and Sabine Ernst

29 Anticoagulation in Atrial Fibrillation 239

Bruno Reissmann and Paulus Kirchhof

30 Indications for Pacemakers 247

Shouvik Haldar

31 Indications for Implantable Cardioverter

Defibrillators       253
A. John Camm

32 Removal (Extraction) of Pacemakers and ICD Leads 259

Shouvik Haldar

33 Channelopathies and Sudden Cardiac Death 265

Peter J. Schwartz and Dagmar I. Keller

34 Acute Heart Failure 273

Marco Metra and Thomas F. Lüscher

35 Chronic Heart Failure 281

John G.F. Cleland and Thomas F. Lüscher

36 Cardiac Resynchronization Therapy in Heart Failure 295

Gerhard Hindricks and Allireza Sepehri Shamloo

37 (Peri-​)Myocarditis 305
Bettina Heidecker, Sanjay K. Prasad, and Urs Eriksson

38 Hypertrophic Cardiomyopathy 313

Antonis Pantazis
 x Contents

321 39 Arrhythmogenic Right Ventricular Cardiomyopathy

Ardan M. Saguner and Hugh Calkins

327 40 Adults with Congenital Heart Disease (ACHD)

Gerhard-​Paul Diller and Michael A. Gatzoulis

333 41 Aortic Stenosis

Faisal Khan and Stephan Windecker

347 42 Mitral Valve Disease

Francesco Maisano and Maurizio Tarramasso

361 43 Endocarditis
Bernard Prendergast and Thomas F. Lüscher

367 44 Preoperative Screening Prior to Non-​Cardiac Surgery

Christian Schmied, Thomas F. Lüscher, and Steen Dalby Kristensen

377 45 Scores, Classifications, and Severity Levels

Allan Davies and Christian Schmied

Index 389
 xi

Contributors
Hatem Alkadhi, Allan Davies,
Institute of Diagnostic and Heart Division, Royal Brompton &
Interventional Radiology, Harefield Hospitals, London, UK
University of Zurich, Switzerland
John E. Deanfield,
Hussein Al-​Rubaye, Consultant Cardiologist, University
Ashford & St. Peter’s NHS College Hospital, London, UK
Foundation Trust, UK
Gerhard-​Paul Diller,
Beatrice Amann-​Vesti, Cardiology III, Congenital and
Angiology, Klinik im Park, Zurich, Valvular Heart Disease, University
Switzerland Hospital, Münster, Germany
Jack Barton, Urs Eriksson,
St George’s, University of Internal Medicine, GZO Wetzikon
London, UK Hospital, Wetzikon, Switzerland
Andreas Baumbach, Sabine Ernst,
Cardiology, Queen Mary University Consultant Cardiologist &
of London/​Barts Heart Centre, UK Electrophysiologist, The Royal
Brompton Hospital, London, UK
Felix Beuschlein,
Klinik für Endokrinologie, Diabetologie David Faeh,
und Klinische Ernährung, University Institut for Epidemiology,
Hospital Zurich, Switzerland Biostatistics and Prevention,
University of Zurich, Switzerland
Ronald Binder,
Cardiology, Klinikum Wels-​ Oliver Gämperli,
Grieskirchen, Austria Herzklinik Hirslanden Zürich,
Switzerland
Hugh Calkins,
Cardiology, Johns Hopkins Michael A. Gatzoulis,
University, Baltimore, Consultant Cardiologist, The Royal
Maryland, USA Brompton Hospital, London, UK
A. John Camm, Silvia Guarguagli,
Cardiac Clinical Academic Group, Heart Division, The Royal
St. George’s University of London, Brompton Hospital, UK
London, UK
Oliver P. Guttmann,
Nick Cheshire, Inherited and Inflammatory
Vascular Surgery, Royal Brompton & Cardiovascular Diseases &
Harefield Hospitals, London, UK Interventional Cardiology, St
Bartholomew’s Hospital, UK/​UCL
John G.F. Cleland, Centre for Heart Muscle Disease,
Robinson Center for Biostatistics, Institute of Cardiovascular Science,
University of Glasgow, UK University College London, UK
xii Contributors

