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E-book: Basic Cardiovascular Physiology: From Molecules to Translational Medical Science

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  • Format: 436 pages
  • Pub. Date: 01-Sep-2022
  • Publisher: River Publishers
  • ISBN-13: 9781000791600
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Basic Cardiovascular Physiology: From Molecules to Translational Medical ScienceLarger Image
  • Format: 436 pages
  • Pub. Date: 01-Sep-2022
  • Publisher: River Publishers
  • ISBN-13: 9781000791600
Other books in subject:

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This book focuses on established cardiovascular principles andhighlights some of the progress achieved by recent research in thecardiovascular field. The book describes the structure and function of theheart and vascular system for the reader to understand how the cardiovascularsystem responds in both health and disease.

This book focuses on established cardiovascularprinciples and highlights some of the progress achieved by recent research inthe cardiovascular field. The authors report the basic concepts related to thefunctioning of the cardiovascular system necessary for medical students tounderstand.

 

To foster learning, in each chapter the fundamentalpoints are highlighted in italics and/or bold. In addition, there are addedboxes that contain some more detailed information about physiologicalmechanisms or deeper analyses of clinical aspects. The book describes thestructure and function of the heart and vascular system for the reader tounderstand how the cardiovascular system responds in both health and disease. Conveyinga unified vision of the function of the heart and the vascular system, theauthors explain the complexity of the system that goes far beyond theintegrated connection between preload, afterload and cardiac contractility.

 

The endothelium covers the internal part of the wholecardiovascular system; therefore, endothelial physiology is treated in severalchapters. Given the importance of coronary circulation in cardiacpathophysiology, this special circulation is described in detail and enrichedwith the most up-to-date information. Several paragraphs and boxes on clinicalimplications are dedicated to the principles of electrophysiology and theelectrocardiogram. A space is also dedicated to myocardial ischemia/reperfusioninjury and cardioprotective procedures. The book is written in a linear andsimple language without compromising the scientific rigor of the various topicscovered.

