The traditions of national physiology, pathophysiology and clinical medicine first of all involve holistic approach to human body that implies the research study of each system to identify its interrelations with other functional systems in scope of their complex dialectical internal unity and dynamic – and all the same dialectic – interrelations with the environment.
This approach has proved to be extremely fruitful for investigation of age-related modifications of the growing heart and the factors that determine the development of cardiovascular system in each age period. They have revealed a strong correlation between the increase of total body size and heart morphogenesis, which violation – if getting over the physiological level of heterohronism – menaces the emergence of the so-called cardiac hypo-evolution that is accompanied by the heart functionality drop. They have also detected a significant degree of correlation between the body weight and the basic dimensions of the heart (its longitudinal axis, diameter, oblique and anteroposterior dimensions) that due to the global phenomenon of acceleration has entailed cardiac enlargement. Until the end of the 1970ies the significant cardiomegaly was not accompanied by the large vessels’ diameter increase, this been one of the preconditions for increased systolic blood pressure in the children and adolescents of today. It has been only within the recent five years that they [R. A. Kalyuzhnaya, N. K. Borisova, 1978] have detected the first signs of the large vessels’ engagement in the long-ongoing process of the heart enlargement.
We should lay special emphasize on the works of such morphologists as A. A. Falk, 1901; V. G. Shtafko, 1936; V. I. Puzik, L. A. Harkov, 1948; A. I. Strukov, 1955; N. I. Gurova, 1978, who obtained the first data on morphological characteristics of the growing organism at different ontogeny stages and have thus laid foundation for further study of the growing organism’ cardiovascular system physiology.
On the basis of morphological data they obtained the first physiological characteristics of the cardiovascular system in children and adolescents, including the norms of its most significant parameters: the heart rate, arterial blood pressure, the electrocardiogram indices and their modifications in response to physical work and other activities [A. I. Arshavsky, 1967; A. A. Biryukovich, 1973; S. Sh. Shamsiev, 1952; R. E. Mazo, 1966; I. N. Woolfson, 1967; R. A. Kalyuzhnaya, 1974; M. K. Oskolkova, 1963, and others].
In compliance with methodological principles of systemacity, i.e. the holistic approach to study of the growing organism development physiology, the primary goal of ontogenetic research work is to determine the interrelations between morpho-functional distinctions of the cardiovascular system of all periods of ontogenesis with the formation of the organism as a whole, as well as of its individual systems. That is, the disclosure of correlations between the heart development pattern and the energy of the total body size growth, the rate of pubescence, the harmony of body, the body tympanum. In this case the object of major interest is the study of correlational between the heart size and volume and the body weight and length, the rate of muscles development. One of the essential criteria of harmonious development is the correspondence between the body length and the size of the heart. The heart’ developmental lag against the total body size rate of growth can cause the so-called hypo-evolution of the heart accompanied by the drop of its functionality [R. A. Kalyuzhnaya, 1973].
The performed analysis of correlation between the body size and the heart size has revealed the index of their interrelation which is not the same for different parameters [L. V. Panava, 1979]. The heart diameter has happened to be correlated mostly to the body weight (the correlation coefficient ranges from 0,384 to 0,664), circumference (r = 0,322—0,630) and the transverse diameter of the chest (r= 0,383—0,652). They have also found sufficiently strong correlations between the body weight and the heart longitudinal axis (/’ = 0,298—0,686), the length of the right ventricle arc’ chord length (the correlation coefficient is 0,384—0,668). The body length is mainly correlated with the oblique diameter of the heart (r = 0,293—0,683) and it shows very low correlation to any other of its dimensions. The frontal area of the heart, it been an integral index of the heart size, is also closely correlated to the body weight (/- = 0,321—0,593%), body length (r = 0,281—0,62%), body surface area (r = 0,377—0,626%), and it shows a strong correlation to the chest circumference – the correlation coefficient between them reaches up the level of 0,602.
The basic heart parameters have happened to be in weak correlation to the chest and legs length, to the width of shoulders and pelvis. The diameter of the aorta, just like the rest of the basic heart parameters, has appeared to be in strong correlation to the body weight (r= 0,271—0,617%).
Ch. V. Panava was to first who analyzed the correlation between the size of the heart and large vessels and the development rate of muscular, adipose and osseous body components and found the highest direct positive correlation to be between the development of muscular system and the size of heart and vessels. Nevertheless in scope of separate correlation analysis of interrelations between the said body components and the heart size the transverse cardiac size has turned out to be more correlated with development of the adipose component of the body weight than of the muscular one.
In view of this and based upon the fact that body type comes as an integral indicator of the nature of correlation between osseous, muscular and adipose components of the body weight, L. V. Panava juxtaposed the development of the heart and vessels with basic body types: the muscular, the thoracic, the digestive and the asthenoid ones. The main criteria of the body type are: the form of the chest, the epigastric angle degree, the ratio of its lateral and longitudinal dimensions, its circumference and the breast bone length. In all age groups these parameters are the lowest among the representatives of the astenoid type, while the children of the digestive type are those who show the highest ones.
The comparative analysis of the heart size and the large vessels diameters in children of different body types has shown the asthenoid frame to be characterized by the smallest size of aorta and pulmonary trunk, which highest value is peculiar to representatives of the muscular physique. The same pattern has been detected in relation to the heart diameter that, though being the smallest in asthenics, reaches its maximum size in case of digestive body type. The same goes with frontal heart surface – the asthenics have the smallest one, while the representatives of the muscular and digestive physiques have this parameter to the highest.
The above-drawn data comes as a clear evidence of fruitfulness of the holistic approach to separate systems and organs development study.
The commentary by E. Akhramieieva, Yoga-therapist
I consider finding the correlation between the size of different human body organs to be a promising and productive field in the medicine of today.
First of all they are interesting because they open up the doors of “individual” medicine. As far as Yoga-therapy is concerned, they enable a more focused and accurate selection of rehabilitation complex for people of various body frames.
Another interesting issue is that the correlations that have been detected match the observations of the ancient physicians. For instance, the intensive direct correlation relationship between the development of muscular system and the size of the heart and vessels discovered by Ch. V. Panava comes in good line with the data taken from Ayurvedic treatises. In Ayurveda they consider the muscular system, the heart and vessels to be controlled by Pitta Dosha (the dosha of fire). The listed body elements are to the best developed in people who have this Dosha predominant in their bodies. In Western medicine the Pitta-Dosha physique corresponds to the normosthenic body type (in compliance with classification of M. V. Chernorutsky), or the athletic body frame.
Based upon our knowledge of these patterns we may suppose that for people of Pitta-Dosha body type the harmonious physical load will be the one that involves harmonious physical stress for the heart, vessels and body muscles. This can be a complex that includes active warm-up, asanas with muscle-strengthening component and Bhastrika.
Finding the correlation between other body components and parameters of physiological functions require further research work to be performed.