Autonomic Innervation Of The Heart

This book explains in detail the potential value of the hybrid modalities, SPECT-CT and PET-CT, in the imaging of cardiac innervation in a wide range of conditions and diseases, including ischemic heart disease, diabetes mellitus, heart failure, amyloidosis, heart transplantation, and ventricular arrhythmias. Imaging of the brain-heart axis in neurodegenerative disease and stress and of cardiotoxicity is also discussed. The roles of the various available tracers are fully considered, and individual chapters address radiopharmaceutical development under GMP, imaging physics, and kinetic modeling software. Highly relevant background information is included on the autonomic nervous system of the heart and its pathophysiology, and in addition future perspectives are discussed. Awareness of the importance of autonomic innervation of the heart for the optimal management of cardiac patients is growing, and there is an evident need for objective measurement techniques or imaging modalities. In this context, Autonomic Innervation of the Heart will be of wide interest to clinicians, researchers, and industry.

Praised for its concise coverage, this highly accessible monograph lays a foundation for understanding the underlying concepts of normal cardiovascular function and offers a welcome alternative to a more mechanistically oriented approach or an encyclopedic physiology text. Clear explanations, ample illustrations and engaging clinical cases and problems provide the perfect guidance for self-directed learning and prepare you to excel in clinical practice.

The Studies in Physiology series provides a concise introduction to developments in complex areas of physiology for a wide audience. Published on behalf of the Physiology Society, Cardiovascular Regulation provides an up-to-date account of our current understanding of the control of the cardiovascular system that is not covered by existing textbooks. Both students and lecturers of cardiovascular and exercise physiology, medicine, dentistry and biomedical sciences will find this book informative and easy to read. Each chapter has numerous summary boxes. 'Essential reading' suggestions provide additional reading for undergraduates and the suggestions for 'Further reading' cover the subject to postgraduate level.

The fifth edition of this book presents clinical data, image acquisition, and interpretation of nuclear cardiology procedures through high quality illustrative image examples. It includes up-to-date and comprehensive coverage of advances in instrumentation, radiotracers, protocols, and clinical studies. New content includes indications in imaging cardiac sarcoidosis, amyloidosis, and device infections as well as recent advances in instrumentation (Hybrid PET/MR). It also provides fresh chapters on the history of nuclear cardiology imaging, radionuclide handling techniques and radiation safety, PET-based myocardial perfusion imaging, and vascular imaging. The entire field is presented in pictographic form that is visually pleasing and conforming to current trends of medical education. The fifth edition of the Atlas of Nuclear Cardiology is an essential reference for cardiologists, radiologists, and nuclear medicine physicians interested in the latest approaches to noninvasive diagnostic cardiovascular nuclear imaging techniques. It also serves as a ready reference textbook for medical students and residents as well as nuclear physicists, nuclear medicine technologists, and radiopharmacists.

This atlas elucidates the role of the neuronal component in normal cardiovascular function and cardiac disorders and discusses the currently available imaging targets and probes. It provides a foundation in cardiac neuronal imaging and image processing and serves as a guide in the effective utilization of these techniques in clinical and research settings. The atlas discusses the principles of autonomic control in the regulation of cardiac function and disease; chemistry and biology of radiotracers designed to target changes in the myocardial sympathetic and parasympathetic innervation as a function of disease or treatment; neuronal imaging in heart failure and reverse remodeling and the use of PET imaging in quantification of cardiac innervation; cardiac sympathetic innervation in ventricular arrhythmias and device therapy; conditions that affect the autonomic nervous system; and the role of myocardial blood flow and cardiac neuronal imaging in denervation and reinnervation in cardiac transplant recipients. Featuring full-color illustrations, schematic diagrams, and diagnostic algorithms, Atlas of Cardiac Innervation is a valuable resource for cardiologists, radiologists, nuclear medicine physicians, and electrophysiologists.

Deglutition or a swallow begins as a voluntary act in the oral cavity but proceeds autonomously in the pharynx and esophagus. Bilateral sequenced activation and inhibition of more than 25 pairs of muscles of mouth, pharynx, larynx, and esophagus is required during a swallow. A single swallow elicits peristalsis in the pharynx and esophagus along with relaxation of upper and lower esophageal sphincters. Multiple swallows, at closely spaced time intervals, demonstrate deglutitive inhibition; sphincters remain relaxed during the entire period, but only the last swallow elicits peristalsis. Laryngeal inlet closure or airway protection is very important during swallow. Upper part of the esophagus that includes upper esophageal sphincter is composed of skeletal muscles, middle esophagus is composed of a mixture of skeletal and smooth muscles, and lower esophagus, including lower esophageal sphincter, is composed of smooth muscles. Peristalsis progresses in seamless fashion, despite separate control mechanism, from the skeletal to smooth muscle esophagus. The esophagus's circular and longitudinal muscle layers contract synchronously during peristalsis. Sphincters maintain continuous tone; neuromuscular mechanisms for tonic closure in the upper and lower esophageal sphincters are different. Lower esophageal sphincter transient relaxation, belching mechanism, regurgitation, vomiting, and reflux are mediated via the brain stem. Table of Contents: Introduction / Central Program Generator and Brain Stem / Pharynx-Anatomy, Neural Innervation, and Motor Pattern / Upper Esophageal Sphincter / Neuromuscular Anatomy of Esophagus and Lower Esophageal Sphincter / Extrinsic Innervation: Parasympathetic and Sympathetic / Interstitial Cells of Cajal / Recording Techniques / Motor Patterns of the Esophagus-Aboral and Oral Transport / Deglutitive Inhibition and Muscle Refractoriness / Peristalsis in the Circular and Longitudinal Muscles of the Esophagus / Neural and Myogenic Mechanism of Peristalsis / Central Mechanism of Peristalsis-Cortical and Brain Stem Control / Peripheral Mechanisms of Peristalsis / Central Versus Peripheral Mechanism of Deglutitive Inhibition / Neural Control of Longitudinal Muscle Contraction / Modulation of Primary and Secondary Peristalsis / Neural Control of Lower Esophageal Sphincter and Crural Diaphragm / Lower Esophageal Sphincter / Swallow-Induced LES Relaxation / Crural Diaphragm Contribution to EGJ and Neural Control / Transient LES Relaxation and Pharmacological Inhibition / Compliance of the EGJ / References

Research centering on blood flow in the heart continues to hold an important position, especially since a better understanding of the subject may help reduce the incidence of coronary arterial disease and heart attacks. This book summarizes recent advances in the field; it is the product of fruitful cooperation among international scientists who met in Japan in May, 1990 to discuss the regulation of coronary blood flow.