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Tables of Contents for Respiratory-Circulatory Interactions in Health and Disease
Chapter/Section Title
Page #
Page Count
Introduction
v
Claude Lenfant
Preface
vii
Contributors
xi
Heart-Lung Interactions: An Overview
1
8
Steven M. Scharf
Michael R. Pinsky
Sheldon Magder
Introduction
1
1
Interaction of Respiratory and Circulatory Systems
2
3
Clinical Situations
5
2
Conclusions
7
2
Part One: BASIC PHYSIOLOGY
Respiratory Physiology
Lung and Chest Wall Mechanics: Basic Concepts
9
24
Joseph R. Rodarte
Introduction
9
1
Respiratory System Statics
9
7
Respiratory System Dynamics
16
4
Heart-Lung Interactions
20
10
Closing
30
3
Respiratory Musicle Function and Blood Flow
33
34
Steven G. Kelsen
Introduction
33
1
Mechanical Action
34
6
Respiratory Muscle Contractile Properties
40
17
Respiratory Muscle Blood Flow
57
10
Cardiovascular Physiology
Right Ventricular Function and Ventricular Interdependence
67
26
William P. Santamore
Alfred A. Bove
Louis J. Dell'Italia
Introduction
67
1
Right Ventricular Diastolic Function
67
2
Diastolic Ventricular Interdependence
69
3
Right Ventricular Systolic Function
72
5
Systolic Ventricular Interaction
77
16
Venous Return
93
20
Sheldon Magder
Steven M. Scharf
Introduction
93
1
Components of the System
94
1
Control of Cardiac Output
95
2
Concepts of Stressed and Unstressed Volume
97
1
Guyton's Graphical Analysis
98
2
Role of the Heart
100
3
Changes in Circuit Function (Changes in the Venous Return Curve)
103
7
An Applied Physiological Approach to Hypotension
110
3
Models of Tissue Oxygen Uptake and Microcirculatory Blood Flow
113
32
Sorel Bosan
Keith R. Walley
Introduction
113
1
A Global Conceptual Model
114
1
Fick's Law
114
1
Oxygen Transport in the Lung
115
1
Oxygen Transport in Peripheral Tissues
116
1
The Krogh Model of Oxygen Transport in the Tissues
117
3
Axial Oxygen Gradient in the Capillaries
120
1
Effect of Red Blood Cells
121
2
Extending the Krogh Model
123
3
Problems with Krogh Models
126
1
Oxygen Delivery-Consumption Relationships
127
2
Mismatch of Oxygen Demand and Supply: Physiologic Arterio-Venous Shunt
129
1
Microvascular Flow
130
3
Heterogeneous Models
133
3
Network Models
136
1
Fractal Network Models
137
3
Conclusions
140
5
Cardiopulmonary Physiology
The Sympathetic Nervous System of the Developing Mammal
145
38
Anthony L. Sica
Bruce W. Hundley
David A. Ruggiero
Phyllis M. Gootman
Introduction
145
1
Early Studies of the Sympathetic Nervous System
146
1
Periodicities in Sympathetic Discharge
147
1
Neuroanatomical Studies of the Brainstem Sympathetic Network
148
7
Baroreceptor and Chemoreceptor Reflexes in Developing Animals
155
17
Concluding Remarks
172
11
Hemodynamic Effects of Ventilation and Ventilatory Maneuvers
183
36
Michael R. Pinsky
Introduction
183
1
Ventilation as Exercise
184
1
Relation Between Lung Volume and Airway, Pleural, and Pericardial Pressure
185
4
Hemodynamic Effects of Changes in Lung Volume
189
6
Hemodynamic Effects of Changes in Intrathoracic Pressure
195
7
Clinical Trials of Different Forms of Mechanical Ventilation
202
6
Conclusion
208
11
Homeostasis of Exercise Gas Exchange: Coupling of Pulmonary and Cardiovascular Function to Cellular Respiration During Exercise
219
38
Karlman Wasserman
William W. Stringer
Introduction
219
2
Coupling of Circulation to Muscle Metabolism
221
19
Coupling of Ventilation to Circulatory Gas Exchange
240
5
Mechanism(s) of Exercise Limitation in Lung Disease
245
6
Summary
251
6
Mechanical Heart-Pericardium-Lung Interactions
257
22
Masao Takata
James L. Robotham
Introduction
257
1
Physiology of the Pericardium
258
5
Pericardium and Cardiorespiratory Interaction
263
2
Pericardial Disease and Cardiac Chamber Interactions
265
10
Conclusions
275
4
Dynamic Volumetric Imaging-Based Assessment of the Intrathoracic Milieu
279
36
Eric A. Hoffman
Binh Q. Tran
Introduction
279
1
Overview of CT and MRI
280
14
Applications to the Study of Heart-Lung Interaction
294
14
Conclusions
308
7
Part Two: PATHOPHYSIOLOGY
Cellular Mechanisms of Acute Hypoxic Pulmonary Vasoconstriction
315
46
J. T. Sylvester
James S. K. Sham
Larissa A. Shimoda
Q. Liu
