Smoking and the cardiovascular system.
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Emerging evidence demonstrates that heart disease may originate during fetal development. This review will focus on the role of maternal nutrition in the development of the fetal cardiovascular system. Emphasis will be placed upon the concept that nutritional inadequacies during gestation may be major programming stimuli that alter fetal cardiac, as well as vascular, physiology and predispose an individual to cardiovascular abnormalities in postnatal life. It is hypothesized that this research area will yield new information, resulting in improved fetal nutrition, growth and development through efficient maternal nutrition before and during pregnancy and will form the basis for nutritional strategies for the primary prevention of cardiovascular disease.
Chemical stimulation of afferents from the stomach and gallbladder has been shown reflexly to activate the cardiovascular system. It is not known, however, whether stimulating afferents from the pancreas evoke similar reflex activity. Therefore we recorded the cardiovascular responses in cats anesthetized with methoxyflurane, while we applied capsaicin (200 micrograms/ml) and bradykinin (0.001-1,000 micrograms/ml) to the surface of the pancreas. Topically applying these algesic substances evoked cardiovascular responses that included increases in systemic arterial pressure, heart rate, left ventricular dP/dt at 40-mmHg developed pressure and systemic vascular resistance. Bilateral vagotomy at the level of the diaphragm did not diminish the cardiovascular responses evoked by capsaicin or bradykinin. In contrast, removal of the celiac and superior mesenteric ganglia abolished the cardiovascular responses demonstrated previously when capsaicin or bradykinin was applied to the pancreas. We conclude that afferent endings in the pancreas can be stimulated reflexly to increase cardiovascular function in cats. This reflex activation represents a potential mechanism for eliciting the cardiovascular changes observed during acute pancreatitis, particularly the marked vasoconstriction that may lead to renal failure.
The meeting "Sex Differences in Cardiovascular Health and Disease" was held in Madison, WI USA, on 24 July 2002.
Using novel synthetic radioligands, we have discovered receptors for the recently paired apelin (APJ orphan receptor), ghrelin (GHS orphan receptor), and urotensin II (orphan GPR14) in the human cardiovascular system and determined their anatomical localisation. In addition, we have established functional vasoactive properties for these three peptides as potential vasoconstrictor/vasodilator mediators and provided evidence for alteration of receptor density in cardiovascular disease. We find that receptors for apelin, ghrelin, and urotensin II are widely distributed in human cardiovascular tissue, suggesting perhaps vasoactive roles for these peptides in human vascular physiology and a potential role in pathophysiology. Apelin and urotensin II are potent vasoconstrictors with low efficacy, consistent with their low receptor density. Ghrelin receptor density was increased (approximately three- to fourfold) with atherosclerosis of coronary artery disease and accelerated atherosclerosis of saphenous vein grafts, compared with normal vessels, highlighting a potentially beneficial role for this novel vasodilator peptide in human vascular disease. Our approach has demonstrated one successful strategy for translating genetic information encoding recently paired orphan receptor ligands into discovery of function. This study has the advantage of focussing on the actual disease processes, which allow the more precise identification of novel therapeutic targets.
Prostaglandins are biologically extremely active substances and an important role has been attributed to them in particular with respect to pathophysiology of the cardiovascular system. In contrast to the extremely potent biological effects in vitro the therapeutic results have been varied so far. On the basis of these reports it has been prematurely concluded that prostaglandins are not of clinical importance. The fact that primary defects, as well as defects associated with the presence of other diseases, occur in conjunction with a disturbance in haemostatic regulation is gaining increasing attention. In contrast to the findings with coagulation disturbances, defects in the prostaglandin system seem predominantly to affect the arterial system. With increasing specificity of detection methods and broadening of the methodological spectrum the number of defects detected in the prostaglandin system is increasing. The place of prostaglandins in the development of vascular diseases and their importance with respect to clinical treatment cannot be assessed definitely as yet in view of the insufficiency of information in all areas at present.