Preface xiii
Acknowledgments xv
List of Boxes
xvii
List of Abbreviations
xix
1 Cardiovascular System
1(16)
1.1 Overview of the Cardiovascular System
1(3)
1.2 Conditions Necessary for Blood Movements in the Cardiovascular System
4(5)
1.3 The Sections of the Cardiovascular System
9(5)
1.4 The Blood Contenied in the Various Sections of the Cardiovascular System
14(3)
2 Structure and Function of the Myocardial Fiber
17(10)
2.1 Myocardial Fiber
17(3)
2.2 Myofibrillar or Contractile Proteins
20(4)
2.3 Regulatory Proteins
24(1)
2.4 Structural Proteins
25(2)
3 Cardiac Electrophysiology
27(14)
3.1 Cardiac Electrophysiology: Overview
27(4)
3.2 Genesis of Resting Membrane Potential
31(4)
3.3 The Action Potential
35(4)
3.4 After Depolarizations
39(2)
4 Functional Tissue of the Heart
41(24)
4.1 The Properties of Functional Tissues of the Heart
41(19)
4.1.1 Automatism or Chronotropism
41(4)
4.1.2 Excitability or Bathmotropism
45(3)
4.1.3 Conductivity or Dromotropism: Origin and Diffusion of the Cardiac Impulse
48(3)
4.1.4 Contractility or Inotropism
51(1)
4.1.4.1 The cross-bridge muscle contraction cycle
51(2)
4.1.4.2 Isometric and isotonic contraction
53(1)
4.1.4.3 Isotonic contraction with a suspended load
54(1)
4.1.4.4 Mixed contraction: isometric and isotonic contraction with a sustained load
55(1)
4.1.4.5 Mixed contraction with different preload and afterloads
55(2)
4.1.4.6 Contractility and the strength of contraction in the heart
57(3)
4.2 Cardiac Contractility and Heavy Meromyosin Isoforms
60(1)
4.3 Excitation-Contraction Coupling
61(4)
5 The Cardiac Cycle
65(30)
5.1 The Heart as a Pressure Gradient Generator
65(1)
5.2 The Phases of the Cardiac Cycle
66(10)
5.2.1 The Isovolumic Systole
68(1)
5.2.2 The Ventricular Ejection Phase
69(1)
5.2.2.1 The ejection with acceleration
69(1)
5.2.2.2 The ejection with deceleration
69(3)
5.2.3 The Protodiastole
72(1)
5.2.4 The Isovolumic Relaxation Phase
73(1)
5.2.5 The Rapid Ventricular Filling Phase
74(1)
5.2.6 The Slow Ventricular Filling Phase
74(1)
5.2.7 The Atrial Systole Phase
75(1)
5.3 The Atrial Pressure Curve
76(1)
5.4 The Cycle of the Right Heart
76(1)
5.5 Changes in the Heart Rate and Duration of the Phases of the Cardiac Cycle
77(3)
5.6 The Hemodynamic Role of Atrial Systole
80(2)
5.7 The Aortic Flow Curve
82(6)
5.7.1 The Sounds and the Heart Murmurs
84(3)
5.7.2 Auscultation Points
87(1)
5.7.3 Murmurs
87(1)
5.8 Cardiac Volumes and Ejection Fraction
88(2)
5.9 The Ventricular Pressure-Volume Loop
90(5)
6 Cardiac Output and the Venous Return to the Heart
95(14)
6.1 The Cardiac Output
95(1)
6.2 Factors Determining the Venous Return to the Heart
96(4)
6.3 The Central Venous Pressure
100(1)
6.4 The Cardiac Output and the Venous Return
101(4)
6.5 The Cardiac Output in the Compensated and Decompensated Heart Failure
105(4)
6.5.1 The Valsalva Maneuver
107(2)
7 Regulation of Cardiac Contraction Force
109(24)
7.1 Intrinsic and Extrinsic Regulation of the Heart Contractile Force
109(15)
7.1.1 Intrinsic Heterometric Regulation of Contractile Force
110(6)
7.1.1.1 Mechanisms of the Frank-Starling law
116(2)
7.1.2 Intrinsic Homeometric Regulation of Contractile Force: Anrep Phenomenon and Bowditch or Scale Phenomenon
118(1)
7.1.2.1 The phenomenon of Anrep
118(1)
7.1.2.2 The Bowditch effect or staircase phenomenon
119(1)
7.1.3 Extrinsic Nervous and Humoral Regulation
120(1)
7.1.3.1 The Nervous Regulation
121(2)
7.1.4 The Humoral Regulation
123(1)
7.2 Combined Effect of Heterometric and Homeometric Regulation
124(3)
7.3 The Regulation of Cardiac Contraction Force and Heart Failure
127(3)
7.4 Heart Efficiency: Effort Required by the Heart for Ventricular End-Diastolic Volume
130(3)
8 Arterial Pressure
133(40)
8.1 The Device and the Law of Poiseuille
