Table Of ContentM. Hori H. Suga J. Baan E.L. Yellin
(Eds.)
Cardiac Mechanics and
Function in the Normal
and Diseased Heart
With iSS Figures
Springer-Verlag Tokyo Berlin Heidelberg New York
London Paris Hong Kong
Dr. MASATSUGU HORI
The First Department of Medicine
Osaka University School of Medicine
Fukushima-ku, Osaka, 553 Japan
Dr. HIROYUKI SUGA
Department of Cardiovascular Dynamics
National Cardiovascular Center Research Institute
Suita, Osaka, 565 Japan
Prof. JAN BAAN
Laboratory of Clinical Physiology
Department of Cardiology
Leiden University Hospital
Leiden, The Netherlands
Prof. EDWARD L. YELLIN
Department of Cardiothoracic Surgery and
Department of Physiology and Biophysics
Albert Einstein College of Medicine
Yeshiva University
The Bronx, NY 10461, USA
ISBN-13: 978-4-431-68020-8 e-ISBN -13: 978-4-431-67957-8
DOl: 10.1007/978-4-431-67957-8
Library of Congress Cataloging-in-PupJication Data
Cardiac mechanics and function in the normal and diseased heart/M. Hori ... [et al.], (eds.).
1. Heart - Muscle - Physiology. 2. Heart - Muscle - Patho-
physiology. I. Hori, M. (Masatsugu), 1945 - .[DNLM: 1. Heart - physiology. 2. Heart
physiopathology. WG 202 C266] QP113.2.C366 1989612.171 - dc20 DNLMIDLC for
Library of Congress
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© Springer-Verlag Tokyo 1989
Softcover reprint of the hardcover 1s t edition 1989
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Typesetting: Koford Prints (Pte) Ltd., Singapore
Foreword
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.
Systems physiology pertains not only to the analysis of interaction at
the organ level; it should be applied to a system at any level of interest,
including cells, cellular organelles, and biological molecules. Whenever
there are SUbcomponents of a system, there is interplay which con
tributes to the determination of the behavior of the system as a whole.
Thus, a cardiac muscle cell is as complex a system as the ventricle itself,
or a singular branch of artery or part of its wall.
The recent worldwide advocacy of molecular and cellular physiology
and pathophysiology by some funding agencies is outrageous. It may
mislead young biomedical researchers into the blind faith that all the
secrets of life and disease lie only in subcellular entities, and one-way ex
plorations into the molecular world promise results of redeeming scien
tific value. True, the up-to-date knowledge gained by high technology is
astounding and exciting. But microscopic details of any matters whether
VI Foreword
living or nonliving, have always fascinated scientists. A true physiologist
has always had to recognize the indispensability of a systems approach in
the attempt to make sense out of quickly accumulating piecemeal know
ledge. This is true even in the simplest physicochemical world; we all
know that thorough knowledge of hydrogen and oxygen atoms does not
allow us to predict the nature of the water molecule. Therefore, despite
(or, rather, because of) the current fascination with molecular and
cellular physiology, a systems approach is all the more a desirable discip
line for investigators in any branch of the sciences. Again, this book pro
vides the physiologist reader with cardiovascular systems analyses at
multiple levels. It illustrates how a systems approach can be applied to
many different corners of the circulatory system's physiology.
Finally, the Cardiovascular System Dynamic Society consists of a very
special breed of circulatory physiologists, biomedical engineers, cardio
logists, and angiologists. They are all well equipped with rigorous
measurement techniques and mathematical tools to deal with cardiovas
cular dynamics. They also see nature from a systems point {)f view and
love to chew on such concepts as matching and optimal control. Ine
vitably, this book strongly reflects these features of the membership. I
hope that the readers like this menu of "System Dynamics" because,
after all, one pursues something if and only if he truly likes it.
Baltimore, 1989 KncHI SAGAWA
Professor
Department of Biomedical Engineering
The Johns Hopkins University
Medical School
It is with great sadness that the editors report the death of Dr. Kiichi Sagawa in
August of 1989. His dedication and expertise will be sorely missed.
