Mechanisms of Action in Disease and Recovery in Integrative Cardiovascular Chinese Medicine

Volume 6

Anika Niambi Al-Shura

• Publisher: Academic Press
• Year: 2020
• Print ISBN: 9780128175781
• eBook ISBN: 9780128175798
• Topic: Biological Sciences
• Subtopic: Biology
• Index: Biological Sciences

Mechanisms of Action in Disease and Recovery in Integrative Cardiovascular Chinese Medicine, volume six in the Integrative Cardiovascular Chinese Medicine series, presents the structure, function and pathology of the cardiovascular system from Traditional Chinese and Western Medicine perspectives. Sections discuss cardiac acu-anatomy, including cardiac cells and heart structure, gastrointestinal cells and mouth, esophagus, stomach, small and large intestine structures, and more, while other chapters cover the qi, yin and yang roles in cardiac rhythm and pumping actions and the pathology of the heart and vascular system and the zang and fu relationship with other body organs.This important reference will aid cardiovascular researchers in the study of integrative Chinese and Western medicine with its clear, structured base that will guide clinical practice and encourage collaboration between Chinese and Western medicine practitioners.- Provides evidence for the mainstreaming of acu-meridian theory and pathophysiology- Explores the detailed connection between heart dysfunction and the disease mechanisms of other organ systems- Combines western medicine anatomy and pathophysiology with TCM aspects of essence, qi, blood and body fluid concept, production and function to explain the cardiovascular system dysfunction, it's independent role and dependent interactions with the functions of other organ systems

Part I

Cardiovascular anatomy

Outline

1. 1. Cardiac cells
2. 2. Cardiac structure
3. 3. Cardiovascular system
4. 4. Meridians and acupoints

1: Cardiac cells

Abstract

In integrative cardiovascular Chinese medicine, the study of the mechanisms of action in disease and recovery begins with physiological functioning of cardiac cells. Aerobic energy metabolism includes various cellular energy sources, occurs within the sarcoplasmic reticulum involving ATP dependent calcium transport and Na⁺/K⁺-ATPase, and other energy sources may include be synthesized from macronutrients and ketones. Myocytes include cardiomyocytes and pacemaker cells, they have high density of mitochondria producing ATP for energy and move through the action potential depolarization and repolarization between systolic and diastolic pressure changes. The endothelial cells function to influence vascular tone, control blood pressure, fluid infiltration in the kidneys, permeability, immunity and angiogenesis.

Keywords

ATP; Cardiomycytes; Endothelium; Energy metabolism; Integrative cardiovascular Chinese medicine; Myocytes; Pacemaker cells

Chapter objectives

The objectives of this chapter are:

• 1. To identify cardiac cell energy sources which include ATP and components of metabolized macromolecules
• 2. To identify and describe the basic physiological functions of cardiomyocytes including positive and negative lusitropy
• 3. To describe endothelial cells and their basic roles in cardiovascular health)

Energy metabolism

Cellular energy source:

1. • Cardiac aerobic requirements Mechanisms of Action in Disease and Recovery in Integrative Cardiovascular Chinese Medicine of adenosine triphosphate (ATP) crucial to functioning.
2. • ATP as a primary energy source and O₂ as the puzzle piece necessary for this.
3. • Within the sarcoplasmic reticulum energy is synthesized through ATP-dependent calcium transport and Na⁺/K⁺-ATPase.
4. • Increasing the mechanical activity of the heart by increasing heart rate and contractility increases myocardial metabolism.
5. Other energy sources:
6. • ○ Fatty acids.
   • ○ Carbohydrates: glucose, glycogen.
   • ○ Amino acids.
   • ○ Ketones.

Myocytes

Myocytes are contractile muscle cells that make up the heart muscle:

1. • They include one to four nuclei per cell.
2. • They have high mitochondrial organelle density within the cell that can produce ATP for energy.
3. • Intercalated disks synchronize the contractions of all cardiomyocytes and regulate the passage of positive and negative electrons. As electric currents repel and attract, they cause electron depolarization, which regulates heartbeat contractions.
4. • They pulsate through automaticity where sodium ions enter the cell until it initiates depolarization. Next, the calcium ions enter and extend depolarization until the potassium ions move out slowly to produce repolarization.
5. • Cardiac action potential depolarization and polarization:
6. • A rest phase: systole, separation of the sodium, potassium, and calcium ions.
7. • Active phase: diastole.
8. • Includes two types of cells:
9. • ○ Cardiomyocytes.
   • ○ Cardiac pacemaker cells.
   • ○ Both cells are joined by intercalculated disks for sodium, potassium, and calcium for easy diffusion and exchange so that the heart can function as a single depolarizating and repolarizating unit.

These cells are about 100 μm long and 10–25 μm in diameter and can stretch, lengthen, and shorten fibers to accommodate the pressure gradients of the filling, relaxing, and pumping actions of those chambers.

Cardiac pacemaker cells are distributed throughout the heart. Isolated, one pacemaker cell can pulse on its own. Two independent cells placed together in proximity will pulse together in synchronicity.

Cardiomyocytes continue to develop and replenish around 50% during a lifetime, but at a slower pace than is depleted with less than 50% placed according to these factors:

1. • Response to overuse, as in extensive heavy exercise over time.
2. • Disease response such as in heart failure and myocardial infarction.
3. • In chronic hypertension pressure overload, cardiomyocytes grow through the state of concentric hypertrophy and are wider in diameter, thickening the septum and walls.

Cardiac muscle cells express their functioning because of inotropy, which is the state of an agent causing the weakening or strengthening of the force of muscular contractions. For example, the increased uptake of calcium in myocytes for contractility produces a positive inotropic effect and calcium overload produces negative inotropy. The rate of myocardial relaxation is lusitropy.

Positive lusitropy

1. • Rapid relaxation state of the heart.
2. • Calcium enters the muscle cell and targets the endoplasmic reticulum organelle causing increased rate of relaxation of the muscle cell.
3. • Phosphorylation of phosphola...

Table of contents

• Cover image
• Title page
• Table of Contents
• Copyright
• In Memory
• Dedication
• Preface
• Dr. Al-Shura biography
• Part I. Cardiovascular anatomy
• Part II. Cardiovascular physiology
• Part III. Pathology
• Index