Assessment of Left Ventricular Function: Current Methods and Clinical Significance

  • Glen W. Hamilton
  • J. Ward Kennedy
Part of the Topics in Cardiovascular Disease book series (TCAD)


Methods of evaluating and understanding the contractile performance of the heart have been actively pursued during much of the past century. Bowditchl demonstrated the all-or-none law of the heart in 1871. From 1895 to 1915, Frank,2 Straub,3 Wiggers,4 and Starlings developed the basic concept that the mechanical energy of contraction (systole) was dependent upon the fiber length at end-diastole. Based on the model of muscle contraction proposed by A. V. Hill,6 numerous investigators7 have developed quantitative methods for assessing the contractile state of the myocardium. Additionally, the effects of afterload (the resistance or impedance) were appreciated and quantitated.7 These three factors (resting fiber length, contractile state, and afterload) are the basic concepts underlying the overall performance of the heart.


Ejection Fraction Left Ventricular Function Mitral Regurgitation Ventricular Volume Left Ventricular Volume 
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  1. 1.
    Bowditch, H. P., Ueber die Eigenthumlichkeiten der Reizbarkeit, welche die Muskelfasern des Herzens zeigen, Verh. K. Sachs Ges. Wochenchnschr. Leipzig, Math. Physische, Cl 23: 652 (1871).Google Scholar
  2. 2.
    Frank, O., Zur Dynamik des Herzmuskels, Ztschr Bio. 32:370 (1895) (trans. by C. B. Chapman and E. Wasserman), Am. Heart J. 58: 282, 467 (1959).CrossRefGoogle Scholar
  3. 3.
    Straub, H., Dynamik des Saugetierherzens: I. Dtsch. Arch. Klin. Med. 115:531 (1914); II. 116: 409 (1914).Google Scholar
  4. 4.
    Wiggers, C. J., Some factors controlling the shape of the pressure curve in the right ventricle, Am. J. Physiol. 33: 382 (1914).Google Scholar
  5. 5.
    Starling, E. H., The Linacre Lecture on the Law of the Heart, Longmans, Green and Co., London (1918).Google Scholar
  6. 6.
    Hill, A. V., The heat of shortening and the dynamic constants of muscle, Proc. R. Soc. London Ser. B 126:136 (1938).Google Scholar
  7. 7.
    Braunwald, E., The Myocardium: Failure and Infarction, H. P. Publishing Co., New York (1974).Google Scholar
  8. 8.
    Dodge, H. T., Sandler, H., Ballew, D. W., and Lord, Jr., J. D., The use of biplane angiocardiography for the measurement of left ventricular volume in man, Am. Heart J. 60: 762 (1960).PubMedCrossRefGoogle Scholar
  9. 9.
    Arvidsson, H., Angiographie determination of left ventricular volume, Acta Radiol. 56: 321 (1961).PubMedCrossRefGoogle Scholar
  10. 10.
    Hunt, D., Baxley, W. A., and Kennedy, J. W., et al.,Quantitative evaluation of eine aortography in the assessment of aortic regurgitation, Am. J. Cardiol. 31:696 (1973).Google Scholar
  11. 11.
    Kennedy, J. W., Trenholme, S. E., and Kasser, I. S., Left ventricular volume and mass from single-plane cineangiocardiogram. A comparison of anteroposterior and right anterior oblique methods, Am. Heart J. 80: 343 (1970).PubMedCrossRefGoogle Scholar
  12. 12.
    Hamilton, G. W., Murray, J. A., and Kennedy, J. W., Quantitative angiography in ischemic heart disease: The spectrum of abnormal left ventricular function and the role of abnormally contracting segments, Circ. 45:1065 (1972).Google Scholar
  13. 13.
    Bruschke, A. V. G., Proudfit, W. L., and Sones, F. M., Jr., Progress study of 590 consecutive nonsurgical cases of coronary disease followed by 5–9 years. II. Ventriculographie and other correlations, Circ. 47:1154 (1973).Google Scholar
  14. 14.
    Murray, J. A., Chinn, N., Peterson, D. R., Influence of left ventricular function on early prognosis in atherosclerotic heart disease, Am. J. Cardiol. 33: 159 (1974).CrossRefGoogle Scholar
