Current Topics in Coronary Research PDF
Preview Current Topics in Coronary Research
CURRENT TOPICS IN CORONARY RESEARCH CURRENT TOPICS IN CORONARY RESEARCH Edited by Colin M. Bloor Department of Pathology University of California at San Diego La Jolla, California and Ra y A. Olsson Division of Medicine Walter Reed AmlY Institute of Research Washington, D.C. PLENUM PRESS • NEW YORK -LONDON Lihrary of Congress Catalog ing in Puhlieation Data Symposium on Current Topics in Coronary Resean'h, Walter Reed Army Institute of Research, 1973. Current topies in coronary research. (Advances in experimental medieine and biology, v. 39) Papers presented in honor of Donald E. Gregg at the Symposium on Current Topirs in Coronary Research, held at the Walter Reed Army Institute of Research, Washington, D.C., March 29-30,1973, and sponsored hy the Biotronex Laboratory and the Walter Reed Army Institute of Research. Includes hihliography references. 1. Coronary heart disease-Research-Congresses 1. Bloor, Colin M., ed. II. Olsson, Ray A., ed. III. Gregg, Donald Eaton, 1902- IV. Biotronex Lahoratory. V. United States. Walter Reed Army Institute of Research, Washington, D.C. VI. Title. vn. Series. [DNLM: 1. Coronary disease-Congresses. 2. Coronary vessels-Congresses. 3. Research-Congresses. WG300 C9ge 1973] RC685.C6S92 1973 616.1'23 73-15916 ISBN 978-1-4615-9022-4 ISBN 978-1-4615-9020-0 (eBook) DOI 10.1007/978-1-4615-9020-0 Papers presented in honor of Dr. Donald E. Gregg at the Symposium on Current Topics in Coronary Researeh held at the Walter Reed Army Institute of Researeh, Washington, D.C., Mareh 29-30, 1973, and supported hy Biotronex Laboratory, Ine., Silver S(lring, Maryland © 1973 Plenum Press, New York Softcover reprint ofthe hardcover lst edition 1973 A Division of Plenum Puhlishing Corporation 227 West 17th Street, New York, N.Y. 10011 United Kingdom edition puhlished by Plenum Press, London A Division of Plenum Publishing Company, Ltd. Davis House (4th Floor), 8 Scruhs Lane, Harlesden, London, NWI0 6SE, England AII rights reserved No part of this puhlieation lIIay hc reprodueed in any form without written permission from the puhlisher ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY Editorial Board: Nathan Back Chairman, Department of Biochemical Pharmacology, School of Pharmacy, State University of New York, Buffalo, New York N. R. Di Luzio Chairman, Department 0/ Physiology, Tulane University School of Medicine, New Orleans, Louisiana Alfred Gellhorn University 0/ Pennsylvania Medical School, Philadelphia, Pennsylvania Bernard Halpern College de France, Director of the Institute of Immuno.Biology, Paris, France Ephraim Katchalski Department of Biophysics, The Weizmann Institute of Science, Rehovoth, Israel David Kritchevsky Wistar Institute, Philadelphia, Pennsylvania Abel Lajtha New York State Research Institute for Neurochemistry and Drug Addiction, Ward's Island, New York Rodolfo Paoletti Institute of Pharmacology and Pharmacognosy, University of Milan, Milan, Italy Volume I THE RETICULOENDOTHELIAL SYSTEM AND ATHEROSCLEROSIS Edited by N. R. Di Luzio and R. Paoletti' 1967 Volume 2 PHARMACOLOGY OF HORMONAL POLYPEPTIDES AND PROTEINS Edited by N. Back, L. Martini, and R. Paoletti' 1968 Volume 3 GERM·FREE BIOLOGY: Experimental and Clinical Aspects Edited by E. A. Mirand and N. Back' 1969 Volume 4 DRUGS AFFECTING LIPID METABOLISM Edited by W. L. Holmes, L. A. Carlson, and R. Paoletti' 1969 VolumeS LYMPHATIC TISSUE AND GERMINAL CENTERS IN IMMUNE RESPONSE Edited by L. Fiore·Donati and M. G. Hanna, Jr. • 1969 Volume 6 RED CELL METABOLISM AND FUNCTION Edited by George J. Brewer' 1970 Volume 7 SURFACE CHEMISTRY OF BIOLOGICAL SYSTEMS Edited hy Martin Blank' 1970 Volume 8 BRADYKININ AND