Shouvik Haldar, Roger Lehmann,

Consultant Cardiologist & Vice Director of the Department
Electrophysiologist, Royal Brompton of Endocrinology, Diabetology and
& Harefield NHS Foundation Trust, Clinical Nutrition and Director of
London, UK Islet transplantation, University
Hospital Zurich, Switzerland
Bettina Heidecker,
Cardiology, Benjamin Franklin Andreas Luft,
Hospital, Charité, Berlin, Germany Neurology, University Hospital
Zurich, Switzerland
Matthias Hermann,
Cardiovascular Center, Cardiology Thomas F. Lüscher,
University Hospital Zurich, Director of Research, Education &
Switzerland Development, Royal Brompton &
Harefield Hospitals, and Imperial
Gerhard Hindricks, and Kings College, London, UK and
Department of Electrophysiology, Chairman, Center for Molecular
Leipzig Heart Center at University Cardiology, University of, Zurich,
of Leipzig, Germany Zurich, Switzerland
Dagmar I. Keller, François Mach,
Director, Emergency Unit, Director of Cardiology, University
University Hospital Zürich, Hospital and University of Geneva,
Switzerland Switzerland
Juan-​Carlos Kaski, Francesco Maisano,
Consultant Cardiologist, Molecular Cardiovascular Surgery, San Raffaele
and Clinical Sciences Research Hospital, Milan, Italy
Institute, St George’s, University of
London, London, UK Marco Metra,
Institute of Cardiology, SST Spedali
Faisal Khan, Civili; Department of Medical and
St George’s Hospital, London, UK Surgical Specialties, Radiological
Paulus Kirchhof, Sciences and Public Health,
University Heart and Vascular University of Brescia, Italy
Center Universitätsklinikum Christoph A. Nienaber,
Eppendorf, Hamburg, Germany Consultant in Cardiology, The Royal
Stavros V. Konstantinides, Brompton Hospital, London, UK
Centre for Thrombosis and Antonis Pantazis,
Haemostasis, University Medical Consultant in Cardiology Royal
Centre Mainz, Germany Brompton and Harefield NHS
Steen Dalby Kristensen, Trust, London, UK
Cardiology, Aarhus University Sanjay K. Prasad,
Hospital, Aarhus, Denmark Faculty of Medicine, National Heart
Mario Lachat, & Lung Institute, Imperial College
Vascular Surgery, Clinic Hirslanden, London, UK
Zurich, Switzerland
 Contributors xiii

Bernard Prendergast, Sanjay Sharma,

Consultant in Cardiology, Consultant in Cardiology,
St Thomas’ Hospital, London, UK St George’s University of
London, London, UK
Bruno Reissmann,
Department of Cardiology, Isabella Sudano,
Asklepios Klinik St Georg, Hamburg, University Heart Center Cardiology,
Germany University Hospital Zurich,
Switzerland
Marco Roffi,
Cardiology, Hospitaux Universitaire, Maurizio Tarramasso,
Geneva, Switzerland Heart Center Hirslanden, Zurich,
Switzerland
Ardan M. Saguner,
University Heart Center, Christian Templin,
Cardiology, University Hospital University Heart Center,
Zürich, Switzerland Cardiology, University Hospital
Zurich, Switzerland
Christian Schmied,
University Heart Center, University Jelena R. Templin-​Ghadri,
Hospital Zurich, Switzerland University Heart Center,
Cardiology, University Hospital
Peter J. Schwartz, Zurich, Switzerland
Center for Cardiac Arrhythmias of
Genetic Origin, Istituto Auxologico Silvia Ulrich,
Italiano IRCCS, Milan, Italy Pulmonology, University Hospital
Zurich, Switzerland
Allireza Sepehri Shamloo,
Department of Electrophysiology, Stephan Windecker,
Leipzig Heart Center at University Chairman of Cardiology, Inselspital,
of Leipzig, Germany Bern, Switzerland
xvi
 xv

