Coronary Circulation in Physiological and Pathophysiological States

The primary problem facing heart specialists continues to be the so-called heart attack - unstable angina, ischemic sudden death and acute myocardial infarction. The mechanisms involved in these events remain poorly understood despite extensive advancements in various therapeutic approaches. This book makes clear what is known and what is not known about coronary circulation. It shows how the regulatory mechanisms, particularly the vasomotor tone, play a role in the pathogenesis of ischemic heart disease. Specific topics are 1) animal models of coronary spasm in the presence of experimental coronary atherosclerosis, 2) endothelium-derived vasoactive factors (EDRF, EDCR) and their modifications by low density lipoproteins, atherosclerotic arterial walls and platelets, 3) the electrophysiology of coronary vascular smooth muscle cells, and 4) the neural regulation of coronary circulation in the conscious state. Entirely new aspects of coronary circulation are a laser doppler velocimeter technique which elucidates control mechanisms of coronary flow and a cell biology approach which elucidates angiogenesis in collateral development.