Coronary Circulation in Physiological and Pathophysiological States
Coronary Circulation in Physiological and Pathophysiological States

Author: Motoomi Nakamura

Publisher: Springer

Published: 2011-12-25

Total Pages: 160

ISBN-13: 9784431681106

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MOTOOMI NAKAMURA As we approach the 21st century, ischemic heart disease is the major cause of death in most of the developed nations of the world. Since the 1970s, much effort and expense have led to designs of coronary thrombolytic therapy, percutaneous coronary angioplasty (PTCA), coronary artery bypass grafting, heart transplantation, automatic defibrillators, as well as to the formation of beta blockers and com pounds which block the calcium channel. Socio-educational programs directed at exercise, diet, instruction in the risk factors of smoking, hyperlipidemia and hypertension have contributed to the decrease in the rate of morbidity and mortality of patients with ischemic heart disease. However, the first clinical event of ischemic heart disease, the so-called "heart attack" and sudden cardiac death continues to present problems, as the mechanisms involved in these events are poorly understood. It has long been thought that ischemic heart disease is the sequence of an organic fixed atherosclerotic obstruction of the epicardial coronary arteries and the role of coronary vasomotion has been given much less attention. Recent clinical and laboratory animal studies revealed that increased tonus and spasm of the large epicardial coronary arteries are the cause of various stages of ischemic heart disease. The role of coronary vasospasm in the development of un stable angina, sudden cardiac death and acute myocardial infarction remains open to debate. Pharmacophysiological studies showed that the epicardial large coronary artery contributes only 5% to regulation of normal coronary flow.

Regulation of Coronary Blood Flow
Regulation of Coronary Blood Flow

Author: Michitoshi Inoue

Publisher: Springer Science & Business Media

Published: 2013-11-09

Total Pages: 330

ISBN-13: 4431683674

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Research centering on blood flow in the heart continues to hold an important position, especially since a better understanding of the subject may help reduce the incidence of coronary arterial disease and heart attacks. This book summarizes recent advances in the field; it is the product of fruitful cooperation among international scientists who met in Japan in May, 1990 to discuss the regulation of coronary blood flow.

Coronary Circulation in Physiological and Pathophysiological States
Coronary Circulation in Physiological and Pathophysiological States

Author: Motoomi Nakamura

Publisher: Springer Science & Business Media

Published: 2012-12-06

Total Pages: 248

ISBN-13: 4431681086

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MOTOOMI NAKAMURA As we approach the 21st century, ischemic heart disease is the major cause of death in most of the developed nations of the world. Since the 1970s, much effort and expense have led to designs of coronary thrombolytic therapy, percutaneous coronary angioplasty (PTCA), coronary artery bypass grafting, heart transplantation, automatic defibrillators, as well as to the formation of beta blockers and com pounds which block the calcium channel. Socio-educational programs directed at exercise, diet, instruction in the risk factors of smoking, hyperlipidemia and hypertension have contributed to the decrease in the rate of morbidity and mortality of patients with ischemic heart disease. However, the first clinical event of ischemic heart disease, the so-called "heart attack" and sudden cardiac death continues to present problems, as the mechanisms involved in these events are poorly understood. It has long been thought that ischemic heart disease is the sequence of an organic fixed atherosclerotic obstruction of the epicardial coronary arteries and the role of coronary vasomotion has been given much less attention. Recent clinical and laboratory animal studies revealed that increased tonus and spasm of the large epicardial coronary arteries are the cause of various stages of ischemic heart disease. The role of coronary vasospasm in the development of un stable angina, sudden cardiac death and acute myocardial infarction remains open to debate. Pharmacophysiological studies showed that the epicardial large coronary artery contributes only 5% to regulation of normal coronary flow.

Coronary Microvascular Dysfunction
Coronary Microvascular Dysfunction

Author: Filippo Crea

Publisher: Springer Science & Business Media

Published: 2013-08-15

Total Pages: 263

ISBN-13: 8847053676

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In the past two decades a number of studies have shown that abnormalities in the function and structure of coronary microcirculation can be detected in several cardiovascular diseases. On the basis of the clinical setting in which it occurs, coronary microvascular dysfunction (CMD) can be classified into four types: CMD in the absence of any other cardiac disease; CMD in myocardial diseases; CMD in obstructive epicardial coronary artery disease; and iatrogenic CMD. In some instances CMD represents an epiphenomenon, whereas in others it represents an important marker of risk or may contribute to the pathogenesis of myocardial ischemia, thus becoming a possible therapeutic target. This book provides an update on coronary physiology and a systematic assessment of microvascular abnormalities in cardiovascular diseases, in the hope that it will assist clinicians in prevention, detection and management of CMD in their everyday activity.

Simulation and Imaging of the Cardiac System
Simulation and Imaging of the Cardiac System

Author: S. Sideman

Publisher: Springer Science & Business Media

Published: 2012-12-06

Total Pages: 448

ISBN-13: 9400949928

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The ultrasound velocity tomography allows measurement of cardiac geometries for various phases in the cardiac cycle. The present tomograph makes reconstruc tions at intervals of 20 ms. Because of a lack of clear (intramural) landmarks (except the roots of the papillairy muscle), it is difficult to pinpoint spatial trajectories of particular points in the heart. Therefore, a second method was developed of injecting radiopaque markers in the heart and following their motion patterns during the cardiac cycle with help of a biplane X-ray equipment. The data obtained with both methods can be implemented in our finite element model of the heart to compute intramural stresses and strains. The results obtained sofar with the extended Darcy equation to account for the interaction of blood rheology and tissue mechanics look promising. Further testing with more sophisticated subjects than mentioned in Figure 9 is required before it will be implemented in our finite element model of the heart. We conclude that analysis of regional cardiac function, including regional myocardial blood flow, requires still a major research effort but the results obtained sofar justify, to our opinion, a continuation in this direction. Acknowledgement The authors acknowledge Dr. C. Borst and coworkers for doing the animal experiments and prof. Van Campen and dr. Grootenboer for their participation is some aspects of this work.

