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Plot of the simultaneous changes in left ventricular circumference, base‐to‐apex length, circumflex‐to‐apex length (L1), aorta‐to‐apex length during a single cardiac contraction in an awake dog. Dimensions are determined with biplane cineradiography of radiopaque markers.
Data obtained from surgically implanted intramyocardial markers in transplanted human hearts by Hansen et al. . Data shown indicate the relationship between left ventricular volume [V(t)] during four successive contractions and torsional rotation [θ(t)] of the apex with respect to the base shown as a clockwise angular rotation during systole.
Data from an isolated servocontrolled canine left ventricular preparation . Solid symbols show peak calculated stress in isovolumic beats. Open symbols depict three isotonic contractions obtained at different afterloads.
Data from an isolated canine left ventricular preparation in which left ventricular pressure and volume are determined throughout contraction . Note that the ratio of pressure to volume reaches a stable maximum at end‐systole.
Data from the same preparation shown in Figure , demonstrating four contractions at variable systolic pressures before and after the administration of norepinephrine. The solid points indicate the maximum pressure‐volume ratio in each contraction. The linear relationship formed by these points has been termed “the end‐systolic pressure‐volume relationship.” The slope of this relationship, designated Emax by Suga and Sagawa , changes with changes in inotropic state induced by norepinephrine.
Schematic diagram of the effects of alterations in preload and afterload on ventricular stroke volume.
Data from conscious animals before (open symbols) and after tachycardia‐induced heart failure (closed symbols). Stroke volume is plotted on the ordinate. Note that baseline stroke volume is maintained by an increase in end‐diastolic volume .
Data from the isolated heart preparation . Note that in isotonic contractions there is a linear relationship between stroke volume or change in circumference (ΔL) and ventricular stress or pressure.
Relationship between global and regional indices of stroke work and ventricular end‐diastolic pressure or ventricular volume in conscious instrumented dogs. Changes in diastolic pressures and volumes were induced by caval occlusion. The relationships between ventricular end‐diastolic pressure and segment work and stroke work are non‐linear, but sensitive to the inotropic effect of calcium. The relationship ventricular between end‐diastolic volume or segment work and stroke work are linear and sensitive to changes in inotropic state.
Left ventricular pressure segment length (SL) relationships determined in the dog by caval occlusion before (solid lines) and after (dotted lines) a sustained increase in end‐diastolic pressure. Following the increases in end‐diastolic pressure the end‐systolic pressure length points are all shifted to the left, indicating a shift in the end‐systolic pressure‐length relationship .
Data from studies on the interaction of the adrenergic system and the force–frequency relationship obtained in intact dogs. The plot shows the relation between heart rate and max dP/dt (left ventricular maximum dP/dt) in conscious dogs standing at rest and during sustained exercise at several heart rates. The lowest heart rate represents the resting condition (C) and the highest heart rate, that during exercise with atrial pacing at 240 beats per minute. The intermediate heart rates show the effects of reducing the pacing rate progressively during continued exercise, with the sinus node rate controlled at a low level by zatebradine. ** = p <0.001 vs. 240 beats/min. Values are mean ± SD.
Schematic diagram of the four major factors influencing myocardial inotropic state .
Relative sensitivity of several indices to inotropic stimulation in an isolated canine heart preparation Ees = slope of the end‐systolic pressure–volume relationship. Ef = ejection fraction, V = volume SW = stroke work; SW/Ved = stroke; MSER = stoke volume/systolic ejection period; VCFmax = maximal value of (−dV/dT)/Ved; dp/dt/IP = maximum +dP/dT/ developed pressure at the time of dp/dtmax.
Relative load sensitivity of several indices determined in an isolated canine heart preparation. The maximum percent change (comparing the highest and lowest load) was calculated for each index See Fig. 20–140 .
Coefficient of variation defined as (SD/mean) × 100 for several inotropic indices determined five times over 3 weeks. C = control; AB = autonomic blockade; AN = anesthesia .
Dimension gauge signals from an open‐chest canine preparation. All three gauges are orientated in the circumferential direction. Gauges are located at three apex base levels (apex, mid, base) .
Finite strains determined in the left ventricular free wall in an open‐chest canine preparation. Data shown are from the inner half of the ventricular wall. E11 = circumferential strain; E22 = longitudinal strain; E33 = radial (wall thickening strain); E12 = circumferential longitudinal shear; E13 = circumferential radial shear; E23 = longitudinal radial shear.
Unpublished data from Villareal et al.
Reconstructed sarcomere lengths (C and D) during a single cardiac cycle. Note that there are marked differences between cavity volume and sarcomere length during filling and ejection and that during isovolumic contraction there are large transitions in sarcomere length without a corresponding change in ventricular volume (B).
Average end‐systolic wall thickening strain (E33) and longitudinal radial shear (E23) in the subendocardium of the left ventricular free wall (solid bars) and septum (hatched bars). B shows the cleavage plane orientation at the two sites.
Proposed mechanism of ventricular wall thickening.
Schematic representation of pressure‐volume area (PVA). Solid line indicates the pressure volume trajectory of a single contraction (P‐V loop) plotted in the end‐systolic and end‐diastolic pressure‐volume framework. The area shown by the diagonal lines is the pressure volume area.
Correlations between cardiac oxygen consumption per beat (VO2) and PVA in control panels (A, C) and following epinephrine (B) and calcium (D). Inset shows the contractions from which the ESPVR is determined for each panel (closed symbols represent isovolumic beats, opening ejecting contractions).
Left ventricular pressure‐volume relationship adapted from the work of Taylor et al. . Dashed line indicates the pressure‐volume relationship corrected for the contribution of the right ventricle in a single animal, and the error bars indicate the SD over 8 animals. Solid line schematically estimates the pressure‐volume relationship on deflation.
Left ventricular pressure diameter relationships from three contractions in a conscious dog. The dashed line indicates the passive pressure diameter relationship determined in the same animal from the end‐diastolic pressure diameter point in several contractions .
Pressure‐volume curves in an isolated buffer perfused rat heart showing the effects of progressive infusion with collagenase. There is a shift toward greater volumes at all pressures that increases with progressive disruption of the extracellular matrix.
Tracings from a conscious dog, illustrating the temporal relationships between mitral valve flow and atrial and left ventricular pressures.
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