Principles of Cardiovascular Neural Regulation in Health and Disease (Basic Science for the Cardiologist Book 6)

This book is an attempt to indicate to researchers and clinicians a simple way to approach the complexity of cardiovascular neural regulation. A conceptual pillar like homeostasis is contrasted with instability and a continuous interaction of opposing mechanisms that have negative and positive feedback characteristics, and is considered to subserve the multitude of patterns pertaining to physiology. However, in pathophysiological conditions the final design is most often replaced by largely purposeless neural mechanisms. The complexity of cardiovascular neural regulation, reflected by the state of sympathovagal balance, is also assessed in the frequency domain. Power spectrum analysis of heart rate and arterial pressure variability, a sophisticated but simply explained approach, provides an unprecedented tool to evaluate this interaction in both physiological and pathophysiological conditions. The elementary characteristics of nonlinear dynamics are also outlined. Finally, the need for an ethical structure for science and medicine is analyzed. Biology of the Arterial Wall is intended as a general reference text concerned with the biology of the vascular cells and the blood vessel wall under physiological and pathological conditions. One of the major functions of the arteries is to maintain a continuous blood flow to the organs whatever the pressure conditions, thanks to the vasomotor tone of the smooth muscle cells. Great advances have been made over the last decade in the understanding of the endothelial cells as integrators and transducers of signals originating from the blood stream. The pluripotent control functions of the endothelial cells in the vessel wall are now well recognized. A review of endothelial functions and dysfunctions is presented. Cell biology and molecular genetic studies have now identified an array of molecules elaborated by endothelial cells and vascular smooth muscle cells and by the blood-borne elements which interact with artery cells, defending the artery against injury and modulating evolving abnormal processes. Molecules which induce or inhibit endothelial and/or smooth muscle cells are currently under great scrutiny. Angiogenesis, which plays a major role in tumor growth, but may also be beneficial as a healing process in muscle ischemia, is discussed. Apoptosis, or programmed cell death, has only recently been recognized as an essential process in blood vessel modeling and remodeling. An overview of apoptosis in the vascular system is presented. It is increasingly evident that the adjustments of the blood vessel wall are made in the presence of deforming disease processes such as hypertension and atherosclerosis. The second part of the book is concerned with the blood vessel wall in disease conditions. Several chapters review the role of the vessel and vascular cells in inflammation, and vascular remodeling during arterial hypertension and aging. One chapter is devoted to atherogenesis, atheroma and plaque instability, followed by the pathophysiology of post-angioplasty restenosis, which is a crucial issue in modern interventional cardiology. Apoptosis or programmed cell death is increasingly considered to be a major factor in the development and progression of cardiovascular disease. In patients with heart failure the activation of apoptosis may result in the loss of irreplaceable cardiac myocytes promoting the clinical course of the syndrome. Moreover, in the coronary arteries inflammation and apoptosis may weaken critical structures of the vessel wall leading to plaque rupture and, subsequently, to myocardial infarction. Given these deleterious consequences, it seems almost paradoxical that programmed cell death is an active process that, if initiated under physiological circumstances, is essential for both coordinated tissue growth or destruction of malignant cells. Apoptosis in Cardiac Biology, written by a team of internationally renowned researchers, gives a timely synopsis of basic mechanisms, cellular and structural targets and, finally, clinical implications of programmed cell death in the heart. The expert authors of this volume give concise overviews on general and cell-specific aspects of programmed cell death in cardiac myocytes and fibroblasts, as well as in vascular smooth muscle and endothelial cells. Furthermore, novel therapeutic options arising from the outstanding pathophysiological significance of cardiac apoptosis are presented. This comprehensive review of Apoptosis in Cardiac Biology will be of interest to both clinicians and basic researchers who are active in the fields of cardiology and atherosclerosis.

Cardiac Ischemia: From Injury to Protection has been divided into six parts. The first part describes the differences between hypoxia and ischemia, animal models, the effects of ischemia on myocardial function and metabolism, and the electrophysiological consequences of ischemia. The second part deals with the mechanisms of cardiomyocyte death in ischemia, structural aspects of irreversible ischemic injury, necrosis and apoptosis of cardiac cells, the role of calcium, and the concept of calcium antagonism. The third chapter is a brief description of reperfusion injury, its clinical relevance, and possible prevention. The fourth part summarizes changes in myocardial vasculature during ischemia and reperfusion. The fifth part is the survey of two main possibilities for increasing cardiac resistance to ischemia and hypoxia, i.e. long-lasting adaptation to chronic hypoxia and short-lasting preconditioning. The last part of the book deals with comparative and ontogenetic aspects of cardiac sensitivity to oxygen deprivation; this chapter also summarizes the ontogenetic differences and limitations in endogenous and exogenous protection of the ischemic/hypoxic heart.

