Composition of common potassium-based cardioplegic solutions.
\\n\\n
IntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
\\n\\nIntechOpen Book Series will be launching regularly to offer our authors and editors exciting opportunities to publish their research Open Access. We will begin by relaunching some of our existing Book Series in this innovative book format, and will expand in 2022 into rapidly growing research fields that are driving and advancing society.
\\n\\nLaunching 2021
\\n\\nArtificial Intelligence, ISSN 2633-1403
\\n\\nVeterinary Medicine and Science, ISSN 2632-0517
\\n\\nBiochemistry, ISSN 2632-0983
\\n\\nBiomedical Engineering, ISSN 2631-5343
\\n\\nInfectious Diseases, ISSN 2631-6188
\\n\\nPhysiology (Coming Soon)
\\n\\nDentistry (Coming Soon)
\\n\\nWe invite you to explore our IntechOpen Book Series, find the right publishing program for you and reach your desired audience in record time.
\\n\\nNote: Edited in October 2021
\\n"}]',published:!0,mainMedia:{caption:"",originalUrl:"/media/original/132"}},components:[{type:"htmlEditorComponent",content:'With the desire to make book publishing more relevant for the digital age and offer innovative Open Access publishing options, we are thrilled to announce the launch of our new publishing format: IntechOpen Book Series.
\n\nDesigned to cover fast-moving research fields in rapidly expanding areas, our Book Series feature a Topic structure allowing us to present the most relevant sub-disciplines. Book Series are headed by Series Editors, and a team of Topic Editors supported by international Editorial Board members. Topics are always open for submissions, with an Annual Volume published each calendar year.
\n\nAfter a robust peer-review process, accepted works are published quickly, thanks to Online First, ensuring research is made available to the scientific community without delay.
\n\nOur innovative Book Series format brings you:
\n\nIntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
\n\nIntechOpen Book Series will be launching regularly to offer our authors and editors exciting opportunities to publish their research Open Access. We will begin by relaunching some of our existing Book Series in this innovative book format, and will expand in 2022 into rapidly growing research fields that are driving and advancing society.
\n\nLaunching 2021
\n\nArtificial Intelligence, ISSN 2633-1403
\n\nVeterinary Medicine and Science, ISSN 2632-0517
\n\nBiochemistry, ISSN 2632-0983
\n\nBiomedical Engineering, ISSN 2631-5343
\n\nInfectious Diseases, ISSN 2631-6188
\n\nPhysiology (Coming Soon)
\n\nDentistry (Coming Soon)
\n\nWe invite you to explore our IntechOpen Book Series, find the right publishing program for you and reach your desired audience in record time.
\n\nNote: Edited in October 2021
\n'}],latestNews:[{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"7614",leadTitle:null,fullTitle:"Fourier Transforms - Century of Digitalization and Increasing Expectations",title:"Fourier Transforms",subtitle:"Century of Digitalization and Increasing Expectations",reviewType:"peer-reviewed",abstract:"The 21st century ushered in a new era of technology that has been reshaping everyday life, simplifying outdated processes, and even giving rise to entirely new business sectors. Today, contemporary users of products and services expect more and more personalized products and services that can meet their unique needs. In that sense, it is necessary to further develop existing methods, adapt them to new applications, or even discover new methods. This book provides a thorough review of some methods that have an increasing impact on humanity today and that can solve different types of problems even in specific industries. Upgrading with Fourier Transformation gives a different meaning to these methods that support the development of new technologies and have a good projected acceleration in the future.",isbn:"978-1-78984-204-3",printIsbn:"978-1-78984-203-6",pdfIsbn:"978-1-78985-340-7",doi:"10.5772/intechopen.77416",price:119,priceEur:129,priceUsd:155,slug:"fourier-transforms-century-of-digitalization-and-increasing-expectations",numberOfPages:160,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"ff3501657ae983a3b42fef1f7058ac91",bookSignature:"Goran S. Nikoli? and Dragana Z. Markovi?-Nikoli?",publishedDate:"December 4th 2019",coverURL:"https://cdn.intechopen.com/books/images_new/7614.jpg",numberOfDownloads:7738,numberOfWosCitations:2,numberOfCrossrefCitations:4,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:6,numberOfDimensionsCitationsByBook:0,hasAltmetrics:0,numberOfTotalCitations:12,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"September 19th 2018",dateEndSecondStepPublish:"November 6th 2018",dateEndThirdStepPublish:"January 5th 2019",dateEndFourthStepPublish:"March 26th 2019",dateEndFifthStepPublish:"May 25th 2019",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,7",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"23261",title:"Prof.",name:"Goran",middleName:"S.",surname:"Nikolic",slug:"goran-nikolic",fullName:"Goran Nikolic",profilePictureURL:"https://mts.intechopen.com/storage/users/23261/images/system/23261.jpg",biography:"Dr. Goran Nikolić was born in Knez Selo (Niš, Serbia) on 1 November 1966. He received his B.Sc. degree in Chemistry (1990), M.Sc. degree in Organic Chemical Technology and Polymer Engineering (1996), and finally his PhD degree in Chemical Engineering (2002) from the University of Niš. Currently, he is a full professor at the same university, on Pharmaceutical-cosmetic engineering group of subjects at Faculty of Technology in Leskovac. His research activities are: quality control and stability of drugs, development of new pharmaceutical products (antianemic, antiseptic), pharmaceutical ingredients (synthesis and characterization), polynuclear and biocomplexes, surfactants. His competences are experience: in team work as a researcher, in project management, and managing of academic institution at different levels (vice dean, department chairman, head of chromatographic and spectrosopic laboratories, president of the quality assurance at the Faculty, and a member of the Committee for the improvement of the quality of the University). He is a member of the several national projects in the technological development area (granted by the Ministry of Science and Technological Development, Republic of Serbia), and member of numerous TEMPUS Joint European projects of sustainable technologies, environmental application and management courses (JPHES 2013, JPHES 2010, MCHEM 2010, IB-JEP 19020). He is a member of Serbian Chemical Society and Physicochemical Association of Serbia, and member of the Editorial Board of the journal Advanced Technologies. He has authored more than 300 scientific papers (in international and national scientific journals, on international conferences), numerous technological solutions for pharmaceutical industry, national monographies, international patents, university textbooks, invitation lecturers. He is the referee in numerous international and national journals, and editor of two international monographs on FTIR spectroscopy (InTech Open).",institutionString:"University of Niš",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"4",institution:{name:"University of Nis",institutionURL:null,country:{name:"Serbia"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:{id:"195523",title:"MSc.",name:"Dragana",middleName:null,surname:"Marković-Nikolić",slug:"dragana-markovic-nikolic",fullName:"Dragana Marković-Nikolić",profilePictureURL:"https://mts.intechopen.com/storage/users/195523/images/system/195523.png",biography:"Dr. Dragana Z. Marković-Nikolić was born on 28 December 1982 in Leskovac (Serbia). She completed her studies at the Faculty of Technology in Leskovac, University of Niš (2007). She recived her PhD degree in Applied Chemistry from the University of Niš (2018). She was elected as a teaching assistant at the High Technologically Artistic Professional School in Leskovac (2011), where she is still working. She is intensively engaged in scientific research in the field of ecological engineering. She published her research results in numerous scientific journals and presented at scientific meetings. She is the author of several technological solutions for industry, practical textbooks and book chapters. As an expert associate (2016), she acquired practical knowledge and skills for the application of contemporary instrumental and analytical methods, as well as skills for scientific research in the field of ecological engineering. She participated in the realization of TEMPUS project titled \\Creation of University-Enterprise Cooperation for Education on Sustainable Technologies\\. She is a member of the Chemical Society of Serbia.",institutionString:"University of Niš",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"0",institution:null},coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"1407",title:"Applied Mathematics",slug:"numerical-analysis-and-scientific-computing-applied-mathematics"}],chapters:[{id:"65719",title:"The Discrete Hankel Transform",doi:"10.5772/intechopen.84399",slug:"the-discrete-hankel-transform",totalDownloads:1219,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"The Hankel transform is an integral transform and is also known as the Fourier-Bessel transform. Until recently, there was no established discrete version of the transform that observed the same sort of relationship to its continuous counterpart as the discrete Fourier transform does to the continuous Fourier transform. Previous definitions of a discrete Hankel transform (DHT) only focused on methods to approximate the integrals of the continuous Hankel integral transform. Recently published work has remedied this and this chapter presents this theory. Specifically, this chapter presents a theory of a DHT that is shown to arise from a discretization scheme based on the theory of Fourier-Bessel expansions. The standard set of shift, modulation, multiplication, and convolution rules are shown. In addition to being a discrete transform in its own right, this DHT can approximate the continuous forward and inverse Hankel transform.",signatures:"Natalie Baddour",downloadPdfUrl:"/chapter/pdf-download/65719",previewPdfUrl:"/chapter/pdf-preview/65719",authors:[{id:"62384",title:"Dr.",name:"Natalie",surname:"Baddour",slug:"natalie-baddour",fullName:"Natalie Baddour"}],corrections:null},{id:"66912",title:"Fourier Transforms for Generalized Fredholm Equations",doi:"10.5772/intechopen.85993",slug:"fourier-transforms-for-generalized-fredholm-equations",totalDownloads:740,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"In this chapter we take the conventional Fredholm integral equations as a guideline to define a broad class of equations we name generalized Fredholm equations with a larger scope of applications. We show first that these new kind of equations are really vector-integral equations with the same properties but with redefined and also enlarged elements in its structure replacing the old traditional concepts like in the case of the source or inhomogeneous term with the generalized source useful for describing the electromagnetic wave propagation. Then we can apply a Fourier transform to the new equations in order to obtain matrix equations to both types, inhomogeneous and homogeneous generalized Fredholm equations. Meanwhile, we discover new properties of the field we can describe with this new technology, that is, mean; we recognize that the old concept of nuclear resonances is present in the new equations and reinterpreted as the brake of the confinement of the electromagnetic field. It is important to say that some segments involving mathematical details of our present work were published somewhere by us, as part of independent researches with different specific goals, and we recall them as a tool to give a sound support of the Fourier transforms.",signatures:"Juan Manuel Velazquez Arcos, Ricardo Teodoro Paez Hernandez, Alejandro Perez Ricardez and Jaime Granados Samaniego",downloadPdfUrl:"/chapter/pdf-download/66912",previewPdfUrl:"/chapter/pdf-preview/66912",authors:[{id:"96912",title:"Dr.",name:"Ricardo Teodoro",surname:"Paez Hernandez",slug:"ricardo-teodoro-paez-hernandez",fullName:"Ricardo Teodoro Paez Hernandez"},{id:"114776",title:"Dr.",name:"Juan Manuel",surname:"Velazquez Arcos",slug:"juan-manuel-velazquez-arcos",fullName:"Juan Manuel Velazquez Arcos"},{id:"179014",title:"MSc.",name:"Jaime",surname:"Granados Samaniego",slug:"jaime-granados-samaniego",fullName:"Jaime Granados Samaniego"},{id:"301091",title:"Dr.",name:"Alejandro",surname:"Perez Ricardez",slug:"alejandro-perez-ricardez",fullName:"Alejandro Perez Ricardez"}],corrections:null},{id:"66329",title:"The RR Interval Spectrum, the ECG Signal, and Aliasing",doi:"10.5772/intechopen.85327",slug:"the-rr-interval-spectrum-the-ecg-signal-and-aliasing",totalDownloads:960,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"We discuss the relationship between the RR interval spectral analysis and the spectral analysis of the corresponding ECG signal from which