This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Linderer, T. Articles by Tyberg, J. V. Search for Related Content PubMed PubMed Citation Articles by Linderer, T. Articles by Tyberg, J. V.

Circulation, Vol 67, 1045-1053, Copyright © 1983 by American Heart Association

ARTICLES

Influence of atrial systole on the Frank-Starling relation and the end- diastolic pressure-diameter relation of the left ventricle

T Linderer, K Chatterjee, WW Parmley, RE Sievers, SA Glantz and JV Tyberg

The influence of atrial systole on the left ventricular function curve (stroke volume vs end-diastolic pressure or end-diastolic diameter) and on the left ventricular end-diastolic pressure diameter relation was studied in nine anesthetized, open-chest dogs whose atrioventricular (AV) node had been completely blocked. Measurements were made during volume loading with the pericardium closed and opened and during alternate AV sequential pacing (to permit atrial contribution to ventricular filling) and AV simultaneous pacing (to prevent atrial contribution). When the pericardium was closed, withdrawal of the atrial contribution shifted the stroke-volume end-diastolic pressure relation downward, but did not shift the stroke volume-end-diastolic diameter relation, i.e., it reduced stroke volume for a given end- diastolic pressure according to a reduction in end-diastolic volume. The downward shift of the stroke volume-end-diastolic pressure relation was caused by an upward shift of the end-diastolic pressure-diameter relation, which, for a given end-diastolic pressure, resulted in a smaller end-diastolic diameter and, thus, in a smaller stroke volume. The reason for the upward shift in the end-diastolic pressure-diameter relation was that the atrium remained full and thus increased pericardial pressure by increasing pericardial volume. Opening the pericardium shifted the end-diastolic pressure-diameter relation downward and to the right, shifted the stroke volume-end-diastolic diameter relation upward and abolished the effect of withdrawal of the atrial contribution on these curves. We conclude that in the presence of an intact pericardium, atrial systole shifts the stroke volume-end- diastolic pressure relation because it shifts the end-diastolic pressure-diameter relation and it improves left ventricular performance by increasing preload.

This article has been cited by other articles:

				J. R. Mitchell, W. A. Whitelaw, R. Sas, E. R. Smith, J. V. Tyberg, and I. Belenkie RV filling modulates LV function by direct ventricular interaction during mechanical ventilation Am J Physiol Heart Circ Physiol, August 1, 2005; 289(2): H549 - H557. [Abstract] [Full Text] [PDF]

				H. I.G.M. Crijns, R. G. Tieleman, I. C. Van Gelder, A. K. Gehi, D. Mehta, L.-F. Hsu, M. Haissaguerre, and P. Jais Ablation for Atrial Fibrillation in Congestive Heart Failure N. Engl. J. Med., March 17, 2005; 352(11): 1148 - 1149. [Full Text] [PDF]

				D. R. Hamilton, R. Sas, and J. V. Tyberg Atrioventricular nonuniformity of pericardial constraint Am J Physiol Heart Circ Physiol, October 1, 2004; 287(4): H1700 - H1704. [Abstract] [Full Text] [PDF]

				L. Padeletti, N. Musilli, M. C. Porciani, A. Colella, L. Di Biase, G. Ricciardi, P. Pieragnoli, A. Michelucci, and G. Gensini Atrial fibrillation and cardiac resynchronization therapy: the MASCOT study Europace, January 1, 2003; 5(s1): S49 - S54. [Abstract] [Full Text] [PDF]

				J. Azpitarte, O. Baun, E. Moreno, R. Garcia-Orta, J. Sanchez-Ramos, and L. Tercedor In Patients With Chronic Atrial Fibrillation and Left Ventricular Systolic Dysfunction, Restoration of Sinus Rhythm Confers Substantial Benefit Chest, July 1, 2001; 120(1): 132 - 138. [Abstract] [Full Text] [PDF]

				I. Kashima, R. Aeba, T. Katogi, and S. Kawada Optimal position of atrial epicardial leads for temporary pacing in infants after cardiac surgery Ann. Thorac. Surg., June 1, 2001; 71(6): 1945 - 1948. [Abstract] [Full Text] [PDF]

				J. B. West and O. Mathieu-Costello Vulnerability of Pulmonary Capillaries in Heart Disease Circulation, August 1, 1995; 92(3): 622 - 631. [Abstract] [Full Text]