Ventricular contractility. Physiology and clinical projection Contractilidad ventricular. Fisiología y proyección clínica

Abstract

© 2016, Sociedad Medica de Santiago. All rights reserved. The contractile state of the heart is the result of myocardial contractility, the intrinsic mechanism that regulates the force and the shortening of the ventricle and determines the ventricular ejection volume. However, the ejection volume is also modulated by ventricular preload (diastolic ventricular volume) and after load (resistance to ejection). Accordingly, a decrease in contractility may be masked by changes in preload or after load, maintaining a normal ejection volume and delaying the diagnosis of myocardial damage. Thus, it is necessary to develop a non-invasive method to measure contractility in the clinical practice. We review in this article the basic principles of cardiac contraction, the concept of contractility and its measurement with the ventricular pressure-volume loop, an experimental method that also measures most of the hemodynamic variables of the cardiac cycle including preload, after load, ventricular wo