Introduction
315
2
Effects of Acute Hypoxia
317
16
Mechanisms of Acute HPV
333
5
Summary and Future Directions
338
23
Pulmonary Edema: Formation and Reabsorption
361
28
Michael A. Matthay
Tsutomu Sakuma
Introduction
361
1
Formation of Pulmonary Edema
362
9
Resolution of Pulmonary Edema
371
5
Role of Aquaporins in Alveolar Fluid Transport
376
2
Alveolar Fluid Transport Under Pathological Conditions
378
4
Summary
382
7
Respiratory-Circulatory Interactions in Obstructive Sleep Apnea
389
16
Virend K. Somers
Krzysztof Narkiewicz
Mikolaj Winnicki
Introduction
389
1
Chemoreflex Responses to Hypoxemia, Hypercapnia, and Apnea
390
1
The Mueller Maneuver
391
1
Baroreflex-Chemoreflex Interactions
391
1
Chemoreflex Responses in Hypertension
392
1
Neural Circulatory Control in Normal Sleep
392
1
Neural Circulatory Control in Sleep Apnea
393
6
Effects of Treatment of Sleep Apnea
399
1
Conclusion
400
5
Effects of Respiratory Muscle Afferent on the Breathing and the Afferent Hypothesis
405
22
Sheldon Magder
Introduction
405
1
Changes in Respiratory Mechanics During Weaning
406
1
Mechanical Effects of High Respiratory Rate
406
2
Control of Breathing
408
13
Potential Clinical Approach
421
1
Conclusion
422
5
Neurohumoral Aspects of Respiratory-Cardiovascular Interactions
427
20
Sami I. Said
Introduction: Functional Interactions
427
1
Neurohumoral Substances Participating in Cardiovascular-Respiratory Interactions
427
2
Physiological Interactions
429
8
Cardiovascular-Pulmonary Interactions in Disease
437
3
Concluding Comments
440
7
Pathophysiology of Pulmonary Hypertension
447
32
Jason X. -J. Yuan
Lewis J. Rubin
Introduction
447
1
Classification of Pulmonary Hypertension
448
4
Cellular Mechanisms of Pulmonary Vasoconstriction and Excitation-Contraction Coupling
452
4
Role of Intracellular Calcium in Pulmonary Vascular Remodeling
456
1
Pathogenic Role of Dysfunctional Potassium Channels in Pulmonary Hypertension
457
10
Anorexigen-Mediated Pulmonary Hypertension: Effect of Fenfluramine on Potassium Channel Expression
467
1
Mechanisms Involved in the Therapeutic Effects of Nitric Oxide and Prostacyclin in Patients with Pulmonary Hypertension
468
3
Summary and Conclusion
471
8
Effect of Systemic Inflammation on Cardiovascular Function
479
18
Bradley D. Freeman
Charles Natanson
Introduction
479
2
Descriptive Studies
481
11
Conclusion
492
5
Part Three: CLINICAL PROBLEMS
Heart Failure
Control of Ventilation in Congestive Heart Failure
497
22
Harly Greenberg
Ventilatory Chemosensitivity in Congestive Heart Failure
497
2
Peripheral Chemoreceptor Sensitivity and Autonomic Tone in CHF
499
3
Control of Ventilation During Exercise in CHF
502
4
Control of Ventilation During Sleep in CHF
506
6
Potential Therapeutic Modalities
512
7
Ventilatory Support in the Failing Heart
519
32
Steven M. Scharf
Introduction
519
1
Principles of Cardiocirculatory Interaction
520
10
Ventilatory Therapy for CHF and Ischemic Heart Disease
530
11
Models to Explain Improved Cardiac Function with CPAP
541
4
Conclusions and Questions
545
6
Sleep-Disordered Breathing
Blood Pressure Regulation and Sleep Apnea
551
26
Urs A. Leuenberger
Clifford W. Zwillich
Introduction
551
1
Relationship Between Sleep Apnea and Hypertension
552
2
The Sympathetic Nervous System in OSA
554
1
Hemodynamic Abnormalities in Hypertension
555
1
Sympathetic Nervous System in Hypertension
556
2
Blood Pressure Regulation During Sleep and During Sleep and During Obstructive Apnea
558
6
Potential Mechanisms of Sustained Increases of Sympathetic Activity and Hypertension in Sleep Apnea
564
3
Vascular Function and Humoral Abnormalities in OSA
567
3
Conclusions
570
7
Pathophysiological Interreactions Between Sleep Apnea and the Heart
577
36
T. Douglas Bradley
Geraldo Lorenzi-Filho
John S. Floras
Introduction
577
1
Effects of Obstructive Sleep Apnea on the Pulmonary Vessels and Right Ventricle
578
3
Effects of Obstructive Sleep Apnea on the Left Ventricle
581
8
Mechanisms of Central Sleep Apnea in Association with Cheyne-Stokes Respiration in Congestive Heart Failure
589
11
Pathophysiologic Consequences of Cheyne-Stokes Respiration with Central Sleep Apnea in Congestive Heart Failure
