Autonomous Movement of the Blood
This Webinar was given on April 14, 2020
A paradigm shift in the understanding of heart and circulation.
The question whether the heart or the peripheral circulation is the main determinant of ‘cardiac output’ continues to be subject of a spirited debate amongst clinicians and cardiovascular physiologists. It is based on the assumption that the heart, a hollow muscular organ equipped with valves, impels the blood through the systemic and pulmonary circuits. This long-standing controversy over the nature of the heart’s function can be resolved by adopting the phenomenon-based, evolutionary model of circulation. The model shows that the movement of blood is primary, originating at the level of the peripheral circulation. The flow exists before the heart is functionally mature and is intricately linked to the metabolic demands of the tissues. The pressure in the vessels is a secondary phenomenon resulting from the rhythmic interruption of blood flow by the heart in combination with the dynamic response of the peripheral vasculature. The heart functions as an organ of restraint, generating pressure, but not flow. The validity of the evolutionary, hemocentric (as opposed to cardiocentric) model of circulation will be supported by examples from embryology, comparative anatomy and clinical scenarios.
The notion of the ‘heart-as-a-pump’ is at the core of the Cartesian, reductionist view of the human being which assumes that lifeless physical and chemical processes active in outer nature simply continue within the living. It will be argued that the cardiovascular system should be viewed as a multidimensional structure at four levels of organization, namely the physical, life, soul and specifically human. The importance of the proposed model therefore goes well beyond a mere academic discussion; in addition to resolving the ongoing debate, such a human-centered approach sets physiology on a firm epistemological ground and opens the door for new directions in biological research.
Conventional, pressure-driven (cardiocentric) and Biological (hemocentric) models of circulation
The notion that the heart is a pump providing the motive force to the blood, an inert fluid is as old as the discovery of the circulation by William Harvey. Clinical practice and an increasing number of circulatory phenomena, however, speak against this simplistic model of circulation.
The purpose of this webinar is to demonstrate by examples from clinical and basic sciences that, in fact, the opposite is the case, namely, that the blood possesses autonomous movement and the heart functions as an organ of restraint, rhythmically interrupting the flow of blood.
ABOUT THE PRESENTER
Branko Furst, MD, FFARCSI
Dr. Furst is a graduate of the University of Ljubljana Medical School, Slovenia and completed residency in anesthesiology in Portsmouth and London, UK. The pursuit of an academic career took him to the US where he joined the faculty at the department of Anesthesiology at Texas Tech University Medical School in El Paso, Texas. His research interest includes cardiovascular physiology, mechanisms of general anesthesia and philosophy of science. He has authored several articles and a monograph The Heart and Circulation – An Integrative Model, currently in its second edition. The German translation of the new edition will be published by Salumed Verlag in spring of 2020. Dr. Furst has lectured on various aspects of the circulation in the US and Europe. Currently he is Professor of Anesthesiology at Albany Medical College, Albany, NY and divides his time between clinical work, research, and resident education.
ABOUT THE HOST
Anne Nicholson is the Program Director at CFAE. She is an Anthropologist and an Educator of Embodied Mindfulness and Experiential Learning. Her 20-year career has been in Technology and Communications. She is living and working in Silicon Valley.