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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 mitoch.

Our hearts have evolved to be extremely efficient, long-lasting pumps that exquisitely match the needs of our bodies. This book is about how the heart does this; how can a heart pump the blood for up to 100 years while the best Formula 1 racing engine has a working life measured in hours? Why is the heart so efficient, and how are worn out parts replaced while working? How does it generate the force to act as a pump, how is it controlled electrically, and how can it repair itself?This book addresses these questions from physiological and molecular perspectives in language that aims to be accessible to all interested in biology and with liberal illustrations.The story of how the heart works is presented in the context of its origins:The book begins with a discussion of why the word heart is universally used as a metaphor for reason and emotion and traces its origins in modern and ancient languages. The last chapter offers advice on how to preserve the heart by matching our lifestyles more closely to how it evolved.

This extensively revised second edition provides a practically applicable guide for the management of cardiac arrhythmia. This subject has continued to expand rapidly, and it is therefore critical to understand the basic principles of arrhythmia mechanisms in order to assist with diagnosis and the selection of an appropriate treatment strategy. Comprehensively revised chapters cover a variety of aspects of cardiac electrophysiology in an easy-to-digest case-based format. For each case of arrhythmia, relevant illustrations, fluoroscopy images, ECGs and endocavity electrograms are used to describe the etiology, classification, clinical presentation, mechanisms, electrophysiology set up and relevant trouble-shooting procedures. New topics covered include the application of new antiarrhythmic drugs in tandem with ablation, techniques for the ablation of atrial fibrillation and electrophysiological assessments available for identifying instances of atrial tachycardia. Clinical Handbook of Cardiac Electrophysiology presents a comprehensive overview of cardiac electrophysiology, making it a valuable reference for practicing and trainee cardiac electrophysiologists, cardiologists, family practitioners, allied professionals and nurses.

This book presents detailed descriptions of how to set up and use several classical cardiac preparations from scratch, including whole heart, atrial, ventricular, and papillary muscles and in vivo small animal preparations. It describes methods for monitoring contraction and contractility.

MRI techniques have been recently introduced for non-invasive qualification of regional myocardial mechanics, which is not achievable with other imaging modalities. Covering more than twenty-three years of developments in MRI techniques for accessing heart mechanics, this book provides a plethora of techniques and concepts that assist readers choose the best technique for their purpose. It reviews research studies and clinical trials that implemented MRI techniques for studying heart mechanics.

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 the basic principles of coronary physiology and of other available techniques that, as an alternative to FFR, allow a more comprehensive assessment of coronary circulation. This is particularly noticeable in the assessment of microcirculation, an unavoidable compartment of coronary circulation that is frequently affected in acute coronary syndromes of in the presence of cardiovascular risk factors or non-coronary heart disease. A deeper understanding of the relationship between epicardial vessel and microcirculatory involvement has started with the advent of newer imaging techniques like invasive optical coherence tomography, and non-invasive CT and NMR techniques. This book aims to be an indispensable tool for clinicians and researches in the field of coronary artery disease. It provides a balanced, comprehensive review of anatomy, physiology and available techniques, discusses both the diagnosis of epicardial vessel and microcirculatory disease, the impact of different diseases at different levels of coronary circulation, and the best way to address a separate or combined assessment of different levels of coronary circulation. ​

This book provides a detailed summary of all aspects of cardiac electrophysiology, presented in an easy to use handbook. For each arrhythmia the aetiology, classification, clinical presentation, mechanism, and electrophysiology is set up (including precise set up and ablation parameters) and trouble-shooting are presented and demonstrated using interesting images, fluoroscopy images, ECG's and electrograms.The overall aim of this book is to provide a logical and practical approach to cardiac arrhythmia management. It acts as a useful resource and, importantly, helps to promote this sub-specialty. This book is aimed at cardiac electrophysiologist's, fellows, cardiologists, physicians, family practitioners, cardiology trainees, students, allied professionals and nurses. Given its succinct summary of electrophysiology is a useful reference guide for the electrophysiology laboratory. It is aimed at an international audience and provides an important guide for those studying for all heart rhythm exams.​

This award-winning thesis investigates the mechanisms underlying cardiac arrhythmia development and termination from an entirely new perspective. By viewing the heart as a complex system, the author uses theoretical tools from nonlinear dynamics combined with numerical simulations and experiments to achieve insights into the relationship between its structure and dynamics, thereby paving the way towards innovative low-energy defibrillation strategies. The work tackles, among other things: the effect of substrate heterogeneity on the spatial-temporal dynamics of cardiac arrhythmias and ways in which weak pulsed electric fields can be used to control these dynamics in heterogeneous cardiac tissue. The long-term vision of this research is to replace the current strategy of applying painful and sometimes tissue damaging electric shock – currently the only reliable way to terminate life-threatening fibrillation – by a more subtle but equally effective intervention. The book maps out a number of promising research directions for biophysicists and medical researchers working on the origins and treatment of cardiac arrhythmias.

