Heart Physiology From Cell to Circulation, 4th ed.
Lionel H. Opie, MD
640 pp. Baltimore, Md: Lippincott Williams & Wilkins; 2003. $99.00. ISBN 0-7817-4278-1
Many excellent basic cardiovascular science and clinical cardiology texts are available to help the academic or practicing cardiologist keep abreast of the rapid developments in these areas. Few, however, combine a lucid and up-to-date description of new and established findings in laboratory research with an informed discussion of their clinical relevance to the pathophysiology and treatment of cardiac disease. This new edition of Dr Opie’s highly regarded book does this extremely well, as indicated in the Forewords written by Dr Eugene Braunwald, a distinguished clinical scientist, and by Dr Arnold Katz, an outstanding basic cardiovascular scientist.
The book is organized into 6 sections, all authored by Dr Opie, who provides excellent continuity, with assistance from 8 distinguished collaborating authors who provide additional expertise in specific areas. The sections are “Basic Cardiovascular Physiology,” “Electrophysiology and Electrocardiogram,” “Calcium and Contraction: Receptors and Signals,” “The Heart,” “The Circulation,” and “Pathophysiology.” Each section has several chapters. All chapters are notable for numerous clear illustrations and figures; excellent, up-to-date references; and questions at the end of each chapter directed at the level of the medical student or cardiology fellow. Several particularly impressive examples should be mentioned, including “Channels, Pumps, and Exchangers” by Dr Opie. This chapter provides an excellent description of the structure and function of the important voltage- and ligand-gated ion channels in cardiac myocytes, a knowledge of which is essential for understanding the cellular basis for the inherited arrhythmias, such as those associated with a long-QT interval. The chapter “Pacemakers, Conduction System, and Electrocardiogram” by Drs Opie and Downey provides a clear description of the biophysics of generation of body surface potentials from electrical activity of the heart and how the changes in the 12-lead ECG during ischemia and infarction and in hypertrophy and bundle-branch block are produced. In “Excitation-Contraction Coupling and Calcium,” Drs Opie and Bers present a comprehensive discussion of the molecular events involved in myocyte calcium ion homeostasis and their alterations in heart failure and arrhythmias. “Myocardial Contraction and Relaxation” by Drs Opie and Solaro is a beautifully illustrated and current description of the molecular organization and function of the contractile elements, including mutations responsible for inherited cardiomyopathies, and molecular effects of ischemia that influence force development.
I am continually amazed (and disappointed) by how much of clinically relevant cardiovascular physiology and pathophysiology, learned when they were 1st- and 2nd-year medical students, has been forgotten by our medical residents by the time they start their cardiology fellowship. I believe this book should be required reading for 1st-year cardiology fellows and will be very useful as well to the established cardiologist wishing to maintain a current knowledge base in cardiovascular science that is relevant to their practice.