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The Heart and Circulation - An Integrative Model (Hardcover, 2014 ed.)
Loot Price: R4,628
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The Heart and Circulation - An Integrative Model (Hardcover, 2014 ed.)
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This book traces the development of the basic concepts in
cardiovascular physiology in the light of the accumulated
experimental and clinical evidence and, rather than making the
findings fit the standard pressure-propulsion mold, let the
phenomena 'speak for themselves'. It starts by considering the
early embryonic circulation, where blood passes through the
valveless tube heart at a rate that surpasses the contractions of
its walls, suggesting that the blood is not propelled by the heart,
but possesses its own motive force, tightly coupled to the
metabolic demands of the tissues. Rather than being an organ of
propulsion, the heart, on the contrary, serves as a damming-up
organ, generating pressure by rhythmically impeding the flow of
blood. The validity of this model is then confirmed by comparing
the key developmental stages of the cardiovascular system in the
invertebrates, the insects and across the vertebrate taxa. The
salient morphological and histological features of the myocardium
are reviewed with particular reference to the vortex. The complex,
energy-dissipating intracardiac flow-patterns likewise suggest that
the heart functions as an organ of impedance, whose energy
consumption closely matches the generated pressure, but not its
throughput. Attention is then turned to the regulation of cardiac
output and to the arguments advanced by proponents of the 'left
ventricular' and of the 'venous return' models of circulation.
Hyperdynamic states occurring in arteriovenous fistulas and
congenital heart defects, where communication exists between the
systemic and pulmonary circuits at the level of atria or the
ventricles, demonstrate that, once the heart is unable to impede
the flow of blood, reactive changes occur in the pulmonary and
systemic circulations, leading to pulmonary hypertension and
Eisenmenger syndrome. Finally, the key points of the nook are
summarized in the context of blood as a 'liquid organ' with
autonomous movement.
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