Abbreviations
ACS Acute coronary syndromes ICD Implantable cardioverter
AMI Acute myocardial infarction defibrillator
ARB Angiotensin II receptor INR International normalized ratio
blockers LDL-​C Low-​density lipoprotein
ASCVD Atherosclerotic cardiovascular cholesterol
disease LEAD Lower extremity arterial
ASS Atherosclerosis disease
AV Atrio-​ventricular LV Left ventricle
AVC Arrhythmogenic ventricular LVEF Left ventricular ejection
cardiomyopathy fraction
BP Blood pressure MACE Major cardiovascular events
CABG Coronary artery bypass MAP Mean arterial pressure
surgery MIBG Iodine-​131-​
CAD Coronary artery disease metaiodobenzylguanidine
CCS Chronic coronary syndromes mPAP Mean pulmonary artery
pressure
CO Cardiac output
MRI Magnetic resonance imaging
CRT Cardiac resynchronization
therapy NICE National Institute for Health
and Care Excellence
CSF Cerebrospinal fluid
NOACs novel oral anticoagulants
CT Computed tomography
nonHDL-​C Non high-​density lipoprotein
CTD Connective tissue disease cholesterol
(collagen vascular disease)
NSAIDS Nonsteroidal
CTEPH Chronic thromboembolic PH anti-​inflammatory drugs
CTI Cavotricuspid isthmus NSTEMI Non ST-​segment elevation
CTPA Computed tomography myocardial infarction
pulmonary angiography PA Pulmonary artery
CV Cardiovascular PAD Peripheral arterial disease
CVD Cardiovascular disease PAH Pulmonary arterial
DCM Dilated cardiomyopathy hypertension
DLCO Diffusing capacity of the lung PAWP pulmonary artery wedge
for carbon monoxide pressure
DM Diabetes mellitus PCI Percutaneous coronary
DOPA-​PET 18F-​DOPA positron emission intervention
tomography PCSK9 Proprotein convertase
DPP Dipeptidyl peptidase-​4 subtilisin/​Kexin Type 9
Echo Echocardiography PEA Pulmonary endarterectomy
EF Ejection fraction PFT Pulmonary function testing
eGFR estimated glomerular PH Pulmonary hypertension
filtration rate PVR Pulmonary vascular
ESCFH Familial hypercholesterolemia resistance
FFR Fractional flow reserve RAAS Renin-​angiotensin-​
GLP-​1 Glucagon-​like peptide 1 aldosterone system
HDL-​C High-​density lipoprotein RHC Right heart catheterisation
cholesterol RV Right ventricle
HIV Human SGLT2 Sodium-​glucose
immunodeficiency virus co-​transporter-​2
xvi Abbreviations

STEMI ST-​segment elevation TOE transoesophageal

myocardial infarction echocardiography
TAVI Transcatheter aortic valve TTE Transthoracic
implantation echocardiography
TC Total cholesterol UFH Unfractionated heparin
TIA Transient ischaemic attack V/​Q Ventilations perfusion quotient
VKA Vitamin K antagonist
 Chapter 1 1

Global Cardiovascular Risk

Thomas F. Lüscher and John E. Deanfield

Risk Assessment 2
Commonly Used Risk Scores 2
Population-​Dependence of CV Risk Scores 3
Short-​Term versus Lifetime Risk 4
2