the RR intervals were evaluated. The ECG signal spectrum is bounded below the frequency fB by using an electronic filter and sampled at rate larger than 2fB, thus excluding aliasing from spectral analysis. A similar procedure cannot be applied to the RR interval spectral analysis, and in this case aliasing is possible. One of our main efforts in this chapter is devoted to the problem of how to detect aliasing in the heart rate spectral analysis. In order to get an insight, we performed an experiment with an adult man, in which the ECG signal was detected in a case where the breathing rate was larger than half the heart rate. A constant breathing rate for time intervals exceeding 5 minutes was monitored with good accuracy using a special breathing procedure. The results show distinctively a very sharp peak in the spectral analysis of the ECG signal, and corresponding (diffused) aliasing peaks in the RR interval spectral analysis. A new method of dealing with unevenly sampled data was developed, which has interesting anti-aliasing properties. There are indications that the VLF peaks of the RR spectrum are originated by aliasing. Some of the LF peaks may have the same property. The chapter is fully based on the preprint arXiv:physics/9911017, submitted on 11 Nov 1999, by authors A. Gersten, O. Gersten, A. Ronen, and Y. Cassuto.",signatures:"Alexander Gersten, Ori Gersten, Adi Ronen and Yair Cassuto",downloadPdfUrl:"/chapter/pdf-download/66329",previewPdfUrl:"/chapter/pdf-preview/66329",authors:[{id:"128591",title:"Prof.",name:"Alexander",surname:"Gersten",slug:"alexander-gersten",fullName:"Alexander Gersten"}],corrections:null},{id:"66464",title:"Directional Denoising Using Fourier Spectrum Cloning",doi:"10.5772/intechopen.85519",slug:"directional-denoising-using-fourier-spectrum-cloning",totalDownloads:961,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Fourier filtering for image denoising consists in masking parts of the Fourier spectrum of an image and using inverse Fourier transform of the masked image to obtain the denoised one. In cases of directional noise, this process can induce artifacts, mainly because of the spatial coherence that exists in the theoretical noise-free image. Moreover, it can lead to loss of low-frequency content that is important in applications such as fringe projection technique, which aims at measuring 3D elevations of a surface. A method based on the principle of Fourier spectrum cloning for the denoising of images is proposed in this chapter. This method improves the PSNR and the SSIM ratio in comparison with spectrum masking denoising. The method will be detailed first, and then examples of image denoising in two different applications will be presented.",signatures:"Laurent Navarro and Jérôme Molimard",downloadPdfUrl:"/chapter/pdf-download/66464",previewPdfUrl:"/chapter/pdf-preview/66464",authors:[{id:"53776",title:"Dr.",name:"Laurent",surname:"Navarro",slug:"laurent-navarro",fullName:"Laurent Navarro"},{id:"295452",title:"Prof.",name:"Jérôme",surname:"Molimard",slug:"jerome-molimard",fullName:"Jérôme Molimard"}],corrections:null},{id:"66652",title:"Analysis of Financial Time Series in Frequency Domain Using Neural Networks",doi:"10.5772/intechopen.85885",slug:"analysis-of-financial-time-series-in-frequency-domain-using-neural-networks",totalDownloads:1564,totalCrossrefCites:2,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Developing new methods for forecasting of time series and application of existing techniques in different areas represents a permanent concern for both researchers and companies that are interested to gain competitive advantages. Financial market analysis is an important thing for investors who invest money on the market and want some kind of security in multiplying their investment. Between the existing techniques, artificial neural networks have proven to be very good in predicting financial market performance. In this chapter, for time series analysis and forecasting of specific values, nonlinear autoregressive exogenous (NARX) neural network is used. As an input to the network, both data in time domain and those in the frequency domain obtained using the Fourier transform are used. After the experiment was performed, the results were compared to determine the potentially best time series for predicting, as well as the convenience of the domain in which better results are obtained.",signatures:"Stefan Nikolić and Goran Nikolić",downloadPdfUrl:"/chapter/pdf-download/66652",previewPdfUrl:"/chapter/pdf-preview/66652",authors:[{id:"23261",title:"Prof.",name:"Goran",surname:"Nikolic",slug:"goran-nikolic",fullName:"Goran Nikolic"},{id:"280401",title:"B.Sc.",name:"Stefan",surname:"Nikolić",slug:"stefan-nikolic",fullName:"Stefan Nikolić"}],corrections:null},{id:"66006",title:"Fourier Transform in Ultrafast Spectroscopy",doi:"10.5772/intechopen.84897",slug:"fourier-transform-in-ultrafast-spectroscopy",totalDownloads:978,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Laser technology allows to generate femtoseconds-long pulses of light. These light pulses can be used to learn about the molecules with which they interact. Consequently, pulsed laser spectroscopy has become an important tool for investigating and characterizing electronic and nuclear structure of protein complexes. These spectroscopic techniques can either be performed in the time or frequency domain. Both the time and frequency domain are linked by Fourier Transform (FT) and thus, FT plays a central role in optical spectroscopy. Ultimately, FT is used to explain how light behaves. It is used to explain spectroscopic techniques and enables the development of new techniques. Finally, FT is used to process and analyze data. This chapter thus illustrates the centrality of FT in ultrafast optical spectroscopy.",signatures:"Adrien A.P. Chauvet",downloadPdfUrl:"/chapter/pdf-download/66006",previewPdfUrl:"/chapter/pdf-preview/66006",authors:[{id:"177016",title:"Dr.",name:"Adrien",surname:"Chauvet",slug:"adrien-chauvet",fullName:"Adrien Chauvet"}],corrections:null},{id:"69339",title:"Establishment of FTIR Database of Roselle Raw Material Originated From Western Coastline in Peninsular Malaysia",doi:"10.5772/intechopen.84837",slug:"establishment-of-ftir-database-of-roselle-raw-material-originated-from-western-coastline-in-peninsul",totalDownloads:501,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Herbs from different geographical regions may differ qualitatively and quantitatively, hence it is crucial to determine the active components of herbs from different regions and build a reference database. This study focused on the database establishment for the authentication of the raw material of roselle (Hibiscus sabdariffa) collected at seven selected locations of the western coastline in Peninsular Malaysia. The validation on the unknown sample at the end of the study is to verify the accuracy of the established database. The inter-material distance (IMD) was presented as the mean distance of each sphere created by each batch of data from different locations. They were clustered with different folders and discriminated by Soft independent modelling by class analogy (SIMCA) algorithm. All materials from seven farms achieved 100% separation rate. The average IMD of these seven locations was 9.04. The FTIR techniques established in this study can be used to distinguish the geographical origin of the selected H. sabdariffa farm samples.",signatures:"Choong Yew Keong, Nor Syaidatul Akmal Mohd Yousof, Jamia Azdina Jamal and Mohd Isa Wasiman",downloadPdfUrl:"/chapter/pdf-download/69339",previewPdfUrl:"/chapter/pdf-preview/69339",authors:[{id:"171079",title:"Dr.",name:"Yew Keong",surname:"Choong",slug:"yew-keong-choong",fullName:"Yew Keong Choong"}],corrections:null},{id:"67344",title:"Application of Fourier Analysis of Cerebral Glucose Metabolism in Color-Induced Long-Term Potentiation: A Novel Functional PET Spectroscopy (fPETS) Study in Mice",doi:"10.5772/intechopen.85641",slug:"application-of-fourier-analysis-of-cerebral-glucose-metabolism-in-color-induced-long-term-potentiati",totalDownloads:815,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Fourier time-series analysis could be used to segregate changes in the ventral and dorsal streams of the visual system in male and female mice. Color memory processes of long-term potentiation and long-term depression could be identified through spectral analysis. We used small animal positron emission tomography and magnetic resonance imaging (PET/MRI) to measure the accumulation of [18F]fluorodeoxyglucose ([18F]FDG) in the mouse brain during light stimulation with blue and yellow filters compared to darkness condition. The mean standardized uptake values (SUV) of [18F]FDG for each stimulus condition was analyzed using standard Fourier analysis software to derive spectral density estimates for each condition. Spectral peaks were identified as originating from the subcortical region (S-peak) by subcortical long-term potentiation (SLTP) or depression (SLTD), and originating from the cortical region (C-peak) by cortical long-term potentiation (CLTP) or depression (CLTD). Luminance opponency occurred at S-peak by SLTP in the dorsal stream in the left visual cortex in male mice. On the other hand, chromatic opponency occurred by wavelength-differencing at C-peak by CLTP in the cortico-subcortical pathways in the ventral stream in the left visual cortex in male mice. In contrast in female mice, during luminance processing, there was resonance phenomenon at C-peak in the ventral stream in the right visual cortex. Chromatic opponency occurred at S-peak by SLTP in the dorsal stream in the right visual cortex in female mice. Application of Fourier analysis improved spatial and temporal resolutions of conventional fPET/MRI methods. Computation of color processing as a conscious experience has wide range applications in neuroscience and artificial intelligence.",signatures:"Philip C. Njemanze, Mathias Kranz and Peter Brust",downloadPdfUrl:"/chapter/pdf-download/67344",previewPdfUrl:"/chapter/pdf-preview/67344",authors:[{id:"53753",title:"Prof.",name:"Peter",surname:"Brust",slug:"peter-brust",fullName:"Peter Brust"},{id:"278369",title:"M.D.",name:"Philip",surname:"Njemanze",slug:"philip-njemanze",fullName:"Philip Njemanze"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"1574",title:"Fourier Transforms",subtitle:"New Analytical Approaches and FTIR Strategies",isOpenForSubmission:!1,hash:"b6a622dfaac1697f3cfdbf08299f1206",slug:"fourier-transforms-new-analytical-approaches-and-ftir-strategies",bookSignature:"Goran Nikolic",coverURL:"https://cdn.intechopen.com/books/images_new/1574.jpg",editedByType:"Edited by",editors:[{id:"23261",title:"Prof.",name:"Goran",surname:"Nikolic",slug:"goran-nikolic",fullName:"Goran Nikolic"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"122",title:"Fourier Transforms",subtitle:"Approach to Scientific Principles",isOpenForSubmission:!1,hash:"53ed2d571e2cf7e9a4fcd81723c4eefd",slug:"fourier-transforms-approach-to-scientific-principles",bookSignature:"Goran Nikolic",coverURL:"https://cdn.intechopen.com/books/images_new/122.jpg",editedByType:"Edited by",editors:[{id:"23261",title:"Prof.",name:"Goran",surname:"Nikolic",slug:"goran-nikolic",fullName:"Goran Nikolic"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5411",title:"Fourier Transforms",subtitle:"High-tech Application and Current Trends",isOpenForSubmission:!1,hash:"5c45d1a91daef66093a42a82448a70f0",slug:"fourier-transforms-high-tech-application-and-current-trends",bookSignature:"Goran S. 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by"}}],publishedBooksByAuthor:[]},onlineFirst:{chapter:{type:"chapter",id:"78193",title:"Potassium and Cardiac Surgery",doi:"10.5772/intechopen.99735",slug:"potassium-and-cardiac-surgery",body:'Intracellular and blood potassium levels have crucial effects on cardiovascular system homeostasis. At the most fundamental level, the potassium concentration gradient across cardiac muscle cell (cardiomyocyte) cell membranes is a chief determinant of cardiomyocyte resting membrane potentials. Indeed, disruptions to this concentration gradient (e.g. via increasing or decreasing extracellular blood potassium levels) can lead to altered cardiomyocyte contractility and excitability. Potassium is also vasoactive, with different effects at different extracellular concentrations. At low (5-8 mM) to moderate (8-16 mM) extracellular levels, potassium relaxes the smooth muscle in blood vessel walls by promoting hyperpolarization of vascular smooth muscle. However, at higher levels (16-25 mM and above) (e.g. cardioplegic concentrations), potassium promotes vasoconstriction by facilitating depolarization. Moreover, potassium is released by vascular endothelial cells in response to various chemical mediators and shear stress, thereby contributing to the action of endothelium-derived hyperpolarizing factor [1]. For all of these reasons and more, keeping track of daily potassium intake is often recommended as a lifestyle modification for chronic cardiovascular diseases such as hypertension.