RELATED KININS: Cardiovascular, Biochemical, and Neural Actions Edited hy F. Sicuteri, M. Rocha e Silva, and N. Back' 1970 Volume 9 SHOCK: Biochemical, Pharmacological, and Clinical Aspects Edited hy A. Bertelli and N. Back' 1970 Volume 10 THE HUMAN TESTIS Edited hy E. Rosemherg and C. A. Paulsen' 1970 Volume 11 MUSCLE METABOLISM DURING EXERCISE Edited hy B. Pernow and B. Saltin • 1971 Volume 12 MORPHOLOGICAL AND FUNCTIONAL ASPECTS OF IMMUNITY Edited hy K. Lindahl·Kiessling, G. AIm, and M. G. Hanna, Jr. • 1971 Volume 13 CHEMISTRY AND BRAIN DEVELOPMENT Edited by R. Paoletti and A. N. Davison· 1971 Volume 14 MEMBRANE·BOUND ENZYMES Edited by G. Porcellati and F. di Jeso • 1971 Volume 15 THE RETICULOENDOTHELIAL SYSTEM AND IMMUNE PHENOMENA Edited by N. R. Di Luzio and K. Flemming· 1971 Volume 16A THE ARTERY AND THE PROCESS OF ARTERIOSCLEROSIS: Patho!!encsis Edited by Stewart Wolf· 1971 Volume 16B THE ARTERY AND THE PROCESS OF ARTERIOSCLEROSIS: Measurement and Modification Edited by Stewart Wolf· 1971 Volume 17 CONTROL OF RENIN SECRETION Edited by Tatiana A. Assaykeen • 19i2 Volume 18 THE DYNAMICS OF :\fERISTEM CELL POPULATIONS Edited by Morton W. Miller and Charles C. Kuehnert • 1972 Volume 19 SPHINGOLIPIDS, SPHINGOLIPIDOSES AND ALLIED DISORDERS Edited by Bruno W. Volk and Stanley '\1. Aronson· 1972 Volume 20 DRUG ABUSE: Nonmedical Use of Dependence.Producing Drugs Edited hy Simon Btesh· 1972 Volume 21 VASOPEPTIDES: Chemistry, Pharmacolo!!y, and Pathophysiolo!!y Edited hy N. Back and F. Si('uteri • 1972 Volume 22 COMPARATIVE J>ATHOPHYSIOLOGY OF CIRCULATORY DISTURBANCES Edited hy Colin M. Bloor· 1972 Volume 23 THE FUNDAMENTAL MECHANISMS OF SHOCK Edited hy Lerner B. Hinshaw and Barhara G. Cox· 1972 Volume 24 THE VISUAL SYSTEM: Neurophysiology, Biophysics, and Their Clinical Applications Edited hy G. B. Arden· 1972 Volume 25 GLYCOLIPIDS, GLYCOPROTEINS, AND MUCOPOLYSACf:HARIDES OF THE NERVOUS SYSTEM Edited by Vittorio Zamhotti, Guido Tettamanti, and Maria!(razia Arri!!oni • 1972 Volume 26 PHARMACOLOGICAL CONTROL OF LIPID METABOLISM Edited hy William L. Holmes, Rodolfo Paoletti, and David Kritchevsky • 1972 Volume 27 DRUGS AND FETAL DEVELOPMENT Edited by M. A. Klin!(herg, A. Abramovici, and.T. Chemke • 19i3 Volume 28 HEMOGLOBIN AND RED CELL STRUCTURE AND FUNCTION Edited hy George J. Brewer· 1972 Volume 29 :mCROE!,;VIRON'IE:"ITAL ASPECTS OF m,m:\ITY Edited hy Rranislav D. Jankuvic and Katarina I,akovic' 1972 Volume 30 HU'L\~ DEVELOP1\IENT A~D THE THYROID GLA~D: Relation to Endemic CrPlini~1l1 Edited hy J. B. Stanhury and R. L. Kroc • 1972 Volume 31 I,\I~UNITY IN VIRAL AND RICKETTSIAL DISEASES Edited by A. Kohn and M. A. Klingherl(' 1973 Volume 32 FL':"ICTIONAL AND STRUCTURAL PROTEINS OF THE :"iERVOl:S SYSTE'1 Edited by .-\. N. Davison, P. 'lande!. and I. G. 'Ior!(an • 1972 Volume 33 :"IEUROHUMORAL AND 'IETABOLIC ASPECTS OF INJlIHY Edited by A. G. R. KO\"a..!', H. B. Stoner, and J. J. Spitzer' 1972 Volume 34 PLATELET FUNCTIO:"I AND THROMBOSIS: A Review of '\Iethod, Edited by 1'.1\1. Mannu .... i and S. Gorini • 1972 Volume 35 ALCOHOL INTOXICATION AND \\ITHDRA WAL: Experimental Studies Edited by 'fiIton '\1. Gross' 1973 Volume 36 RECEPTORS FOR REPRODL'CTIVE HORMO:"iES Edited hy Bert \\. O"falley and Anthony R. 'leans' 1973 Volume 37A OXYGEN TRA~Sl'ORT TO TISSl'E: Instrumentation, Methods, and Physiology Edited hy Haim I. Richer and J)ualw F. Bruley' 19i3 Volume 3iB OXYGEN TRANSPORT TO TbSUE: Pharmacology, Mathematical Studies, and Neonatology Edited by Duane F. Bruley and Haim I. Bicher • 1<17:1 Volume 38 HUMA~ HYl'ERLIPOPROTEI~E,\IIAS: Prindples and .'