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Chapter 22: Crossbridge and Muscle Properties, Energetics, and Pressure-Volume Area -- Chapter 23: Constancy and Variability of Oxygen Costs of Mechanical Energy (PVA) and Contractility (Emax) -- Chapter 24: Tight Coupling between Regional Myocardial Oxygen Consumption and Contractile Function -- Chapter 25: Force-Frequency Relation, Force-Interval Relation, and Mechanical Restitution -- Chapter 26: Elastance-Based Mechanical Restitution Provides Data from the Intact Heart Not Available from Any Other Technique -- Chapter 27: Contractility Indices -- Chapter 28: Searching for Indices of Contractility Is Counterproductive -- Chapter 29: Rapid Contractile Upregulation Rematches Stroke Work to ...
The cardiac system represents one of the most exciting challenges to human ingenuity. Critical to our survival, it consists of a tantalizing array of interacting phenomena, from ionic microscopic transport, membrane channels and receptors through cellular metabolism, energy production to fiber mechanics, microcirculation, electrical activation to the global, clinically observed, function, which is measured by pressure, volume, coronary flow, heart rate, shape changes and responds to imposed loads and pharmaceutical challenges. It is a complex interdisciplinary system requiring the joint efforts of the life sciences, the exact sciences, engineering and technology to understand and control the...
Physiologists have long been interested in the interaction, or coupling, between the heart and the vasculature. The early literature consists mainly of phenomenological descriptions of cardiac alterations resulting from specific interventions in the vasculature. Hundreds of studies, for example, describe functional aspects of hypertrophied myocardium associated with the excessive vascular loading produced by various types of experimental hypertension. Recently, the concepts of ventricular/vascular interaction have found important clinical application. The widespread use of vaso dilators and of intraaortic counterpUlsation balloons for unloading an ov erburdened, diseased heart is a prime exa...
This book addresses and corrects widespread misconceptions regarding heart physiology. Such misconceptions include: the voltage in cells is attributed to potassium ion concentration differences between the extracellular and intracellular compartments, which are the same in all organs of the body, whereas the voltage in cells of these same organs vary widely. This book argues that depolarisation and repolarisation can be explained by electron outflow and mitochondrial production, respectively; and that the trigger for internal calcium ion release is calcium ions bound to the inner leaflet of the cell membrane. In the book, Starling’s Law is contrasted with contractility increase, and it is posited that hypertension is not caused by salty diet, coronary artery disease risk is not correlated with total cholesterol (rather, only with some specific cholesterols), and that drug administration should be titrated.
The heart and lung are intricately linked. When the heart is affected by disease, the lungs will often show some related pathological or clinical conditions and vice versa. Pulmonary heart disease is by definition a condition when the lungs cause the heart to fail. The left ventricle in combination with the other structures in the “left heart” pumps blood throughout the body. The right ventricle (and structures of the “right heart”) pumps blood to the lungs where it is oxygenated and returned to the left heart for distribution. In normal circumstances, the right heart pumps blood into the lungs without any resistance. The lungs usually have minimal pressure and the right heart easily...
The tenth Henry Goldberg Workshop is an excellent occasion to recall our goals and celebrate some of our humble achievements. Vision and love of our fellow man are combined here to: 1) Foster interdisciplinary interaction between leading world scientists and clinical cardiologists so as to identify missing knowledge and catalyze new research ideas; 2) relate basic microscale, molecular and subcellular phenomena to the global clinically manifested cardiac performance; 3) apply conceptual modelling and quantitative analysis to better explore, describe, and understand cardiac physiology; 4) interpret available clinical data and design new revealing experiments; and 5) enhance international coop...
The cardiac system represents one of the most exciting challenges to human ingenuity. Critical to our survival, it consists of a tantalizing array of interacting phenomena, from ionic transport, membrane channels and receptors through cellular metabolism, energy production to fiber mechanics, microcirculation, electrical activation to the global, clinically observed, function, which is measured by pressure, volume, coronary flow, heart rate, shape changes and responds to imposed loads and pharmaceutical challenges. It is a complex interdisciplinary system requiring the joint efforts of the life sciences, the exact sciences, engineering and technology to understand and control the pathologies...
Photoplethysmography (PPG) is a non-invasive optical technique widely used in the study and monitoring of the pulsations associated with changes in blood volume in a peripheral vascular bed. Over the last thirty years, there has been a significant increase in the number of published articles on PPG, describing both basic and applied research. Throughout these publications the PPG has been hailed as a non-invasive, low cost, and simple optical measurement technique applied at the surface of the skin to measure a whole host of physiological parameters.
Since the introduction of coronary angiography, a key technique in understanding coronary artery disease, a number of paradigms regarding its study and interpretation have taken place. Following an emphasis on improved angiographic and subsequent intracoronary imaging techniques, functional assessment of coronary circulation has demonstrated to have major implications for diagnosis and treatment of coronary artery disease. Fractional flow reserve, a pressure derived index of stenosis severity, constitutes the best example of the current importance of physiological assessment in clinical practice. However, the acceptance of FFR by cardiologists contrasts with important voids in knowledge on t...