Harnessing the pivotal role of potassium in cardiovascular physiology has proved quite useful for cardiovascular surgery, namely in the form of hyperkalemic (high potassium) cardioplegia. Indeed, throughout the past several decades, a large body of research has testified to the ability of externally administered hyperkalemic solutions to arrest cardiac contractility [2]. This, in conjunction with the development of cardiopulmonary bypass (CPB, also known as the “heart-lung machine”), revolutionized cardiac surgery [3]. These days, many highly invasive procedures like coronary artery bypass grafting are routine with minimal risk of postoperative mortality.
However, hyperkalemic cardioplegia is not without its consequences. Hyperkalemic cardioplegia and reperfusion following CPB have been associated with perioperative and postoperative tissue damage and microvascular dysfunction across several different vascular beds. Moreover, hyperkalemic cardioplegia is also associated with postoperative myocardial dysfunction and reduced cardiac output. Furthermore, blood potassium abnormalities after hyperkalemic cardioplegia-reperfusion, chiefly hypokalemia (but also hyperkalemia, to a lesser degree) are common postoperative challenges in the cardiac ICU. Both abnormalities significantly elevate the risk of arrythmias and, if not managed properly, cardiac arrest and sudden death.
This chapter will discuss the basics of potassium cardioplegia with an emphasis on clinical relevance, beginning with a brief history. Subsequent sections will elaborate on the basic physiology, before considering several perioperative and postoperative adverse effects of hyperkalemic cardioplegia. When possible, information about treatment and clinical management is included. The chapter will conclude with a brief mention of up-and-coming alternatives to hyperkalemic cardioplegia.
As early as the late 1800s, physiologists were starting to become aware of the ability of potassium compounds to arrest cardiac contractility, beginning with individuals like Sidney Ringer who observed that potassium chloride froze the heart in diastole and calcium stimulated the heart during systole [2]. Moving into the start of the 20th century, further investigations revealed associations between high serum potassium and cardiac arrest following ventricular fibrillation; studies also revealed associations between cardioplegia and restoration of sinus rhythm following coronary artery administration of potassium chloride solution and subsequent washout [2]. However, in most of these cardioplegic experiments (often conducted in dogs), refractory ventricular fibrillation and post-procedure reperfusion damage to the myocardium limited discussion of the clinical usefulness of these findings.
During the 1950s, British physician Dennis Melrose hypothesized that the problem with potassium chloride cardioplegia was chloride; therefore, he created a cardioplegic solution using potassium citrate, and tested it on a canine model of cardiopulmonary bypass [4]. Injection of the “Melrose solution”, of potassium citrate plus warm oxygenated whole blood in a 9:1 blood:potassium ratio, into the aortic roots of hypothermic dogs, produced near-immediate cardiac arrest. Reperfusion and washout of cardioplegic solution resulted in restoration of heart function to pre-procedure levels [2]. Within a few years, the Melrose group successfully induced potassium citrate cardioplegia in humans.
Unfortunately, future studies would reveal that in many cases, the Melrose potassium citrate solution still produced post-cardioplegia ventricular fibrillation and myocardial dysfunction [5]. This led to a general pause in clinical application of potassium cardioplegia between the 1960s and early 1980s, in favor of other options mostly involving induction of hypothermic cardiac arrest, which turned out to be no better with respect to postoperative damage than the Melrose solution.
Eventually, research into techniques for potassium cardioplegia would pick up again, and the result would be development of novel solutions for cardioplegia and intraoperative organ preservation. Numerous studies in animal models have validated the principles of diastolic cardiac arrest due to depolarizing potassium cardioplegia [2, 3, 6, 7, 8, 9, 10]. In addition, invention and refinement of heart-lung machines to accompany cardioplegia in the operative room (CPB) opened many new possibilities for cardiac surgery. Today, potassium cardioplegia is an integral tool for cardiac surgeons performing a variety of highly invasive procedures such as coronary artery bypass grafting and aortic valve replacements.
Despite variability in composition, delivery, and temperature, most cardioplegic solutions in use today involve some level of potassium chloride as the main inducer of cardiac arrest, along with ions such as magnesium, low-dose calcium and bicarbonate, the latter of which is particularly important for controlling solution pH [6]. The “original” hyperkalemic cardioplegic solution was the Melrose formula of the 1950s that was discussed earlier, consisting of potassium citrate and warm blood in a 9:1 blood:potassium ratio. However, due to the high incidence of postoperative complications including ventricular fibrillation, this solution is no longer in major clinical use.
In general, cardioplegic solutions fall under two broad umbrellas: crystalloid vs. blood, and warm vs. cold (Table 1). Two crystalloid cardioplegic solutions worth noting are the Custodiol (also known as Bretschneider) and St. Thomas solutions [7]. The St. Thomas solution, introduced first by Hearse and colleagues in 1975, is an example of a short acting cardioplegic solution involving potassium chloride concentrations between 10 and 30 mM [8]. In general, the St. Thomas solution requires repeat dosing, roughly every 20 minutes, to sustain cardioplegia for long durations [7, 9]. Furthermore, myocardial acidosis has been noted between doses of St. Thomas solution [10].
St. Thomas Cardioplegia | Custodiol Cardioplegia | Del Nido Cardioplegia | Buckberg Cardioplegia | Warm Calafiore Cardioplegia (one variant) | |
---|---|---|---|---|---|
K+ | 16 mM | 9 mM | 26 mM | Cold induction: 36 mM Maintenance: 36 mM Reperfusion: 15 mM | 18–20 mM for inducing arrest, repeat delivery every 20 min with decreasing K concentrations |
Ca | 1.2 mM | 0.015 mM | 1.3 mM | ||
Mg | 16 mM | 4 mM | 2 g of 50% magnesium sulfate | 15.5 mM | |
Na | 110 mM | 15 mM | |||
NaHCO3 | 10 mM | 13 mM | |||
Other Components | 18 mM Histidine hydrochloride 18 mM histidine 2 mM tryptophan 30 mM mannitol 1 mM potassium hydrogen 2-ketoglutarate | 13 mL of 1% lidocaine 3.2 g/L of 20% mannitol | 62.5 mL glutamate/aspartate | 500 mL 5% dextrose 4 mM tris(hydroxymethyl)aminomethane Core body temperature maintained at 37 degrees Celsius | |
Blood vs. Crystalloid | Crystalloid | Crystalloid | 4:1 crystalloid: blood ratio | 4:1 crystalloid: blood ratio | Normothermic blood |
Composition of common potassium-based cardioplegic solutions.
In contrast, the Custodiol solution is a form of long acting, single dose cardioplegia consisting primarily of potassium chloride, sodium chloride, and magnesium sulfate as the chief electrolytes [11]. Additional components of the Custodiol solution include tryptophan (membrane stabilization) and histidine buffer (to maintain pH and buffer against byproducts of anaerobic glycolysis that build up during cardioplegia). Curiously, the relatively low levels of potassium (9 mM) and sodium (15 mM) in Custodiol appear to induce cardioplegia through a form of hyperpolarized arrest as opposed to depolarized arrest, unlike most other potassium cardioplegic solutions that have potassium concentrations in the range of 16-36 mM and sodium concentrations in the range of 10-110 mM (see Table 1 for detailed solution ion concentrations).
The general rationale for blood-based cardioplegia has centered on the theory that cardioplegic solutions containing blood are more “physiologic” than crystalloid solutions. For example, blood can support aerobic respiration and may be able to preserve normal myocardial metabolism during surgery. Therefore, blood cardioplegia may reduce the negative consequences of prolonged ischemia during CPB [11]. However, insufficient evidence exists currently to verify that hypothesis, and so any purported advantages of blood over crystalloid cardioplegia are for the time being mainly speculative.
Three hyperkalemic cardioplegic solutions in clinical use that contain blood are the Del Nido, Buckberg, and Calafiore solutions. The Del Nido solution uses a crystalloid:blood ratio of 4:1, and like the Custodiol solution is a long-acting cardioplegic solution, with one dose of 20 ml/kg providing myocardial protection for up to 60–90 minutes [7, 12]. Chief ionic ingredients include potassium chloride for rapid depolarized arrest, sodium bicarbonate to scavenge protons and buffer intracellular pH, and magnesium to block calcium channels and prevent intracellular calcium accumulation during cardioplegic arrest, thereby promoting postoperative myocardial recovery [12, 13]. Lidocaine in the Del Nido solution acts as a sodium channel blocker to mitigate against the sodium “window current” and reduce intracellular sodium accumulation [14].
