Basic Cardiovascular Physiology: From Molecules to Translational Medical Science

Front Cover
Basic Cardiovascular Physiology: From Molecules to Translational Medical Science
Contents
Preface
Acknowledgments
List of Boxes
List of Abbreviations
1 Cardiovascular System
	1.1 Overview of the Cardiovascular System
	1.2 Conditions Necessary for Blood Movements in the Cardiovascular System
	1.3 The Sections of the Cardiovascular System
	1.4 The Blood Contenied in the Various Sections of the Cardiovascular System
2 Structure and Function of the Myocardial Fiber
	2.1 Myocardial Fiber
	2.2 Myofibrillar or Contractile Proteins
	2.3 Regulatory Proteins
	2.4 Structural Proteins
3 Cardiac Electrophysiology
	3.1 Cardiac Electrophysiology: Overview
	3.2 Genesis of Resting Membrane Potential
	3.3 The Action Potential
	3.4 After Depolarizations
4 Functional Tissue of the Heart
	4.1 The Properties of Functional Tissues of the Heart
		4.1.1 Automatism or Chronotropism
		4.1.2 Excitability or Bathmotropism
		4.1.3 Conductivity or Dromotropism: Origin and Diffusion of the Cardiac Impulse
		4.1.4 Contractility or Inotropism
			4.1.4.1 The cross-bridge muscle contraction cycle
			4.1.4.2 Isometric and isotonic contraction
			4.1.4.3 Isotonic contraction with a suspended load
			4.1.4.4 Mixed contraction: isometric and isotonic contraction with a sustained load
			4.1.4.5 Mixed contraction with different preload and afterloads
			4.1.4.6 Contractility and the strength of contraction in the heart
	4.2 Cardiac Contractility and Heavy Meromyosin Isoforms
	4.3 Excitation-Contraction Coupling
5 The Cardiac Cycle
	5.1 The Heart as a Pressure Gradient Generator
	5.2 The Phases of the Cardiac Cycle
		5.2.1 The Isovolumic Systole
		5.2.2 The Ventricular Ejection Phase
			5.2.2.1 The ejection with acceleration
			5.2.2.2 The ejection with deceleration
		5.2.3 The Protodiastole
		5.2.4 The Isovolumic Relaxation Phase
		5.2.5 The Rapid Ventricular Filling Phase
		5.2.6 The Slow Ventricular Filling Phase
		5.2.7 The Atrial Systole Phase
	5.3 The Atrial Pressure Curve
	5.4 The Cycle of the Right Heart
	5.5 Changes in the Heart Rate and Duration of the Phases of the Cardiac Cycle
	5.6 The Hemodynamic Role of Atrial Systole
	5.7 The Aortic Flow Curve
		5.7.1 The Sounds and the Heart Murmurs
		5.7.2 Auscultation Points (Figure 5.7)
		5.7.3 Murmurs (Figure 5.8)
	5.8 Cardiac Volumes and Ejection Fraction
	5.9 The Ventricular Pressure-Volume Loop
6 Cardiac Output and the Venous Return to the Heart
	6.1 The Cardiac Output
	6.2 Factors Determining the Venous Return to the Heart
	6.3 The Central Venous Pressure
	6.4 The Cardiac Output and the Venous Return
	6.5 The Cardiac Output in the Compensated and Decompensated Heart Failure
		6.5.1 The Valsalva Maneuver
7 Regulation of Cardiac Contraction Force
	7.1 Intrinsic and Extrinsic Regulation of the Heart Contractile Force
		7.1.1 Intrinsic Heterometric Regulation of Contractile Force
			7.1.1.1 Mechanisms of the Frank-Starling law
		7.1.2 Intrinsic Homeometric Regulation of Contractile Force: Anrep Phenomenon and Bowditch or Scale Phenomenon
			7.1.2.1 The phenomenon of Anrep
			7.1.2.2 The Bowditch effect or staircase phenomenon
		7.1.3 Extrinsic Nervous and Humoral Regulation
			7.1.3.1 The Nervous Regulation
		7.1.4 The Humoral Regulation
	7.2 Combined Effect of Heterometric and Homeometric Regulation