Esta nueva edición de Cardiología en el deporte, completamente revisada y actualizada, aborda los efectos del ejercicio físico sobre la salud cardiovascular, tanto en el deportista de alto rendimiento como en el de base, sin olvidar la práctica del ejercicio como medida de promoción de la salud en personas de todas las edades. Se trata de una obra original e innovadora, que incorpora los resultados de estudios realizados por los propios autores durante los últimos años. La obra se divide en dos partes: la primera trata sobre los efectos del ejercicio desde diferentes perspectivas, desde la fisiopatológica hasta la clínica, y la segunda consiste en una fascinante colección de casos clínicos, incluyendo no solo valoraciones clínicas sino también recomendaciones de ejercicio. Cardiología en el deporte está dirigido a cardiólogos, especialistas en Medicina de la Educación Física y Deporte, médicos de familia y profesores de Educación Física especializados en el Área de Salud. Nueva edición completamente revisada y actualizada de esta obra que aborda los efectos del ejercicio físico sobre la salud cardiovascular, tanto en el deportista de alto rendimiento como en el de base. Esta nueva edición incorpora los resultados de estudios realizados por los propios autores durante los últimos años. Dos partes claramente diferenciadas, la primera trata sobre los efectos del ejercicio desde diferentes perspectivas, desde la fisiopatológica hasta la clínica, y la segunda consiste en una fascinante colección de casos clínicos, incluyendo no solo valoraciones clínicas sino también recomendaciones de ejercicio.

This book is the ultimate reference on patent foramen ovale (PFO), a defect in the septum of the heart estimated to be present in more than twenty percent of the adult population and a proven cause of systemic embolism. All chapters have been written by internationally recognized experts in the field and cover PFO genetics and anatomy in addition to the effect PFO can have on various different organs and its supposed involvement in several conditions and clinical syndromes such as migraine, diving incidence, platynea orthodeoxia, economy class syndrome, sleep apnea and persistent desaturations in mild right ventricular dysfunction. As PFO anatomy varies significantly between individuals, chapters have also been included on the diagnostic tools, methods and techniques for appropriate assessment, detection and characterization of PFO. Furthermore, the multitude of available closure devices and techniques for PFO closure are discussed together with current and ongoing trial data. The book concludes with guidance and instruction on establishing a successful PFO program.Patent Foramen Ovale will be an essential text for the whole adult and pediatric interventional community, general cardiologists, internists, primary care physicians, neurologists and device companies in addition to medical students, graduate students and fellows in training.

could go on for several pages. Thus the book edited This book emphasizes the fundamental, functional aspects of cardiology. Within the last thirty years, by Sperelakis IS a potent reminder of the almost for­ the rift between clinical and investigative cardiology gotten fact that cardiology has twO sites, inextrica­ has widened, because of the overwhelming devel­ bly related. opment of new clinical procedures, both diagnostic The book deals with subjects in which Dr. Sper­ and therapeutic. Almost forgotten is the fact that elakis has pioneered: ultrastructure of heart muscle, we owe most of the clinical advances to theoretical electrophysiology, cardiac contractility, and ion ex­ and experimental observations. I need not remind change. An extension of these subjects is the chapter the reader of the work of Carrel, who performed the dealing with fundamental topics of the coronary cir­ first experimental coronary bypass in 1902, or the culation. work of the brothers Curie in 1880, both physicists, This book is indeed a timely reminder of the im­ who discovered piezoelectricity, the keystone in ech­ portance of the fundamental aspects of cardiology. ogradiography; of the works of Langley, who intro­ Emphasis on clinical aspects of cardiology alone will duced the receptors concept; of Ahlquist in 1946, result in a sterile and unproductive future for a field who first differentiated between alpha and beta re­ that has made such stunning advances during the ceptors; of Fleckenstein, a physiologist who pi­ last thirty years to the benefit of millions of people.

