Cardiovascular System Dynamics Edited by J. Baan, A. Noordergraaf, and J. Raines (review)

BOOK REVIEWS Cardiovascular System Dynamics. Edited by J. Baan, A. Noordergraaf, and J. Raines. Cambridge, Mass.: M.LT. Press, 1978. Pp. 618. $70.00. This volume contains the proceedings of the International Conference on Cardiovascular System Dynamics, held April 6-10, 1975. "Cardiovascular system dynamics" is the argot for the multidisciplinary study of the cardiovascular system . The editors attribute, probably correctly, the current state of our asymmetrical understanding of the cardiovascular system to "the pressures of fashion and as a consequence of particularly vigorous or successful leadership. . . . Unavoidably , this has resulted in strongly diverging levels of understanding for different aspects of the system." They also rue the fact that investigators "pursue their own interests, even within subspecialties, rather than work in an integrated fashion." They argue, "the prevalence of cardiovascular disease and the poor level of insight into the cardiovascular system operation mandate reorientation and appropriate action." The conference is the beginning of the Manhattan Project to deal with this unregulated state of affairs, in which "workers with different goals and different viewpoints must be brought together to ensure the pursuit of realistic, down to earth efficient approaches." The coverleaf amplifies this pretentiousness, when it describes this conference as marking "the coming of age of this field" and leading to the founding of the Cardiovascular System Dynamics Society (one of the editors is its first president ). It then alludes to the bringing together of outstanding researchers in the life sciences and physical sciences "in order to integrate their findings more intricately. . . ." They have succeeded. Despite these distractions, the primary purpose of integrating ideas cannot be faulted, and the editors have worked hard to accomplish this. In this they had help. The individual contributions in this text are generally well done. While orchestration of what is unregulated can never be harmonious, the individual artists, isolated in their effort, prove worthy to their task and talent. Creativity remains a lonely, solo act. It was. It is. It will be. This text is testimony to this. It is a 62-chapter compilation of the research efforts of the participants, which collectively provides an understanding of the control of the cardiovascular system and some of its clinical implications, as of 1975. For example, in the first section, the mechanics of myocardial and skeletal muscle sarcomers are described along classical lines, followed by a new theory of the molecular mechanism of muscle contraction and an attempted application of these principles to clinical heart disease. The other 1 1 sections Permission to reprint a book review printed in this section may be obtained only from the author. Perspectives in Biology and Medicine ¦ Summer 1979 | 621 are handled in similar fashion and concern the coronary circulation, ventricular dynamics, the arterial system, the microcirculation, the venous system, pulmonary vasculature, control mechanisms in specific vascular beds, overall cardiovascular system control, theoretical and experimental methods applied to the cardiovascular system, and, finally, cardiovascular instrumentation and computer analysis. In all, a tour de force reference work, from the laboratory bench to the bedside. One is tempted to compare this effort with the Handbook ofPhysiology, circulation series, published several years ago by the American Physiological Society. But the present text is not a series of review articles; rather, it is a presentation of the recent work of these investigators, previously presented in the main elsewhere. This format served the purpose ofbringing their work up to date and allowed for some speculative considerations. Those interested in these areas of study and future investigators need not fear that all problems have been solved or included here. One area which this reviewer would have wished included is the role of the central nervous system's control of the cardiovascular system. Is it not time that symposia, dedicated to integration, include this still-developing area? In the index, under brain stem, there is one page reference; under brain, of the seven indexed items, none deal with the brain's control of the cardiovascular system. One also laments the paucity of biochemical studies in the heavy emphasis on hemodynamics. Is the cardiovascular system merely a plumbing arrangement? Aside from the coverleaf's goal of making things more "intricate" and the figure inversions, as in figure 14 to...