Inotropic changes in the left ventricle: the effect of changes in heart rate, aortic pressure and end‐diastolic pressure

Abstract

1. Under conditions where heart rate, mean aortic pressure and enddiastolic pressure in the left ventricle are held constant, the intravenous infusion of isoprenaline is accompanied by large changes in d P/d t max in the left ventricle. 2. Under similar conditions, during stepwise increments in the rate of infusion of isoprenaline the changes in d P/d t max (measured at a constant paced heart rate) were proportional to changes in the free (intrinsic) heart rate. It is concluded that d P/d t max is a quantitative index of inotropic changes in the left ventricle. 3. In comparison to d P/d t max, three other variables which have been used to indicate inotropic changes in the heart (peak pressure in the left ventricle, duration of systole and stroke work at constant end‐diastolic pressure), were shown to be unreliable indices of inotropic changes. 4. Using d P/d t max to indicate inotropic changes, alteration in the heart rate while mean aortic pressure and end‐diastolic pressure in the left ventricle were held constant, and in mean aortic pressure while heart rate ane end‐diastolic pressure in the left ventricle were held constant, were each shown to be accompanied by small inotropic changes in the heart. 5. Under similar conditions, changes in end‐diastolic pressure in the left ventricle alone were not accompanied by inotropic changes as indicated by d P/d t max.