Ischemic heart disease is the leading cause of morbidity and mortality in the developed world. The high metabolism and oxygen demand of the cardiac myocardium depends on both a high blood flow and a rich capillary density. For this reason, the growth of the coronary vasculature is vital, not only in early development, but also in the adult faced with various stresses. Novel technologies have enabled the discovery of the molecular mechanisms underlying the growth and assembly coronary vessels, and this volume covers the hierarchy of the coronary vasculature from its embryonic origins through its postnatal growth, adulthood, and senescence. Chapters address normal coronary development, coronary anomalies and their possible underlying developmental errors, coronary vessel adaptations to exercise training, aging, hypoxia, myocardial ischemia, and cardiac hypertrophy.This comprehensive overview of current research in coronary vessels and myocardial perfusion was written by Dr. Robert J. Tomanek, Emeritus Professor of Anatomy and Cell Biology at the University of Iowa. The book reviews, discusses, and integrates findings from various areas of coronary vasculature research, and as a result, will be a valuable reference source for cardiovascular scientists and physicians for many years to come.

Knowledge of cardiac ion channels and transporters has advanced remarkably in the last two decades with the development of patch-clamp and molecular biological techniques. This textbook offers a comprehensive overview of structures and functions of ion channels and transporters in the heart. Readers are first introduced to the molecular biology and electrophysiology of all the important ion channels. After discussing their developmental changes, the pharmacology and pathophysiology of clinically-relevant ion channels are reviewed. Molecular aspects of the cardiac excitation-contraction coupling and intracellular Ca2+ regulation by ion transporters are also described. The book will be useful to electrophysiologists, cardiac physiologists and pharmacologists, and molecular biologists interested in ion channels at all levels. For research specialists, the book will provide a perspective of the field. The book can be used as a reference source for working scientists in the fields of ion channels, biophysics, cardiac electrophysiology, and pharmacology. It is aimed at graduate and medical students, designed for use as a textbook for graduate and medical courses.

The goal of this book is to provide an integrated overview of some intriguing problems of cardiac electrophysiology. Topics have been selected that encompass mainly aspects which have been a matter of concern and interest in our Department over the past few years. We requested from the authors not only that they provide information about their own investiga­ tions, but also that they integrate their results with those published by oth­ ers. Furthermore, we urged them to be speculative in their interpretations in order to encourage exploration of related areas of investigation. To this end, the authors have presented their,contributions in sufficient detail so that the information may not only educate the reader but also encourage and chal­ lenge him. It is through the concept of total integration -from in vitro to in vivo, from animal to man, from the pure scientist to the clinician -that we hope to advance our understanding of cardiac electrophysiology. The book brings together scientific work in which important advances have been made in the seventies, and in which even more substantial pro­ gress is likely to be made in the present decade. The chapters have been written by investigators who are authorities in the relevant scientific field. No attempt at summarizing has been made as this may not seldom lead to oversimplification, a risk that we do not dare take. The table of contents and list of contributors are, in this regard, self-explanatory.

The first edition of this book was quite successful. As in the first edition, the book is divided into two major sections: cardiac muscle and coronary circula­ Several complimentary book reviews appeared soon tion. The book is multidisciplinary and includes after the first edition was published, and written and membrane biophysics, electrophysiology, physiol­ oral words of praise and appreciation were given both ogy, pathophysiology, pharmacology, biochemistry, to the publisher and to me by quite a few individuals. and ultrastructure. Thus, the book attempts ro It is because of such positive comments and reactions that the publisher and I decided to embark on a integrate all relevant aspects of the factors influenc­ second edition of Physiology and Pathophysiology of the ing the function of the heart as a vital organ under Heart. The second edition was long in preparation, normal and various abnormal conditions. The book taking over a year to complete. All chapter contri­ also attempts to set the foundation for an under­ butors were asked to revise, improve, and update standing of the action and mechanism of action of a their articles, and all have done so with enthusiasm number of classes of cardioactive drugs.

Nature is totally amoral! There are at least 3-4 million people in France alone who suffer from arterial hypertension, and whose cardiovascular system is submitted day and night to both a haemodynamic and hormonal stress. In all cases, the vasculature hypertrophies as does the myocardium. This growth process is obviously mainly detrimental at the outset since it lowers compliance of the arteries and makes them stiffer. In contrast, myocardial hypertrophy is initially beneficial since the growth process multiplies the number of contractile units and by so doing improves external work. In addition, according to Starling's law, wall stress is lowered. Growth factors playa major role in this amoral process as a trigger for hypertrophy at the vascular level, and very likely at the level of the myocardium. Another major point of interest is the role of growth factors as determinants of restenosis after angioplasty and also of atherogenesis. Several chapters in this book are directly or indirectly concerned with this problem which is far from being purely academic since several groups are currently trying to control these processes by gene transfer. Certainly, one of the major clinical questions arising from such studies is why restenosis is not more frequent in clinical practice. After de-endotheliazation, the biologist would predict on the basis of recent studies on growth factors, and in contrast with current clinical opinion, that hypertrophy would occur in all cases with more or less complete restenosis.

