Gross- man Grossman - kardio.hr list 2009 1-2 6a.pdf · Gross-mani autori smatraju da je otponac...

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2009;4(1-2):6.

jetke raste s porastom tlaka, raste s poveÊanjem veliËineπupljine, a smanjuje se s porastom debljine klijetke. Gross-man i autori smatraju da je otponac dilatacije klijetke u po-rastu enddijastoliËkog wall stressa. Porasli enddijastoliËniwall stress oslobaa Ëimbenike u miokardu koji Êe stimuli-rati replikaciju i produæivanje kontraktilnog materijala re-zultirajuÊi u proπirenje πupljine. Porasli peak sistolic wallstress stimulira hipertrofiju paralelnom repliciranju kon-traktilnog materijala u miocitima. To Êe sve imati za poslje-dicu da poveÊanjem πupljine srca raste i posljediËni wallstress.

“I kao πto pretpostavljamo da zrak poput stupa svojomteæinom djeluje odozgo prema dolje, tako i kod tekuÊinamoramo zamisliti stupove od dotiËne tekuÊe tvari, koji se,svaki pojedini svojom osnovicom opiru o jednake dijelovedna one posude koja tekuÊinu sadræava, i odozgo vrπe pri-tisak, pa tako pritiπÊe to dno te svojim jednakim dijelovan-jem izmeu sebe tvore ravnoteæu. A veÊe je djelovanjeodozgo u smislu teæine, koja je veÊas u duæem ili viπemstupu negoli u kraÊem ili niæem, uz pretpostavku da je ri-jeË o istoj debljini.

Srce se kreÊe zbog zraËenja koje mu πalje mozak,zbog zraËenja i utjecaja koji dolaze iz glave kroz æivce po-sredstvom æivËane tekuÊine i titranjem Ëvrstog dijela ovo-jnice bez sudjelovanja tekuÊine.”

Baglivi je bio svjestan teπkog problema otkrivanja tajnizdravlja i bolesti i dugog puta znanstvenika do cilja.

“Kako smo to uËinili do danas, do mjeseca listopada1701. kada ovo piπemo, tako neÊemo ni ubuduÊe prestatidok ovaj teπki predmet posve ne obradimo. Ako se ovo ne-zadovoljnima ne svia dovoljno, izazov je svima pristu-paËan i ostavljena je prigoda da se uËini bolje. Ako se svi-a dobrima i poπtenima, to je nagrada koju æelimo i za svojnapor.

Stoga neka bude tako!”Problem ulaska u veliku tajnu rada srca i srËanih pore-

meÊaja nije ni danas, tristo godina poslije Baglivija, sasvimrijeπen. I put se nastavlja.

geometry. Wall stress of the left ventricle increases with ris-ing pressure, increases with an increase in the cavity size,and decreases with an increase in the ventricle thickness.Grossman et al consider that the trigger of the ventricle di-latation is in increase in the end-diastolic wall stress. Theincreased end-diastolic wall stress releases the factors inthe myocardium which will stimulate the replication andextension of the contractile material resulting in the dilata-tion of the cavity. The increased peak systolic wall stressstimulates the hypertrophy to the parallel replication of thecontractile material in myocytes. All this will result in cau-sing increased consequential wall stress by enlargement ofthe heart cavity.

“And as we may presume that the air just like a columnexerts force with its weight from the top downwards, so wemust also imagine fluids like columns of the respective flu-id, which each by itself presses against equal parts of thebottom of the container holding the liquid, exerting pres-sure from above, and pressing that base thus forming a bal-ance with their equal interaction. Greater force is exertedfrom the top in terms of weight, which is greater in thelonger or the taller column, than it is on the shorter or thelower column presuming that the same thickness is con-cerned.

The heart moves because of the radiation received fromthe brain, because of the radiation and influence receivedfrom the head through the nerves by nervous fluid and theoscillation of the solid part of the coat without the assis-tance of the fluid.”

Baglivi was aware of a difficult problem related with re-vealing the secrets of health and disease and a long jour-ney to reach the scientific target.

“As we learned it until today, until October 1701 as weare writing this, so shall we not stop in the future until wecompletely solve this difficult case. If this is not to the lik-ing of the dissatisfied, the challenge is accessible to every-one and opportunity to do ones best is given. If it is to theliking of good and honest, it is the reward we seek for ourtoils.

So be it!”The problem of disclosing the big secret of the heart

functioning and heart disorders has still not been solved to-day, three hundred years after Baglivi. So the journey con-tinues.

Vijesti News

Received: 1st Dec 2008

E-mail: antun.car@du.htnet.hr

Literature

1. De fibra motrice et morbosa. Prometej, 1997.

2. Sutherland et al. Doppler Myocardial Imaging. Hasselt, Belgium, 2006.

3. Guyton. Medicinska fiziologija. Medicinska knjiga, 2004.

4. Feingebaum H. Echocardiography.

5. Braunwald. Heart Disease.

Simpozij“Bolesti srËanih valvula”Zagreb, 20. veljaËe 2009.

Hrvatski lijeËniËki zbor, Hrvatsko kardioloπko druπtvo (Radnaskupina za bolesti valvula) i Hrvatsko druπtvo za kardiotorakalnukirurgiju i anesteziologiju organiziraju Simpozij BOLESTISR»ANIH VALVULA koji Êe se odræati 20. veljaËe u prostorijamaHrvatskog lijeËniËkog zbora, u ©ubiÊevoj 9 u Zagrebu, s poËet-kom u 9:30 sati. Program simpozija i pristupnicu moæete preuzetina www.kardio.hr.

Symposium “Heart Valve Diseases”

Zagreb, 20th February 2009

Croatian Medical Association, Croatian Cardiac Society (Task

Force for valve diseases) and Croatian Cardiothoracic Surgery

and Anesthesiology Society organize a Symposium “HEART

VALVE DISEASES” to be held on 20th February in the premises of

the Croatian Medical Association, at ©ubiÊeva 9 in Zagreb, com-

mencing at 9:30 o’clock. More info at www.kardio.hr.