THECARDIOVASCULAR SYSTEM–PHYSIOLOGY, DIAGNOSTICSAND CLINICALIMPLICATIONS EditedbyDavidC.Gaze The Cardiovascular System – Physiology, Diagnostics and Clinical Implications Edited by David C. Gaze Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Iva Simcic Technical Editor Teodora Smiljanic Cover Designer InTech Design Team First published April, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechopen.com The Cardiovascular System – Physiology, Diagnostics and Clinical Implications, Edited by David C. Gaze p. cm. ISBN 978-953-51-0534-3 Contents Preface IX Section 1 Cardiovascular Physiology 1 Chapter 1 Control of Cardiovascular System 3 Mikhail Rudenko, Olga Voronova, Vladimir Zernov, Konstantin Mamberger, Dmitry Makedonsky, Sergey Rudenko and Sergey Kolmakov Chapter 2 Molecular Control of Smooth Muscle Cell Differentiation Marker Genes by Serum Response Factor and Its Interacting Proteins 23 Tadashi Yoshida Chapter 3 Trans Fatty Acids and Human Health 43 Sebastjan Filip and Rajko Vidrih Chapter 4 Control and Coordination of Vasomotor Tone in the Microcirculation 65 Mauricio A. Lillo, Francisco R. Pérez, Mariela Puebla, Pablo S. Gaete and Xavier F. Figueroa Chapter 5 Hemodynamics 95 Ali Nasimi Chapter 6 Adenosinergic System in the Mesenteric Vessels 111 Ana Leitão-Rocha, Joana Beatriz Sousa and Carmen Diniz Chapter 7 Endothelial Nitric Oxide Synthase, Nitric Oxide and Metabolic Disturbances in the Vascular System 135 Grażyna Lutosławska VI Contents Section 2 Cardiovascular Diagnostics 155 Chapter 8 The Diagnostic Performance of Cardiovascular System and Evaluation of Hemodynamic Parameters Based on Heart Cycle Phase Analysis 157 Mikhail Rudenko, Olga Voronova, Vladimir Zernov, Konstantin Mamberger, Dmitry Makedonsky, Sergey Rudenko, Yuri Fedossov, Alexander Duyzhikov, Anatoly Orlov and Sergey Sobin Chapter 9 Biophysical Phenomena in Blood Flow System in the Process of Indirect Arterial Pressure Measurement 179 Mikhail Rudenko, Olga Voronova and Vladimir Zernov Chapter 10 Interrelation Between the Changes of Phase Functions of Cardiac Muscle Contraction and Biochemical Processes as an Algorithm for Identifying Local Pathologies in Cardiovascular System 195 Yury Fedosov, Stanislav Zhigalov, Mikhail Rudenko, Vladimir Zernov and Olga Voronova Chapter 11 Application of Computational Intelligence Techniques for Cardiovascular Diagnostics 211 C. Nataraj, A. Jalali and P. Ghorbanian Chapter 12 Analysis of Time Course Changes in the Cardiovascular Response to Head-Up Tilt in Fighter Pilots 241 David G. Newman and Robin Callister Section 3 Clinical Impact of Cardiovascular Physiology and Pathophysiology 255 Chapter 13 Physical Activity and Cardiovascular Health 257 Raul A. Martins Chapter 14 Cardiovascular Disease Risk Factors 279 Reza Amani and Nasrin Sharifi Chapter 15 Cardiovascular and Cerebrovascular Problems in the Development of Cognitive Impairment: For Medical Professionals Involved in the Treatment of Atherosclerosis 311 Michihiro Suwa Chapter 16 French Paradox, Polyphenols and Cardiovascular Protection: The Oestrogenic Receptor-α Implication 319 Tassadit Benaissa, Thierry Ragot and Angela Tesse Contents VII Chapter 17 Importance of Dermatology in Infective Endocarditis 345 Servy Amandine, Jones Meriem and Valeyrie-Allanore Laurence Chapter 18 Cardiovascular Risk Factors: Implications in Diabetes, Other Disease States and Herbal Drugs 365 Steve Ogbonnia Chapter 19 Morphology and Functional Changes of Intestine, Trophology Status and Systemic Inflammation in Patients with Chronic Heart Failure 383 G.P. Arutyunov and N.A. Bylova Chapter 20 Evaluation and Treatment of Hypotension in Premature Infants 419 Shoichi Ezaki and Masanori Tamura Chapter 21 Role of Echocardiography in Research into Neglected Cardiovascular Diseases in Sub-Saharan Africa 445 Ana Olga Mocumbi Chapter 22 Psychophysiological Cardiovascular Functioning in Hostile Defensive Women 465 Francisco Palmero and Cristina Guerrero Preface The cardiovascular system includes the heart located centrally in the thorax and the vessels of the body which carry blood. The cardiovascular (or circulatory) system supplies oxygenfrominspired air,viathe lungs to the tissuesaround the body.It is also responsible fortheremovalofthewasteproduct, carbon diox idevia air expired from the lungs. The cardiovascular system also transports nutrients such as electrolytes, amino acids, enzymes, hormones which are integral to cellular respiration,metabolismandimmunity. This book is not meant to be an all encompassing text on cardiovascular physiology and pathology rather a selection of chapters from experts in the field wh o describe recent advances in basic and clinical sciences. As such, the text is divided into three mainsections: 1. Cardiovascular Physiology – In this section, the control of the cardiovascular system is discussed in particular the heaemodynamic mechanisms controlling blood volume, flow and the regulation of sy stolic blood pressure. The next chapter investigates the molecular control of smooth muscle cell (SMC) differentiation marker genes by serum response factor (SRF) including the interaction ofmyocardin as apotent cofactor of SRF in SMC differentiation.The chapteralsodetailstheinteractionofGATA‐6,Klf4,LIM‐onlyproteinsCRP1and 2 and PIAS‐1with SRF. The followingchapter reportson transfatty acids (TFA) and human health, deta iling the biochemistry of trans fats as well as recommendeddailyintake.Thechapterdescribesbothanimalandhumanstudies of TFA. There are