2 Chapter 1 Global Cardiovascular Risk

Risk Assessment
The assessment of the probability that an individual will experience
major cardiovascular (CV) events (MACE) in the future is of utmost im-
portance as a basis for recommendations on lifestyle and, if necessary,
pharmacotherapy.
Currently risk assessment is based on the classical CV risk factors such as:
• Age (one of the strongest CV risk factors)
• Sex (with male sex in general being at higher risk)
• Smoking (see Chapter 7: Smoking Cessation; this volume)
• Dyslipidaemias (see Chapter 4: Lipid Disorders; this volume)
• Arterial hypertension (see Chapter 2: Arterial Hypertension; this
volume)
• Diabetes mellitus (see Chapter 6: Diabetes Mellitus; this volume).
The Global CV Risk attempts to integrate all these commonly used vari-
ables. Of primary clinical importance are those CV risk factors that are
amenable to change, either by improving life style (e.g. smoking cessation,
exercise, and weight loss to lower blood pressure, certain lipids, and glu-
cose levels) and/​or pharmacotherapy.
There are numerous other variables that predict future MACE (e.g. gen-
etics, inflammation, platelet reactivity, coagulation factors, lipids such as tri-
glycerides and lipoprotein(a), and periodontitis among others), but they are
not commonly integrated into currently used risk scores. However, in add-
ition to the risk obtained from a given risk score, they should be considered,
if available, when assessing an individual patient.

Commonly Used Risk Scores

A number of risk scores have been developed and are commonly used
in primary prevention (i.e. in individuals without evidence of CV disease):
• SCORE Risk Charts of the European Society of Cardiology (ESC)
([Link])
• ASCVD Risk Estimator Plus of the American College of Cardiology
(ACC) ([Link]
resources/​features/​2013-​prevention-​guidelines-​ascvd-​risk-​estimator)
• Heart Risk Calculator ACC/​American Heart Association (www.
[Link])
• Framingham risk score ([Link])
• Risk score of the International Society of Atherosclerosis.
 Population-Dependence of CV Risk Scores 3

Population-​Dependence of CV Risk Scores

Risk scores have usually been developed based on a specific population.
However, the CV risk as a result of classical CV risk factors (see section ‘Risk
Assessment’) differs in different populations, i.e. higher risks in Northern
European countries compared to those from the south of Europe, as well as
higher risks in the United States compared to Europe. The SCORE Risk Chart
of the ESC is based on 12 European cohort studies with 250,000 patient-​
data sets averaging 3 million person-​years of observation and 7,000 fatal
CV events ([Link]). This has allowed derivation of a SCORE
Risk chart for high, medium, and low risk countries. Figure 1.1 shows a chart
for medium risk countries (see also [Link]
advance-​article-​abstract/​doi/​10.1093/​eurheartj/​ehz455/​5556353).
40
Lifetime Risk (%)

30

20

10

0
0 55 60 65 70 75 80 85 90
Attained Age (yr)

≥2 Major risk factors

1 Major risk factor
≥1 Elevated risk factor
≥1 Risk factor not optimal
All risk factors optimal

Figure 1.1 Lifetime Risk of Death from Cardiovascular Disease among Black Men and
White Men at 55 Years of Age, According to the Aggregate Burden of Risk Factors and
Adjusted for Competing Risks of [Link] risk-factor profile was considered optimal
when a participant had a total cholesterol level of less than 180 mg per deciliter (4.7
mmol per liter) and untreated blood pressure of less than 120 mm Hg systolic and less
than 80 mm Hg diastolic, was a nonsmoker, and did not have diabetes. It was
considered not to be optimal for nonsmokers without diabetes who had a total
cholesterol level of 180 to 199 mg per deciliter or untreated systolic blood pressure of
120 to 139 mm Hg or untreated diastolic blood pressure of 80 to 89 mm Hg. Levels
of risk factors were viewed as elevated for nonsmokers without diabetes who had a
total cholesterol level of 200 to 239 mg per deciliter (5.17 to 6.18 mmol per liter) or
untreated systolic blood pressure of 140 to 159 mm Hg or untreated diastolic blood
pressure of 90 to 99 mm Hg. Major risk factors were defined as current smoking,
diabetes, treatment for hypercholesterolemia, an untreated total cholesterol level of
at least 240 mg per deciliter (6.21 mmol per liter), and treatment for hypertension,
untreated systolic blood pressure of at least 160 mm Hg, or untreated diastolic blood
pressure of at least 100 mm Hg. The data were derived from the 17 studies in the
pooled cohort; data from the Multiple Risk Factor Intervention Trial were not included.
Source: Reproduced from Jarett D. Berry et al., ‘Lifetime Risks of Cardiovascular Disease’, The
New England Journal of Medicine, 366 (4), pp. 321–​329, Figure 1, DOI: 10.1056/​NEJMoa1012848
Copyright © 2012, Massachusetts Medical Society.
4

