Document Detail

Force-frequency relation in patients with left ventricular hypertrophy and failure.
MedLine Citation:
PMID:  9833138     Owner:  NLM     Status:  MEDLINE    
Our study demonstrated a loss of normal systolic contractile enhancement with increasing heart rate in patients with ventricular hypertrophy and symptoms of congestive heart failure. This decline in systolic reserve was not accompanied by worsening of diastolic function, and would therefore not seem to reflect underlying ischemia. Rather, it was more likely related to abnormalities of excitation-contraction coupling, particularly in light of findings of both increased post-rest potentiation and a reduced recirculation fraction. In contrast, mechanical restitution was unchanged, suggesting that alterations in Ca2+ release from the SR did not play a major role. Finally, we showed that increasing heart rate adversely affects the efficiency of ventriculo-vascular coupling in LVH hearts. This suggested another explanation of how dysfunction of cardiac force-frequency behavior can lead to limited cardiovascular reserve and contribute to clinical symptoms of exertional intolerance. Future efforts aimed at enhancing the force-frequency response, perhaps by enhancing the SR-ATPase, or manipulating its regulation, should prove helpful in ameliorating the limitations of LVH patients associated with rapid heart rate.
D A Kass
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Basic research in cardiology     Volume:  93 Suppl 1     ISSN:  0300-8428     ISO Abbreviation:  Basic Res. Cardiol.     Publication Date:  1998  
Date Detail:
Created Date:  1999-02-19     Completed Date:  1999-02-19     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0360342     Medline TA:  Basic Res Cardiol     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  108-16     Citation Subset:  IM    
Division of Cardiology, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.
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MeSH Terms
Cardiac Output, Low / physiopathology*
Case-Control Studies
Heart Rate / physiology*
Hemodynamics / physiology
Hypertrophy, Left Ventricular / physiopathology*
Middle Aged
Myocardial Contraction / physiology*
Physical Exertion / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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