Basic and Clinical Neurocardiology

The progression of heart disease is associated with changes in the neurohumoral mechanisms that control cardiac function. The degree to which this neurohumoral remodeling occurs, even before overt signs of cardiac disease become manifest, is important for prognosis. To determine why some patients experience sudden death while others sustain life in the presence of severely compromised cardiac function, the neuronal control of cardiac electrical and mechanical events must be considered. Starting at the level of individual neurons and building upwards, this book describes the synergistic interactions that occur among intrathoracic and CNS feedback loops to permit precise control of regional cardiac behavior. On this basic science foundation, subsequent clinical chapters explore the remodeling that occurs in this system with aging, with the evolution of specific cardiac pathologies, and with the psychological concomitants of heart disease. Most importantly, these chapters provide unique insights into how specific therapies like beta-andrenergic receptor blockade not only affect cardiomyocytes directly but also mitigate the adverse neurohumoral changes that accompany disease processes, such as heart failure and essential hypertension. The paradigm advanced in this volume is that heart disease is a multifaceted phenomenon involving the interplay of neurohumoral, cardiomyocyte and structural elements, each of which depends on the other. With our cumulative understanding of these interdependent processes, new avenues for time-appropriate, targeted methods of treating heart diseases can be developed.

The progression of heart disease is associated with changes in the neurohumoral mechanisms that control cardiac function. The degree to which this neurohumoral remodeling occurs, even before overt signs of cardiac disease become manifest, is important for prognosis. To determine why some patients experience sudden death while others sustain life in the presence of severely compromised cardiac function, the neuronal control of cardiac electrical and mechanical events must be considered. Starting at the level of individual neurons and building upwards, this book describes the synergistic interactions that occur among intrathoracic and CNS feedback loops to permit precise control of regional cardiac behavior. On this basic science foundation, subsequent clinical chapters explore the remodeling that occurs in this system with aging, with the evolution of specific cardiac pathologies, and with the psychological concomitants of heart disease. Most importantly, these chapters provide unique insights into how specific therapies like beta-andrenergic receptor blockade not only affect cardiomyocytes directly but also mitigate the adverse neurohumoral changes that accompany disease processes, such as heart failure and essential hypertension. The paradigm advanced in this volume is that heart disease is a multifaceted phenomenon involving the interplay of neurohumoral, cardiomyocyte and structural elements, each of which depends on the other. With our cumulative understanding of these interdependent processes, new avenues for time-appropriate, targeted methods of treating heart diseases can be developed.

Doody Review Services

Reviewer:Magdi Mohamed Saba, MB, BCh, MSc(Ochsner Clinic Foundation)
Description:This book addresses the intriguing field of neurocardiology, an emerging discipline devoted to the study of neural control of the cardiovascular system. The first eight chapters review current knowledge on the physiology and functional anatomy of this specialized nervous system and detail cardiac neuro-myocyte interactions. The latter chapters address the clinical arena, stressing the role of the cardiovascular nervous system in common syndromes such as angina, hypertension and heart failure.
Purpose:The book is intended to render state-of-the-art knowledge in neurocardiology, an emerging field undergoing immense research.
Audience:This book will be of interest to cardiovascular basic science and clinical investigators, including those interested in cardiac function and electrophysiology.
Features:The 15 chapters in this expanded second edition comprise a comprehensive review of neurocardiology. Basic science findings are pragmatically detailed in the first eight chapters. The second half of the book focuses on specific clinical conditions, offering valuable insights into the intricate role played by the nervous system in hypertension, angina, and heart failure. Chapters on the effects of aging on neurocardiovascular control and psychological factors in heart disease are particularly novel and interesting. By definition, not by design, the subject matter is rather dry. Illustrations are acceptable, but at times difficult to follow due to inadequate legends or incorrect annotation.
Assessment:This is an authoritative reference on the central role assumed by the nervous system in cardiovascular function, which should be owned by every library frequented by cardiovascular researchers.

University of Montreal Faculty of Medicine

East Tennessee State University