Buckberg’s cardioplegia is a dextrose and saline-based solution that, similar to the Del Nido solution, consists of a crystalloid:blood ratio of 4:1 [15]. Other components include potassium chloride as the primary depolarizing agent, a tromethamine buffer, and citrate phosphate double dextrose to serve as a calcium chelator. However, unlike the Del Nido solution, Buckberg cardioplegia must be given as three separate formulations, some of which must be administered in multiple doses [15]. First, an induction solution stops the heart, and additional infusions of induction solution must be given every 15 to 20 minutes throughout the procedure. Second, a maintenance solution must be administered to sustain cardiac arrest and provide oxygen and nutrients to the cardiomyocytes. Finally, a reperfusion solution containing glutamate and aspartate is administered prior to removal of the aortic cross clamp to provide the heart with nutrients prior to restarting myocardial contractions.
Calafiore cardioplegia differs from Buckberg and Del Nido in that blood forms the sole foundation of Calafiore cardioplegic solution [16]. Indeed, the original rational proposed by Calafiore et al. was that blood alone, without any crystalloid component, contained everything necessary to prevent ischemia–reperfusion damage. Therefore, simply administering a cardioplegic solution consisting of blood plus extra potassium would be enough to safely stop and later, restart the heart [16]. Moreover, unlike most other forms of cardioplegia in use, the original Calafiore solution was normothermic throughout administration; however, some subsequent variations of Calafiore cardioplegia have used cold blood [16, 17].
Most current methods for administering cardioplegic solutions involve cold cardioplegia, most often cold crystalloid solutions delivered after reducing core body temperature to hypothermic levels [18]. For example, the induction and maintenance solutions for Buckberg cardioplegia are delivered at 4 degrees Celsius after cooling core temperature to below 30 degrees Celsius, with reperfusion solution delivered at 37 degrees Celsius [15]. Similarly, del Nido and Custodiol cardioplegia are often given at 4 degrees Celsius after induction of systemic hypothermia [15, 19].
This practice stems from experimental evidence suggesting that mild hypothermia can protect the myocardium from ischemic damage during cardioplegia [20]. Hypothermia reduces the basal metabolic rate of the heart, which in turn reduces oxygen consumption—an effect augmented by potassium-induced arrest during hyperkalemic cardioplegia [21]. A variety of potential mechanisms may be at play. In animal models of cardiac arrest, mild hypothermia (32–35 degrees Celsius) has been shown to reduce post-arrest infarct size, possibly through various signal transduction pathways, such as Akt and mTOR signaling, both of which are altered during the course of hypothermia [20]. Another potential cardioprotective mechanism of hypothermia may be reduced phosphorylation of various mitogen activated protein kinases (MAPK) like ERK1/2 that normally activate pro-inflammatory mediators like COX-2 (arachidonic acid metabolism) [18]. In general, many details concerning mechanisms of hypothermic myocardial protection during cardioplegia remain to be elucidated.
However, cold hyperkalemic cardioplegia may also inhibit myocardial enzymes that are important for the metabolic and functional recovery of the heart after surgery [22, 23]. Moreover, sustained systemic hypothermia (especially at temperatures below 20 degrees Celsius) during cardiac surgery has also been associated with ventricular fibrillation after rewarming [21]. Given these negative consequences, an increasing amount of attention has been given to the possibility of warm hyperkalemic cardioplegia, primarily warm blood hyperkalemic cardioplegia. Unlike cold hyperkalemic cardioplegic solutions, warm cardioplegic solution is typically administered at between 30 and 35 degrees Celsius under normothermic, as opposed to hypothermic, CPB [24]. Potential advantages of warm blood hyperkalemic cardioplegia over cold crystalloid may include improved myocardial restoration, reduced intracellular swelling, improved membrane stabilization, and reduced hypoxic red blood cell deformation [25].
Of course, warm hyperkalemic cardioplegia is not without its own consequences. Some studies have reported increased likelihoods of perioperative strokes and encephalopathy [26]. Moreover, warm hyperkalemic cardioplegia may contribute to vasodilation during cardiopulmonary bypass, requiring increased use of alpha agonists during operation to maintain stable arterial perfusion pressures [25]. There are also several variations of warm cardioplegia; one common technical variant is “hot shot” cardioplegia, which involves warm induction and subsequent cold cardioplegia, followed by a warm reperfusion [27].
Comparing the effectiveness of warm vs. cold hyperkalemic cardioplegia remains an inconclusive subject of intense debate. A meta-analysis by Fan et al., reported no differences between length of stay, stroke incidence, and atrial fibrillation between patients undergoing warm vs. cold cardioplegia [28]. However, warm cardioplegia correlated with better postoperative cardiac indices and lower peak creatine kinase MB concentrations than cold cardioplegia [28]. The latter findings, along with reduced postoperative cardiac troponin levels, have been replicated in other studies [29, 30]. Meanwhile, other studies comparing warm blood and cold crystalloid hyperkalemic cardioplegia do not show significant differences with respect to perioperative myocardial infarction and low cardiac output syndrome [31].
In general, administration of hyperkalemic cardioplegic solution can be done in either retrograde or anterograde fashion. Prior to both, IV heparin is administered, and the patient’s core body temperature is lowered to hypothermic levels, after which the aortic cross-clamp is placed and cardiopulmonary bypass is initiated [7]. Anterograde cardioplegia refers to delivering cardioplegic solution through a cannula inserted just proximal to the aortic cross-clamp. From there, the solution can flow into the left and right coronary arteries that supply the myocardium [32]. With anterograde cardioplegia, arrest usually occurs within 30 to 60 seconds. Retrograde cardioplegia may be considered in patients with complications such as severe coronary artery damage (e.g. severe stenosis) or aortic valve damage. Unlike anterograde administration, in retrograde administration the cardioplegia catheter is inserted into the coronary sinus from the right atrium, and solution is injected at a lower pressure (given the lower tolerance of the coronary sinus walls to turbulent flow) to avoid coronary sinus perforation [32].
Under physiological circumstances, the cardiomyocyte resting membrane potential is largely determined by two key factors: action of the sodium-potassium ATPase, and the high resting permeability of cardiomyocyte cell membranes to potassium [33]. First, the sodium-potassium ATPase hydrolyzes ATP to continuously pump potassium into the cell and sodium out of the cell, with a relative ratio of 3Na out/2 K in per molecule of ATP. Because it is the primary ion pump active while the cell is at rest, the sodium-potassium ATPase plays a critical role in generating the characteristic sodium and potassium electrochemical gradients across the cardiomyocyte cell membrane (high potassium and low sodium inside the cell relative to out). Second, at rest the cardiomyocyte cell membrane is most permeable to potassium while being relatively impermeable to other ions. This results in a resting membrane potential for cardiomyocytes that is close to the Nernst equilibrium potential for potassium, roughly −85 to -90 mV.
During cardiac muscle contraction, sinoatrial node stimulation induces a transient increase in the resting membrane potential of cardiomyocytes, which in turn opens voltage-gated sodium channels once the membrane potential surmounts -65 mV. Due to the high inward ion driving force on sodium (based on the considerable difference between the Nernst potential for sodium and the resting membrane potential), sodium ions flow through the sodium channels into the cardiomyocyte and further depolarize the cell until it reaches about 20 mV. At this point, sodium channels inactivate and L-type voltage gated calcium channels take over the maintenance of the action potential, allowing influx of calcium ions and producing the classic plateau depolarization of cardiac ventricular action potentials. Eventually, as calcium channels close and membrane potential begins to dip, delayed rectifier potassium channels open and restore membrane potential to the resting state. By this point, enough calcium has entered the cardiomyocyte to promote calcium-induced calcium release from intracellular calcium stores in the cardiomyocyte sarcoplasmic reticula, allowing muscle contraction to occur.
Extracellular hyperkalemia is the core principle underpinning most warm blood and cold crystalloid cardioplegic solutions. Essentially, administration of hyperkalemic solution takes advantage of the pivotal role of the potassium electrochemical gradient in determining cardiomyocyte resting membrane potential in order to elevate the resting membrane potential to a less negative value than typical baseline level. For example, physiologic extracellular potassium levels are often in the range of 3.5–5 mM, producing a resting membrane potential around -85 mV. During cardiac surgery involving cardioplegia, hyperkalemic solutions often raise extracellular potassium to the range of 10-40 mM (often midway in this range, around the 25 mM level), elevating cardiomyocyte resting membrane potentials to anywhere between −65 to -40 mV [34]. Arresting cardiomyocytes at this new range of elevated membrane potentials promotes fast sodium channel inactivation, thereby blocking myocardial action potential conduction. It also blocks repolarization, which is why hyperkalemic cardioplegia induces what is called “depolarized arrest.” Finally, it is important to note that cardioplegic arrest also significantly reduces cardiomyocyte oxygen consumption in a manner reminiscent of how severe ischemia depletes cellular ATP reserves [33].
Despite its clinical usefulness in reversibly arresting the heart during cardiac surgery, sustained depolarized hyperkalemic cardioplegia is not without some negative perioperative consequences. First, while most voltage-gated “fast” sodium channels are inactivated at membrane potentials above -50 mV (a frequent target cardiomyocyte membrane potential for potassium cardioplegia), resulting in generally poor membrane sodium conductance, not
Similarly, ATP depletion and reduced myocardial oxygen consumption during hyperkalemic cardioplegia leads to myocardial ischemia. Ischemia forces myocardial cells to resort to anaerobic glycolysis for energy production, which generates lactate as a byproduct. Increasing lactate levels in cardiomyocytes produces a metabolic acidosis and promotes increased activity of the H+/Na antiporter to move protons out of the cells at the expense of bringing in more sodium [36]. Finally, the combination of high extracellular potassium, intracellular acidosis, and hypothermia due to cold cardioplegic solution inhibits action of the sodium-potassium ATPase, which further facilitates the buildup of intracellular sodium [34].
Note that -50 mV is also in the vicinity of the reversal potential of the sodium/calcium exchanger [37, 38]. Under normal circumstances, the sodium/calcium exchanger moves 3 Na in for every 1 Ca moved out of the cell. However, due to the sodium window current and depolarized arrest in hyperkalemic cardioplegia, the sodium/calcium exchanger eventually begins operating in reverse, moving 3 Na out for every 1 Ca in, producing a so-called calcium “window current.” Moreover, if the hyperkalemic cardioplegic solution holds cardiomyocyte membrane potentials above -50 mV, e.g. at around -40 mV, then voltage-gated slow calcium channels will begin to activate, causing further calcium influx [39]. All of these reasons help explain why many hyperkalemic cardioplegic solutions in clinical practice are also hypocalcemic relative to physiological extracellular calcium levels (or contain calcium channel blockers), to attempt to mitigate the severity of myocardial calcium loading [34].
