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Advances in cardiology: The myocardium
BOOK REVIEWS
view of previous workers’ attempts at visualization of the different components of the vascular bed and then presents his original observations using his combined methodologic approach. Where pertinent, the author extends his anatomic observations to clinical correlates, although he is careful to point out that this postmortem demonstration of patency or communication of vessels does not necessarily imply that they functioned during life as patent or anastomosing channels. However, he reasonably states that the finding of obliterated channels can be construed to mean nonfunctional. Examples are given of severe pulmonary stenosis or atresia wherein arterial bronchopulmonary anastomoses do not become obliterated, as is usual, but remain patent and are present in large numbers. The author likens the “pruning” of the pumonary arterial tree that is observed in roentgenograms of patients with pulmonary hypertension and vascular obstruction to the plexiform lesions he found at perpendicular branch points of the pulmonary arterial system. He also comments on the natural collateral venous path of the neonatal lung whereby true bronchial veins communicate with pulmonary veins and serve to decompress the pulmonary venous system of the neonate by draining the blood into the azygos system; this may be the explanation for the usual absence of rales in the lungs of a young baby with left-sided cardiac failure. The monograph concludes with an extensive and comprehensive list of references. Dr. Robertson accomplishes his objective of summarizing the contributions of microangiography to the field of pulmonary vascular morphology in a way that should prove interesting and helpful to pediatric cardiologists, neonatalogists, pulmonary physiologists and pathologists. Mary Allen Engle, MD New York, New York
ADVANCES IN CARDIOLOGY: THE MYOCARDIUM, edited by Ralph Reader. Basel, Switzerland, S. Karger, 1974, 364 pages, $41.05
The proceedings of a conference on the myocardium organized by the National Heart Foundation of Australia in 1973 form the basis of the text. The presentations are by laboratory research workers and clinicians from Australia and other overseas nations who have contributed significantly to their respective areas of endeavor. The keynote address by Dr. P. I. Korner provides a succinct review of the salient points in the papers, which concern cardiac structure, excitation and conduction, contraction, muscle mechanics, myocardial metabolism, hypertrophy, coronary blood flow, clinical assessment of cardiac function, arrhythmias and coronary vein bypass surgery. The papers are well organized and the authors often present their most recent work and current theories in addition to reviewing their field of research. The photomicrographs are highly detailed, the diagrams denoting mechanisms of action are usefully designed and the presentations are selectively referenced. This volume represents an up-to-date source of material in basic and clinical modern cardiology and will be of interest to basic researchers, clinicians and students. Although the price may reflect the inflated cost of medical research as well as devaluation of the U.S. dollar, the text is highly recommended.
MECHANJSMS OF HYPERTENSION, edited by Mohlnder B. Sambhl. New York, American Elsevier, 1973, 389 pages, $57.70
This volume, a record of a workshop conference on hypertension that took place in Los Angeles in 1973, is characterized by an unusually wide variation in quality, from very good to mediocre. For the internist, cardiologist or any practicing physician, the book confuses rather than clarifies the subject of hypertension. Some aspects, such as renin, angiotensin, aldosterone and prostaglandin, are overemphasized, whereas “benign” essential hypertension and its treatment are underemphasized, making much of the book irrelevant to the clinician, since 90 percent of the hypertensive patients he sees have “benign” essential hypertension. The price of the volume seems somewhat excessive since the workshop was supported by several drug companies. The clinician will find the book confusing and unrewarding, but it will undoubtedly be of value to scientists interested in the chemistry of the hypertensive process although it contains little that is not published elsewhere. Milton Mendlowitz, MD New York, New York
7TH EUROPEAN CONFERENCE ON MICROCIRCULATION. PARi I: METHODOLOGY ON MICROCIRCULATION, edlted by J. Dltzel, MD and D. H. Lewls, MD. Basel, S. Karger, 546 pages, $104
This book comprises 80 papers presented at the 7th European Congress on Microcirculation. Part I contains a detailed explanation of methods used in the study of microcirculation and reviews the experience of internationally known pioneers in this field. The book is divided into seven chapters. The first chapter extensively discusses methods utilized for assessment of microcirculation within various organ tissues, The second deals with rheology and the influence of different physical properties of blood cells and components on microcirculation; there is a good discussion of methods and results for each study. The third chapter discusses myocardial blood flow and effects of various factors on regional coronary and collateral blood flow. The effects of intramyocardial pressure on subendocardial blood flow and the effects of clinical disease states such as left ventricular hypertrophy and acute myocardial infarction on microcirculation and coronary collateral vessels are also discussed. Other chapters deal with the use of the light microscope and electron microscope in the study of red cell agglutination and cell aggregation and general aspects of the study of microcirculation and their application in clinical states, emphasizing methods. The table of contents is somewhat limited but does not distract from the value of the book. Printing style and editing are excellent; there is sufficient information within every paper to explain its purpose, methods and conclusions. This volume is a compendium of the study of microcirculation and is a highly specialized book of great importance to the students of this field; it is not intended for general cardiologists or clinically oriented students of cardiology. However, the highly sophisticated methods utilized and the results obtained are of value to any academician’s general knowledge of microcirculation within various tissues.