List of Contributors
The address can be found at the page numbers indicated
J. Alexander 81 Y. Kita 283
M. Arakawa 147 A. Kitabatake 263, 277, 301, 325
T. Arts 75 K. Kimura 263
H. Asanoi 335 O. Kohmoto 131
J. Baan 189 I. Komuro 63
P.H.M. Bovendeerd 75 J.W. Krueger 23
D. Burkhoff 81 M. Kurabayashi 63
J.R. Elbeery 165 H. Kusuoka 55
G. Elzinga 199 J.C. Lucke 165
S.M. Factor 45 K. Maehara 137
M.P. Feneley 165 G.W. Maier 165
S. Futaki 157 E. Marban 3, 55
W.H. Gaasch 291 Y. Maruyama 137
W. Gaynor 165 T. Masuyama 277
J.C. Gilbert 103 N. Matsubara 263
S.A. Glantz 103 I. Mirsky 91
D.O. Glower 165 S. Momomura 131
Y. Goto 157 T. Morozumi 263
D.H. Harpole 165 M. Nakamura 207, 257
K. Hashimoto 343 K. Nakano 249
S. Hirakawa 147 S. Nikolic 121, 165
Y. Hirota 283 T. Ohya 131
M. Hori 263, 277, 301, 325 C.O. Olsen 165
T. Horikoshi 35 H. Piene 211
M. Iizuka 131 F.W. Prinzen 75
M. Inoue 325 J.S. Rankin 165
Y. Ishida 263 R.S. Reneman 75
K. Iwakura 301 Y. Saeki 35
T. I wazumi 13 K. Sagawa 81
G. Izzi 291 S. Sasayama 335
T. Kamada 263, 277, 301 H. Sato 325
J.S. Karliner 315 S. Satoh 137
S. Kaseda 257 V.J.A. Schouten 199
D.A. Kass 81 T. Serizawa 131
K. Kawamura 283 G. Shimizu 283
VIII List of Contributors
K. Shiozawa 35 K. Todaka 207
E.R. Smith 237 H. Tomoike 257
H. Suga 157 G.P. Toorop 199
M. Sugawara 249 H. Tsuchimochi 63
M. Sugimachi 207 J.V. Tyberg 237
T. Sugimoto 131 G.S. Tyson, Jr. 165
S. Sugiura 81 Y. Urabe 257
K. Sunagawa 207 K.H. van Hoeven 45
T. Takishima 137 E. T. van der Velde 189
K. Tamura 121 M.L. Weisfeldt 55
T. Tamura 121 N. Westerhof 199
T. Tanaka 147 Y. Yazaki 63
A. Tani 263 E.L. Yellin 121, 225
J. Tanouchi 277
Table of Contents
Chapter A. CeUuIar Aspect of Cardiac Mechanics
Chapter Preface
M. HORI ................................................ 1
Ca2+ Transients in Perfused Hearts: Fundamental Properties of
the Chemical Signals Underlying Ventricular Mechanics
E. MARBAN ............................................. 3
Mechanics of the Sarcomere
T. IWAZUMI ............................................ 13
Rapid Relengthening in Isolated Cardiac Cells and the Origin of
Diastolic Recoil
J.W. KRUEGER.......................................... 23
Isotonic Segment Dynamics of Isolated Cardiac Muscle
Y. SAEKI, T. HORIKOSHI, K. SHIOZAWA .................... 3S
Pathology of the Cardiac Collagen Matrix: Mechanical and
Functional Effects
K.H. VAN HOEVEN, S.M. FACTOR.......................... 4S
The Cellular Basis of Stunned Myocardium
H. KUSUOKA, E. MARBAN, M.L. WEISFELDT ................ SS
Isozymic Changes in Human Cardiac Myosins Due to Overload
Y. YAZAKI, H. TSUCHIMOCHI, M: KURABAYASHI, I. KOMURO .. 63
Chapter B. Mechanical Properties of the Ventricle
Chapter Preface
E.L. YELLIN ............................................ 73
Integrity of Myocardial" Fiber Structure Maintained by Fiber
Load Induced Local Growth
T. ARTS, P.H.M. BOVENDEERD, F.W. PRINZEN, R.S. RENEMAN 7S
x
Table of Contents
Contractility and Pump Function of In Vivo Left Ventricle and
Its Coupling with Arterial Load: Testing the Assumptions
K. SAGAWA, D.A. KAss, S. SUGIURA, D. BURKHOFF,
J. ALEXANDER .......................................... 81
The Concept of Systolic Myocardial Stiffness with Applications to
the Assessment of Myocardial Contractility in Health and Disease
I. MIRSKY .............................................. 91
