Physiology of Myocardial Contraction

  • Mark R. Starling

Abstract

The principal function of the heart is to propel oxygenated blood to the peripheral tissues to meet their metabolic demands. The systemic arterial and venous systems provide the conduits. The interaction of the left ventricle (LV) with the arterial and venous systems is therefore integral to the satisfactory performance of this vital function. It is important to understand how the normal heart functions and how it interacts with the systemic arterial and venous systems as a prelude to comprehending how it is affected by various pathologic conditions. This chapter provides a physiologic framework for understanding normal cardiac contraction and relaxation and the interaction of the LV with the systemic arterial and venous systems by developing seven basic concepts. Taken together, these concepts can be used to provide insight into abnormal cardiac mechanisms in pathophysiologic conditions.

Keywords

Sarcomere Length Contractile Element Myocardial Contraction Left Ventricular Volume Left Ventricular Pressure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Parmley WW, Sonnenblick EH: Series elasticity in heart muscle. Circ Res 1967, 20: 112–123.PubMedCrossRefGoogle Scholar
  2. 2.
    Sonnenblick EH: Force-velocity relations in mammalian heart muscle. Am J Physiol 1962, 202: 931–939.PubMedGoogle Scholar
  3. 3.
    Burns JW, Covell JW, Ross J: Mechanics of isotonic left ventricular contractions. Am J Physiol 1973, 224: 725–732.PubMedGoogle Scholar
  4. 4.
    Kentish JC, Wrzosek A: Changes in force and cytosolic Ca2+ concentration after length changes in isolated rat ventricular trabeculae. J Physiol 1998, 506: 431–444.PubMedCrossRefGoogle Scholar
  5. 5.
    Braunwald E, Sonnenblick EH, Ross J: Mechanisms of cardiac contraction and relaxation. In Heart Disease: A Textbook of Cardiovascular Medicine, edn 3. Edited by Braunwald E. Philadelphia: WB Saunders; 1988: 383–425.Google Scholar
  6. 6.
    Gordon AM, Huxley AF, Julian FJ: The variation in isometric tension with sarcomere length in vertebrate muscle fibers. J Physiol 1966, 184: 170–192.PubMedGoogle Scholar
  7. 7.
    Spotnitz HM, Sonnenblick EH, Spiro D: Relation of ultrastructure to function in the intact heart: sarcomere structure relative to pressure-volume curves of intact left ventricles of dog and cat. Circ Res 1966, 18: 49–66.PubMedCrossRefGoogle Scholar
  8. Sonnenblick EH, Ross J, Covell JW, et al The ultrastructure of the heart in systole and diastole. Circ Res 1967, 21:423–431.Google Scholar
  9. Ross J Jr, Sonnenblick EH, Covell JW, et al Architecture of the heart in systole and diastole: technique of rapid fixation and analysis of left ventricular geometry. Circ Res 1967, 21:409–421.Google Scholar
  10. 10.
    Berne RM, Levy MN: Cardiovascular Physiology, edn 3. St Louis: Mosby; 1977.Google Scholar
  11. 11.
    Badke FR, O’Rourke RA: Cardiovascular physiology. In Internal Medicine, edn 1. Edited by Stein JH. Boston: Little, Brown and Co.; 1983: 407–423.Google Scholar
  12. 12.
    Mirsky I: Left ventricular stresses in the intact human heart. Biophys J 1969, 9: 189–208.Google Scholar
  13. 13.
    Ross J: Applications and limitations of end-systolic measures of ventricular performance. Fed Proc 1984, 43:2418–2422.Google Scholar
  14. 14.
    Potts JT, McKeown KP, Shoukas AA: Reduction in arterial compliance alters carotid baroreflex control of cardiac output in a model of hypertension. Am J Physiol 1998, 274 (suppl H): 1121–1131.Google Scholar
  15. 15.