133(5)
8.2 The Mechanical Factors of Arterial Pressure
138(3)
8.2.1 Increased Stroke Volume
138(1)
8.2.2 Increase in Heart Rate
139(1)
8.2.3 Increasing Total Peripheral Resistance
140(1)
8.3 Measurement of Resistance
141(1)
8.4 Parallel Arrangement of District Resistance
142(2)
8.5 The Regulation of Vascular Resistance
144(2)
8.6 The Arterial Windkessel and the Arterial Pressure
146(2)
8.7 The Impedance to Ventricular Ejection
148(1)
8.8 The Velocity of Propagation and the Length of Pressure Wave
149(4)
8.9 The Oscillations of I, II and III Order of Arterial Pressure
153(1)
8.10 The Mechanisms of Control of Arterial Pressure
154(9)
8.10.1 Short-term Control Mechanisms
156(1)
8.10.1.1 Ischemic response of the central nervous system (CNS)
157(1)
8.10.1.2 Baroreceptor system
157(2)
8.10.1.3 Chemoreceptor system
159(1)
8.10.2 Medium-term Control Mechanisms
160(1)
8.10.2.1 Exchanges of liquid through the capillary wall
160(1)
8.10.2.2 Renin-angiotensin-aldosterone system
161(1)
8.10.2.3 Stress-relaxation phenomenon
162(1)
8.10.3 The Long-term Control Mechanisms
162(1)
8.10.3.1 Kidney-body fluids system
162(1)
8.11 Hemodynamic and Arterial Pressure Modifications in the Physical Exercise
163(2)
8.12 The Measurement of Arterial Pressure in Humans
165(1)
8.13 The Arterial Pulse
166(2)
8.14 The Venous Pulse
168(5)
9 Work and Heart Metabolism
173(8)
9.1 The Work of the Heart
173(3)
9.2 Heart Performance
176(2)
9.3 The Metabolism of the Myocardium
178(3)
10 Electrocardiogram
181(56)
10.1 The Definition of Electrocardiogram and Dipole Theory
181(11)
10.2 Morphology and the Meaning of Electrocardiographic Waves
192(7)
10.2.1 Electrocardiographic Intervals and Segments
196(3)
10.3 Electrocardiographic Leads on the Front Plane and the Electrical Axis of the Heart
199(10)
10.3.1 Leads on the Frontal Plane
199(1)
10.3.1.1 Bipolar limb leads
199(3)
10.3.1.2 Unipolar limb leads
202(5)
10.3.2 Leads on the Horizontal Plane
207(2)
10.4 Electrocardiographic Aspects of Conduction Disorders and of the Main Arrhythmias
209(28)
10.4.1 Conduction Disorders
209(1)
10.4.1.1 Sino-atrial block
210(1)
10.4.1.2 Atrio-ventricular blocks
210(4)
10.4.1.3 The bundle-branch block
214(1)
10.4.2 Extrasystoles and Tachyarrhythmias
215(1)
10.4.2.1 Extrasystoles
215(5)
10.4.2.2 Tachyarrhythmias
220(17)
11 Vascular Hemodynamics
237(24)
11.1 Introduction
237(1)
11.2 The Total Energy of Fluids
237(4)
11.2.1 The Lateral, Head and Tail Pressures
239(2)
11.3 The Blood Viscosity
241(3)
11.4 The Laminar Flow and the Turbulent Flow
244(3)
11.5 The Visco-Elastic and Contractile Features of Vessels
247(4)
11.6 The Miogenic Regulation of the Radius of Resistance Vessels
251(2)
11.7 The Flow of the Blood According to the Waterfall Model
253(2)
11.8 The Wave of Flow Along the Arterial Tree
255(1)
11.9 The Microcirculation
256(5)
12 Nervous Control of the Cardiovascular System
261(28)
12.1 The Innervation of the Cardiovascular System
261(2)
12.2 Action of the Sympathetic and Vagal Nerves on the Heart
263(4)
12.2.1 Action of the Sympathetic Nerves on the Heart
264(2)
12.2.2 Action of the Vagus on the Heart
266(1)
12.3 Action of the Sympathetic Fibers on the Vessels
267(1)
12.4 The Sympathetic and Parasympathetic Receptors of the Cardiovascular Apparatus
268(8)
12.4.1 Adrenergic Receptors
268(1)
12.4.1.1 Alpha-receptors
269(3)
12.4.1.2 Beta-receptors
272(3)
12.4.2 Acetylcholine Receptors
275(1)
12.5 The Nervous Control Centers of the Cardiovascular Apparatus
276(3)
12.6 The Nervous Reflex Control of the Cardiovascular Apparatus
279(6)
12.6.1 The Baroreceptors
279(3)
12.6.2 The Ventricular Receptors
282(1)
12.6.3 Atrial Receptors are of Different Types
283(1)
12.6.4 Chemoreceptors
283(1)
12.6.5 The Axonic Reflexes
284(1)
