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.
1: David J. Adams and Javier Cuevas: Electrophysiological Properties of Intrinsic Cardiac Neurons 2: Magda Horackova: Colocalization of Multiple Neurochemicals in Mammalian Intrathoracic Neurons 3: J.A. Armour and G.C. Kember: Cardiac Sensory Neurons 4: Jeffrey L. Ardell: Intrathoracic Neuronal Regulation of Cardiac Function 5: Robert D. Foreman, Mike JL DeJongste, and Bengt Linderoth: Integrative Control of Cardiac Function by Cervical and Thoracic Spinal Neurons 6: Michael C. Andresen, Diana L. Kunze, and David Mendelowitz: Central Nervous System Regulation of the Heart 7: David F. Cechetto: Forebrain Control of Healthy and Diseased Hearts 8: Phyllis M. Gootman: Ontogeny of the Cardiac Nervous System 9: James G. Dobson, Jr. and R.A. Fenton: Aging and Neural Responses in the Heart 10: Christer Sylven: The Genesis of Pain during Myocardial Ischemia and Infarction 11: Rene Cardinal and Pierre L. Page: Neuronal Modulation of Atrial and Ventricular Electrical Properties 12: Louis J. Dell'Italia and Jeffrey L. Ardell: Sympathetic Nervous System in the Evolution of Heart Failure 13: J. Michael Wyss, Scott H. Carlson, and Suzanne Oparil: The Pathogenesis of Hypertension 14: Christine Gagnon, Srikanth Ramachandruni, Edith E. Bragdon, and David S. Sheps: Psychological Aspects of Heart Disease 15: Jeffrey L. Ardell, Louis J. Dell'Italia and J. Andrew Armour: Remodeling of the Cardiac Neuronal Hierarchy in Heart Disease