Vascular Wall Under Physiological Conditions -- Morphologic Aspects Of The Large Artery Vascular Wall / Bernard I. Levy And Alain Tedgui -- Mechanics Of The Large Artery Vascular Wall / Bernard I. Levy -- Neurohumoral Control Of The Vascular System / Stéphane Laurent -- Endothelial Function And Dysfunction / Paul Vanhoutte And Chantal Boulanger -- Mechanical Factors And Vascular Biology / Alain Tedgui, Stéphanie Lehoux And Bernard I. Levy -- Angiogenic Growth Factors / Cedric J. Gaultier And Jean-baptiste Michel -- Angiogenesis / Harry A.j. Struijker Boudier [and Others] -- Vascular Aging / Joël Belmin -- Vascular Wall Under Pathological Conditions -- Vessel And Inflammation / Catherine Bernard -- Apoptosis In Normal And Pathological Vessels / Ziad Mallat And Alain Tedgui -- Stiffnes Of Wall Materials In Human Hypertension / Michel E. Safar -- Pathobiology Of Atherosclerosis / Alain Tedgui, Catherine Bernard And Ziad Mallat -- Arterial Gene Transfer / Laurent J. Feldman And Ph. Gabriel Steg. Edited By Bernard I. Levy And Alain Tedgui. Includes Bibliographical References And Index.

Cardiology is an area of great recent triumphs in pharmacological and surgical treatment, yet cardiovascular disease remains the leading cause of death and disability in the industrialized world. Coronary disease, heart failure, stroke and sudden arrhythmic cardiac death challenge both medical practitioners and scientists.
With the dawning of the new 'molecular' era, there is an awakened hope that a more fundamental understanding of biologic processes may eventually lead to new progress in the prevention and treatment of these persistent and seemingly intransigent problems.
Molecular Cardiology in Clinical Practice brings together an outstanding panel of experts in cardiovascular disease who have been at the forefront of the application of molecular medicine to cardiology. Its intent is to help bridge the gap between modern medical practice and modern science, in the belief that an understanding of basic principles can lead to new insight into the problems of cardiac patients.

The book contains black-and-white illustrations.

Molecular Cardiology for the Cardiologist, Second Edition provides a short, easily readable summary of what the new biology brings to cardiology. Special efforts have been made to include comprehensive diagrams and drawings, as well as teaching tables, and also to keep the size of the second edition within the modest limits of the first edition. The book remains divided into 5 parts. The first part is a general introduction to the new terminology. The second part is devoted to the normal structure of the heart and vessels. Parts 3 and 4 deal with physiopathology. One of the important contributions of molecular biology to cardiology is a better understanding of the general process of adaptation of the heart and vessels to a permanent mechanical overloading. Such a process is generally called remodeling, and results from coordinate changes in the expression of the genes. The last part of the book includes information on gene and cellular therapy. New Language Of Biology -- From Chromosome To Gene -- Current Technologies -- Gene Transfers -- Genome-based Methods -- Normal Heart And Vessels. Molecular Structure In Relation To Physiology -- Membrane Proteins And Electrical Activity -- Sarcomere Structure And Contractility Cytoskeleton -- Extracellular Matrix And Tissue Compliance -- Vasoactive Endothelial Substances -- Heart And Vessels As Endocrines -- Cardiac And Vascular Growth -- Cell Death -- Cardiac And Vascular Remodelling -- Cardiac Hypertrophy And Failure -- Senescent Heart And Vessels -- Genetics For Nongeneticians -- Inherited Diseases -- Monogenic Cardiovascular Diseases -- Multigenic Cardiovascular Diseases And Risk Factors -- Gene Therapy And Cell Transplant. By Bernard Swynghedauw. Includes Bibliographical References (p. [273]-295) And Index. Front Matter....Pages i-xvii General Concepts and Hypotheses in the Study of Cardiovascular Neural Regulation....Pages 1-30 Pathophysiological Mechanisms and the Loss of a Finalistic Purpose....Pages 31-64 The Sympathovagal Balance Explored in the Frequency Domain....Pages 65-107 Pathophysiological Alterations of Sympathovagal Balance....Pages 109-147 Variability and Nonlinear Dynamics....Pages 149-168 The Necessary Apical Principle in Science and Medicine....Pages 169-180 Back Matter....Pages 181-222 "The intent of Molecular Cardiology for the Cardiologist, Second Edition, is to provide a short, easily readable summary of what the new biology brings to cardiology. Special efforts were made to include comprehensive diagrams and drawings, as well as teaching tables, and also to keep the size of the second edition within the modest limits of the first edition."--BOOK JACKET The beginnings of scientific medicine can be traced to ancient Greece, where Hippocrates, in the fourth century BC, is credited with developing the concept that illness is caused by factors inside the body, rather than supernatural external forces. Edited By Heribert Schunkert, G.a.j. Riegger. Includes Bibliographical References And Index. Includes Bibliographical References And Index. Myocardial hypoxia is the result of disproportion between oxygen supply and demand.