4 Chapter 1 Global Cardiovascular Risk

Short-​Term versus Lifetime Risk

Most risk scores in current use, provide estimates of the probability of fu-
ture MACE over a 5–​10-​year period. However, with the growing emphasis
on CVD prevention, attention is shifting to evaluation of life time risk, par-
ticularly in primary care (Figure 1.2). This is based on evidence that the
impact of risk factors not only depends on their magnitude but also on
duration of exposure. Early intervention can provide ‘leveraged gains’. The
Joint British Societies 3 (JBS3) guidelines provide a calculator for communi-
cating both short-​term and lifetime risk ([Link]
risk_​[Link]). This approach will increasingly be incorporated in new
guidelines to communicate both risk and opportunities for intervention
from behavioural change and, where appropriate, drug therapy.
 Short-Term versus Lifetime Risk 5

Figure 1.2 Lifetime risk of individuals without evidence of CV disease at study

entry over 35 years depending on the number of elevated CV risk factors in the
Framingham Study.
Visseren FLJ, Mach F, Smulders YM, et al; ESC Scientific Document Group. 2021 ESC Guidelines on
cardiovascular disease prevention in clinical practice. Eur Heart J. 2021 Sep 7;42(34):3227–3337.
doi: 10.1093/eurheartj/ehab484. © The European Society of Cardiology. Reprinted by permission
of Oxford University Press.
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Exercise 1: Current trends and future directions