	7.3 The Regulation of Cardiac Contraction Force and Heart Failure
	7.4 Heart Efficiency: Effort Required by the Heart for Ventricular End-Diastolic Volume
8 Arterial Pressure
	8.1 The Device and the Law of Poiseuille
	8.2 The Mechanical Factors of Arterial Pressure
		8.2.1 Increased Stroke Volume
		8.2.2 Increase in Heart Rate
		8.2.3 Increasing Total Peripheral Resistance
	8.3 Measurement of Resistance
	8.4 Parallel Arrangement of District Resistance
	8.5 The Regulation of Vascular Resistance
	8.6 The Arterial Windkessel and the Arterial Pressure
	8.7 The Impedance to Ventricular Ejection
	8.8 The Velocity of Propagation and the Length of Pressure Wave
	8.9 The Oscillations of I, II and III Order of Arterial Pressure
	8.10 The Mechanisms of Control of Arterial Pressure
		8.10.1 Short-term Control Mechanisms
			8.10.1.1 Ischemic response of the central nervous system (CNS)
			8.10.1.2 Baroreceptor system
			8.10.1.3 Chemoreceptor system
		8.10.2 Medium-term Control Mechanisms
			8.10.2.1 Exchanges of liquid through the capillary wall
			8.10.2.2 Renin-angiotensin-aldosterone system
			8.10.2.3 Stress-relaxation phenomenon
		8.10.3 The Long-term Control Mechanisms
			8.10.3.1 Kidney-body fluids system
	8.11 Hemodynamic and Arterial Pressure Modifications in the Physical Exercise
	8.12 The Measurement of Arterial Pressure in Humans
	8.13 The Arterial Pulse
	8.14 The Venous Pulse
9 Work and Heart Metabolism
	9.1 The Work of the Heart
	9.2 Heart Performance
	9.3 The Metabolism of the Myocardium
10 Electrocardiogram
	10.1 The Definition of Electrocardiogram and Dipole Theory
	10.2 Morphology and the Meaning of Electrocardiographic Waves
		10.2.1 Electrocardiographic Intervals and Segments
	10.3 Electrocardiographic Leads on the Front Plane and the Electrical Axis of the Heart
		10.3.1 Leads on the Frontal Plane
			10.3.1.1 Bipolar limb leads
			10.3.1.2 Unipolar limb leads
		10.3.2 Leads on the Horizontal Plane
	10.4 Electrocardiographic Aspects of Conduction Disorders and of the Main Arrhythmias
		10.4.1 Conduction Disorders
			10.4.1.1 Sino-atrial block
			10.4.1.2 Atrio-ventricular blocks
			10.4.1.3 The bundle-branch block
		10.4.2 Extrasystoles and Tachyarrhythmias
			10.4.2.1 Extrasystoles
			10.4.2.2 Tachyarrhythmias
11 Vascular Hemodynamics
	11.1 Introduction
	11.2 The Total Energy of Fluids
		11.2.1 The Lateral, Head and Tail Pressures (Figure 11.1)
	11.3 The Blood Viscosity
	11.4 The Laminar Flow and the Turbulent Flow
	11.5 The Visco-Elastic and Contractile Features of Vessels
	11.6 The Miogenic Regulation of the Radius of Resistance Vessels
	11.7 The Flow of the Blood According to the Waterfall Model
	11.8 The Wave of Flow Along the Arterial Tree
	11.9 The Microcirculation
12 Nervous Control of the Cardiovascular System
	12.1 The Innervation of the Cardiovascular System
	12.2 Action of the Sympathetic and Vagal Nerves on the Heart
		12.2.1 Action of the Sympathetic Nerves on the Heart
		12.2.2 Action of the Vagus on the Heart
	12.3 Action of the Sympathetic Fibers on the Vessels
	12.4 The Sympathetic and Parasympathetic Receptors of the Cardiovascular Apparatus
		12.4.1 Adrenergic Receptors
			12.4.1.1 Alpha-receptors
			12.4.1.2 Beta-receptors
		12.4.2 Acetylcholine Receptors
	12.5 The Nervous Control Centers of the Cardiovascular Apparatus
	12.6 The Nervous Reflex Control of the Cardiovascular Apparatus
