© 1998 by European Society of Cardiology
Copyright © 1998, European Society of Cardiology
Physiopharmacological evaluation of myocardial performance
how to study modulation by cardiac endothelium and related humoral factors?
Department of Physiology and Medicine, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium
* Corresponding address: Tel.: +32 3 218 02 77; Fax: +32 3 218 02 76; E-mail: stsys@ruca.ua.ac.be
Received 5 January 1998; accepted 11 March 1998
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1 Introduction — the reductionist approach: how far? |
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When conducting human or animal experiments in a search for an understanding of the regulation and dysfunction of the cardiovascular system, clinicians and scientists have been confronted with the complexity of this system. Although complexity could be studied at any magnification, it has, in general, followed a reductionist approach [1, 2]. In this way, by bypassing or eliminating as many interacting processes as possible, our view on cardiac performance has become ever narrower in scope. For example, excluding neurohumoral control and uncoupling the heart from the peripheral circulation reduced our experimental approach from in-situ animal experiments to isolated experimental conditions, as e.g. the Langendorff-perfused heart and various, more recent, modified versions of it, where the heart is no longer necessarily considered as an input–output pump with ventricular filling (end-diastolic pressure and volume) and cardiac output (systolic pressure and stroke volume) as major features. With the heart as a muscular
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2 Endothelial modulation of myocardial performance — the need for cardiomyocyte cell membrane and cytoplasm |
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3 Minimally required information — instantaneous force and triple control of it |
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3.1 Load and (in)activation
3.2 (Non)uniformity
3.3 Extracardiac modulators
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4 Specific properties of the isolated intact cardiomyocyte — the need for force measurement at physiologic lengths |
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4.1 Measurements of length
4.2 Measurement of force
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5 Specific properties of the isolated papillary muscle — the need for reappraisal |
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5.1 Nonuniformity in isolated papillary muscle
5.2 Importance of variations in isometric twitch duration
5.3 Isometric twitch duration and endothelial modulation of myocardial performance
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6 Conclusion |
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