Cytosolic calcium loading during hyperkalemic cardioplegia contributes to cardiomyocyte damage through several mechanisms [40]. Enhanced activation of calcium dependent proteases and lipases (e.g. phospholipases) contributes to plasma membrane phospholipid degradation, ultrastructural changes in the sarcolemmal membrane, and accumulation of pathological catabolic byproducts. Enhanced activation of calcium-dependent ATPases accelerates depletion of intracellular ATP stores that have already been lowered following hypothermic arrest. This further perturbs cardiomyocyte sarcolemmal calcium transport channels that rely on ATP to maintain intracellular calcium homeostasis. Moreover, hypoxia during hyperkalemic cardioplegia increases mitochondrial calcium uptake via reversal of mitochondrial sodium/calcium exchangers in a manner akin to reversal of cardiomyocyte cell membrane sodium/calcium exchangers [41].
Mitochondria can only endure so much calcium uptake before the onset of irreversible damage. Indeed, following reperfusion after hyperkalemic cardioplegia arrest, mitochondria exhibit increased oxygen free radical production and reduced superoxide dismutase activity, indicative of heightened oxidative stress [41]. Sustained oxidative stress can lead to opening of mitochondrial permeability transition pores (MPTP), which promote mitochondrial swelling and mitochondrial membrane rupture. An assortment of mitochondrial enyzmes and molecules, such as cytochrome c, leak out into the cytosol through the MPTPs [41]. Cytochrome c is implicated in intrinsic apoptotic pathways through activation of cytosolic caspases and subsequent formation of myocardial apoptosomes [41].
Myocardial apoptosis during hyperkalemic cardioplegic ischemia–reperfusion merits further consideration for two major reasons. First, several studies have shown associations between hyperkalemic cardioplegic arrest and endothelial cell and cardiomyocyte apoptosis [42, 43, 44]. Second, several independent pathways of myocardial cell injury converge on apoptosis. Examples include mitochondrial oxidative stress and activation of an intrinsic apoptotic pathway (introduced earlier), or an extrinsic pathway driven by elevated humoral factors such as Fas or TNF-alpha acting on pro-apoptosis cell membrane receptors [44, 45]. Both intrinsic and extrinsic pathways converge upon a similar final common pathway that is chiefly regulated by two key protein groups: the Bcl-2 and cysteine protease caspase families [46, 47].
Within the Bcl-2 family, two proteins are particularly significant: Bcl-2 itself, and Bad. The former is anti-apoptotic while the latter is pro-apoptotic. Phosphorylation inhibits Bad, blocking it from inactivating Bcl-2 [48]. Farther downstream in apoptotic signaling, cleavage of caspase 3 and poly ADP-ribose polymerase (PARP) is essential for ensuring final progression towards apoptosis. Meanwhile, apoptosis may also proceed via a caspase-independent pathway involving release of the mitochondrial flavoprotein apoptosis-inducing factor (AIF) from the mitochondria into the cytosol through MPTPs [49, 50].
A possible framework for understanding myocardial apoptosis after hyperkalemic CPB is as follows [48]. Activation of the intrinsic (mitochondrial) pathway leads to increased Bad activation/decreased Bcl-2 activation, which initiates the caspase cascade. Activation of the extrinsic pathway bypasses Bcl-2/Bad to directly activate the caspase cascade. As more and more caspases become activated, eventually terminal caspases, such as caspase 3, will be cleaved, leading to PARP cleavage. By this point, apoptosis has been irreversibly induced; DNA fragmentation and cell death quickly follow. In contrast, AIF translocation from the mitochondria to the cytosol may directly activate downstream/terminal caspases, bypassing initial/intermediary constituents of the caspase cascade.
Studies have shown that caspase 3 cleavage and Bcl-2/Bad phosphorylation are significantly increased in myocardial tissue following hyperkalemic cold-blood cardioplegia and reperfusion, even as total protein levels do not change [48]. Meanwhile, myocardial AIF levels increase slightly, accompanied by a trend towards nuclear translocation, consistent with a model of AIF induced chromatin condensation and DNA fragmentation as a mechanism of cell injury [48]. Note that both pro-apoptotic (e.g. caspase 3) and anti-apoptotic (e.g. phosphorylated Bad) mediators are activated—nevertheless, given the downstream terminal position of caspase 3, the overall balance in myocardial cells appears to be tipped in favor of pro-apoptotic signaling.
Different formulations of hyperkalemic cardioplegia (e.g. cold crystalloid, warm blood, etc.) may exhibit differing degrees of myocardial protection and prevention of apoptosis. Indeed, evidence exists suggesting that cold blood hyperkalemic cardioplegia is superior to warm blood, warm crystalloid, and cold crystalloid cardioplegia, in terms of increased Bad phosphorylation and decreased caspase 3 activation [51]. Taken together, this combination of events appears to result in less apoptosis. In addition, these effects are associated with improved left ventricular function following cardioplegic arrest. However, this is not a universal finding in the literature. More work must be done to verify these conclusions and confirm if there truly is a definitive benefit to any one technique of hyperkalemic cardioplegia with respect to prevention of apoptosis.
An extensive body of research has established that hyperkalemic solutions induce significant vasoconstriction when experimentally applied to coronary artery and aortic ring preparations [2]. Thus, it is no surprise that hyperkalemic cardioplegia induces significant functional changes to the microcirculation, especially the coronary circulation [52]. For example, a sizeable number of patients undergoing hyperkalemic cardioplegia experience coronary artery spasm [52].
Potassium can influence coronary vasoconstriction in several ways. Holding coronary vascular smooth muscle membrane potentials at sustained depolarization during hyperkalemic cardioplegia increases the likelihood of generating contractions [53]. Potassium may also act indirectly to cause vasospasm through action on the coronary endothelium. Indeed, endothelial vasoconstrictive and vasorelaxant factors govern homeostatic regulation of coronary vasomotor tone. These factors influence vascular smooth muscle through modulation of various cell membrane potassium channels, including calcium-activated potassium channels and ATP-activated potassium channels [54, 55]. Important endothelial-derived relaxing factors include nitric oxide, endothelial-derived hyperpolarizing factor (EDHF), and cyclooxygenase enzymes. Important endothelial-derived constricting factors include endothelin-1 and thromboxane A2.
Porcine models of hyperkalemic cardioplegia showed that hyperkalemia significantly attenuated EDHF-mediated relaxation in coronary artery preparations [56, 57]. Moreover, hyperkalemic vasoconstriction has also been linked with impaired nitric oxide release [58] and impaired acetylcholine-dependent vascular relaxation [59, 60]. Potential mechanisms at play may involve potassium-induced inhibition of G protein and non-G protein signal transduction pathways, increased reactive oxygen and nitrogen species generation, decreased activity of endothelial nitric oxide synthase, and increased arachidonic acid metabolism [2]. Curiously, hyperkalemic cardioplegia has also been associated with decreased responsiveness of human coronary arterioles to the endothelial vasoconstrictors endothelin-1 and thromboxane A2 [61, 62]. These findings testify to the complexity of mechanisms underpinning coronary vasomotor dysfunction following hyperkalemic cardioplegia, most of which remain to be elaborated.
Despite its cardioprotective effects, hyperkalemic cardioplegia-reperfusion can exert detrimental effects on the myocardial and coronary endothelium, promoting endothelial dysfunction [63, 64]. One aspect of endothelial dysfunction—production of various endothelium-derived relaxing and contracting factors—was discussed earlier due to its relevance in coronary vasospasm. Other important features of endothelial dysfunction during hyperkalemic cardioplegic arrest include endothelial injury, inflammation, reactive oxygen species production, coagulation cascade dysfunction, and endothelial tight junction degradation [52, 65, 66, 67]. All these adverse effects may occur with potassium levels as low as 10 mM, well within the realm of most hyperkalemic cardioplegic solutions [2]. To elaborate, potassium concentrations of 30 mM in St. Thomas and Custodiol cardioplegic solutions proved considerably more damaging to the vascular endothelium than potassium concentrations of 20 mM, demonstrating the importance of strict potassium limits in hyperkalemic cardioplegic solutions [6].
A variety of structural changes to the vascular endothelium have been observed in experimental models of hyperkalemic cardioplegia. Key examples include endothelial intracellular vacuolization, membrane blebbing, adventitial fibrosis, and overall reduced viability [68, 69]. Furthermore, hyperkalemic cardioplegia promotes increased lipid uptake and cholesterol deposition in vascular intimae in primate models of post-graft venous atherosclerosis [70]. In addition, compromised endothelial adherens junctions during hyperkalemic cardioplegia mediate increased vascular permeability and tissue edema [67]. Indeed, animal models of cardioplegia/CPB show increased post-procedure VE cadherin, beta-catenin, and gamma-catenin fragments, all of which are important structural components of adherens junctions [71]. In humans, increased endothelial cadherin phosphorylation, and decreased overall beta-catenin levels, have been observed in atrial tissue following hyperkalemic cardioplegia/CPB [72].
Details of specific mechanisms underlying these endothelial disturbances remain largely unclear; however, many possibilities exist. For example, it is generally agreed that depolarization induced by hyperkalemic cardioplegia is a critical initiating step of the underlying pathophysiology [2]. Endothelial depolarization increases activation of neutrophils, inflammation, voltage sensitive NAPDH oxidases, and platelets [62, 63, 73, 74]. Inflammation and neutrophil activation often reinforce each other, as pro-inflammatory cytokines like IL-1, IL-6, and TNF-alpha further stimulate endothelial changes that promote neutrophil extravasation. NADPH oxidase catalyzes formation of important reactive oxygen species such as superoxide anions, which if left unchecked are severely cytotoxic. The amount of superoxide production during hyperkalemic cardioplegia has been linked to the extent of endothelial depolarization and translocation of the small G protein Rac from the cytosol to plasma membrane [75].
With respect to coagulation, potassium depolarization appears to have a direct stimulatory effect via enhancing ADP and collagen-induced platelet aggregation, along with an indirect effect through increased superoxide production [76, 77]. The latter appears to act through inhibition of endothelial NTPDases [78]. Membrane hyperpolarization reverses all these actions.
When left unchecked, sustained myocardial dysfunction following hyperkalemic cardioplegia-reperfusion may lead to myocardial stunning, a form of postoperative left ventricular dysfunction [1]. Myocardial stunning often manifests as markedly reduced cardiac output without obvious evidence of infarction or injury (e.g. no signs of elevated troponin or CKMB in blood). Like myocardial apoptosis, myocardial stunning represents another final common pathway of convergence for several different pathophysiological mechanisms of hyperkalemic cardioplegia, chiefly dysregulated free radical production, coagulation imbalances, and excessive catecholamine release [1]. However, unlike with apoptosis, in this scenario injury results from abnormal myocardial contractility as opposed to myocardial cell death.
