The assessment of myocardial performance in the intact heart is usually based upon the concept of an inverse relationship between force and velocity. Since Sonnenblick showed that the velocity of the contractile element VCE is proportional to the relative rate of pressure rise during the isovolumic phase, this scheme has been applied to several experimental and clinical studies [3–7, 9, 14, 15]. Although controversy still exists as to the proper choice of the muscle model and as to the comparability of Vmax from different subjects, there is general agreement that the rate of pressure rise cannot be interpreted in the case of valvular insufficiency [1, 10, 13]. The parameters of the ejection phase, too, are dependent on the loading conditions of the ventricle. An acute increase of the afterload, for instance, combined with no change of contractility results in a reduction of the ejection fraction and of the velocity of fiber shortening [8, 12].
Aortic Stenosis Myocardial Function Power Index Aortic Insufficiency Myocardial Performance
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