Black Holes of Smooth Muscle Physiology: Myogenic Automaticity and Vascular Basal Tone

The term ‘vascular tone’ refers to blood vessels existing in a state of partial constriction. Arterial vascular tone is particularly important, having two vital physiological functions: to maintain arterial blood pressure essential for an adequate arterio-venous pressure-gradient and thus blood flow throughout the body; and to modulate blood flow to the various tissues and organs in concert with their metabolic requirements. Ultimately, vascular tone is subject to the degree of vascular smooth muscle cell contraction. The biology of vascular smooth muscle contraction and relaxation has been an area of intense study for over a century, from Bayliss’s observations on the effects of pressure changes on bat-wing arteries to modern investigations of miRNA, molecular microscopy and the whole variety of ‘omics’. Agents modulating vascular tone are amongst the most widely prescribed drugs in the world. Yet, disorders of vascular tone persist, from primary hypertension to coronary and cerebral vasospasm to the recently identified ‘NOCA’ diseases (Ischemia, Angina or Myocardial Infarction with Non-Occluded Coronary Arteries). At the outset of this engrossing and comprehensive new book, Anatoly Soloviev argues that failure to understand the fundamental mechanisms controlling basal vascular smooth muscle tone - a “black hole” at the centre of vascular physiology - is impeding development of effective therapeutic strategies against diseases, or indeed syndromes involving abnormal vessel constriction. The book sets out to explore the hole and fill it with some engrossing, cogently argued theories. Ideas and evidence are communicated in the author unique style combining physiology and biophysics with other scientific disciplines, history, literate quotations and admirable acknowledgement of his Ukranian, Russian and eastern European forebears and colleagues.