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Cardiac Preload, Afterload, and Heart Failure

Cardiac Preload, Afterload, and Heart Failure Abstract The performance of the heart is regulated by the level of myocardial contractility and the cardiac preload and afterload. These factors, previously of interest primarily to basic scientists, are now clinically important for an understanding of both cardiac function and therapeutics. In this brief review, the essence of these concepts is summarized and related to the treatment of cardiac failure. (Arch Intern Med 1982;142:819-822) References 1. Gould L, Zahir M, Ellinger S: Phentolamine and cardiovascular performance. Br Heart J 1969;154:1969. 2. Majid PA, Sharma B, Taylor SH: Phentolamine for vasodilator treatment of severe heart failure. Lancet 1971;2:719-723.Crossref 3. Cohn JN, Franciosa JA: Vasodilator therapy of cardiac failure. N Engl J Med 1977;297:27-31, 254-258.Crossref 4. Mason DT: Symposium on vasodilator and inotropic therapy of heart failure. Am J Med 1978;65:101-216.Crossref 5. Mason DT, Awan NA, Jaye JJ, et al: Treatment of acute and chronic congestive heart failure by vasodilators: Afterload reduction. Arch Intern Med 1980;140:1577-1581.Crossref 6. Glantz SA, Parmley WW: Factors which affect the diastolic pressure-volume curve. Circ Res 1978;42:171-180.Crossref 7. Sonnenblick EH: Determinants of active state in heart muscle: Force, velocity, instantaneous muscle length. Fed Proc 1965;24:1396-1409. 8. Little RC: Physiology of the Heart and Circulation , ed 2. Chicago, Year Book Medical Publishers, 1981. 9. McDonald DA: Blood Flow in Arteries , ed 2. Baltimore, Williams & Wilkins Co, 1974. 10. Murgo JP, Westerhof NW, Giolma JP, et al: Aortic input impedance in normal man: Relationship to pressure wave forms. Circulation 1980;62:105-116.Crossref 11. Milnor WR: Pulsatile blood flow. N Engl J Med 1972;287:27-31.Crossref 12. Skilling HH: Electrical Engineering Circuits . New York, John Wiley & Sons Inc, 1960, pp 61-104. 13. Milnor WR: Arterial impedance as ventricular afterload. Circ Res 1975;36:565-570.Crossref 14. Imperial ES, Levey MN, Zieske HR: Outflow resistance as an independent determinant of cardiac performance. Circ Res 1961;9:1148-1155.Crossref 15. Weber KT, Janicki JS, Reeves RC, et al: Determinants of stroke volume in the isolated canine heart. J Appl Physiol 1974;37:742-747. 16. Weber KT, Janicki JS, Hefner LD: Left ventricular force-length relations of isovolumic and ejecting contraction. Am J Physiol 1976;231:337-343. 17. Suga H, Kitabatake A, Sagawa K: End-systolic pressure determines stroke-volume from fixed end-diastolic volume in the isolated canine left ventricle under a constant contractile state. Circ Res 1979;44:238-249.Crossref 18. Sagawa K: The end-systolic pressure-volume relation of the ventricle: Definition, modification and clinical use. Circulation 1981;63:1223-1227.Crossref 19. Wilcken DEL, Charlier AA, Heffman JIE, et al: Effects of alterations in aortic impedance on the performance of the ventricles. Circ Res 1964;14:283-293.Crossref 20. Braunwald E, Ross J Jr, Sonnenblick EH: Mechanism of Contraction of the Normal and Failing Heart , ed 2. Boston, Little Brown & Co, 1976. 21. Weber KT, Janicki JS: The dynamics of ventricular contraction: Force, length and shortening. Fed Proc 1980;39:188-195. 22. Mason DT: Afterload reduction and cardiac performance. Am J Med 1978;65:115-125. 23. Sodums MT, Walsh RA, O'Rouke RA: Digitalis in heart failure. JAMA 1981;264:158-160.Crossref 24. Cohn JN: Vasodilator therapy for heart failure: The influence of impedance on left ventricular performance. Circulation 1973;68:5-7.Crossref 25. Loeb HS, Gunnar RM: Treatment of pump failure in acute myocardial infarction. JAMA 1981;245:2093-2096.Crossref 26. Chattergee K, Parmby WW, Massie B, et al: Oral hydralazine therapy for chronic refractory heart failure. Circulation 1976;54:879-883.Crossref 27. Lemberg L: Digitalis in congestive heart failure: Fact or fantasy. Arch Intern Med 1978;138:451-454.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Cardiac Preload, Afterload, and Heart Failure