Postoperative imbalances in a variety of different electrolytes, including calcium, magnesium, potassium, and phosphate, have been observed following cardioplegia/CPB. Here, we will focus on potassium, beginning with hypokalemia. Hypokalemia can be defined as a serum potassium level that is less than 3.5 mEq/L [78]. Postoperative hypokalemia is a common finding after cardiac surgery involving hyperkalemic cardioplegia and CPB, and manifests almost immediately after the patient is weaned off the bypass circuitry [79]. Hence IV potassium supplementation during cardioplegia is extremely important to mitigate against the most severe manifestations [80].
However, even with electrolyte supplementation in the operating room, CPB poses a high risk of post-procedure electrolyte depletion [81]. The pivotal role of potassium in normal cardiac contractility means that disturbances in potassium homeostasis significantly increase the risk of arrythmias and, in severe cases, sudden cardiac arrest. Indeed, arrythmias, especially atrial tachyarrhythmias (e.g. atrial fibrillation, atrial flutter) and, less frequently, ventricular arrhythmias, are a major source of morbidity and mortality following cardiac surgery [82, 83].
Specific mechanisms underpinning this phenomenon remain largely unclear; however, a variety of possibilities exist [78]. For example, poor oral intake of potassium-rich foods prior to cardiac surgery may contribute to enhanced depletion during surgery. In addition, prolonged preoperative use of digoxin, along with thiazide and loop diuretics may play a role. These agents may cause hypomagnesemia (low magnesium levels), which can contribute to extracellular potassium depletion. Under normal circumstances, intracellular magnesium binds to and blocks the pores of renal outer medullary potassium (ROMK) channels in the distal nephron, preventing outward flux of potassium into the renal tubular network [78]. Thus hypomagnesemia may remove this physiologic limiter, leading to increased renal clearance of potassium.
A hyperactive aldosterone response to stress may also be implicated, particularly in the context of congestive heart failure [78, 80]. Moreover, increased catecholamine (norepinephrine and epinephrine) release during cardiopulmonary bypass may facilitate hypokalemia given the influence of catecholamines on plasma potassium [84, 85]. Animal models have shown that elevated catecholamine levels can produce first, a transient hyperkalemia due to activation of hepatic calcium-dependent potassium channels by alpha adrenergic stimulation and second, a sustained hypokalemia by stimulation of skeletal muscle Na-K ATPase [86]. Such studies need to be replicated in humans undergoing cardiopulmonary bypass-hyperkalemic cardioplegia in order to verify the applicability of these putative mechanisms.
Because glucose is often given during cardioplegia, insulin may also be administered to minimize the chances of hyperglycemia. However, given that insulin acts as a regulator of potassium distribution between intracellular and extracellular fluid compartments by stimulating Na-K ATPase activity, it is possible that insulin administration during and after cardioplegia may contribute to potassium depletion [87]. Next, given that many cardioplegic solutions in current practice are cold hyperkalemic solutions, any potential impact of hypothermia on potassium homeostasis during cardiac surgery cannot be ignored. As with insulin, hypothermia has been linked to an intracellular shift of potassium away from the extracellular space through as-yet unelaborated mechanisms [88]. Finally, the CPB circuit itself has been shown to significantly dilute overall blood plasma protein concentrations, which may also affect plasma ion homeostasis [89].
In general, treatment of postoperative hypokalemia largely centers on administration of potassium chloride (KCl) solution to elevate extracellular potassium concentrations to physiologic levels. Indeed, in the case of pediatric cardiac ICU patients for whom enteral potassium supplementation is contraindicated, IV KCl administration is one of the only available tools for correcting hypokalemia [90]. For most patients, this proves sufficient to correct the imbalance and stave off the development of hypokalemia-induced arrhythmias. However, in a small minority, external KCl solution does not reverse the hypokalemia—and so in these patients, the chances of arrhythmias increase exponentially.
Although hypokalemia is the most common potassium electrolyte abnormality following hyperkalemic cardioplegia-CPB, postoperative hyperkalemia may occur under certain, albeit rarer, circumstances. In general, postoperative hyperkalemia is a concern mainly in patients with renal failure undergoing CPB, most likely due to renal tubular dysfunction [91]. Severe hyperkalemia may be treated with IV calcium gluconate, an insulin-dextrose regimen, and diuretics [92]. If a patient has end-stage renal disease, dialysis may be the best option to treat hyperkalemia, along with IV calcium to stabilize the myocardium and IV insulin to shift potassium into cells [93].
Hyperkalemic cardioplegia is by far the most widely used method of cardioplegia in current clinical practice. However, because of the numerous perioperative repercussions of hyperkalemic cardioplegia, a variety of attempts have been made to explore alternative approaches. Given that many adverse effects of hyperkalemic cardioplegia stem from its induction of depolarized arrest, one popular avenue of investigation has been the possibility of hyperpolarized arrest. Hyperpolarization is the natural resting state of cardiomyocytes, so in theory, arresting the heart at its baseline hyperpolarized state may better preserve physiological integrity. In isolated animal heart models, hyperpolarized arrest has been achieved via pharmacologic activation of ATP-sensitive potassium channels [94, 95]. Following reperfusion, this form of hyperpolarized arrest appeared to lead to improved postischemic functional recovery when compared to hearts protected with depolarized arrest.
Meanwhile, so-called “polarized arrest” has been proposed as another alternative to hyperkalemic cardioplegia. The core principle behind this concept is administration of sodium channel blockers, such as procaine in humans or tetrodotoxin in animal models [96]. Sodium channel blockade prevents depolarization-induced activation of calcium currents, which normally carry out the bulk of the cardiomyocyte action potential. Overall, in animal models, tetrodotoxin-induced polarized arrest reduces metabolic demands during ischemia, including myocardial oxygen consumption, more so than hyperkalemic cardioplegia [96]. Furthermore, polarized arrest may produce less significant postoperative ionic imbalances, with further protection provided by coincident administration of sodium/potassium/chloride transporter and sodium/proton exchanger inhibitors [96]. Nonetheless, more work needs to be done to verify the broader clinical applicability of these alternatives to hyperkalemic cardioplegia.
By taking advantage of the pivotal role of potassium in cardiomyocyte physiology, hyperkalemic cardioplegia has become an integral tool for cardiac surgery. From the early days of Dennis Melrose’s simple potassium citrate solution to complex modern-day formulations such as the Del Nido and Buckberg media, approaches to developing and administering hyperkalemic cardioplegic solutions have evolved considerably, with a continuing focus on developing the most cardioprotective and least damaging solutions possible. While initial approaches to hyperkalemic cardioplegia revolved around hypothermic solutions, normothermic/“warm” solutions, along with blood as opposed to crystalloid-based solutions, are gaining momentum as potential alternatives to mitigate adverse perioperative consequences of cold hyperkalemic cardioplegia. Some of those consequences include myocardial calcium loading, myocardial apoptosis, coronary vasomotor dysfunction, myocardial endothelial dysfunction, and myocardial stunning. With any form of hyperkalemic cardioplegia, plasma potassium abnormalities following reperfusion, mainly postoperative hypokalemia, remain a persistent clinical concern. And while most patients respond well to IV KCl supplementation, some do not and proceed to develop fatal arrythmias, underscoring the need for further research to understand the mechanisms at play and develop new treatments. In the future, it is possible that other approaches such as hyperpolarized or polarized arrest may challenge the widespread use of depolarized hyperkalemic cardioplegic arrest. Nevertheless, for the time being, hyperkalemic cardioplegia remains dominant in cardiac surgery, and will likely continue to be so for some time to come.
The authors have no acknowledgements.
The authors declare no conflicts of interest.
The authors have no other notes or declarations.
This is a brief overview of the main steps involved in publishing with IntechOpen Compacts, Monographs and Edited Books. Once you submit your proposal you will be appointed a Author Service Manager who will be your single point of contact and lead you through all the described steps below.