		12.6.1 The Baroreceptors
		12.6.2 The Ventricular Receptors
		12.6.3 Atrial Receptors are of Different Types
		12.6.4 Chemoreceptors
		12.6.5 The Axonic Reflexes
	12.7 The Control of the Blood Volume and the Bainbridge Reflex
13 Humoral Control of the Cardiovascular System
	13.1 Catecholamines
	13.2 Endothial Factors
		13.2.1 Nitric Oxide
		13.2.2 Endothelial Derived Hyperpolarizing Factors
		13.2.3 Endothelial Contraction Factors
		13.2.4 Endothelial Dysfunction
	13.3 Other Humoral Factors That Act on the Cardiovascular Apparatus
		13.3.1 Serotonin
		13.3.2 Prostaglandins
		13.3.3 Plasma Kinins
		13.3.4 Histamine
		13.3.5 Antidiuretic Hormone
		13.3.6 Natriuretic Factors
		13.3.7 Orexins or Hypocretins
	13.4 Renin-Angiotensin-Aldosterone System
	13.5 Apeline and the APJ Receptor
14 District Circulations
	14.1 Coronary Circulation
		14.1.1 The Coronary Arteries and the Microcirculation
		14.1.2 The Venous Coronary Circulation
		14.1.3 Anastomosis of the Coronary Circulation
		14.1.4 The Resistance of the Coronary Circulation
			14.1.4.1 The phasic coronary flow and the compressive resistance
			14.1.4.2 Coronary autoregulative resistance
			14.1.4.3 Coronary viscous resistance
		14.1.5 Metabolic Mechanism
		14.1.6 Nervous Mechanisms
		14.1.7 Humoral Mechanisms
		14.1.8 Endothelial Mechanisms
		14.1.9 Myogenic Mechanism
		14.1.10 Coronary Flow at Rest and Under Stress
		14.1.11 Reactive Hyperemia
		14.1.12 The Coronary Reserve
	14.2 Cerebral Circulation
		14.2.1 Autoregulation and Metabolic Regulation
		14.2.2 Nervous Regulation
	14.3 Splanchnic Circulation
		14.3.1 The Splenic Circulation and the Spleen
		14.3.2 The Mesenteric Circulation and the Intestinal Villi
		14.3.3 The Hepatic Circulation
	14.4 Circulation in the Skeletal Muscle
	14.5 Renal Circulation
	14.6 Cutaneous Circulation
15 Pulmonary Circulation
	15.1 The Characteristics of Pulmonary Circulation
	15.2 Variations of Volume of the Lung and the Resistance to the Blood Flow
	15.3 The Chemical and Nervous Regulation of the Pulmonary Circulation
	15.4 The Formation of the Pulmonary Edema
16 Coordinated Cardiovascular Adaptations
	16.1 Physical Exercise
	16.2 Alerting Response
	16.3 Responses to Hemorrhage
17 Myocardial Protection Against Ischemia-Reperfusion Injury
	17.1 Ischemia and Reperfusion Injury
	17.2 Pre-Conditioning and Post-Conditioning
	17.3 Pharmacological Pre-Conditioning and Post-Conditioning
18 Lymphatic Circulation
	18.1 Formation of the Linfa
	18.2 Lymphatic Vessels
	18.3 Lymphatic Flow
19 Functional Imaging of the Cardiovascular System: How to Study Human Physiology In Vivo
	19.1 Functional Imaging vs Anatomical Imaging
	19.2 Functional Methods of Analysis
		19.2.1 Cardiac Catheterization
			19.2.1.1 Measurement of cardiac output
			19.2.1.2 Fractional flow reserve (FFR)
			19.2.1.3 Electrophysiological mapping
			19.2.1.4 Positron emission tomography (PET)
		19.2.2 Single-Photon Emission Tomography (SPECT)
		19.2.3 Echocardiography
		19.2.4 Computerized Axial Tomography (CAT or CT)
		19.2.5 Cardiovascular Magnetic Resonance
	19.3 Physiological Parameters in Clinical Practice
		19.3.1 Contractile Function
		19.3.2 Myocardial Perfusion
		19.3.3 Myocardial Vitality
		19.3.4 Assessment of Blood Flow in Large Vessels and Cardiac Output
		19.3.5 Myocardial Oxygenation
		19.3.6 Electric Activation
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