Update 1987 pp 263-270 | Cite as

Assessment of Myocardial Function

  • J. P. Goldstein
Part of the Update in Intensive Care and Emergency Medicine book series (UICM, volume 3)


Evaluation of myocardial function remains a key factor in the assessment of the critically ill patient. In the intact circulation, cardiac output is determined by several factors, including loading conditions, heart rate and ventricular contractility. Preload represents the diastolic volume during ventricular filling which distends the relaxed ventricular wall. Afterload is essentially related to the pressure distributed around the ventricular wall during systole and therefore to the aortic blood pressure. Finally, intrinsic ventricular contractility represents the velocity of contraction and the shortening capacity of the ventricle [1]. Therefore, a low cardiac output can be due to a significant decrease in ventricular contractility, to a change in loading conditions, or to both. On the other hand, an increase in cardiac output during administration of pharmacological agent may be related to an increase in the inotropic state, to a reduction in afterload, to an increase in preload, or to a combination of these factors.


Right Ventricle Stroke Work Intraventricular Pressure Series Elastic Element Inotropic State 
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© Springer-Verlag Berlin Heidelberg 1987

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  • J. P. Goldstein

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