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- Title
The diastolic filling of the left ventricle.
- Authors
Rankin, J. S.; Olsen, C. O.
- Abstract
In the intact heart, the determinants of myocardial function are closely interrelated. Alterations in enddiastolic volume indirectly influence afterload and inotropism, whereas alterations in systolic function indirectly affect diastolic filling. The direct determinants of diastolic left ventricular filling include capacitance blood volume, diastolic filling time, atrial contraction, ventricular geometry and the passive visco-elastic properties of the myocardium. Diastolic mural inertia is insignificant. Simultaneous relaxation and filling occur during the early rapid-filling phase, but this period is brief compared to the remainder of diastole. Therefore, at physiological heart rates, systolic relaxation has a relatively minor influence on filling.Diastolic filling appears to be a completely passive phenomenon. The relationship between diastolic mural force and fiber length is determined principally by the elastic properties of the muscle and by viscous properties during dynamic filling. The compliance of the myocardium significantly influences the degree of diastolic mural deformation, end-diastolic fiber length, and therefore systolic function. The geometry of diastolic filling is determined by the anisotropic characteristics of the left ventricular wall. The stiffer major axis circumference increases less than the minor axis circumference during filling, and chamber eccentricity decreases linearly as end-diastolic volume increases. Under normal conditions, right ventricular pressure and volume have minimal effects on left ventricular filling. However, increased diastolic right ventricular pressure can alter the geometry of the left ventricle and influence filling significantly. Thus diastolic filling of the intact left ventricle represents the complex interaction of multiple physiological variables.
- Publication
European Heart Journal, 1980, Vol 1, Issue suppl_1, p95
- ISSN
0195-668X
- Publication type
Article
- DOI
10.1093/eurheartj/1.suppl_1.95