600
3
Summary
603
10
Cardiovascular Responses to Obstructive Apneas: Lessons from Animal Models
613
28
Steven M. Scharf
Ling Chen
Harly Greenberg
Christopher P. O'Donnell
Introduction: Obstructive Sleep Apnea
613
1
Animal Models and the Study of OSA
614
1
Cardiovascular Effects of Induced Sleep Apnea in Animals
614
10
Anesthetized Animal Models in Which Certain Features of OSA Are Simulated
624
7
Sedated Animal Models Without Arousal During Apneas
631
6
Conclusions
637
4
Sleep Apnea and Right Ventricular Function
641
10
Thomas E. Podszus
Christian Ole Feddersen
Steven M. Scharf
Introduction
641
1
Right Heart Morphology in OSA
642
2
Right Heart Function in OSA
644
2
Right Heart Pathophysiology in OSA
646
5
Pulmonary Failure
Chronic Obstructive Pulmonary Disease
651
30
Samuel L. Krachman
Martin J. Tobin
Background
651
1
Pulmonary Gas Exchange in COPD
652
3
Control of Breathing in COPD
655
5
Respiratory Muscle Pump Dysfunction
660
5
Increased Respiratory Muscle Pump Load
665
10
Conclusion
675
6
Circulatory Effects of COPD
681
24
Bartolome R. Celli
Regina Frants
Introduction
681
1
Systemic Venous Return
682
4
Right Ventricular Function and Ventricular Interdependence
686
4
Pulmonary Vascular Compartment
690
5
Left Ventricular Performance
695
4
Conclusions
699
6
Critical Care
Invasive and Noninvasive Assessment of Cardiocirculatory Function: Balloon-Tipped Catheters and Echocardiography
705
34
Claude Perret
Francois Feihl
Alain Cariou
Introduction
705
1
History
706
3
Information Provided by the PAC
709
14
Echocardiography: A Complementary Role
723
5
Changing Strategy
728
11
Heart-Lung Interactions in Sepsis
739
24
Sheldon Magder
Definition of Sepsis
739
2
Cardiovascular and Pulmonary Responses to Sepsis
741
1
Mechanism of High Cardiac Output
742
16
Summary
758
5
Nitric Oxide and Cardiopulmonary Failure in Sepsis
763
30
Rubin Cohen
Introduction
763
1
Nitric Oxide Synthases
764
1
Nitric Oxide in Septic Shock: Effects on Hemodynamics
764
10
Nitric Oxide in the Normal Heart
774
1
Nitric Oxide and the Heart in Endotoxemia
774
5
Nitric Oxide: Not Just an Endothelial-Derived Relaxing Factor
779
3
Regulation of iNOS
782
1
Summary
783
10
Databases and Outcomes in Cardiopulmonary Care
793
14
Alan S. Multz
Corrado P. Marini
Introduction
793
1
Databases
794
4
Outcomes Data and Scoring Systems
798
9
Mechanical Ventilation with PEEP
807
30
Henry E. Fessler
Introduction
807
1
History of MV and Peep
808
1
Basic Concepts
809
1
Effects of PEEP
810
16
Clinical Issues
826
4
Summary
830
7
Cardiocirculatory Management in Acute Lung Injury and ARDS
837
24
Rene Gust
Daniel P. Schuster
Introduction
837
1
Optimizing Substrate Delivery
838
5
Theoretical Basis for Fluid Restriction in ALI/ARDS
843
2
Experimental Evidence Supporting Active Reduction of Pc in ALI/ARDS
845
5
Clinical Evidence for the Value of Fluid Restriction in ALI/ARDS
850
1
Other Clinical Approaches to Reducing Pc
851
3
Summary and Management Recommendations
854
7
Diagnostic Information from the Respiratory Variations in Central Hemodynamics Pressures
861
22
Sheldon Magder
Introduction
861
1
Principles of Pressure Measurements
861
8
Diagnostic Uses of Respiratory Variations in Central Hemodynamics
869
5
Change in Abdominal Pressure
874
1
Information from the Hemodynamic Waveforms
875
5
Summary
880
3
Abdominal-Circulatory Interactions
883
22
Peter Goldberg
Introduction
883
1
Animal Data
883
9
Human Data
892
9
Summary
901
4
Inhaled Nitric Oxide and Acute Lung Injury
905
14
Didier Payen
Introduction
905
1
NO: A Gas
905
3
NO: A ``Selective'' Pulmonary Vasodilator
908
1
NO Inhalation Impact on Bronchial Tree and Surfactant
909
1
Inhaled NO in Acute Lung Injury
910
2
Extra-Gas Exchange Effects
912
1
Clinical Trials on Inhaled NO in Adult ARDS
913
6
Inhaled Nitric Oxide for Persistent Pulmonary Hypertension of the Newborn: Basis for Evolving Therapeutic Guidelines
919
26
Dennis Davidson
Introduction
919
1
PPHN Pathophysiology: Basic and Clinical
920
5
Development of Inhaled Nitric Oxide for PPHN
925
1
Clinical Trials: Efficacy
926
3
Safety Considerations
929
4
Disease-Related Responses to I-NO
933
4
Conclusion
937
8
Index
945