Chairman's Introduction

Guz, A.

doi:10.1002/9780470720066.ch1

Cited by 2 publications

(1 citation statement)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An understanding of the concepts that relate to preload and its importance for understanding heart function benefits from a historical perspective, and such a perspective can be found in complementary reviews that describe the early contributions to the formulation and understanding of what has become commonly known as the Frank-Starling mechanism (26,33,42,64). It was experiments in the early 19th century in skeletal muscle that first showed that progressive stretching of a resting muscle before contraction results in not only an increase in resting tension, but also greater tension development and energy production during contraction (33).…”

Section: Introductionmentioning

confidence: 99%

Understanding preload and preload reserve within the conceptual framework of a limited range of possible left ventricular end-diastolic volumes

Peverill

2020

Advances in Physiology Education

View full text Add to dashboard Cite

Preload has been variously defined, but if there is to be a direct relationship with activity of the Frank-Starling mechanism in its action to increase the force and extent of contraction, preload must directly reflect myocardial stretch. The Frank-Starling mechanism is activated during any stretch of a cardiac chamber beyond its resting size, which is present immediately before contraction. Every left ventricle has an intrinsic and limited range of possible volumes at end diastole. There is a curvilinear relationship between left ventricular (LV) end-diastolic pressure (LVEDP) and LV end-diastolic volume (LVEDV), and, at maximal or near maximal LVEDV, there will be a high LVEDP. Within the possible range, the LVEDV will be determined by the extent of filling, any change in LVEDV will result in changed activity of the Frank-Starling mechanism, and change in LVEDV might, therefore, be considered to represent change in preload. On the other hand, it is the difference between the current and the maximal possible LVEDV (or the preload reserve) that may be of the most clinical relevance. There is a reciprocal relationship between preload and preload reserve, with minor or absent LV preload reserve indicating that there will be either minimal or no increase in stroke volume following intravenous fluid administration. As left atrial pressure can remain within the normal range when the LVEDP is elevated, it is LVEDP, and not left atrial pressure, that provides the most reliable guide to preload reserve in an individual at a specific period in time.

show abstract

Section: Introductionmentioning

confidence: 99%

Understanding preload and preload reserve within the conceptual framework of a limited range of possible left ventricular end-diastolic volumes

Peverill

2020

Advances in Physiology Education

View full text Add to dashboard Cite

show abstract

Historical perspective on heart function: the Frank–Starling Law

Sequeira

Velden

2015

Biophys Rev

View full text Add to dashboard Cite

More than a century of research on the FrankStarling Law has significantly advanced our knowledge about the working heart. The Frank-Starling Law mandates that the heart is able to match cardiac ejection to the dynamic changes occurring in ventricular filling and thereby regulates ventricular contraction and ejection. Significant efforts have been attempted to identify a common fundamental basis for the Frank-Starling heart and, although a unifying idea has still to come forth, there is mounting evidence of a direct relationship between length changes in individual constituents (cardiomyocytes) and their sensitivity to Ca 2+ ions. As the Frank-Starling Law is a vital event for the healthy heart, it is of utmost importance to understand its mechanical basis in order to optimize and organize therapeutic strategies to rescue the failing human heart. The present review is a historic perspective on cardiac muscle function. We Brevive^a century of scientific research on the heart's fundamental protein constituents (contractile proteins), to their assemblies in the muscle (the sarcomeres), culminating in a thorough overview of the several synergistically events that compose the Frank-Starling mechanism. It is the authors' personal beliefs that much can be gained by understanding the Frank-Starling relationship at the cellular and whole organ level, so that we can finally, in this century, tackle the pathophysiologic mechanisms underlying heart failure.

show abstract

Chairman's Introduction

Cited by 2 publications

References 12 publications

Understanding preload and preload reserve within the conceptual framework of a limited range of possible left ventricular end-diastolic volumes

Understanding preload and preload reserve within the conceptual framework of a limited range of possible left ventricular end-diastolic volumes

Historical perspective on heart function: the Frank–Starling Law

Contact Info

Product

Resources

About