Potassium channels (K+) are membrane-spanning proteins which serve many important functions and are becoming a hot topic in physiology. K+ channels determine or modulate many functions of vascular smooth muscle, endothelial and inflammatory cells, and thus are central to regulation of arterial tone and control of cell proliferation. They are also promising targets for antihypertensive treatments with drugs which open and close specific types of K+ channels, making for an active field of research. With their ability to control vascular tone, voltage-gated K+ channels play a significant role in both pulmonary and systemic hypertension as well as in cardiac arrhythmias. This book will highlight the latest discoveries by leading researchers pertaining to the role of K+ channels in the heart and blood vessels in normal physiology and a variety of disease states.

This collection of reviews will be of considerable interests to biologists and MDs working on any aspect of cardiovascular function. With state-of-the-art reviews written by competent experts in the field, the content is also of interest for MSc and PhD students in most fields of cardiovascular physiology.

Cardiac Electrophysiology: A Visual Guide for Nurses, Techs, and Fellows fulfills the need of allied health personnel and new fellows for a practical, hands-on pictorial guide that clearly illustrates the essential concepts of clinical cardiac electrophysiology. More than 70 high-quality tracings, diagrams, fluoroscopic images, and electroanatomic maps accompanied by detailed discussions of each image offer a fundamental understanding of cardiac electrophysiology equipment, principles, and procedures: • Catheter placement, hardware connections, and intracardiac signals • Normal electrogram sequences associated with sinus rhythm • Methodologies used to uncover the mechanisms of common clinical tachycardias In addition, commentaries provided throughout the book introduce more advanced principles for readers who want to delve further into the EP study. Authored by a team of experts, Cardiac Electrophysiology: A Visual Guide for Nurses, Techs, and Fellows is an invaluable resource for a complex technology, providing superb guidance in acclimating new trainees and personnel to the EP laboratory and empowering them with the knowledge and skills needed to practice clinical electrophysiology. New to the Second Edition: • A new unit—Cardiac Electrical Axis • 16 video clips with a focus on electrogram sequences • An illustrated glossary and abbreviations list • A free eBook included

Cardiac Dynamics is the name of a relatively young field of study, born from the fruitful interaction between branches of two different disciplines: medicine and physics.'Dynamics'is the branch of physics which deals with the action of forces on bodies or particles in motion or at rest.'Cardiac'relates to the clinical field of cardiology but also to cardiophysiology, both of which are specialized branches of medicine. Narrower than the well­ established field of Hemodynamics, Cardiac Dynamics is restricted to dynamic phenomena occurring in and around the heart. The mathematical treatment of such phenomena, however, is vastly more complex because of the intricate nature of the mechanisms involved in the cardiac action. Thus, whereas hemodynamics is concerned with predominantly passive (visco-) elastic structures - vessels - containing time-variant flow of viscous flui- blood -, the mechanical study of the heart requires additional con­ siderations such as: active elastic components representing the contractile mechanism of cardiac muscle, complex geometry and fiber structure in the myocardial wall, autoregulatory mechanisms, and intricate flow patterns associated with valve motion. Viewed in this light it is not surprising that attempts to describe ventricular pump function and to quantify contractile performance have not reached the level of sophistication which is common in e. g. arterial hemodynamics. For the same reason, many of the often simplified approaches to describe ventricular mechanics failed to stand up to more rigorous theoretical, experimental or clinical testing.

Growth Hormone and the Heart endeavors to bring together knowledge that has been accumulated in the area of GH and the heart, from basic to clinical studies, by research groups working on this topic throughout the world. Lessons from different experimental models and from several human diseases (acromegaly, adult GH deficiency, heart failure) suggest to endocrinologists and cardiologists that GH may not only have a role in the physiology and pathophysiology of heart function, but that GH itself may have a place in the treatment of primary heart diseases (such as dilated cardiomyopathy) or of cardiac complications of hypopituitarism. Growth Hormone and the Heart will be a useful update of the research produced in the field of cardiovascular endocrinology. The Editors also hope that this book will serve as the primary step in the recognition of the wide physiological and clinical significance of GH and heart interactions.