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1982.00340170179027
Publisher site
See Article on Publisher Site

Abstract

Abstract The performance of the heart is regulated by the level of myocardial contractility and the cardiac preload and afterload. These factors, previously of interest primarily to basic scientists, are now clinically important for an understanding of both cardiac function and therapeutics. In this brief review, the essence of these concepts is summarized and related to the treatment of cardiac failure. (Arch Intern Med 1982;142:819-822) References 1. Gould L, Zahir M, Ellinger S: Phentolamine and cardiovascular performance. Br Heart J 1969;154:1969. 2. Majid PA, Sharma B, Taylor SH: Phentolamine for vasodilator treatment of severe heart failure. Lancet 1971;2:719-723.Crossref 3. Cohn JN, Franciosa JA: Vasodilator therapy of cardiac failure. N Engl J Med 1977;297:27-31, 254-258.Crossref 4. Mason DT: Symposium on vasodilator and inotropic therapy of heart failure. Am J Med 1978;65:101-216.Crossref 5. Mason DT, Awan NA, Jaye JJ, et al: Treatment of acute and chronic congestive heart failure by vasodilators: Afterload reduction. Arch Intern Med 1980;140:1577-1581.Crossref 6. Glantz SA, Parmley WW: Factors which affect the diastolic pressure-volume curve. Circ Res 1978;42:171-180.Crossref 7. Sonnenblick EH: Determinants of active state in heart muscle: Force, velocity, instantaneous muscle length. Fed Proc 1965;24:1396-1409. 8. Little RC: Physiology of the Heart and Circulation , ed 2. Chicago, Year Book Medical Publishers, 1981. 9. McDonald DA: Blood Flow in Arteries , ed 2. Baltimore, Williams & Wilkins Co, 1974. 10. Murgo JP, Westerhof NW, Giolma JP, et al: Aortic input impedance in normal man: Relationship to pressure wave forms. Circulation 1980;62:105-116.Crossref 11. Milnor WR: Pulsatile blood flow. N Engl J Med 1972;287:27-31.Crossref 12. Skilling HH: Electrical Engineering Circuits . New York, John Wiley & Sons Inc, 1960, pp 61-104. 13. Milnor WR: Arterial impedance as ventricular afterload. Circ Res 1975;36:565-570.Crossref 14. Imperial ES, Levey MN, Zieske HR: Outflow resistance as an independent determinant of cardiac performance. Circ Res 1961;9:1148-1155.Crossref 15. Weber KT, Janicki JS, Reeves RC, et al: Determinants of stroke volume in the isolated canine heart. J Appl Physiol 1974;37:742-747. 16. Weber KT, Janicki JS, Hefner LD: Left ventricular force-length relations of isovolumic and ejecting contraction. Am J Physiol 1976;231:337-343. 17. Suga H, Kitabatake A, Sagawa K: End-systolic pressure determines stroke-volume from fixed end-diastolic volume in the isolated canine left ventricle under a constant contractile state. Circ Res 1979;44:238-249.Crossref 18. Sagawa K: The end-systolic pressure-volume relation of the ventricle: Definition, modification and clinical use. Circulation 1981;63:1223-1227.Crossref 19. Wilcken DEL, Charlier AA, Heffman JIE, et al: Effects of alterations in aortic impedance on the performance of the ventricles. Circ Res 1964;14:283-293.Crossref 20. Braunwald E, Ross J Jr, Sonnenblick EH: Mechanism of Contraction of the Normal and Failing Heart , ed 2. Boston, Little Brown & Co, 1976. 21. Weber KT, Janicki JS: The dynamics of ventricular contraction: Force, length and shortening. Fed Proc 1980;39:188-195. 22. Mason DT: Afterload reduction and cardiac performance. Am J Med 1978;65:115-125. 23. Sodums MT, Walsh RA, O'Rouke RA: Digitalis in heart failure. JAMA 1981;264:158-160.Crossref 24. Cohn JN: Vasodilator therapy for heart failure: The influence of impedance on left ventricular performance. Circulation 1973;68:5-7.Crossref 25. Loeb HS, Gunnar RM: Treatment of pump failure in acute myocardial infarction. JAMA 1981;245:2093-2096.Crossref 26. Chattergee K, Parmby WW, Massie B, et al: Oral hydralazine therapy for chronic refractory heart failure. Circulation 1976;54:879-883.Crossref 27. Lemberg L: Digitalis in congestive heart failure: Fact or fantasy. Arch Intern Med 1978;138:451-454.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Apr 1, 1982

References