Hiroyuki Suga - Böcker

Most of the progress in cardiac energetics in recent years has been spurred by the pressure-volume area concept, the natural extension into energetics of earlier pioneering work delineating the time-varying elastance framework for ventricular contraction. The book draws together a broad spectrum of researchers - basic, applied and clinical - having a shared interest in the energetics of cardiac muscle and ventricle, providing an overview of the current state of the art.

Most of the progress in cardiac energetics in recent years has been spurred by the pressure-volume area concept, the natural extension into energetics of earlier pioneering work delineating the time-varying elastance framework for ventricular contraction. The book draws together a broad spectrum of researchers - basic, applied and clinical - having a shared interest in the energetics of cardiac muscle and ventricle, providing an overview of the current state of the art.

Heart failure is a syndrome caused by a heart dysfunction that leads to insuf­ ficient blood in the peripheral tissues for their metabolic demands. This syn­ drome still remains an obscure clinical entity and even its definition is disputed. It has become increasingly apparent that heart failure may relate not only to cardiac dysfunction but also to other physiological alterations involved in the maintenance of circulatory homeostasis. In 1988, the Japanese Circulation Society organized a three-year project for research on heart failure. The research group consisted of ten investigators, all relatively young but well recognized internationally for their research accomplishments. This book represents a compilation of the achievements by this group during the past three years which have led to new insights into the pathophysiologic mechanisms of heart failure, and diagnosis, evaluation and treatment of this syndrome. Contents include research into the cellular biology of congestive heart failure, and a framework of pressure-volume relationships enabling assessment of ventricular contraction energetics or coupling of ventricular properties and arterial load. This conceptual framework is of vital significance, particularly when we consider the failing heart as an energy-depleted state. An understanding of the neuroendocrine responses to explain the pathophy­ siology of congestive heart failure is perhaps the most important advance, and has led to new developments in therapy. This book also includes an analysis of mechanical factors, including both regional, and global ventricular functions, and this is related to the under­ standing of the pathophysiology of congestive heart failure.

Cardiovascular dynamics is a field in which modelling and systems analysis have formed an extremely important discipline. For example, understanding of even such a fundamental function of the circulation as the relationship between central venous pressure apd cardiac output has required evolution of a pertinent model based on years of exhaustive ex­ perimental investigations by Starling, Starr, and Guyton. Hemodynamic analyses of pulsatile pressures and flows in the arteries and veins have been a continuing challenge taken up by champions of fluid dynamics such as Frank, Wetterer, Taylor, and Wormersley, just to mention a few names, and some kind of model was always proposed as a conceptual framework. An even greater challenge to cardiovascular dynamicists was how to analyze the intermittent coupling of the ventricle and the arterial or venous vasculature through the valve. The availability of numerical solutions by computer and the recently evolved ventricular model with a time-varying elastance and a pressure-dependent internal resistance opened the way to analysis of this coupling. The ever­ increasing speed of computers has also facilitated trips between the fre­ quency and the time domain, even on-line for some experimental studies. This book contains many analyses dedicated to the interactions between the heart and the vasculature, providing the reader with findings at the cutting edge of current research in this field.