details on the analytical determinationof TFA as well as their potential antioxidants. There is also a comprehensive overview of TFA and legislative control in food production and consumption. This is followed by a chapteronthecontrolandcoordinationofvasomotortoneinthemicrocirculation; concentrating on the cellular membrane potential and potassium channels, the role of prosta glandins, nitric oxide and endothelium‐derived hyperpolarizing factor asparacrine signalling in the wallof the vessel. There isalso detail ofthe roleofgapjunctionsinvascularsmoothmuscleandendotheliumcommunication processes. The following chapter discusses the concept of hemodynamics, detailing the relationship between physical factors and th e effect on blood flow through the vessel in laminar or turbulent flow patterns. The principles of X Preface velocity, elasticity and compliance are described. Furthermore the clinical implications such as alteration to blood flow during atherosclerosis and arteriosclerosis are described. The penultimate chapter of this section describes the adenosinergic system in the mesenteric vessels which form the splanchnic circulation.Thechapterdetailstheroleofadenosinefromitsproductiontotissu e concentration controlled by nucleoside transporter membrane proteins, namely equilibrative and concentrative nucleoside transporters. The family member subtypes are of these transporter proteins are described thoroughly.The final chapter of section one concentrates on endothelial nitric oxide synthase (eNOS), nitric oxide (NO) and subsequent metabolic disturbances within the vascular system.Anoverviewofvasculardysfunctionisgivenalongwiththebiochemistry of eNOS/NO. The endogenous eNOS and NO inhibitor asymmetric dimethylarginine anditsroleinthevascularsystemisalsoreviewed.Thereader is also given theimportanceof lifestyle on thevascularsystem,concentrating on dietaryhabitsandphysicala ctivityontheeNOS/NOsystem. 2. CardiovascularDiagnostics–Section 2isconcerned withmodalities used in the diagnosis and monitoring of parameters associated with the cardiovascular system. The first chapter entitled ‘the diagnostic performance of cardiovascular system and evaluation of hemodynamic parameters based on heart cycle phase analysis describes the deve lopment and use of theelectrocardiogram (ECG) and the rheogram. Furthermore the use of both the ECG and rheogram to assess cardiovascularfunction in normal and diseased states aredescribed. Thesecond chapter describes the biophysical phenomena of blood flow during indirect arterialpressuremeasurement.Theroleof theoscillograminmeasuringsy stolic and diastolic arterial pressure is well described compared to the practice of auscultation of Korotkovsounds. The chapteralso notes thepeculiarities seen in someoscillogramreadings.The third chapterdescribestheinterrelationbetween changes of phase function of cardiac muscle concentration and the biochemical processes as an algorithm for identify ing pathological processes within the cardiovascularsystem.Inthischaptertheauthorsoutlinetheirvisionofthemain biochemical processes determining the clinical meaning of the pathology diagnosed with the aid of the cardiac cycle analysis method.Selection of the therapeuticagentsaimed atnormalizationofthediagnosedfunctionaldeviations takingintoaccountthebiochemicalprocessesunderlyingthesefunctionsresulted in the recovery of the functions.The next chapter investigates computational intelligence techniques in cardiovascular diagnostics. Continual monitoring of cardiac function in the acute care setting can allow the detection of cardiac arrhythmias.Continuouswavelettransformandprincipalcomponentanal ysisare described in detail. The application of these techniques within a multi-layer perceptron neural network is demonstrated. The final chapter of this section analysesthe time course changes in the cardiovascular response to head‐up tilt in fighter pilots. In this interesting chapter the authors describe the physiological adaptations that occur following frequent exposure to G‐force acceleration. By [...]... 20 describes the evaluation and treatment of hypotensive premature infants which is a common phenomenon in the first few weeks of life; describing the interplay between hypovolaemia, tissue hypoxia and myocardial dysfunction. The clinical presentation is described along with diagnostic modalities used to detect hypotensive cardiac problems, followed by the treatment ... changes For this purpose, rheography should be used A rheogram shows changes in the arterial pressure An ECG and a RHEO are produced by using signals of different nature To record an ECG used is electric potential, and for RHEOgraphy employed are changes in amplitudes of high-frequency AC under the influence of changing blood volumes in blood circulation, which produce changes in the conductivity within . a chapteronthecontrolandcoordinationofvasomotortoneinthemicrocirculation; concentrating on the cellular membrane potential and potassium channels, the role of prosta glandins, nitric oxide and endothelium‐derived. marker genes by serum response factor (SRF) including the interaction ofmyocardin as apotent cofactor of SRF in SMC differentiation.The chapteralsodetailstheinteractionofGATA‐6,Klf4,LIM‐onlyproteinsCRP1and 2. as recommendeddailyintake.Thechapterdescribesbothanimalandhumanstudies of TFA. There are details on the analytical determinationof TFA as well as their potential antioxidants. There is also a comprehensive overview of TFA and legislative