Signal transduction pathways are at the core of most biological processes and are critical regulators of heart physiology and pathophysiology. The heart is both a transmitter and dynamic receptor of a variety of intracellular and extracellular stimuli, playing a critical role of an integrator of diverse signaling mechanisms. Alterations in signaling pathways are contributing factors in the development and progression of a broad spectrum of diseases, ranging from dysrhythmias and atherosclerosis to hypertension and the metabolic syndrome. Targeting specific components of these signaling pathways has been shown to be effective in preclinical studies with significant therapeutic impact. This book brings together current knowledge in cardiovascular cell signal transduction mechanisms, advances in novel therapeutic approaches to improve cardiac function, and discussion of future directions. Presented from a post-genomic perspective, this exciting book introduces important new ideas in cardiovascular systems biology. It is an invaluable reference for cardiology researchers and practitioners.

How exciting it is to see a field so well established as the ren- angiotensin system continue to grow and mature. Originally, following the original identification of renin by Tigerstedt and Bergman over 100 years ago, workers in this area spent years attempting to establish its role in experimental and renal hypertension. The early work by Goldblatt, in 1934, demonstrated that the placement of a clip around a renal artery was clearly related to the subsequent development of hypertension. However, it wasn't until the simultaneous finding by two different geographically separated teams, Page, et al, in the United States and Braun-Menendez, et al, in Argentina that the peptide angiotensin was identified. Thus, the rate-limiting enzyme renin was released from the kidney and catalyzed a biochemical cascade which was eventually shown to produce the elevated arterial pressure. Subsequently, many workers contributed to the elucidation of the concept and sequence of angiotensin I1 generation. Thus, the enzyme renin acted upon its protein substrate, produced in the liver, to liberate the decapeptide angiotensin I which, upon circulating through the pulmonary circulation, finally produced the potent octapeptide angiotensin. Several important subsequent findings demonstrated that angiotensin I1 promoted the release of the adrenal corticosteroid from that gland, thereby resulting in a larger system, the renin-angiotensin-aldosterone system. Further, this system demonstrated a classical biofeedback and the circulating octapeptide was shown to have additional biological activities in organs other than heart, vessels, kidney, adrenals, and even brain.

Mitochondria have been pivotal in the development of some of the most important ideas in modern biology. Since the discovery that the organelle has its own DNA and specific mutations were found in association with neuromuscular and cardiovascular diseases and with aging, an extraordi-nary number of publications have followed, and the term mitochondrial medicine was coined. Furthermore, our understanding of the multiple roles that mitochondria play in cardiac cell homeostasis opened the door for intensive experimentation to understand the pathogenesis and to find new treatments for cardiovascular diseases. Besides its role in adenosine triphosphate generation, mitochondria regu-late a complex network of cellular interactions, involving (1) generation and detoxification of reactive oxygen species, including superoxide anion, hy-drogen peroxide, and hydroxyl radical; (2) maintenance of the antioxidant glutathione in a reduced state and adequate level of mitochondrial matrix superoxide dismutase; (3) cytoplasmic calcium homeostasis, particularly under conditions of cellular calcium loading; (4) transport of metabolites between cytoplasm and matrix; (5) both programmed (apoptosis) and necrotic cell death; and (6) cell growth and development. It is therefore not surprising that this organelle has come to be the center stage in many current investigations of cardiovascular diseases, aging, and agi- related disease. Concomitant with these advances, an impressive effort is under- way for the development of new tools and methodologies to study mitochondrial structure and function, including powerful ways to visualize, monitor, and alter the organelle function to assess the genetic consequences of these perturbations.

Recent studies have shown that the heart possesses an intrinsic renin angiotensin system that is controlled by tissue-specific parameters that are activated by biomechanical stress. This book reviews the latest information on the way in which both the plasma and cardiac renin angiotensin systems affect heart function. It covers the cell and molecular biology of these systems, with contributions on renin synthesis, uptake and the intracellular signalling pathways. Particular insight comes from transgenic mouse models in which either mouse or human genes for various components of the renin angiotensin system are expressed. Other topics covered include wound healing as well as the trophic effects of aldosterone. Contains the most recent findings on the renin angiotensin system and the heart Written by an international team of distinguished scientists Covers both the cellular and molecular basis of the renin angiotensin system and the clinical relevance of this research

This book describes the basic, pathophysiologic, and clinical importance of the reciprocal relationships and interactions between the respiratory and cardiovascular systems, examining mechanical responses caused by lung volume and thoracic pressure. Emphasizes humoral and neurophysical interactions occurring in diseases that lead to cardiorespi