    Glantz SA, Parmley WW: Factors which affect the diastolic pressure-volume curve. Circ Res 1978, 42: 171–180.PubMedCrossRefGoogle Scholar
  16. 16.
    Gilbert JC, Glantz SA: Determinants of left ventricular filling and of the diastolic pressure-volume relation. Circ Res 1989, 64: 827–852.PubMedCrossRefGoogle Scholar
  17. 17.
    Mirsky I: Assessment of diastolic function: suggested methods and future considerations. Circulation 1984, 69: 836–841.PubMedCrossRefGoogle Scholar
  18. Hess OM, Bhargava V, Ross J, et al The role of the pericardium in interactions between the cardiac chambers. Am Heart J 1983, 106:1377–1383.Google Scholar
  19. Shirato K, Shabetai R, Bhargava V, et al Alteration of the left ventricular diastolic pressure-segment length relation produced by the pericardium. Circulation 1978, 57:1191–1197.Google Scholar
  20. 20.
    Rothe CF: Physiology of venous return: an unappreciated boost to the heart. Arch Intern Med 1986, 146: 977–982.PubMedCrossRefGoogle Scholar
  21. 21.
    Guyton AC, Jones CE, Coleman TG: Graphical analysis of cardiac output regulation. In Circulatory Physiology: Cardiac Output and Its Regulation, edn 2. Edited by Guyton AC, Jones CE, Lobwan TG. Philadelphia: WB Saunders; 1973: 237–252.Google Scholar
  22. 22.
    Ross J: Afterload mismatch and preload reserve: a conceptual framework for the analysis of ventricular function. Prog Cardiovasc Dis 1976, 18: 255–264.PubMedCrossRefGoogle Scholar
  23. Lee JD, Tajimi T, Ptritti J, et al Preload reserve and mechanisms of afterload mismatch in normal conscious dog. Am J Physiol 1986, 250:H464–H473.Google Scholar
  24. Kaseda S, Tomoike H, Ogata I, et al End-systolic pressure-volume, pressure-length and stress-strain relations in canine hearts. Am J Physiol 1985, 249:H648–H654.Google Scholar
  25. Maughan WL, Sunagawa K, Burkhoff D, et al Effect of heart rate on the canine end-systolic pressure-volume relationship. Circulation 1985, 72:654–659.Google Scholar
  26. 26.
    Suga H, Sagawa K: Instantaneous pressure-volume relationships and their ratio in the excised supported canine left ventricle. Cire Res 1974, 35: 117–126.CrossRefGoogle Scholar
  27. 27.
    Mitchell JH, Wallace AG, Skinner NS: Intrinsic effects of heart rate on left ventricular performance. Are J Physiol 1963, 205: 41–48.Google Scholar
  28. Covell JW, Ross J, Taylor R, et al Effects of increasing frequency of contraction on the force-velocity relation of left ventricle. Cardiovasc Res 1967, 1:2–8.Google Scholar
  29. Higgins CB, Vatner SF, Franklin D, et al Extent of regulation of the heart’s contractile state in the conscious dog by alteration in the frequency of contraction. J Clin Invest 1973, 52:1187–1194.Google Scholar
  30. 30.
    Klautz RJ, Baan J, Teitel DF: The effect of sarcoplasmic reticulum blockade on the force/frequency relationship and systolic contraction patterns in the newborn pig heart. Eur J Physiol 1997, 435: 130–136.CrossRefGoogle Scholar
  31. Latham RD, Rubal BJ, Sipkema P, et al Ventricular/vascular coupling and regional arterial dynamics in the chronically hypertensive baboon: correlation with cardiovascular structural adaptation. Cire Res 1988, 63:798–811.Google Scholar
  32. 32.
    Finkelstein SM, Collins VR: Vascular hemodynamic impedance measurement. Prog Cardiovasc Dis 1982, 24: 401–418.PubMedCrossRefGoogle Scholar
  33. 33.
    Nichols WW, Conti CR, Walker WE, Milnor WR: Input impedance of the systemic circulation in man. Cire Res 1977, 40: 451–458.CrossRefGoogle Scholar
