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During several decades of this century, the classical physiological studies on the cardiovascular system have greatly improved our knowledge on the function of this system under normal and pathological conditions. This knowledge was the basis of the breakthrough for diagnostic techniques like the Swan-Ganz catheter, coronary arteriography, left and right heart biopsies, and invasive measurements of contractility, as well as therapeutic tools including aortocoronary bypass surgery, percutanous transluminal coronary angioplasty, and a broad field of pharmacological interventions for the whole...

Inotropic stimulation of the myocardium, as well as vasodilation and diuresis as essential principles in the treatment of congestive heart failure have recently met with considerable criticism and reevaluation. It is generally agreed that unloading of the heart, either through vasodilation and/or diuresis, improves the working conditions of the dilated, failing heart. It reduces myocar dial oxygen consumption through reduction of chamber radius and, thereby, wall tension as the major determinants of myocardial oxygen consumption. Inotropic stimulation, quite in contrast, does not conserve...

The myocardium in heart failure: Cellular and subcellular alterations in the failing human myocardium. H. Just Medizinische Universitatsklinik Freiburg i. Br., Innere Medizin III - Kardiologie, FRG The syndrome of heart failure continues to be a major challenge to clinicians and scientists. Incidence and mortality of the disease are high, the patient is disabled, and is permanently threatened by the high morbidity and mortality. The clinician faces a syndrome of complex pathophysiology. Multiple causes or underlying disorders of the heart have to be differentiated from heart failure itself,...

During several decades of this century, the classical physiological studies on the cardiovascular system have greatly improved our knowledge on the function of this system under normal and pathological conditions. This knowledge was the basis of the breakthrough for diagnostic techniques like the Swan-Ganz catheter, coronary arteriography, left and right heart biopsies, and invasive measurements of contractility, as well as therapeutic tools including aortocoronary bypass surgery, percutanous transluminal coronary angioplasty, and a broad field of pharmacological interventions for the whole...