Ischaemic heart failure: a new explanation of its cause and preventability

Abstract

When the heart contracts, it compresses its own arteries, so that blood flow in the coronary circulation comes to a standstill during systole. The heart must be supplied with blood from an auxiliary supply during diastole. The auxiliary pump is the aorta and its branches. When the stroke volume is injected into the aorta, it is overfilled and distended, storing energy in stretched elastic tissues. During diastole the contraction of these tissues maintains diastolic pressure. The hardest working organ in the body, the heart, therefore is supplied with blood only intermittently and only at diastolic pressure. In addition a layer of calcium tends to accumulate in the aorta, deteriorating its elasticity. It is suggested that this auxiliary pump is the weakest link in the circulatory system. If it fails, the heart dies of ischaemia. The calcium requirements of the body vary greatly in various age groups; 99% of the calcium content of the adult body is in the skeleton, which is complete by the age of 32 years. After that calcium requirements decrease. Catering for such varying calcium needs the gut to be impermeable to calcium. A special substance, 1,25,-dihydroxycholecalciferol, secreted by the liver and kidneys is needed to transfer calcium through the intestinal wall. When calcium needs are satisfied, the synthesis of cholecalciferol is discontinued, and the calcium in food in the intestines is excreted. To cater for the other extreme, when the calcification of the infant skeleton needs much calcium, nature produces a special nutrient, milk, not only rich in calcium, but containing a substance promoting its transference through the intestinal wall. The human habit of consuming the milk of another species is harmful because it invalidates the natural expedient of limiting calcium intake when it is not needed. The calcium excess resulting from milk consumption tends to calcify the aorta, deteriorating its elasticity, resulting in lower diastolic pressure. When that becomes inadequate, the heart dies of ischaemia.