12.7 The Control of the Blood Volume and the Bainbridge Reflex
285(4)
13 Humoral Control of the Cardiovascular System
289(24)
13.1 Catecholamines
289(2)
13.2 Endothial Factors
291(10)
13.2.1 Nitric Oxide
291(4)
13.2.2 Endothelial Derived Hyperpolarizing Factors
295(2)
13.2.3 Endothelial Contraction Factors
297(2)
13.2.4 Endothelial Dysfunction
299(2)
13.3 Other Humoral Factors That Act on the Cardiovascular Apparatus
301(7)
13.3.1 Serotonin
301(1)
13.3.2 Prostaglandins
302(1)
13.3.3 Plasma Kinins
302(1)
13.3.4 Histamine
303(1)
13.3.5 Antidiuretic Hormone
304(1)
13.3.6 Natriuretic Factors
305(2)
13.3.7 Orexins or Hypocretins
307(1)
13.4 Renin-Angiotensin-Aldosterone System
308(1)
13.5 Apeline and the APJ Receptor
309(4)
14 District Circulations
313(44)
14.1 Coronary Circulation
313(26)
14.1.1 The Coronary Arteries and the Microcirculation
313(2)
14.1.2 The Venous Coronary Circulation
315(1)
14.1.3 Anastomosis of the Coronary Circulation
316(1)
14.1.4 The Resistance of the Coronary Circulation
316(1)
14.1.4.1 The phasic coronary flow and the compressive resistance
316(5)
14.1.4.2 Coronary autoregulative resistance
321(2)
14.1.4.3 Coronary viscous resistance
323(1)
14.1.5 Metabolic Mechanism
323(3)
14.1.6 Nervous Mechanisms
326(3)
14.1.7 Humoral Mechanisms
329(1)
14.1.8 Endothelial Mechanisms
330(2)
14.1.9 Myogenic Mechanism
332(1)
14.1.10 Coronary Flow at Rest and Under Stress
332(2)
14.1.11 Reactive Hyperemia
334(2)
14.1.12 The Coronary Reserve
336(3)
14.2 Cerebral Circulation
339(3)
14.2.1 Autoregulation and Metabolic Regulation
340(1)
14.2.2 Nervous Regulation
341(1)
14.3 Splanchnic Circulation
342(5)
14.3.1 The Splenic Circulation and the Spleen
343(1)
14.3.2 The Mesenteric Circulation and the Intestinal Villi
343(2)
14.3.3 The Hepatic Circulation
345(2)
14.4 Circulation in the Skeletal Muscle
347(3)
14.5 Renal Circulation
350(4)
14.6 Cutaneous Circulation
354(3)
15 Pulmonary Circulation
357(10)
15.1 The Characteristics of Pulmonary Circulation
357(5)
15.2 Variations of Volume of the Lung and the Resistance to the Blood Flow
362(2)
15.3 The Chemical and Nervous Regulation of the Pulmonary Circulation
364(1)
15.4 The Formation of the Pulmonary Edema
365(2)
16 Coordinated Cardiovascular Adaptations
367(10)
16.1 Physical Exercise
367(4)
16.2 Alerting Response
371(1)
16.3 Responses to Hemorrhage
372(5)
17 Myocardial Protection Against Ischemia-Reperfusion Injury
377(12)
17.1 Ischemia and Reperfusion Injury
377(3)
17.2 Pre-Conditioning and Post-Conditioning
380(7)
17.3 Pharmacological Pre-Conditioning and Post-Conditioning
387(2)
18 Lymphatic Circulation
389(6)
18.1 Formation of the Linfa
389(1)
18.2 Lymphatic Vessels
390(2)
18.3 Lymphatic Row
392(3)
19 Functional Imaging of the Cardiovascular System: How to Study Human Physiology In Vivo
395(16)
19.1 Functional Imaging vs Anatomical Imaging
395(1)
19.2 Functional Methods of Analysis
396(6)
19.2.1 Cardiac Catheterization
396(1)
19.2.1.1 Measurement of cardiac output
396(1)
19.2.1.2 Fractional flow reserve (FFR)
397(1)
19.2.1.3 Electrophysiological mapping
398(1)
19.2.1.4 Positron emission tomography (PET)
399(1)
19.2.2 Single-Photon Emission Tomography (SPECT)
399(1)
19.2.3 Echocardiography
400(1)
19.2.4 Computerized Axial Tomography (CAT or CT)
400(1)
19.2.5 Cardiovascular Magnetic Resonance
401(1)
19.3 Physiological Parameters in Clinical Practice
402(9)
19.3.1 Contractile Function
402(2)
19.3.2 Myocardial Perfusion
404(2)
19.3.3 Myocardial Vitality
406(1)
19.3.4 Assessment of Blood Flow in Large Vessels and Cardiac Output
407(1)
19.3.5 Myocardial Oxygenation
408(1)
19.3.6 Electric Activation
408(3)
About the Authors 411
Pasquale Pagliaro, Claudia Penna, Raffaella Rastaldo
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