Determinants of Diastolic Function
S.A. GLAN1Z, J.e. GILBERT ............................... 103
Equilibrium Volume and Passive Pressure-Volume Relationship
in the Intact Canine Left Ventricle
S. NIKOLIC, K. TAMURA, T. TAMURA, E.L. YELLIN .......... 121
Discrepancy Between Slow Relaxation and Increased Myocardial
Stiffness
T. SERIZAWA, O. KOHMOTO, M. IIZUKA, T. OHYA,
S. MOMOMURA, T. SUGIMOTO ............................ 131
Coronary Circulation and Cardiac Function
Y. MARUYAMA, S. SATOH, K. MAEHARA, T. TAKISHIMA 137
Pressure-Volume Relation of the Left Atrium in Man
M. ARAKAWA, T. TANAKA, S. HIRAKAWA ................... 147
Chapter C. Ventricular Function and Interaction Between Heart and
Vessels
Chapter Preface
J. BAAN ................................................ 155
Energetics of the Heart
H. SUGA, S. FuTAKI, Y. GOTO ............................ 157
An Energetic Analysis of Myocardial Performance
J.S. RANKIN, J.R. ELBEERY, J.e. LUCKE, W. GAYNOR,
D.H. HARPOLE, M.P. FENELEY, S. NIKOLIC, G.W. MAIER,
G.S. TYSON JR., e.O. OLSEN, D.D. GLOWER. . . . . . . . . . . . . . .. 165
Ventricular Pressure-Volume Relations Demonstrate Positive
Inotropic Effect of Increased Arterial Impedance
J. BAAN, E.T. VAN DER VELDE ............................ 189
Physiological and Pharmacological Interventions on Coupling of
Heart and Arterial Load
N. WESTERHOF, G.P. TOOROP, G. ELZINGA, V.J.A. SCHOUTEN 199
Ventricular Matching with the Arterial System in Chronically
Instrumented Dogs
K. SUNAGAWA, M. SUGIMACHI, K. TODAKA, M. NAKAMURA ... 207
Table of Contents XI
Right Ventricular Function in Relation to Pulmonary Arterial
Impedance
H. PlENE ............................................... 211
Dynamics of Left Ventricular Filling
E.L. YELLIN ............................................ 225
Ventricular Interaction and the Role of the Pericardium: Effects
of Right Ventricular Loading
J.V. TYBERG, E.R. SMITH ................................ 237
Chapter D. Regional and Chamber Mechanics in Iscbemic and
Hypertrophic Hearts
Chapter Preface
H. SUGA ............................................... 247
A New Method of Analyzing Regional Myocardial Function of
the Ventricle
M. SUGAWARA, K. NAKANO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 249
Regional Wall Motion in the Ischemic Heart
H. TOMOIKE, Y. URABE, S. KASEDA, M. NAKAMURA ......... 257
Assessment of Left Ventricular Filling Patterns in Patients with
Hypertrophic Cardiomyopathy
Y. ISHIDA, A. TANI, N. MATSUBARA, T. MOROZUMI, M. HORI,
A. KITABATAKE, K. KIMURA, T. KAMADA .................. 263
Assessment of Diastolic Function of Hypertrophic Heart by
Doppler Echocardiography
A. KITABATAKE, T. MASUYAMA, J. TANOUCHI, M. HORI,
T. KAMADA ............................................ 277
Assessment of Cardiac Function in Diseased Heart by
Catheterization Study
Y. HIROTA, G. SHIMIZU, Y. KITA, K. KAWAMURA ........... 283
Clinical Diagnosis and Management of Left Ventricular Diastolic
Dysfunction
W.H. GAASCH, G. IzzI ................................... 291
Chapter E. Cardiac Function in Heart Failure
Chapter Preface
M. HORI ............................................... 299
Neurohumoral Abnormalities and Adrenoceptor Changes in
Chronic Heart Failure
M. HORI, K. IWAKURA, A. KITABATAKE, T. KAMADA ........ 301