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Problems",isOpenForSubmission:!1,hash:"39ff133e87b1d1f1a07d872ff755762b",slug:"updates-in-volcanology-a-comprehensive-approach-to-volcanological-problems",bookSignature:"Francesco Stoppa",coverURL:"https://cdn.intechopen.com/books/images_new/409.jpg",editedByType:"Edited by",editors:[{id:"57017",title:"Prof.",name:"Francesco",middleName:null,surname:"Stoppa",slug:"francesco-stoppa",fullName:"Francesco Stoppa"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],booksByTopicTotal:8,seriesByTopicCollection:[],seriesByTopicTotal:0,mostCitedChapters:[{id:"25980",doi:"10.5772/25264",title:"Hydrovolcanic vs Magmatic Processes in Forming Maars and Associated Pyroclasts: The Calatrava -Spain- Case History",slug:"hydrovolcanic-vs-magmatic-processes-in-forming-maars-and-associated-pyroclasts-the-calatrava-spain-c",totalDownloads:2862,totalCrossrefCites:8,totalDimensionsCites:25,abstract:null,book:{id:"409",slug:"updates-in-volcanology-a-comprehensive-approach-to-volcanological-problems",title:"Updates in Volcanology",fullTitle:"Updates in Volcanology - A Comprehensive Approach to Volcanological Problems"},signatures:"F. Stoppa, G. Rosatelli, M. Schiazza and A. Tranquilli",authors:[{id:"57017",title:"Prof.",name:"Francesco",middleName:null,surname:"Stoppa",slug:"francesco-stoppa",fullName:"Francesco Stoppa"},{id:"62737",title:"Dr.",name:"Gianluigi",middleName:null,surname:"Rosatelli",slug:"gianluigi-rosatelli",fullName:"Gianluigi Rosatelli"},{id:"62738",title:"Mr",name:"Mariangela",middleName:null,surname:"Schiazza",slug:"mariangela-schiazza",fullName:"Mariangela Schiazza"},{id:"62739",title:"Mr",name:"Andrea",middleName:null,surname:"Tranquilli",slug:"andrea-tranquilli",fullName:"Andrea Tranquilli"}]},{id:"51948",doi:"10.5772/64129",title:"Fumarolic Minerals: An Overview of Active European Volcanoes",slug:"fumarolic-minerals-an-overview-of-active-european-volcanoes",totalDownloads:2270,totalCrossrefCites:8,totalDimensionsCites:24,abstract:"The fumarolic mineralogy of the Icelandic active volcanoes, the Tyrrhenian volcanic belt (Italy) and the Aegean active arc (Greece) is investigated, and literature data surveyed in order to define the characteristics of the European fumarolic systems. They show broad diversity of mineral associations, with Vesuvius and Vulcano being also among the world localities richest in mineral species. Volcanic systems, which show recession over a longer period, show fumarolic development from the high-temperature alkaline halide/sulphate, calcic sulphate or sulphidic parageneses, synchronous with or immediately following the eruptions, through medium-temperature ammonium minerals, metal chlorides, or fluoride associations to the late low-temperature paragenesis dominated by sulphur, gypsum, alunogen, and other hydrous sulphates. The situation can be different in the systems that are not recessing but show fluctuations in activity, illustrated by the example of Vulcano where the high-temperature association appears intermittently. A full survey of the mineral groups and species is given in respect to their importance and appearance in fumarolic associations.",book:{id:"5311",slug:"updates-in-volcanology-from-volcano-modelling-to-volcano-geology",title:"Updates in Volcanology",fullTitle:"Updates in Volcanology - From Volcano Modelling to Volcano Geology"},signatures:"Tonči Balić-Žunić, Anna Garavelli, Sveinn Peter Jakobsson, Kristjan\nJonasson, Athanasios Katerinopoulos, Konstantinos Kyriakopoulos\nand Pasquale Acquafredda",authors:[{id:"183593",title:"Dr.",name:"Tonci",middleName:null,surname:"Balic-Zunic",slug:"tonci-balic-zunic",fullName:"Tonci Balic-Zunic"},{id:"183700",title:"Prof.",name:"Anna",middleName:null,surname:"Garavelli",slug:"anna-garavelli",fullName:"Anna Garavelli"},{id:"183701",title:"Dr.",name:"Sveinn Peter",middleName:null,surname:"Jakobsson",slug:"sveinn-peter-jakobsson",fullName:"Sveinn Peter Jakobsson"},{id:"183702",title:"Prof.",name:"Athanasios",middleName:null,surname:"Katerinopoulos",slug:"athanasios-katerinopoulos",fullName:"Athanasios Katerinopoulos"},{id:"188833",title:"Dr.",name:"Kristjan",middleName:null,surname:"Jonasson",slug:"kristjan-jonasson",fullName:"Kristjan Jonasson"},{id:"188834",title:"Dr.",name:"Konstantinos",middleName:null,surname:"Kyriakopoulos",slug:"konstantinos-kyriakopoulos",fullName:"Konstantinos Kyriakopoulos"},{id:"188835",title:"Dr.",name:"Pasquale",middleName:null,surname:"Acquafredda",slug:"pasquale-acquafredda",fullName:"Pasquale Acquafredda"}]},{id:"51105",doi:"10.5772/63486",title:"How Polygenetic are Monogenetic Volcanoes: Case Studies of Some Complex Maar‐Diatreme Volcanoes",slug:"how-polygenetic-are-monogenetic-volcanoes-case-studies-of-some-complex-maar-diatreme-volcanoes",totalDownloads:1943,totalCrossrefCites:5,totalDimensionsCites:15,abstract:"The increasing number of field investigations and various controlled benchtop and large‐scale experiments have permitted the evaluation of a large number of processes involved in the formation of maar‐diatreme volcanoes, the second most common type of small‐volume subaerial volcanoes on Earth. A maar‐diatreme volcano is recognized by a volcanic crater that is cut into country rocks and surrounded by a low‐height ejecta rim composed of pyroclastic deposits of few meters to up to 200 m thick above the syn‐eruptive surface level. The craters vary from 0.1 km to up to 5 km wide and vary in depth from a few dozen meters to up to 300 m deep. Their irregular morphology reflects the simple or complex volcanic and cratering processes involved in their formation. The simplicity or complexity of the crater or the entire maar itself is usually observed in the stratigraphy of the surrounding ejecta rings. The latter are composed of sequences of successive alternating and contrastingly bedded phreatomagmatic‐derived dilute pyroclastic density currents (PDC) and fallout depositions, with occasional interbedded Strombolian‐derived spatter materials or scoria fall units, exemplifying the changes in the eruptive styles during the formation of the volcano. The entire stratigraphic sequence might be preserved as a single eruptive package (small or very thick) in which there is no stratigraphic gap or significant discordance indicative of a potential break during the eruption. A maar with a single eruptive deposit is quantified as monogenetic maar, meaning that it was formed by a single eruptive vent from which only a small and ephemeral magma erupted over a short period of time. The stratigraphy may also display several packages of deposits separated either by contrasting discordance surfaces or paleosoils, which reflect multiple phases or episodes of eruptions within the same maar. Such maars are characterized as complex polycyclic maars if the length of time between the eruptive events is relatively short (days to years). For greater length of time (thousands to millions of years), the complex maar will be quantified as polygenetic. These common depositional breaks interpreted as signs of temporal interruption of the eruptions for various timescales also indicate deep magma system processes; hence magmas of different types might erupt during the formation of both simple and complex maars. The feeding dikes can interact with groundwater and form closely distributed small craters. The latter can coalesce to form a final crater with various shapes depending on the distance between them. This observation indicates the significant role of the magmatic plumbing system on the formation and growth of complex and polygenetic maar‐diatreme volcanoes.",book:{id:"5311",slug:"updates-in-volcanology-from-volcano-modelling-to-volcano-geology",title:"Updates in Volcanology",fullTitle:"Updates in Volcanology - From Volcano Modelling to Volcano Geology"},signatures:"Boris Chako Tchamabé, Gabor Kereszturi, Karoly Németh and\nGerardo Carrasco‐Núñez",authors:[{id:"51162",title:"Dr.",name:"Károly",middleName:null,surname:"Németh",slug:"karoly-nemeth",fullName:"Károly Németh"},{id:"62029",title:"Dr.",name:"Gabor",middleName:null,surname:"Kereszturi",slug:"gabor-kereszturi",fullName:"Gabor Kereszturi"},{id:"182834",title:"Dr.",name:"Boris",middleName:null,surname:"Chako Tchamabé",slug:"boris-chako-tchamabe",fullName:"Boris Chako Tchamabé"},{id:"183809",title:"Dr.",name:"Gerardo",middleName:null,surname:"Carrasco-Núñez",slug:"gerardo-carrasco-nunez",fullName:"Gerardo Carrasco-Núñez"}]},{id:"49656",doi:"10.5772/61974",title:"Optical Satellite Remote Sensing of the Coastal Zone Environment — An Overview",slug:"optical-satellite-remote-sensing-of-the-coastal-zone-environment-an-overview",totalDownloads:2469,totalCrossrefCites:7,totalDimensionsCites:15,abstract:"Optical remote-sensing data are a powerful source of information for monitoring the coastal environment. Due to the high complexity of coastal environments, where different natural and anthropogenic phenomenon interact, the selection of the most appropriate sensor(s) is related to the applications required, and the different types of resolutions available (spatial, spectral, radiometric, and temporal) need to be considered. The development of specific techniques and tools based on the processing of optical satellite images makes possible the production of information useful for coastal environment management, without any destructive impacts. This chapter will highlight different subjects related to coastal environments: shoreline change detection, ocean color, water quality, river plumes, coral reef, alga bloom, bathymetry, wetland mapping, and coastal hazards/vulnerability. The main objective of this chapter is not an exhaustive description of the image processing methods/algorithms employed in coastal environmental studies, but focus in the range of applications available. Several limitations were identified. The major challenge still is to have remote-sensing techniques adopted as a routine tool in assessment of change in the coastal zone. Continuing research is required into the techniques employed for assessing change in the coastal environment.",book:{id:"5104",slug:"environmental-applications-of-remote-sensing",title:"Environmental Applications of Remote Sensing",fullTitle:"Environmental Applications of Remote Sensing"},signatures:"Ana C. Teodoro",authors:[{id:"18485",title:"Dr.",name:"Ana",middleName:null,surname:"Teodoro",slug:"ana-teodoro",fullName:"Ana Teodoro"}]},{id:"49851",doi:"10.5772/62122",title:"Detection of Tree Crowns in Very High Spatial Resolution Images",slug:"detection-of-tree-crowns-in-very-high-spatial-resolution-images",totalDownloads:3240,totalCrossrefCites:8,totalDimensionsCites:13,abstract:"The requirements for advanced knowledge on forest resources have led researchers to develop efficient methods to provide detailed information about trees. Since 1999, orbital remote sensing has been providing very high resolution (VHR) image data. The new generation of satellite allows individual tree crowns to be visually identifiable. The increase in spatial resolution has also had a profound effect in image processing techniques and has motivated the development of new object-based procedures to extract information. Tree crown detection has become a major area of research in image analysis considering the complex nature of trees in an uncontrolled environment. This chapter is subdivided into two parts. Part I offers an overview of the state of the art in computer detection of individual tree crowns in VHR images. Part II presents a new hybrid approach developed by the authors that integrates geometrical-optical modeling (GOM), marked point processes (MPP), and template matching (TM) to individually detect tree crowns in VHR images. The method is presented for two different applications: isolated tree detection in an urban environment and automatic tree counting in orchards with an average performance rate of 82% for tree detection and above 90% for tree counting in orchards.",book:{id:"5104",slug:"environmental-applications-of-remote-sensing",title:"Environmental Applications of Remote Sensing",fullTitle:"Environmental Applications of Remote Sensing"},signatures:"Marilia Ferreira Gomes and Philippe Maillard",authors:[{id:"177110",title:"Dr.",name:"Philippe",middleName:null,surname:"Maillard",slug:"philippe-maillard",fullName:"Philippe Maillard"},{id:"177172",title:"Ph.D.",name:"Marilia",middleName:"Ferreira",surname:"Gomes",slug:"marilia-gomes",fullName:"Marilia Gomes"}]}],mostDownloadedChaptersLast30Days:[{id:"66703",title:"P-Wave Teleseismic Tomography: Evidence of Imprints of