Charles E. Rackley, MD, FACC
Hooshang Bolooki, MD Miami, Florida
Birmingham, Alabama
August 1975
The American Journal of CARDIOLOGY
Volume 36
273
view of previous workers’ attempts at visualization of the different components of the vascular bed and then presents his original observations using his combined methodologic approach. Where pertinent, the author extends his anatomic observations to clinical correlates, although he is careful to point out that this postmortem demonstration of patency or communication of vessels does not necessarily imply that they functioned during life as patent or anastomosing channels. However, he reasonably states that the finding of obliterated channels can be construed to mean nonfunctional. Examples are given of severe pulmonary stenosis or atresia wherein arterial bronchopulmonary anastomoses do not become obliterated, as is usual, but remain patent and are present in large numbers. The author likens the “pruning” of the pumonary arterial tree that is observed in roentgenograms of patients with pulmonary hypertension and vascular obstruction to the plexiform lesions he found at perpendicular branch points of the pulmonary arterial system. He also comments on the natural collateral venous path of the neonatal lung whereby true bronchial veins communicate with pulmonary veins and serve to decompress the pulmonary venous system of the neonate by draining the blood into the azygos system; this may be the explanation for the usual absence of rales in the lungs of a young baby with left-sided cardiac failure. The monograph concludes with an extensive and comprehensive list of references. Dr. Robertson accomplishes his objective of summarizing the contributions of microangiography to the field of pulmonary vascular morphology in a way that should prove interesting and helpful to pediatric cardiologists, neonatalogists, pulmonary physiologists and pathologists. Mary Allen Engle, MD New York, New York
ADVANCES IN CARDIOLOGY: THE MYOCARDIUM, edited by Ralph Reader. Basel, Switzerland, S. Karger, 1974, 364 pages, $41.05
The proceedings of a conference on the myocardium organized by the National Heart Foundation of Australia in 1973 form the basis of the text. The presentations are by laboratory research workers and clinicians from Australia and other overseas nations who have contributed significantly to their respective areas of endeavor. The keynote address by Dr. P. I. Korner provides a succinct review of the salient points in the papers, which concern cardiac structure, excitation and conduction, contraction, muscle mechanics, myocardial metabolism, hypertrophy, coronary blood flow, clinical assessment of cardiac function, arrhythmias and coronary vein bypass surgery. The papers are well organized and the authors often present their most recent work and current theories in addition to reviewing their field of research. The photomicrographs are highly detailed, the diagrams denoting mechanisms of action are usefully designed and the presentations are selectively referenced. This volume represents an up-to-date source of material in basic and clinical modern cardiology and will be of interest to basic researchers, clinicians and students. Although the price may reflect the inflated cost of medical research as well as devaluation of the U.S. dollar, the text is highly recommended.
MECHANJSMS OF HYPERTENSION, edited by Mohlnder B. Sambhl. New York, American Elsevier, 1973, 389 pages, $57.70
This volume, a record of a workshop conference on hypertension that took place in Los Angeles in 1973, is characterized by an unusually wide variation in quality, from very good to mediocre. For the internist, cardiologist or any practicing physician, the book confuses rather than clarifies the subject of hypertension. Some aspects, such as renin, angiotensin, aldosterone and prostaglandin, are overemphasized, whereas “benign” essential hypertension and its treatment are underemphasized, making much of the book irrelevant to the clinician, since 90 percent of the hypertensive patients he sees have “benign” essential hypertension. The price of the volume seems somewhat excessive since the workshop was supported by several drug companies. The clinician will find the book confusing and unrewarding, but it will undoubtedly be of value to scientists interested in the chemistry of the hypertensive process although it contains little that is not published elsewhere. Milton Mendlowitz, MD New York, New York
7TH EUROPEAN CONFERENCE ON MICROCIRCULATION. PARi I: METHODOLOGY ON MICROCIRCULATION, edlted by J. Dltzel, MD and D. H. Lewls, MD. Basel, S. Karger, 546 pages, $104
This book comprises 80 papers presented at the 7th European Congress on Microcirculation. Part I contains a detailed explanation of methods used in the study of microcirculation and reviews the experience of internationally known pioneers in this field. The book is divided into seven chapters. The first chapter extensively discusses methods utilized for assessment of microcirculation within various organ tissues, The second deals with rheology and the influence of different physical properties of blood cells and components on microcirculation; there is a good discussion of methods and results for each study. The third chapter discusses myocardial blood flow and effects of various factors on regional coronary and collateral blood flow. The effects of intramyocardial pressure on subendocardial blood flow and the effects of clinical disease states such as left ventricular hypertrophy and acute myocardial infarction on microcirculation and coronary collateral vessels are also discussed. Other chapters deal with the use of the light microscope and electron microscope in the study of red cell agglutination and cell aggregation and general aspects of the study of microcirculation and their application in clinical states, emphasizing methods. The table of contents is somewhat limited but does not distract from the value of the book. Printing style and editing are excellent; there is sufficient information within every paper to explain its purpose, methods and conclusions. This volume is a compendium of the study of microcirculation and is a highly specialized book of great importance to the students of this field; it is not intended for general cardiologists or clinically oriented students of cardiology. However, the highly sophisticated methods utilized and the results obtained are of value to any academician’s general knowledge of microcirculation within various tissues.
Charles E. Rackley, MD, FACC
Hooshang Bolooki, MD Miami, Florida
Birmingham, Alabama
August 1975
The American Journal of CARDIOLOGY
Volume 36
273