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The concept of depressor reflexes originating in the heart was introduced by von Bezold in 1867 and was later revived by Jarisch. The Bezold-Jarisch reflex originates in cardiac sensory receptors with nonmyelinated vagal afferent pathways. The left ventricle, particularly the inferoposterior wall, is a principal location for these sensory receptors. Stimulation of these inhibitory cardiac receptors by stretch, chemical substances or drugs increases parasympathetic activity and inhibits sympathetic activity. These effects promote reflex bradycardia, vasodilation and hypotension (Bezold-Jarisch reflex) and also modulate renin release and vasopressin secretion. Conversely, decreases in the activity of these inhibitory sensory receptors reflexly increase sympathetic activity, vascular resistance, plasma renin activity and vasopressin.Long regarded as pharmacologic curiosities, it is now clear that reflexes originating in these inhibitory cardiac sensory receptors are important to the pathophysiology of many cardiovascular disorders. This paper reviews the role of inhibitory cardiac sensory receptors in several clinical states including 1) bradycardia, hypotension and gastrointestinal disorders with inferoposterior myocardial ischemia and infarction, 2) bradycardia and hypotension during coronary arteriography, 3) exertional syncope in aortic stenosis, 4) vasovagal syncope, 5) neurohumoral excitation in chronic heart failure, and 6) the therapeutic effects of digitalis.

In their recent paper, Dr. Bettencourt and colleagues [(1)][1] report similar accuracy for the detection of coronary artery disease (CAD) between cardiac magnetic resonance (CMR) perfusion and an integrated computed tomography (CT) perfusion/angiography protocol. Unfortunately, the authors did not

We read with interest the paper by Koo et al. ([1][1]) regarding the diagnostic accuracy of noninvasive measurement of fractional flow reserve (FFR) from coronary computed tomography angiography data (FFRCT). We do recognize the potential clinical and economic relevance of the validation of a

The paper by Taylor et al. [(1)][1] on a new method for the calculation of fractional flow reserve (FFR) from cardiac computed tomography (CTA) images of the coronary arteries is elegant and interesting, with some striking pictures, and it offers the possibility of calculating this important