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Articles in PresS, published online ahead of print June 13, 2002
Am J Physiol Heart Circ Physiol, 10.1152/ajpheart.01041.2001
Submitted on November 29, 2001
Accepted on June 6, 2002
1 Section of Environmental Physiology, Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
2 Clinical Physiology, Faculty of Health Sciences, Linkoping University, Linkoping, Sweden
* To whom correspondence should be addressed. E-mail: patrik.sundblad{at}fyfa.ki.se.
End-diastolic volume and left ventricular stroke volume (LVSV) are increased in supine compared to upright position, but the contribution of long-axis (LAS) and short-axis shortening (SAS) to these changes with change in posture has not been established. We examined long- and short-axis motion and dimensions with echocardiography in ten healthy subjects in upright and supine positions. Long-axis length at end-diastole was almost identical whereas the diastolic short-axis diameter was increased in supine position. At end-systole there was a decreased long-axis and increased short-axis length in supine vs upright. Both long-axis and short-axis shortening were enhanced in supine vs upright (LAS; 9.±2.2mm vs 15.1±3.1mm (p<0.001), SAS; 12.7±3.2mm vs 16.3±2.8mm (p<0.001)), presumably via Starling mechanisms. Long-axis shortening increased more in the lateral part of the mitral annulus than in the septal part (7.7 ± 2.6mm vs 4.0 ± 2.8mm (p<0.006)), which indicates that the more spherical form, in supine, induces more stretch at the lateral free wall than in the ventricular septum. These findings support the notion that Starling mechanisms affect systolic LAS.
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