• Nikolai Kolev
  • Günter Huemer
  • Michael Zimpfer


When preload and afterload are kept constant, stroke volume is dependent on contractility, or the inotropic state of the myocardium.1 The inotropic state of the myocardium is an intrinsic property that reflects the strength of the muscle fiber, which in turn is influenced by the neurohormonal (especially cardiac sympathetic nerves) and metabolic (pH, Ca++, etc.) milieu. Traditionally, a change in contractility in the intact heart can be defined as an alteration in overall cardiac performance that occurs independently of alterations in preload, afterload or heart rate. Because of the latter confounding variables, it has been difficult to assess left ventricular contractility in humans and particularly in the acute change of settings in surgery.2–3


Cardiac Output Aortic Valve Main Pulmonary Artery Left Ventricular Outflow Tract Left Ventricular Pressure 
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Copyright information

© Springer-Verlag/Wien 1995

Authors and Affiliations

  • Nikolai Kolev
    • 1
  • Günter Huemer
    • 1
  • Michael Zimpfer
    • 2
  1. 1.Department of Anesthesiology and General Intensive CareUniversity of ViennaAustria
  2. 2.University of ViennaAustria

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