  15. 15.
    Oldham, H. N., Kong, Y., Bartel, A. G., Morris, J. J., Jr., Behar, V. S., Peter, R. H., Rosali, R. A., Young, G., Jr., and Sabiston, D. C., Risk factors in coronary artery bypass surgery, Surg. 105: 918 (1972).Google Scholar
  16. 16.
    Hammermeister, K. E., and Kennedy, J. W., Predictors of surgical mortality in patients undergoing direct myocardial revascularization, Circulation (Suppl. II) 50:112 (1974).Google Scholar
  17. 17.
    Cohn, P. F., Gorlin, R., Cohn, L. H., and Collins, J. J., Jr., Left ventricular ejection fraction as a prognostic guide in surgical treatment of coronary and valvular heart disease, Am. J. Cardiol. 34:136 (1974).Google Scholar
  18. 18.
    Yatteau, R. F., Peter, R. H., Behar, V. S., Bartel, A. G., Rosali, R. A., and Kong, Y., Ischemic cardiomyopathy: The myopathy of coronary disease, Am. J. Cardiol. 34:520 (1974).Google Scholar
  19. 19.
    Rees, G., Bristow, J. D., Kremkau, E. L., Green, G. S., Herr, R. H., Griswold, H. E., and Stan, A., Influence of aortocoronary bypass surgery on left ventricular performance. N. Engl. J. Med. 284:1116 (1971).Google Scholar
  20. 20.
    Arbogast, R., Solignac, A., and Bourassa, M. G., Influence of aortocoronary saphenous vein bypass surgery on left ventricular volumes and ejection fraction, Amer. J. Med. 54: 290 (1973).PubMedCrossRefGoogle Scholar
  21. 21.
    Bolooki, H., Mallon, S., Ghahramani, A., Sommer, L.. Vargas, A., Stavin, D., and Kaiser, G. A., Objective assessment of the effects of aorto-coronary bypass operation on cardiac function, J. Thorac. Cardiovasc. Surg. 66: 916 (1973).PubMedGoogle Scholar
  22. 22.
    Deal, P., Elliott, L. P., Bartley, T. D., Wheat, M. W., Jr, and Ramsey, H. W., Quantitative left ventriculography in the immediate postoperative period after aorto-coronary bypass, J. Thorac. Cardiovasc. Surg. 66:1 (1973).Google Scholar
  23. 23.
    Chatterjee, K., Swan, H. J. C., Parmley, W. W., Sustaita, H., Marcus, H. S., and Matloff, J., Influence of direct myocardial revascularization on left ventricular asynergy and function in patients with coronary heart disease, Circulation 47: 276 (1973).PubMedCrossRefGoogle Scholar
  24. 24.
    Hammermeister, K. E., Kennedy, J. W., Hamilton, G. W., Stewart, D. K., Gould, K. L., Lipscomb, K., and Murray, J. A., Aortocoronary saphenous vein bypass. Failure of successful grafting to improve resting left ventricular function in chronic angina, N. Engl. J. Med. 290:186 (1974).Google Scholar
  25. 25.
    Shepherd, R. L., Itscoitz, S. B., Glancy, D. L., Stinson, E. B., Reis, R. L., Olinger, G. N., Clark, C. E., and Epstein, S. E., Deterioration of myocardial function following aorto-coronary bypass operation, Circ. 49: 467 (1974).CrossRefGoogle Scholar
  26. 26.
    Seattle Heart Watch, unpublished data from J. A. Murray (1975).Google Scholar
  27. 27.
    Fischl, S. J., Herman, M. V., and Gorlin, R., The intermediate coronary syndrome. Clinical, angiographie and therapeutic aspects, N. Engl. J. Med. 288:1193 (1973).Google Scholar
  28. 28.
    Doces, J., Stewart, D., and Kennedy, J. W., Quantitative assessment of left ventricular function following successful aortic valve replacement, Circulation (Suppl. III to Vol. 49 ) 50: 21 (1974).Google Scholar
  29. 29.
    Doces, J., and Kennedy, J. W., Quantitative assessment of left ventricular function following successful mitral valve surgery, Am. J. Cardiol. 35:132 (1975).Google Scholar

Copyright information

© Springer Science+Business Media New York 1977

Authors and Affiliations

  • Glen W. Hamilton
    • 1
  • J. Ward Kennedy
    • 1
  1. 1.Nuclear Medicine and Cardiology ServicesVeterans Administration HospitalSeattleUSA

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