Copyright © 1994 by the European Society of Cardiology.
© 1994 The European Society of Cardiology
Influence of the force—frequency relationship on haemodynamics and left ventricular function in patients with non-failing hearts and in patients with dilated cardiomyopathy
Medizinische Klinik III, Universität Freiburg Germany
Received 27 May 1993; revised 20 September 1993; .
Coresspondence: Gerd Hasenfuss, MD, Medzinische Klinik III, Universität Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany
Abstract
In isolated human myocardium it was shown that a positive force-frequency relationship occurs in non-failing myocardium; however, the force-frequency relationship was found to be inverse in myocardium from failing human hearts. In order to investigate the clinical relevance of these experimental findings, the influence of heart rate changes on haemodynamics and left ventricular function was studied in eight patients without heart failure and in nine with failing dilated cardiomyopathy (NYHA II–III). Right ventricular pacing was performed at a rate slightly above sinus rate and at 100, 120 and 140 beats. min–1 Haemodynamic parameters were obtained by right heart catheterization and by high-fidelity left ventricular pressure measurements. Left ventricular angiography was performed at basal pacing rate and at 100 and 140 beats. min–1 With increasing heart rate, cardiac index increased in patients with normal left ventricular function from 2·9 ± 0·2 to 3·5 ± 0·21. min–1. m–2 (P<0·01) and decreased continuously in patients with dilated cardiornyopathy from 2·6 ± 0·1 to 2·2 ± 0·11. min–1 . m–2 (P<0·05). With increasing heart rate, the maximum rate of left ventricular pressure rise increased in non-failing hearts from 1388 ± 86 to 1671 ± 88 mmHg. s–1 (P<0·01) and did not change in failing hearts.
Ejection fraction decreased from 27 ± 3% to 19 ± 2% in patients with dilated cardiomyopathy (P<0·05) when the pacing rate was changed from 84 ± 2 beats. min–1 to 140 beats. min–1, which was associated with a significantly increase in end-systolic volume without significantly changes in end-diastolic volume. In patients with normal left ventricular function, when the pacing rate was changed from 85 ± 3 beats. min–1 to 140 beats. min–1, end-diastolic volume decreased significantly by 13%, whereas left ventricular end-systolic volume and ejection fraction did not significantly change. Left ventricular systolic and end-diastolic pressures did not significantly change with pacing tachycardia in either group. The frequency-related changes in left ventricular volumes and pressures indicate that the differrent haemodynamic effects of pacing tachycardia in both groups of patients result predominantly from frequency effects on myocardial function and not from frequency effects on preload or afterload. These data indicate that recent experimental findings of positive force-frequency effects in non-failing and negative force-frequency effects in failing human myocardium are relevant for the intact heart.
Key Words: Force-frequency relationship • heart failure • dilated cardiomyopathy • left ventricular function • haemodynamics
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  C. H. Manisty, K. Willson, J. E. R. Davies, Z. I. Whinnett, R. Baruah, Y. Mebrate, P. Kanagaratnam, N. S. Peters, A. D. Hughes, J. Mayet, et al. Induction of oscillatory ventilation pattern using dynamic modulation of heart rate through a pacemaker Am J Physiol Regulatory Integrative Comp Physiol, July 1, 2008; 295(1): R219 - R227. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Heusch and R. Schulz The role of heart rate and the benefits of heart rate reduction in acute myocardial ischaemia Eur. Heart J. Suppl., September 1, 2007; 9(suppl_F): F8 - F14. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Hiranandani, K. D. Varian, M. M. Monasky, and P. M. L. Janssen Frequency-dependent contractile response of isolated cardiac trabeculae under hypo-, normo-, and hyperthermic conditions J Appl Physiol, May 1, 2006; 100(5): 1727 - 1732. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Vollmann, L. Luthje, P. Schott, G. Hasenfuss, and C. Unterberg-Buchwald Biventricular Pacing Improves the Blunted Force-Frequency Relation Present During Univentricular Pacing in Patients With Heart Failure and Conduction Delay Circulation, February 21, 2006; 113(7): 953 - 959. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Ohshima, S. Isobe, H. Izawa, M. Nanasato, A. Ando, A. Yamada, K. Yamada, T. S. Kato, K. Obata, A. Noda, et al. Cardiac Sympathetic Dysfunction Correlates With Abnormal Myocardial Contractile Reserve in Dilated Cardiomyopathy Patients J. Am. Coll. Cardiol., December 6, 2005; 46(11): 2061 - 2068. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Hudmon, H. Schulman, J. Kim, J. M. Maltez, R. W. Tsien, and G. S. Pitt CaMKII tethers to L-type Ca2+ channels, establishing a local and dedicated integrator of Ca2+ signals for facilitation J. Cell Biol., November 7, 2005; 171(3): 537 - 547. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Grosu, T. Bombardini, M. Senni, V. Duino, M. Gori, and E. Picano End-systolic pressure/volume relationship during dobutamine stress echo: a prognostically useful non-invasive index of left ventricular contractility Eur. Heart J., November 2, 2005; 26(22): 2404 - 2412. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Developed in Collaboration With the American Colle, Endorsed by the Heart Rhythm Society, S. A. Hunt, W. T. Abraham, M. H. Chin, A. M. Feldman, G. S. Francis, T. G. Ganiats, M. Jessup, M. A. Konstam, et al. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult--Summary Article: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure) J. Am. Coll. Cardiol., September 20, 2005; 46(6): 1116 - 1143. [Full Text] [PDF]
|
|
|
|
|
|
S. A. Hunt, W. T. Abraham, M. H. Chin, A. M. Feldman, G. S. Francis, T. G. Ganiats, M. Jessup, M. A. Konstam, D. M. Mancini, K. Michl, et al. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult--Summary Article: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): Developed in Collaboration With the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: Endorsed by the Heart Rhythm Society Circulation, September 20, 2005; 112(12): 1825 - 1852. [Full Text] [PDF]
|
|
|
|
 |
|
 L. Luthje, C. Unterberg-Buchwald, D. Dajani, D. Vollmann, G. Hasenfuss, and S. Andreas Atrial Overdrive Pacing in Patients with Sleep Apnea with Implanted Pacemaker Am. J. Respir. Crit. Care Med., July 1, 2005; 172(1): 118 - 122. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. M. Harris, G. D. Mills, X. Chen, H. Kubo, R. M. Berretta, V. S. Votaw, L. F. Santana, and S. R. Houser Alterations in Early Action Potential Repolarization Causes Localized Failure of Sarcoplasmic Reticulum Ca2+ Release Circ. Res., March 18, 2005; 96(5): 543 - 550. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Ferro, C. Duilio, M. Santomauro, and A. Cuocolo Walk test at increased levels of heart rate in patients with dual-chamber pacemaker and with normal or depressed left ventricular function Eur. Heart J., December 1, 2003; 24(23): 2123 - 2132. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Vogel, M. M.H. Cheung, J. Li, S. B. Kristiansen, M. R. Schmidt, P. A. White, K. Sorensen, and A. N. Redington Noninvasive Assessment of Left Ventricular Force-Frequency Relationships Using Tissue Doppler-Derived Isovolumic Acceleration: Validation in an Animal Model Circulation, April 1, 2003; 107(12): 1647 - 1652. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Schillinger, J. W Fiolet, K. Schlotthauer, and G. Hasenfuss Relevance of Na+-Ca2+ exchange in heart failure Cardiovasc Res, March 15, 2003; 57(4): 921 - 933. [Full Text] [PDF]
|
|
|
|
|
|
Recommendations for exercise training in chronic heart failure patients Eur. Heart J., January 2, 2001; 22(2): 125 - 135. [PDF]
|
|
|
|
|
|
S. H. M. de Groot, M. Schoenmakers, M. M. C. Molenschot, J. D. M. Leunissen, H. J. J. Wellens, and M. A. Vos Contractile Adaptations Preserving Cardiac Output Predispose the Hypertrophied Canine Heart to Delayed Afterdepolarization-Dependent Ventricular Arrhythmias Circulation, October 24, 2000; 102(17): 2145 - 2151. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. I. Miyamoto, F. del Monte, U. Schmidt, T. S. DiSalvo, Z. B. Kang, T. Matsui, J. L. Guerrero, J. K. Gwathmey, A. Rosenzweig, and R. J. Hajjar Adenoviral gene transfer of SERCA2a improves left-ventricular function in aortic-banded rats in transition to heart failure PNAS, January 18, 2000; 97(2): 793 - 798. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U Ravens and D Dobrev Regulation of sarcoplasmic reticulum Ca2+-ATPase and phospholamban in the failing and nonfailing heart Cardiovasc Res, January 1, 2000; 45(1): 245 - 252. [Full Text] [PDF]
