Heart rate as a determinant of cardiac function Basic mechanisms and
In a variety of cardiac diseases the influence of heart rate on cardiac function is altered and both heart rate and heart rate variability are of great relevance for the prognosis of cardiac patients. This book provides a summary of the current knowledge
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Heart rate as a determinant of cardiac function
G. Hasenfuss . H. Just
Editors
Heart rate as a determinant of cardiac function Basic mechanisms and clinical significance
t
Springer
Prof. Dr. G. Hasenfuss Abteilung Kardiologie und Pneumologie der Universitat Gottingen Robert-Koch-StraBe 40,37075 Gottingen, Germany Prof. Dr. H. Just Medizinische Fakultat, Ethik Kommission Elsasser StraBe 2a, Haus la, 79110 Freiburg, Germany
Die Deutsche Bibliothek - CIP Cataloging-in-Publication-Data A catalogue record for this publication is available from Die Deutsche Bibliothek This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilm or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from SteinkopffVeriag. Violations are liable for prosecution under the German Copyright Law. ISBN-13: 978-3-642-47072-1 DOl: 10.1007/978-3-642-47070-7
e-ISBN-13: 978-3-642-47070-7
SteinkopffVeriag is a company in the BertelsmannSpringer publishing group © SteinkopffVeriag Darmstadt 2000 Softcover reprint of the hardcover 1st edition 2000 The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product liability: The publishers cannot guarantee the accuracy of any information about the application of operative techniques and medications contained in this book. In every individual case the user must check such information by consulting the relevant literature. Medical Editor: Sabine Ibkendanz - English Editor: Mary K. Gossen Production: Heinz J. Schafer Cover design: Erich Kirchner, Heidelberg Typesetting: Typoservice, Griesheim Printed on acid-free paper
Introduction
Numerous studies have indicated that in a variety of cardiac diseases the influence of heart rate on cardiac function is altered and that both heart rate and heart rate variability are of great relevance for the prognosis of cardiac patients. Heart rate is an important determinant of cardiac function. In humans and most animal species, increased heart rate during exercise enhances cardiac output through an increased number of beats per minute as well as by its action on myocardial performance. The latter effect, termed the force-frequency relation, strength-interval relation or TREPPE (staircase) phenomenon was first observed by Bowditch in the isolated frog heart. Recent studies demonstrated that in failing human myocardium the force-frequency relation is flattened or inversed. The altered force-frequency relation results from disturbed function at the level of the myocyte due to distu
