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The Heart and Circulation

An Integrative Model

  • Book
  • © 2014

Overview

Authors:
  1. Branko Furst

    1. Department of Anesthesiology, Albany Medical College, Albany, USA

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  • Presents a coherent model addressesing the controversies and future developments in basic science circulatory research and clinical cardiology

  • Defines the inconsistencies of the commonly accepted pressure-propulsion model of circulation

  • Provides evidence for a new circulation model with the potential to change the way in which we think about circulation radically?

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Table of contents (21 chapters)

  1. Front Matter

    Pages i-xxix
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  2. Embryonic Circulation

    1. Front Matter

      Pages 1-1
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    2. Early Embryo Circulation

      • Branko Furst
      Pages 3-10

    3. The Onset of Circulation

      • Branko Furst
      Pages 11-19

    4. Hemodynamics of the Early Embryo Circulation

      • Branko Furst
      Pages 21-29

    5. Flow Patterns in the Early Embryo Circulation

      • Branko Furst
      Pages 31-35

    6. Is There a Circulation Without a Heart?

      • Branko Furst
      Pages 37-40

    7. The Embryo Heart Is Not a Peristaltic Pump

      • Branko Furst
      Pages 41-46

    8. Flow Perturbation Experiments

      • Branko Furst
      Pages 47-51

    9. Heart Rate Perturbations

      • Branko Furst
      Pages 53-56

    10. The Heart as Generator of Pressure

      • Branko Furst
      Pages 57-60

    11. Ventriculo-Vascular Interaction

      • Branko Furst
      Pages 61-64

    12. A Brief Comparative Phylogeny

      • Branko Furst
      Pages 65-85

    13. Evolutionary Aspect of the Rhythmic System

      • Branko Furst
      Pages 87-92

  3. Mature Circulation

    1. Front Matter

      Pages 93-93
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    2. Functional Morphology of the Heart

      • Branko Furst
      Pages 95-109

    3. Regulation of Cardiac Output

      • Branko Furst
      Pages 111-131

    4. Circulatory and Respiratory Functions of the Blood

      • Branko Furst
      Pages 133-141

    5. Models of the Heart

      • Branko Furst
      Pages 143-163

    6. Cardiovascular Response During Exercise

      • Branko Furst
      Pages 165-179
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Keywords

About this book

​This book traces the development of the basic concepts in cardiovascular physiology in the light of the accumulated experimental and clinical evidence and, rather than making the findings fit the standard pressure-propulsion mold, let the phenomena ‘speak for themselves’. It starts by considering the early embryonic circulation, where blood passes through the valveless tube heart at a rate that surpasses the contractions of its walls, suggesting that the blood is not propelled by the heart, but possesses its own motive force, tightly coupled to the metabolic demands of the tissues.  Rather than being an organ of propulsion, the heart, on the contrary, serves as a damming-up organ, generating pressure by rhythmically impeding the flow of blood. The validity of this model is then confirmed by comparing the key developmental stages of the cardiovascular system in the invertebrates, the insects and across the vertebrate taxa. The salient morphological and histological features of the myocardium are reviewed with particular reference to the vortex. The complex, energy-dissipating intracardiac flow-patterns likewise suggest that the heart functions as an organ of impedance, whose energy consumption closely matches the generated pressure, but not its throughput. Attention is then turned to the regulation of cardiac output and to the arguments advanced by proponents of the ‘left ventricular’ and of the ‘venous return’ models of circulation. Hyperdynamic states occurring in arteriovenous fistulas and congenital heart defects, where communication exists between the systemic and pulmonary circuits at the level of atria or the ventricles, demonstrate that, once the heart is unable to impede the flow of blood, reactive changes occur in the pulmonary and systemic circulations, leading to pulmonary hypertension and Eisenmenger syndrome. Finally, the key points of the nook are summarized in the context of blood as a ‘liquid organ’ with autonomous movement.​

Reviews

“Dr. Furst has commendably reviewed the origin and historical development of the heart-as-a-pump concept and amassed, as well, a very considerable weight of evidence undermining it and supporting an alternative model of the heart as an organ of impedance. This book will be particularly well received by all those who, like myself, experience a growing lack of confidence in the cardiocentric model of circulation. … I recommend this book to all open-minded cardiovascular physiology enthusiasts without reservation … .” (Anthony M. O’Leary, Anesthesiology, Vol. 124 (4), April, 2016)

“With this monograph Branko Furst succeeded to lay a foundation for a new physiology of the cardiovascular system. His excellent overview and presentation of a wide selection of topics is presented with clarity and depth of knowledge. … this book will serve as a basis for a more encompassing, specifically human cardiovascular physiology arising from the evolutionary-biologic model of circulation.” (Original book review in German language, Hans Christoph Kümmell, Der Merkurstab, Vol. 67 (3), 2014)

Authors and Affiliations

  • Department of Anesthesiology, Albany Medical College, Albany, USA

    Branko Furst

About the author

Branko Furst, MD, FFARCSI, graduated from University of Ljubljana Medical School, Slovenia in 1978 and spent a year practicing family medicine. After completing a residency in anesthesiology at various London (UK) hospitals he worked a short time as an emergency room physician, and then continued his career in anesthesiology at Texas Tech University Health Sciences Center in El Paso, Texas.

The author currently holds the position of Associate Professor in Anesthesiology at Albany Medical College, Albany, NY, where his time is shared between clinical work, resident teaching and research.

 

Bibliographic Information

  • Book Title: The Heart and Circulation

  • Book Subtitle: An Integrative Model

  • Authors: Branko Furst

  • DOI: https://doi.org/10.1007/978-1-4471-5277-4

  • Publisher: Springer London

  • eBook Packages: Medicine, Medicine (R0)

  • Copyright Information: Springer-Verlag London 2014

  • Hardcover ISBN: 978-1-4471-5276-7Published: 22 August 2013

  • eBook ISBN: 978-1-4471-5277-4Published: 13 August 2013

  • Edition Number: 1

  • Number of Pages: XXIX, 226

  • Topics: Cardiology

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