|
|
|
|
 |
|
 C.H. Davies and Y. Bashir Beta-blockers for heart failure-time to think the unthinkable? QJM, November 1, 1999; 92(11): 673 - 678. [Full Text] [PDF]
|
|
|
|
 |
|
 V. J. Kadambi, N. Ball, E. G. Kranias, R. A. Walsh, and B. D. Hoit Modulation of force-frequency relation by phospholamban in genetically engineered mice Am J Physiol Heart Circ Physiol, June 1, 1999; 276(6): H2245 - H2250. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Andersson, S.-O. Stromblad, M. Lomsky, and F. Waagstein Heart rate dependency of cardiac performance in heart failure patients treated with metoprolol Eur. Heart J., April 2, 1999; 20(8): 575 - 583. [Abstract] [PDF]
|
|
|
|
 |
|
 T Laperche, D Logeart, A Cohen-Solal, and R Gourgon Potential interests of heart rate lowering drugs Heart, April 1, 1999; 81(4): 336 - 341. [Full Text]
|
|
|
|
|
|
B. O'Rourke, D. A. Kass, G. F. Tomaselli, S. Kaab, R. Tunin, and E. Marban Mechanisms of Altered Excitation-Contraction Coupling in Canine Tachycardia-Induced Heart Failure, I : Experimental Studies Circ. Res., March 19, 1999; 84(5): 562 - 570. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Hasenfuss, W. Schillinger, S. E. Lehnart, M. Preuss, B. Pieske, L. S. Maier, J. Prestle, K. Minami, and H. Just Relationship Between Na+-Ca2+–Exchanger Protein Levels and Diastolic Function of Failing Human Myocardium Circulation, February 9, 1999; 99(5): 641 - 648. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Hasenfuss Animal models of human cardiovascular disease, heart failure and hypertrophy Cardiovasc Res, July 1, 1998; 39(1): 60 - 76. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Hasenfuss Alterations of calcium-regulatory proteins in heart failure Cardiovasc Res, February 1, 1998; 37(2): 279 - 289. [Full Text] [PDF]
|
|
|
|
|
|
S. Richard, F. Leclercq, S. Lemaire, C. Piot, and J. Nargeot Ca2+ currents in compensated hypertrophy and heart failure Cardiovasc Res, February 1, 1998; 37(2): 300 - 311. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Neumann, U. Ravens, and G. Heusch Characterization of excitation-contraction coupling in conscious dogs with pacing-induced heart failure Cardiovasc Res, February 1, 1998; 37(2): 456 - 466. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. R.W. Money-Kyrle, C. H. Davies, H. K. Ranu, P. O'Gara, N. Singh Kent, P. A. Poole-Wilson, and S. E. Harding The role of cAMP in the frequency-dependent changes in contraction of guinea-pig cardiomyocytes Cardiovasc Res, February 1, 1998; 37(2): 532 - 540. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Holubarsch, J Ludemann, S Wiessner, T. Ruf, H Schulte-Baukloh, S Schmidt-Schweda, B Pieske, H Posival, and H Just Shortening versus isometric contractions in isolated human failing and non-failing left ventricular myocardium: dependency of external work and force on muscle length, heart rate and inotropic stimulation Cardiovasc Res, January 1, 1998; 37(1): 46 - 57. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C.H. Davies, K. Davia, J.G. Bennett, J.R. Pepper, P.A. Poole-Wilson, and S.E. Harding Reduced Contraction and Altered Frequency Response of Isolated Ventricular Myocytes From Patients With Heart Failure Circulation, November 1, 1995; 92(9): 2540 - 2549. [Abstract] [Full Text]
|
|
|
|
|
|
S. D. Prabhu and G. L. Freeman Postextrasystolic Mechanical Restitution in Closed-Chest Dogs : Effect of Heart Failure Circulation, November 1, 1995; 92(9): 2652 - 2659. [Abstract] [Full Text]
|
|
|
|
|
|
B. Pieske, B. Kretschmann, M. Meyer, C. Holubarsch, J. Weirich, H. Posival, K. Minami, H. Just, and G. Hasenfuss Alterations in Intracellular Calcium Handling Associated With the Inverse Force-Frequency Relation in Human Dilated Cardiomyopathy Circulation, September 1, 1995; 92(5): 1169 - 1178. [Abstract] [Full Text]
|
|
|
|
 |
|
 U. Kirchhefer, J. Neumann, H. A. Baba, F. Begrow, Y. M. Kobayashi, U. Reinke, W. Schmitz, and L. R. Jones Cardiac Hypertrophy and Impaired Relaxation in Transgenic Mice Overexpressing Triadin 1 J. Biol. Chem., February 2, 2001; 276(6): 4142 - 4149. [Abstract] [Full Text] [PDF]
|
|