Cardiac function and myocardial contractility: A perspective

摘要: Abstract Improved understanding of cardiac muscle and whole heart function has substantially benefited clinical diagnosis therapy. Knowledge the influence systolic loading conditions been key importance in these advances, role peripheral circulatory responses is beginning to be appreciated. Dissociations between myocardial contractility are described, including acute failure due afterload mismatch associated with normal contractility, ventricular depressed chronic mitral regurgitation. Frameworks for assessing examined. Standard invasive noninvasive approaches can now usefully supplemented by end-systolic pressure-volume wall stress-volume frameworks, former being particularly useful analyzing concept "afterload limited preload reserve" latter studying adaptations. The venous return illustrated within frameworks a description vasopressor stress test produce an apparent descending limb left function, steady state vasodilator therapy failing heart. changes determining output response vasodilator, addition effects reduced on ventricles, emphasized. Finally, problem patients regurgitation examined and, patient severe few symptoms, tentative guidelines recommending operation avoid irreversible dysfunction postoperatively presented.