Current Topics in Coronary Research

311 Pages·1973·9.718 MB·English

by  Robert M. Berne, Rafael Rubio (auth.), Colin M. Bloor, Ray A. Olsson (eds.)

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.