\lethuds Edited by R. FumagaIli, G. Rieci, and S. Gorini • 1973 \"olunll> 39 Ct:RHENT TOPICS IN CORONARY RESEARCH Edill>£i hy Colin :\1. B1uor and Ray A. Olssun • 197:1 Volume 40 METAL IONS IN BIOLOGICAL SYSTEMS: Studies of Some Biochemical and Environmental Problems Edited by Sanat K. Dhar • 1973 Volume 41A PURINE METABOLISM IN MAN: Enzymes and Metabolic Pathways Edited by O. Sperling, A. De Vries, and J. B. Wyngaarden • 1973 Volume 41B PURINE METABOLISM IN MAN: Biuchemistry and Pharmacology of Uric Acid Metabolism Edited by O. Sperling, A. De Vries, .and J. B. Wyngaarden • 1973 FOREWORD How can you adequately honor a man of deeds with mere words? Dr. Donald Eaton Gregg is recognized throughout the scientific world for his distinguished contributions to our knowledge of the coronary circulation, his advances in experimental instrumentation and design, his scientific integrity and his lasting influence on other investigators. His research associates over the years are now liberally scattered over the entire world. Their accomplishments and activities reflect the quality of their training in his Department of Cardiorespiratory Diseases at the Walter Reed Army Institute of Research. The positions of prestige occupied by these men attest to Dr. Gregg's ability to select and inspire men of talent, yet in his usual modest way he insists that he was only fortunate to be in the right place at the right time. Thus, at the time of Dr. Gregg's retirement as Chief of the Department of Cardiorespiratory Diseases, a position he has held since 1950, his associates thought that a scientific symposium was the most appropriate way to honor a man of his stature. Accordingly, on March 29-30, 1973 a Symposium on Current Topics in Coronary Research was held at the Walter Reed Army Institute of Research. Its objectives were to define our present state of knowl edge and, more importantly, define the basic questions requiring further experimentation in four major areas of coronary research, i.e., metabolic control of coronary blood flow, transmural myocardial flow gradients, coronary collateral circulation and clinical prob lems in aortico-coronary bypass surgery. The symposium participants were either research associates, former and present, of Dr. Gregg or recognized investigators with unusual expertise in the problem areas being discussed. Not only were the research achievements clearly presented, but also the relaxed tenor of this small conference encouraged frank discussion and an interchange that is uncommon at conventional gatherings. We want to express our sincere appreciation to the Symposium chairman, Dr. David C. Sabiston, for stimulating healthy debate while presiding at the sessions. vii viii FOREWORD This volume contains the presented papers and their discussions at the Symposium. Because it is a statement of progress in rapidly moving areas of research, its usefulness to other investigators depends on rapid publication. To achieve this, the papers and discussion received minimal editing. Although one may not agree with all the opinions expressed herein, the editors' and partici pants' consensus is that these viewpoints are all worthy of con sideration and further experimental test. We are also greatly indebted to several individuals whose co operation made the rapid publication of this volume possible - to Hrs. Jeanne Hanks for her careful and intelligent handling of the laborious stenography to }lr. Joseph L. McGuire, President, Biotronex Laboratory, Inc. for his generous support of the symposium and the prepara tion of this volume to the editors of Plenum Press for their splendid work and assistance in publishing this volume and particularly for their permission to include the discussion of the papers since this was a vital part of the proceedings. Colin N. Bloor Ray A. Olsson PARTICIPANTS SYHPOS Iillf SPONSOR: Biotronex Laboratory, Inc., Silver Spring, Haryland, Joseph P. ~1cGuire, President Walter Reed Army Institute of Research, Washington, D.C. SYMPOSIUM CHAIRMAN: D. C. Sabiston, Department of Surgery, Duke University, Durham, North Carolina PARTICIPANTS: G. Baroldi, Instituto de Anatomica E. Istologia Patologica, Hilano, Italy E. Bassenge, Physiologisches Institut, Universitat Munchen, Munchen, German Federal Republic R. M. Berne, Department of Physiology, University of Virginia, Charlottesville, Virginia C. M. Bloor, Department of Pathology, University of California, San Diego, La Jolla, California G. Buckberg, Department of Surgery, University of California at Los Angeles, Los Angeles, California J. Coffman, Department of Hedicine, Boston University, Boston, l1assachusetts R. D. Coye, School of Medicine, Wayne State University, Detroit, Hichigan R. W. Eckstein, University Hospitals, Case-Western Reserve University, Cleveland, Ohio E. C. Elliot, Department of Cardiorespiratory Diseases, Walter Reed Army Institute of Research, Washington, D.C. T. B. Ferguson, Department of Thoracic and Cardiovascular Surgery, Washington University, St. Louis, Missouri L. C. Fisher, Stamford Medical Group, Stamford, Connecticut H. K. Gentry, Department of Cardiorespiratory Diseases, Walter Reed Army Institute of Research ix x PARTICIPANTS S. R. Gilford, Gilford Instrument Laboratories, Inc., Oberlin, Ohio R. Gorlin, Department of Medicine, Peter Bent Brigham Hospital, Boston, Massachusetts D. E. Gregg, Department of Cardiorespiratory Diseases, Walter Reed Army Institute of Research, Washington, D.C. R. J. Hall, Texas Heart Institute, Houston, Texas C. R. Honig, Department of Physiology, University of Rochester, Rochester, New York A. Huvos, Department of Medicine, Faulkner Hospital, Boston, Hassachusetts E. E. Joyce, Ophthalmology, Coral Gables, Florida R. Kadatz, Abt. Biologische Forschung, Dr. Karl Thomas Gmb H., Biberach an der Riss, German Federal Republic A. A. Kattus, Department of Medicine, University of California at Los Angeles, Los Angeles, California D. T. Kelly, Department of Medicine, Johns Hopkins University, Baltimore, Maryland E. Khouri, Department of Cardiorespiratory Diseases, Walter Reed Army Institute of Research, Washington, D.C. A. S. Leon, Department of Clinical Pharmacology, Hoffmann-La Roche, Nutley, New Jersey F. H. Longino, Pitt Surgical Associates, Inc., Greenville, North Carolina W. P. HcKeever, Wilmette, Illinois J. B. Harsh, Department of Biochemistry, University of Pennsylvania, Philadelphia, Pennsylvania F. R. Hautz, Chardon, Ohio T. W. Noir, Department of Hedicine, Case Western Reserve University, Cleveland, Ohio G. G. Nahas, Department of Anesthesiology, Columbia University, New York, New York R. Patterson, Department of Cardiorespiratory Diseases, Walter R~ec Army Institute of Research, Washington, D.C. B. Pitt, Department of Medicine, Johns Hopkins University, Baltimore, Maryland W. Pritchard, Department of Hedicine, Case Western Reserve University, Cleveland, Ohio C. Rayford, Washington, D.C. R. Ross, Department of Hedicine, Johns Hopkins University, Baltimore, Naryland W. Schaper, Institute of Experimental Cardiology, Hax-Planck Gesselschaft, Bad Nauheim, German Federal Republic J. Shaw, Department of Hedicine, Johns Hopkins University, Baltimore, Naryland J. A. Snow, Department of Cardiology, Veterans Administration Hospital, Washington, D.C. A. S. Wechsler, Department of Surgery, Duke University, Durham, North Carolina H. H. Williams, Jr., Department of Hedicine, Yeshiva University, Bronx, New York H. L. Wray, Department of Cardiorespiratory Diseases, Walter Reed Army Institute of Research, Washington, D.C.
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