Ventricular Function at Rest and During Exercise / Ventrikelfunktion in Ruhe und w?hrend Belastung

H. RoSKAMM This International Symposium to be held on the occasion of the third anniversary of our institution and under the auspices of the European Society of Cardiology is entitled "Ventricular Function at Rest and During Exercise". We have chosen the general term "ventricular function", because we want to include the different aspects of myocardial function like contrac­ tility, relaxation and compliance and their influence upon the overall pumping function of the heart. Heart failure at rest is a rather advanced outcome of a continuous spectrum of function disturbances. In order to grade these, it is reasonable to differentiate between pump function of the heart as a whole and muscle function of the myocardium. Compen­ satory factors like hypertrophy or the Frank-Starling mechanism may maintain the overall pump function of the ventricle, despite a defect in the underlying myocardial contractility. The time sequence of the func­ tional disturbances may be as follows (Fig. 1): EXERCISE £""-----,--------------, >- " 5 ~, ~ ~, ~ '~ I o u f--~__;_;IJ"_'_~'"'"* t REST II Fig. 1. Schematic presen­ REDUCTION OF CON REDUCTION OF CON PUMP FAILURE tation of time sequence of TRACTILITY RESERVE TRACTllITY . or REST progression in deteriortation _ TIME of ventricular function xvn The lower line represents contractility at rest, the upper one contrac­ tility during maximum exercise; the range between these two lines can be called contractility reserve.