When a muscle contracts against a load less than one that would result in an isometric contraction, it shortens and does external work. In skeletal muscle at a particular initial length, and in heart muscle at a particular length and inotropic state, the extent and speed of shortening and the efficiency of the contraction depend upon the load (2-5). In an earlier study we showed that in the normal conscious dog at rest the systemic load and the left ventricle were so matched that during contraction maximal external work was done and maximal power was transferred to the systemic circulation (6). These conclusions were reached by studying successive contractions at different loads, but the load itself was not measured directly. The present study concerns the development of methods to measure the load in man, based on ventricular volume and pressure measurements. The relationships between external work and power transfer, velocity of muscle shortening, and load during left ventricular contraction were investigated. MethodsTheoretical considerations. The relation between force, and pressure and volume in the heart was recognized byStephen Hales (7). In recent years it has been outlined in detail by several authors (8, 9). The force acting radially on the inner surface of the ventricle at any time during systole is the product of the intraventricular pressure and surface area at that time. If the left ventricle is assumed to be a sphere (surface area = TrD2), the mean force acting on the ventricle over the whole of systole (PT) may be ex-* Submitted for publication November 23, 1964; accepted April 22, 1965. This work was supported by grant no. G.168 from the National Heart Foundation of Australia. Some of these data were presented at the February 1965 meeting of the Australian Physiological Society and appeared in abstract form (1). where FT is the mean force opposing ventricular ejection; P is the instantaneous intraventricular pressure during systole; D is the instantaneous diameter during systole of the ventricle, which is assumed to be spherical; t1 is the time at end diastole; and t2 is the time at end systole. This is taken as the point at the end of ventricular contraction at which the intraventricular pressure falls to its lowest level. If the walls and the cavity of the ventricle, which is assumed to be spherical, are considered to be transected by an imaginary plane that passes through the equator, the mean force tending to separate the ventricle into two hemispheres during contraction (FM) is related to the mean force opposing ejection (FT) in the ratio of r2/D2 (where r = radius), i.e., 0.25. This is the resultant mean force (FM) exerted by all the myocardial fibers perpendicular to this plane.In terms of the model there are periods at the beginning and at the end of systole, corresponding to isovolumetric contraction and relaxation, during which there is no fiber shortening and no change in D. The forces opposing ejection during these phases of systole can be determined if end-diastolic and end-systol...