  34. Murgo JP, Westerhof N, Giolma JP, et al Aortic input impedance in normal man: relationship to pressure wave forms. Circulation 1980, 62:105–116.Google Scholar
  35. Nishioka O, Maruyama Y, Ashikawa K, et al Effects of changes in afterload impedance on left ventricular ejection in isolated canine hearts: dissociation of end-ejection from end-systole. Cardiovasc Res 1987, 21:107–118.Google Scholar
  36. 36.
    Britman NA, Levine HJ: Contractile element work: a major determinant of myocardial oxygen consumption. J Clin Invest 1964, 43: 1397–1408.PubMedCrossRefGoogle Scholar
  37. Suga H, Hayashi T, Shirahata M, et al Regression of cardiac oxygen consumption on ventricular pressure-volume area in dog. Ani J Physiol 1981, 240:H320–F1325.Google Scholar
  38. Suga H, Yasumura Y, Nozawa T, et al Prospective prediction of Oz consumption from pressure-volume area in dog hearts. Ani J Physiol 1987, 252:H1258–H1264.Google Scholar
  39. 39.
    Monroe G, French GN: Left ventricular pressure-volume relationships and myocardial oxygen consumption in the isolated heart. Cire Res 1961, 9: 362–374.CrossRefGoogle Scholar
  40. 40.
    Suga H: External mechanical work from relaxing ventricle. Ani J Physiol 1979, 236: H494 - H497.Google Scholar
  41. Suga H, Hisano R, Hirata S, et al Heart rate-independent energetics and systolic pressure-volume area in dog hearts. Am J Physiol 1983, 244:H206–H214.Google Scholar
  42. Suga H, Hisano R, Goto Y, et al Effect of positive inotropic agents on the relation between oxygen consumption and systolic pressure-volume area in canine left ventricle. Cire Res 1983, 53:306–318.Google Scholar
  43. Sonnenblick EH, Ross J, Covell JW, et al Velocity of contraction as a determinant of myocardial oxygen consumption. Ani J Physiol 1965, 209:919–927.Google Scholar
  44. 44.
    Gibbs CL, Gibson WR: lsoprenaline, propranolol and the energy output of rabbit cardiac muscle. Cardiovasc Res 1972, 6: 508–515.PubMedCrossRefGoogle Scholar
  45. Nozawa T, Yasumura Y, Futaki S, et al Relation between oxygen consumption and pressure-volume area of in situ dog heart. Am J Physiol 1987, 253:H31–H40.Google Scholar
  46. Starling MR, Mancini GBJ, Montgomery DG, et al Relation between maximum time-varying elastance pressure-volume areas and myocardial oxygen consumption in dogs. Circulation 1991, 83:304–314.Google Scholar
  47. 47.
    Corr PB, Yamada KA, Witkowski FX: Mechanisms controlling cardiac autonomic function and their relation to arrythmogenesis. In The Heart and Cardiovascular System. Edited by Fozzard HA, Haber E, Jennings RB, et al. New York: Raven Press; 1986: 1357–1371.Google Scholar
  48. 48.
    Levy MN, Martin PJ: Neural control of the heart. In Physiology and Pathophysiology of the Heart, edn 1. Edited by Sperilakis N. Boston: Martinus Nijhoff Publishing; 1984: 337–354.Google Scholar
  49. 49.
    Levy MN: Sympathetic-parasympathetic interactions in the heart. Cire Res 1971, 29: 437–445.CrossRefGoogle Scholar
  50. DeGeest H, Levy MN, Zieske H, et al Depression of ventricular contractility by stimulation of the vagus nerves. Cire Res 1963, 17:222–235.Google Scholar
  51. 51.
    Vatner SF, Rutherford JD, Ochs HR: Baroreflex and vagal mechanisms modulating left ventricular contractile responses to sympathomimetic amines in conscious dogs. Cire Res 1979, 44: 195–207.CrossRefGoogle Scholar

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© Springer Science+Business Media New York 2005

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  • Mark R. Starling

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