Deccan Mantle Plume below the Kachchh Rift Zone, Gujarat, India",slug:"p-wave-teleseismic-tomography-evidence-of-imprints-of-deccan-mantle-plume-below-the-kachchh-rift-zon",totalDownloads:2602,totalCrossrefCites:2,totalDimensionsCites:2,abstract:"The Indian plate had experienced the Deccan volcanism at 65 Ma when it moved over the Re-union hotspot, which has altered lithospheric structure below the Kachchh rift zone (KRZ). To quantify the influence of Deccan volcanism on the crust-mantle, the present chapter focuses on the delineation of the upper mantle structure below the KRZ, through the modeling of crust corrected P-residuals and P-wave teleseismic tomography. The crust corrected normalized P-residuals suggest dominant negative residuals associated with the central KRZ, indicating crustal and lithospheric thinning below the KRZ. A low velocity down to a depth of 170 km below the central KRZ is detected through the teleseismic tomography using these P-residuals. However, these residuals also show positive values for the surrounding un-rifted zones. Note that a low shear velocity zone extending from 100–120 km to 170–220 km depth beneath the central KRZ has already been revealed by the modeling of P-RFs. This reduction in seismic velocity in the upper mantle could be explained by the presence of trapped carbonatite/partial melts related to the Deccan volcanism. The influx of volatile CO2 emanating from the carbonatite melts in the asthenosphere might be generating lower crustal earthquakes occurring in the KRZ.",book:{id:"7677",slug:"forecasting-volcanic-eruptions",title:"Forecasting Volcanic Eruptions",fullTitle:"Forecasting Volcanic Eruptions"},signatures:"Prantik Mandal",authors:[{id:"279344",title:"Dr.",name:"Prantik",middleName:null,surname:"Mandal",slug:"prantik-mandal",fullName:"Prantik Mandal"}]},{id:"49608",title:"Remote Sensing of Mountain Glaciers and Related Hazards",slug:"remote-sensing-of-mountain-glaciers-and-related-hazards",totalDownloads:2386,totalCrossrefCites:1,totalDimensionsCites:5,abstract:"Mountain glaciers are highly sensitive to temperature and precipitation fluctuations and active geomorphic agents in shaping the landforms of glaciated regions which are direct imprints of past glaciations, providing reliable evidence of the evolution of the past Cryosphere and contain important information on climatic variables. But most importantly, glaciers have aroused a lot of concern in terms of glacier area changes, thickness change, mass balance and their consequences on water resources as well as related hazards. The contribution of glacier mass loss to global sea-level rise and increasing number of glacier-related hazards are the most important and current socioeconomic concerns. Therefore, understanding the dynamics of the changes and constant monitoring of glaciers are essential for studying climate, water resource management and hydropower and also to predict and evade glacier-related hazards. The recent advances in the techniques of earth observations have proved as a boon for investigating glaciers and glacier-related hazards. Remote sensing technology enables extraction of glacier parameters such as albedo/reflectance/scattering, glacier area, glacier zones and facies, equilibrium line, glacier thickness, volume, mass balance, velocity and glacier topography. The present chapter explores the prospective of remote sensing technology for understanding and surveying glaciers formed at high, inaccessible mountains and glacier-induced hazards.",book:{id:"5104",slug:"environmental-applications-of-remote-sensing",title:"Environmental Applications of Remote Sensing",fullTitle:"Environmental Applications of Remote Sensing"},signatures:"Pratima Pandey, Alagappan Ramanathan and Gopalan\nVenkataraman",authors:[{id:"18342",title:"Prof.",name:"Ramanathan",middleName:null,surname:"Alagappan",slug:"ramanathan-alagappan",fullName:"Ramanathan Alagappan"},{id:"177179",title:"Dr.",name:"Pratima",middleName:null,surname:"Pandey",slug:"pratima-pandey",fullName:"Pratima Pandey"},{id:"178231",title:"Prof.",name:"Gopalan",middleName:null,surname:"Venkataraman",slug:"gopalan-venkataraman",fullName:"Gopalan Venkataraman"}]},{id:"60548",title:"Volcanic Glass and its Uses as Adsorbent",slug:"volcanic-glass-and-its-uses-as-adsorbent",totalDownloads:1601,totalCrossrefCites:1,totalDimensionsCites:3,abstract:"Volcanic glasses are an amorphous phyllosilicates formed by the fast cooling of the magma. The physicochemical properties of volcanic glasses are directly related to their chemical composition. Thus, the rhyolitic magma, which presents the highest SiO2 percentage, displays a high viscosity, which leads to explosive eruptions by the ex-solution of H2O, CO2, and SO2, when the pressure diminishes generates a macroporous structure with interesting applications in construction, as abrasive, acoustic, filter as well as in the agriculture field. The macroporosity of volcanic glass allows to host large molecules as biomolecules, tensoactives, or dyes. On the other hand, the existence of hydroxyl groups in this amorphous aluminosilicate also favors the adsorption of cations and anions, so the volcanic glass is an economical adsorbent to retain heavy metals or radioactive cations.",book:{id:"6104",slug:"volcanoes-geological-and-geophysical-setting-theoretical-aspects-and-numerical-modeling-applications-to-industry-and-their-impact-on-the-human-health",title:"Volcanoes",fullTitle:"Volcanoes - Geological and Geophysical Setting, Theoretical Aspects and Numerical Modeling, Applications to Industry and Their Impact on the Human Health"},signatures:"Juan Antonio Cecilia, Miguel Armando Autie-Pérez, Juan Manuel\nLabadie-Suarez, Enrique Rodríguez Castellón and Antonia Infantes\nMolina",authors:[{id:"126325",title:"Dr.",name:"Enrique",middleName:null,surname:"Rodríguez-Castellón",slug:"enrique-rodriguez-castellon",fullName:"Enrique Rodríguez-Castellón"}]},{id:"57502",title:"The Characteristics of Volcanic Eruption in Indonesia",slug:"the-characteristics-of-volcanic-eruption-in-indonesia",totalDownloads:1846,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"This chapter discusses the unique characteristics of the volcanic eruptions in Indonesia. We know that Indonesia has 147 volcanoes and 76 of them are active volcanoes and spread along the islands of Java, Lesser Sunda, Sumatra, and Celebes. The characteristics of Indonesian volcanoes are quite unique in terms of the formation process, eruption phenomenon, and the resulting natural disasters. Most volcanoes in Indonesia consist of stratovolcanoes, but this does not mean that the resulting eruptions are always explosive and they have a long period. This can be seen from the activity of Semeru that always erupts effusively every day, Sinabung that has a very short eruption period, Tangkuban Perahu eruption that occurs suddenly with the lack of early signs, and Merapi and Kelud that have eruption period that is getting shorter. Based on the results of our study it can be known that the types of volcanic eruption are influenced by the structure of the constituent rocks of the volcanoes. However, the presence of external control factors in the form of large-scale earthquakes will affect their periodicity. The large earthquakes can affect the stability of the magma chamber that can trigger a premature eruption.",book:{id:"6104",slug:"volcanoes-geological-and-geophysical-setting-theoretical-aspects-and-numerical-modeling-applications-to-industry-and-their-impact-on-the-human-health",title:"Volcanoes",fullTitle:"Volcanoes - Geological and Geophysical Setting, Theoretical Aspects and Numerical Modeling, Applications to Industry and Their Impact on the Human Health"},signatures:"Eko Hariyono and Liliasari S",authors:[{id:"214360",title:"Dr.",name:"Eko",middleName:null,surname:"Hariyono",slug:"eko-hariyono",fullName:"Eko Hariyono"},{id:"219699",title:"Prof.",name:"Liliasari",middleName:null,surname:"S",slug:"liliasari-s",fullName:"Liliasari S"}]},{id:"51105",title:"How Polygenetic are Monogenetic Volcanoes: Case Studies of Some Complex Maar‐Diatreme Volcanoes",slug:"how-polygenetic-are-monogenetic-volcanoes-case-studies-of-some-complex-maar-diatreme-volcanoes",totalDownloads:1939,totalCrossrefCites:5,totalDimensionsCites:15,abstract:"The increasing number of field investigations and various controlled benchtop and large‐scale experiments have permitted the evaluation of a large number of processes involved in the formation of maar‐diatreme volcanoes, the second most common type of small‐volume subaerial volcanoes on Earth. A maar‐diatreme volcano is recognized by a volcanic crater that is cut into country rocks and surrounded by a low‐height ejecta rim composed of pyroclastic deposits of few meters to up to 200 m thick above the syn‐eruptive surface level. The craters vary from 0.1 km to up to 5 km wide and vary in depth from a few dozen meters to up to 300 m deep. Their irregular morphology reflects the simple or complex volcanic and cratering processes involved in their formation. The simplicity or complexity of the crater or the entire maar itself is usually observed in the stratigraphy of the surrounding ejecta rings. The latter are composed of sequences of successive alternating and contrastingly bedded phreatomagmatic‐derived dilute pyroclastic density currents (PDC) and fallout depositions, with occasional interbedded Strombolian‐derived spatter materials or scoria fall units, exemplifying the changes in the eruptive styles during the formation of the volcano. The entire stratigraphic sequence might be preserved as a single eruptive package (small or very thick) in which there is no stratigraphic gap or significant discordance indicative of a potential break during the eruption. A maar with a single eruptive deposit is quantified as monogenetic maar, meaning that it was formed by a single eruptive vent from which only a small and ephemeral magma erupted over a short period of time. The stratigraphy may also display several packages of deposits separated either by contrasting discordance surfaces or paleosoils, which reflect multiple phases or episodes of eruptions within the same maar. Such maars are characterized as complex polycyclic maars if the length of time between the eruptive events is relatively short (days to years). For greater length of time (thousands to millions of years), the complex maar will be quantified as polygenetic. These common depositional breaks interpreted as signs of temporal interruption of the eruptions for various timescales also indicate deep magma system processes; hence magmas of different types might erupt during the formation of both simple and complex maars. The feeding dikes can interact with groundwater and form closely distributed small craters. The latter can coalesce to form a final crater with various shapes depending on the distance between them. This observation indicates the significant role of the magmatic plumbing system on the formation and growth of complex and polygenetic maar‐diatreme volcanoes.",book:{id:"5311",slug:"updates-in-volcanology-from-volcano-modelling-to-volcano-geology",title:"Updates in Volcanology",fullTitle:"Updates in Volcanology - From Volcano Modelling to Volcano Geology"},signatures:"Boris Chako Tchamabé, Gabor Kereszturi, Karoly Németh and\nGerardo Carrasco‐Núñez",authors:[{id:"51162",title:"Dr.",name:"Károly",middleName:null,surname:"Németh",slug:"karoly-nemeth",fullName:"Károly Németh"},{id:"62029",title:"Dr.",name:"Gabor",middleName:null,surname:"Kereszturi",slug:"gabor-kereszturi",fullName:"Gabor Kereszturi"},{id:"182834",title:"Dr.",name:"Boris",middleName:null,surname:"Chako Tchamabé",slug:"boris-chako-tchamabe",fullName:"Boris Chako Tchamabé"},{id:"183809",title:"Dr.",name:"Gerardo",middleName:null,surname:"Carrasco-Núñez",slug:"gerardo-carrasco-nunez",fullName:"Gerardo Carrasco-Núñez"}]}],onlineFirstChaptersFilter:{topicId:"658",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:89,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:104,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:32,numberOfPublishedChapters:318,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:12,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:141,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:113,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:106,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:5,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:15,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. 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