Julien I.E. Hoffman – författare

Coronary heart disease is one of the major health problems in indus­ trialized nations because of its high incidence and severity. Recent innovations in medical and surgical treatment of coronary heart dis­ ease have increased the importance of accurate diagnostic methods for determining the severity of coronary disease, identifying potential treatment alternatives, and evaluating the results of treatment. Great advances have also been made in basic research on coronary circula­ tion and its interaction with myocardial contraction and relaxation and neural and humoral control. With respect to these developments, the papers included in the present monograph deal with important topics concerned with the basic mechanism of coronary circulation as well as ones of clinical relevance. It is directed toward physicians (cardiologists, cardiac surgeons, cardiac radiologists, anestheologists, and others) and basic scientists (e.g., physiologists, bioengineers). We would like to em­ phasize the importance of a multidisciplinary approach in which basic scientists and clinicians work closely together. This volume consists of nine chapters. Chapter 1 contains macro­ scopic and microscopic descriptions of coronary vascular anatomy, which is closely related to the functions of coronary circulation. In Chap. 2 two methods in current use to evaluate phasic coronary blood velocity waveforms are presented, i.e., the laser Doppler and ultrasound Doppler methods. Chapter 3 describes the mechanical properties of coronary circulation, a knowledge of which is indispens­ able for an understanding of coronary arterial and venous blood flow velocity waveforms in relation to cardiac contraction and relaxation.

Coronary heart disease is one of the major health problems in indus­ trialized nations because of its high incidence and severity. Recent innovations in medical and surgical treatment of coronary heart dis­ ease have increased the importance of accurate diagnostic methods for determining the severity of coronary disease, identifying potential treatment alternatives, and evaluating the results of treatment. Great advances have also been made in basic research on coronary circula­ tion and its interaction with myocardial contraction and relaxation and neural and humoral control. With respect to these developments, the papers included in the present monograph deal with important topics concerned with the basic mechanism of coronary circulation as well as ones of clinical relevance. It is directed toward physicians (cardiologists, cardiac surgeons, cardiac radiologists, anestheologists, and others) and basic scientists (e.g., physiologists, bioengineers). We would like to em­ phasize the importance of a multidisciplinary approach in which basic scientists and clinicians work closely together. This volume consists of nine chapters. Chapter 1 contains macro­ scopic and microscopic descriptions of coronary vascular anatomy, which is closely related to the functions of coronary circulation. In Chap. 2 two methods in current use to evaluate phasic coronary blood velocity waveforms are presented, i.e., the laser Doppler and ultrasound Doppler methods. Chapter 3 describes the mechanical properties of coronary circulation, a knowledge of which is indispens­ able for an understanding of coronary arterial and venous blood flow velocity waveforms in relation to cardiac contraction and relaxation.

Coronary circulation research is advancing at a rapid rate. Not only are inno­ vative techniques for studying myocardial perfusion being developed, new mechanisms related to coronary blood flow control and mechanics are also being discovered. The progress in this field justifies an update in the form of this new monograph. The book is divided into the following sections: "Measurement of Coronary Blood Flow and Assessment of Myocardial Per­ fusion" discusses advances in perfusion measurements in humans as well as nonradioactive microsphere methods. . "Coronary Flow Dynamics" elucidates the effect of heart contraction on coronary flow, perfusion, and reserve distribution as well as systolic-diastolic interaction. Models-a frequent topic of debate-are used to quantify hypotheses. "Models of Coronary Circulation" attempts to elucidate the concept of tissue pressure. "Regulatory Mechanisms of Coronary circulation and its Clinical Relevance": N u.merous mechanisms affecting coronary flow have been defined and studied at the level of isolated vessels and whole organs. The chapters in this section provide an in-depth analysis of a selection of these mechanisms and their inter­ actions. "Pathophysiology of Coronary Circulation in Ischemic Heart Disease" considers important aspects of factors which restrict perfusion of the myocardium in ischemic heart disease. An understanding these factors is of crucial importance in the management of patients. "Small Vessel Disorder in Coronary Circulation" describes circulatory flow and how it can be influenced by drugs.