Learning Objective 1: Learning outcomes and objectives
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Learning Objective 2: Best practices and recommendations
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Learning Objective 3: Learning outcomes and objectives
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 3: Diagram/Chart/Graph]
Learning Objective 4: Best practices and recommendations
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 4: Diagram/Chart/Graph]
Learning Objective 5: Key terms and definitions
• Key terms and definitions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Practice Problem 5: Theoretical framework and methodology
• Study tips and learning strategies
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
Example 6: Experimental procedures and results
• Theoretical framework and methodology
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Key Concept: Literature review and discussion
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Important: Historical development and evolution
• Best practices and recommendations
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 9: Diagram/Chart/Graph]
Definition: Current trends and future directions
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Quiz 2: Best practices and recommendations
Practice Problem 10: Best practices and recommendations
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 11: Literature review and discussion
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Definition: Research findings and conclusions
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 13: Key terms and definitions
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Critical analysis and evaluation
• Learning outcomes and objectives
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Current trends and future directions
• Case studies and real-world applications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Note: Statistical analysis and interpretation
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Statistical analysis and interpretation
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 18: Diagram/Chart/Graph]
Key Concept: Practical applications and examples
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Practice Problem 19: Problem-solving strategies and techniques
• Assessment criteria and rubrics
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
References 3: Assessment criteria and rubrics
Important: Comparative analysis and synthesis
• Comparative analysis and synthesis
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 21: Key terms and definitions
• Fundamental concepts and principles
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Important: Best practices and recommendations
• Assessment criteria and rubrics
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Study tips and learning strategies
• Comparative analysis and synthesis
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Ethical considerations and implications
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Key terms and definitions
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 26: Diagram/Chart/Graph]
Important: Case studies and real-world applications
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Example 27: Ethical considerations and implications
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Note: Research findings and conclusions
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 29: Diagram/Chart/Graph]
Practice Problem 29: Research findings and conclusions
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
Chapter 4: Comparative analysis and synthesis
Important: Interdisciplinary approaches
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 31: Fundamental concepts and principles
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Current trends and future directions
• Best practices and recommendations
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Definition: Experimental procedures and results
• Best practices and recommendations
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 34: Practical applications and examples
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 35: Experimental procedures and results
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 36: Diagram/Chart/Graph]
Important: Case studies and real-world applications
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Comparative analysis and synthesis
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Note: Interdisciplinary approaches
• Learning outcomes and objectives
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Definition: Experimental procedures and results
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Part 5: Learning outcomes and objectives
Practice Problem 40: Literature review and discussion
• Research findings and conclusions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Important: Experimental procedures and results
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
Key Concept: Practical applications and examples
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Remember: Comparative analysis and synthesis
• Research findings and conclusions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Definition: Best practices and recommendations
• Study tips and learning strategies
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Comparative analysis and synthesis
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
Important: Interdisciplinary approaches
• Current trends and future directions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Important: Best practices and recommendations
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 48: Learning outcomes and objectives
• Best practices and recommendations
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Interdisciplinary approaches
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
Topic 6: Historical development and evolution
Important: Ethical considerations and implications
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Definition: Experimental procedures and results
• Case studies and real-world applications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 52: Case studies and real-world applications
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
[Figure 53: Diagram/Chart/Graph]
Note: Study tips and learning strategies
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Example 54: Fundamental concepts and principles
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Experimental procedures and results
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
[Figure 56: Diagram/Chart/Graph]
Key Concept: Theoretical framework and methodology
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 57: Interdisciplinary approaches
• Case studies and real-world applications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 58: Historical development and evolution
• Current trends and future directions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Historical development and evolution
• Fundamental concepts and principles
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Quiz 7: Experimental procedures and results
Example 60: Study tips and learning strategies
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 61: Assessment criteria and rubrics
• Current trends and future directions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Example 62: Ethical considerations and implications
• Comparative analysis and synthesis
- Sub-point: Additional details and explanations
- Example: Practical application scenario
[Figure 63: Diagram/Chart/Graph]
Remember: Problem-solving strategies and techniques
• Case studies and real-world applications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Historical development and evolution
• Research findings and conclusions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Ethical considerations and implications
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
[Figure 66: Diagram/Chart/Graph]
Remember: Historical development and evolution
• Comparative analysis and synthesis
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Ethical considerations and implications
• Research findings and conclusions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 68: Diagram/Chart/Graph]
Important: Fundamental concepts and principles
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Research findings and conclusions
• Current trends and future directions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Appendix 8: Learning outcomes and objectives
Key Concept: Ethical considerations and implications
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Learning outcomes and objectives
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
[Figure 72: Diagram/Chart/Graph]
Note: Comparative analysis and synthesis
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 73: Literature review and discussion
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Definition: Practical applications and examples
• Study tips and learning strategies
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Current trends and future directions
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 76: Diagram/Chart/Graph]
Practice Problem 76: Learning outcomes and objectives
• Best practices and recommendations
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Key Concept: Experimental procedures and results
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Important: Research findings and conclusions
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Practice Problem 79: Best practices and recommendations
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Topic 9: Literature review and discussion
Key Concept: Assessment criteria and rubrics
• Key terms and definitions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Note: Current trends and future directions
• Fundamental concepts and principles
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Practical applications and examples
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Statistical analysis and interpretation
• Current trends and future directions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Definition: Historical development and evolution
• Current trends and future directions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
[Figure 85: Diagram/Chart/Graph]
Key Concept: Statistical analysis and interpretation
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Critical analysis and evaluation
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Definition: Historical development and evolution
• Research findings and conclusions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 88: Diagram/Chart/Graph]
Definition: Practical applications and examples
• Case studies and real-world applications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Definition: Literature review and discussion
• Fundamental concepts and principles
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Abstract 10: Critical analysis and evaluation
Important: Comparative analysis and synthesis
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 91: Practical applications and examples
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
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