Historical Aspects: The Frank-Starling Mechanism

  • Christian J. F. Holubarsch
Part of the Basic Science for the Cardiologist book series (BASC, volume 10)


To guarantee sufficient blood supply to all organs during a life of a mammalian organism, arterial blood pressure has to be controlled permanently within narrow physiological ranges. This is achieved by several biological systems that regulate peripheral circulation as well as a number of mechanisms influencing the vigor of the heart beat. The following mechanisms influence cardiac contractile performance in concert: (1) The Frank-Starling mechanism [1,2]; (2) the Bowditch-Treppe [3]; (3) the sympathetic and parasympathetic nervous system [4]; and (4) some vasoactive hormones (angiotensins [5,6], endothelin [7,8,9]). The preload or muscle-length dependency of cardiac contractile performance has been called Frank-Starling mechanism (FSM), because the German physiologist Otto Frank was the first who gave a profound description and an exact definition of this fundamental physiological phenomenon already in 1895: “…this finding falls under the above mentioned law established by Fick [10] for skeletal muscle and by me for the heart muscle: The maximal tension of isometric contraction at first increases with augmentation of the initial length (or initial tension [end-diastolic]). It is inherent in the above law that the absolute strength is represented by the maximal tensions of the first part of the isometric family curves” (Figure 1).


Stroke Volume Sarcomere Length Constrictive Pericarditis Left Ventricular Stroke Volume Frog Heart 
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© Springer Science+Business Media New York 2002

Authors and Affiliations

  • Christian J. F. Holubarsch
    • 1
  1. 1.Department of Cardiology & Angiology, Medizinische KlinikUniversity of FreiburgFreiburgGermany

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