Continuing demand for this book confirms that it remains relevant over 30 years after its first publication. The fundamental explanations are largely unchanged, but in the new introduction to this second edition the authors are on hand to guide the reader through major advances of the last three decades. With an emphasis on physical explanation rather than equations, Part I clearly presents the background mechanics. The second part applies mechanical reasoning to the component parts of the circulation: blood, the heart, the systemic arteries, microcirculation, veins and the pulmonary circulation. Each section demonstrates how an understanding of basic mechanics enhances our understanding of the function of the circulation as a whole. This classic book is of value to students, researchers and practitioners in bioengineering, physiology and human and veterinary medicine, particularly those working in the cardiovascular field, and to engineers and physical scientists with multidisciplinary interests.

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Stiffening of blood vessel walls occurs in the early stages of atherosclerosis, and this process is known to occur earlier in diabetic subjects. The effect could be due, in part, to glycation. Although collagen is responsible for ensuring the ultimate tensile strength of the tissue, elastin largely determines the compliance of the vessel wall in the normal physiological range of pressures and this appears to be closely matched to haemodynamic requirements. Changes in elastin are therefore likely to affect optimal function of the tissue. We have investigated the susceptibility of elastin to glycation and effects of glycation on its mechanical and physicochemical properties. We found that purified elastin and a collagen-elastin preparation from the porcine thoracic aorta rapidly incorporated glucose and ribose, the extent increasing linearly with increasing concentration and reaching a maximum after 7 days at 37 degrees C. Biochemical analysis showed that about one of the five lysines available per elastin monomer was glycated after 12 days incubation at a sugar concentration of 250 mmol/l. In long-term incubations glycation was associated with the appearance of the advanced glycation end products, the fluorescent cross-link pentosidine and the non-fluorescent putative cross-link NFC-1. In both purified elastin and the whole elastin-collagen matrix the slope of the force-extension curve increased significantly with glycation. The greatest increase in stiffness was observed in the elastin-collagen preparation after ribose incubation (250 mmol/l for 1 month), where the slope, at large strain, increased by 56 +/- 19% (mean +/- SD, n = 12). The diameter of the tissue at 1 N force also changed: for elastin there was an increase in length of approximately 5%, but for the elastin-collagen there was a decrease of similar magnitude indicating that glycation introduces differential strains within the fibrous protein matrix. Potentiometric titration demonstrated that glycation was associated both with loss of basic groups and shifts in pK of the acidic groups, which indicated changes in the environment of the charge groups due to conformational rearrangements. Changes in ion binding were dependent on pH, and were consistent with a reduction in effective anionic charge. Calcium binding to elastin was increased at acid pH, but decreased at higher pH. We suggest that these effects are not only due to changes in the charge profile, but also in the conformation of the molecule resulting from glycation of the charged lysine and arginine side-chain residues.

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