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Cardiovascular fluid mechanics is now used as a tool in determining
diagnosis, treatment, and prognosis by physicians and surgeons
working in the fields of cardiology and angiology. The text is
based on a considerable amount of clinical and experimental data on
blood flow in the heart and large vessels obtained using various
methods such as ultrasound pulsed Doppler velocimetry (including
Doppler color flow imaging), catheter-tip electromagnetic
velocimetry, hot-film anemometry, and laser Doppler velocimetry.
The book will introduce medical researchers and clinicians to this
rapidly developing field and allow them to apply the knowledge and
the methods of fluid mechanics to practical medicine.
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."
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."
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