SUMMARY The present study evaluated potential mechanisms for the slow length-dependent change in myocardial contractile state. Using 40 isolated right ventricular cat papillary muscles, we found that 10 mM caffeine reversed the subsequent slow change in myocardial performance following a change in muscle length. Since caffeine acts both at the sarcolemma and the sarcoplasmic reticulum, we attenuated the sarcolemmal influx of calcium with verapamil, manganese, and low external calcium concentration. None of these interventions altered the caffeine reversal of the length-dependent effect. It thus appears that the length-dependent alteration of contractile state is of intracellular origin, and probably related to altered calcium handling by the sarcoplasmic reticulum. Circ Res 47: 592-598, 1980 THE relationship between muscle length and cardiac performance has been described by the FrankStarling relationship. After an increase in end-diastolic fiber length along the ascending limb of this relationship, there is an increase in cardiac performance. At any given length, positive inotropic agents can further increase cardiac performance. Thus, the traditional view was that these two mechanisms for altering cardiac performance were independent of each other. The Frank-Starling relationship was explained by a variation in the number of crossbridges formed between the contractile proteins (Gordon et al., 1966). The positive inotropic response was explained by an increase in the rate of interaction of these cross-bridges (Katz, 1970).Contrary to the traditional belief that these two mechanisms for altering cardiac performance were separate from one another, we reported a slow length-dependent change in myocardial contractile state (Parmley and Chuck, 1973). In isolated cat papillary muscles, the immediate response to an increase of muscle length was followed by a slow additional increase in performance. Thus, in addition to the instantaneous length, the length history becomes an important determinant of the "FrankStarling" response. Subsequent studies have suggested that the immediate increase in force along the ascending limb is due not so much to myofilament and cross-bridge overlap, but to a lengthdependent alteration in the amount of calcium activating these cross-bridges (Allen et al., 1974;Jewell, 1977;Lakatta and Jewell, 1977;Fabiato and Fabiato, 1975 Received June 4, 1979; accepted for publication May 27,1980. tions the traditional separation between alterations in performance due to length and contractility. In our early attempts to identify a mechanism for the slow time-dependent coupling between muscle length and contractile state, we ruled out crosssectional area, release of stored catecholamines, temperature effects (24°-37°C), or series viscous elements as mechanisms for this observation (Parmley and Chuck, 1973). We did find, however, that varying the external calcium concentration changed the magnitude of the slow response, suggesting a calcium-mediated mechanism. In this paper, we report additional s...