The effect of low-frequency electromagnetic field on the coagulant and fibrinolytic properties of blood and tissues of the cardiovascular system was studied. Phase character of changes in the coagulative properties of blood as well as in those of the heart and aorta was established. Irradiation of rats for 8 days is attended by an increase in the coagulating and fibrinolytic activity of blood and simultaneous inhibition of the thromboplastic compounds of the heart and vascular wall. Increase of exposure to 20 days leads to inactivation of tissue and plasma blood coagulation factors. The possible mechanism of these changes is discussed.
Ever since the effect of prostaglandins on vasal tone and cardiac function was discovered, an impressive series of studies has been conducted on their relations with the cardiovascular system. These studies have been extended to the prostaglandin system compounds discovered in more recent times. Of these, particular importance is being attached to prostacycline, though to be implicated in the physiological control of platelet clumping and also in that of renin secretion. Further investigation of the part played by prostacycline and other prostaglandins in cardiovascular disease has given unusually promising interim results.
Numerical modeling of the human cardiovascular system has always been an active research direction since the 19th century. In the past, various simulation models of different complexities were proposed for different research purposes. In this paper, an improved numerical model to study the dynamic function of the human circulation system is proposed. In the development of the mathematical model, the heart chambers are described with a variable elastance model. The systemic and pulmonary loops are described based on the resistance-compliance-inertia concept by considering local effects of flow friction, elasticity of blood vessels and inertia of blood in different segments of the blood vessels. As an advancement from previous models, heart valve dynamics and atrioventricular interaction, including atrial contraction and motion of the annulus fibrosus, are specifically modeled. With these improvements the developed model can predict several important features that were missing in previous numerical models, including regurgitant flow on heart valve closure, the value of E/A velocity ratio in mitral flow, the motion of the annulus fibrosus (called the KG diaphragm pumping action), etc. These features have important clinical meaning and their changes are often related to cardiovascular diseases. Successful simulation of these features enhances the accuracy of simulations of cardiovascular dynamics, and helps in clinical studies of cardiac function.
The effects of ritodrine hydrochloride were evaluated in 25 toxemic patients in active labor utilizing continuous electronic monitoring of fetal and maternal cardiovascular systems and uterine activity. Fetal scalp blood and free flowing maternal antecubital venous blood was obtained for pH, Po2, Pco2, base deficit and blood glucose determinations prior to and immediately following the study period. The initial ritodrine dose was 50 mug/min for 15 minutes. The dose was increased by 50 mug/min each 15 minutes until there was a clinically apparent reduction in uterine activity. Once this was accomplished, the infusion was maintained for 30 minutes. There was a consistent increase in the maternal heart rate (MHR) and a significant rise in fetal heart rate (FHR) late in the infusion and in the postinfusion period. There was a widening of the maternal pulse pressure mainly due to a reduction in diastolic pressure with little change in the mean blood pressure. Maternal and fetal pH decreased and base deficit increased during the study although the PO2 and PCO2 remained unchanged. Maternal and fetal blood glucose rose significantly following ritodrine infusion.
Possible in vivo interactions of serotonin and noradrenaline were investigated in 7 anesthetized mongrel dogs. The hemodynamic effects of three different doses of serotonin (10, 50 and 100 micrograms/kg/min) were analyzed with and without noradrenaline treatment (0.05-0.1 micrograms/kg/min). There were no significant differences in peripheral and cardiac responses between the pure serotonin effect and the hemodynamic effects of a parallel serotonin-noradrenaline infusion. The discussed amplifying effect of serotonin on the adrenergic system could not be observed in the total canine cardiovascular system.
Initial clinical application of a system for digital subtraction angiography (DSA) to the human cardiovascular system in 88 patients is reported. The equipment consisted of a specially designed computer system integrated with a fluoroscopic and radiographic apparatus for digitization, manipulation, and display of data. After intravenous injection of contrast material, adequate visualization of the heart and carotid, thoracic, abdominal, and femoral arteries was obtained with sufficient quality to obviate conventional angiography in many clinical settings. In this mode, nonselective opacification is obtained. However, DSA was also used to extend the capability of selective angiography. The availability of quantitative information permitted the determination of rates of transit of contrast material in various organs which may give insights of their physiologic performance.
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