Perioperative Hemodynamic Monitoring and Goal Directed Therapy
Perioperative Hemodynamic Monitoring and Goal Directed Therapy

Author: Maxime Cannesson

Publisher: Cambridge University Press

Published: 2014-09-04

Total Pages: 301

ISBN-13: 1316061442

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This unique book provides clinicians and administrators with a comprehensive understanding of perioperative hemodynamic monitoring and goal directed therapy, emphasizing practical guidance for implementation at the bedside. Successful hemodynamic monitoring and goal directed therapy require a wide range of skills. This book will enable readers to: • Detail the rationale for using perioperative hemodynamic monitoring systems and for applying goal directed therapy protocols at the bedside • Understand the physiological concepts underlying perioperative goal directed therapy for hemodynamic management • Evaluate hemodynamic monitoring systems in clinical practice • Learn about new techniques for achieving goal directed therapy • Apply goal directed therapy protocols in the perioperative environment (including emergency departments, operating rooms and intensive care units) • Demonstrate clinical utility of GDT and hemodynamic optimization using case presentations. Illustrated with diagrams and case examples, this is an important resource for anesthesiologists, emergency physicians, intensivists and pneumonologists as well as nurses and administrative officers.

ABC of Hypertension
ABC of Hypertension

Author: D. Gareth Beevers

Publisher: John Wiley & Sons

Published: 2010-07-15

Total Pages: 89

ISBN-13: 1405171359

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Hypertension is a condition which affects millions of peopleworldwide and its treatment greatly reduces the risk of strokes andheart attacks. This fully revised and updated edition of the ABCof Hypertension is an established guide providing all thenon-specialist needs to know about the measurement of bloodpressure and the investigation and management of hypertensivepatients. This new edition provides comprehensively updated andrevised information on how and whom to treat. The ABC of Hypertension will prove invaluable to generalpractitioners who may be screening large numbers of patients forhypertension, as well as nurse practitioners, midwives and otherhealthcare professionals.

How Tobacco Smoke Causes Disease
How Tobacco Smoke Causes Disease

Author: United States. Public Health Service. Office of the Surgeon General

Publisher:

Published: 2010

Total Pages: 728

ISBN-13:

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This report considers the biological and behavioral mechanisms that may underlie the pathogenicity of tobacco smoke. Many Surgeon General's reports have considered research findings on mechanisms in assessing the biological plausibility of associations observed in epidemiologic studies. Mechanisms of disease are important because they may provide plausibility, which is one of the guideline criteria for assessing evidence on causation. This report specifically reviews the evidence on the potential mechanisms by which smoking causes diseases and considers whether a mechanism is likely to be operative in the production of human disease by tobacco smoke. This evidence is relevant to understanding how smoking causes disease, to identifying those who may be particularly susceptible, and to assessing the potential risks of tobacco products.

The Gastrointestinal Circulation
The Gastrointestinal Circulation

Author: Peter R. Kvietys

Publisher: Morgan & Claypool Publishers

Published: 2010

Total Pages: 127

ISBN-13: 1615041176

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The microcirculation of the gastrointestinal tract is under the control of both myogenic and metabolic regulatory systems. The myogenic mechanism contributes to basal vascular tone and the regulation of transmural pressure, while the metabolic mechanism is responsible for maintaining an appropriate balance between O2 demand and O2 delivery. In the postprandial state, hydrolytic products of food digestion elicit a hyperemia, which serves to meet the increased O2 demand of nutrient assimilation. Metabolically linked factors (e.g., tissue pO2, adenosine) are primarily responsible for this functional hyperemia. The fenestrated capillaries of the gastrointestinal mucosa are relatively permeable to small hydrolytic products of food digestion (e.g., glucose), yet restrict the transcapillary movement of larger molecules (e.g., albumin). This allows for the absorption of hydrolytic products of food digestion without compromising the oncotic pressure gradient governing transcapillary fluid movement and edema formation. The gastrointestinal microcirculation is also an important component of the mucosal defense system whose function is to prevent (and rapidly repair) inadvertent epithelial injury by potentially noxious constituents of chyme. Two pathological conditions in which the gastrointestinal circulation plays an important role are ischemia/reperfusion and chronic portal hypertension. Ischemia/reperfusion results in mucosal edema and disruption of the epithelium due, in part, to an inflammatory response (e.g., increase in capillary permeability to macromolecules and neutrophil infiltration). Chronic portal hypertension results in an increase in gastrointestinal blood flow due to an imbalance in vasodilator and vasoconstrictor influences on the microcirculation. Table of Contents: Introduction / Anatomy / Regulation of Vascular Tone and Oxygenation / Extrinsic Vasoregulation: Neural and Humoral / Postprandial Hyperemia / Transcapillary Solute Exchange / Transcapillary Fluid Exchange / Interaction of Capillary and Interstitial Forces / Gastrointestinal Circulation and Mucosal Defense / Gastrointestinal Circulation and Mucosal Pathology I: Ischemia/Reperfusion / Gastrointestinal Circulation and Mucosal Pathology II: Chronic Portal Hypertension / Summary and Conclusions / References / Author Biography