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• W2078497965 abstract "The sequence of human precordial movements prior to ejection has been compared with the rate of alteration in pressure in the cardiac chambers and great vessels of dogs. By the latter technique, simultaneous reciprocal changes in adjacent chambers appear to provide suggestive information concerning the movements of the intervening structure. Thus, a sharp decline in the aortic curve associated with increased rate of rise in the left ventricle may signify a downward pull on the annulus of the closed aortic valve. Similar indirect evidence concerning the movements of the interventricular septum, the atrioventricular cusps, etc., was obtained and utilized as a means of arriving at a tentative interpretation of the precordial movements. Pending evidence obtained by more direct techniques, we believe that the sequence of motions prior to ejection is as follows. The small initial deflections appear to begin in the left ventricle and in both sets of papillary muscles. Then there seems to be headward and, soon, rightward motion of blood associated with mitral and tricuspid closure, respectively. This is followed by a large backward precordial movement, which is assumed to be due to contraction of the interventricular septum. The next motion is a pull of the several valve rings toward the apex, producing a tendency toward shortening of both the transverse and vertical dimensions of the ventricles. At the same time, there appears to be headward bulge of the still closed semilunar valves. As the right ventricle starts to eject, three additional motions occur. These are ascribed to (1) a small forward-footward recoil, (2) a second downward pull on the aortic ring, and (3) displacement of the interventricular septum to the right. When the isometric period of the left ventricle ends and its ejection begins, a larger recoil motion is seen. According to these interpretations, the spread of contraction is similar to that of excitation. Throughout the ventricular mass the electromechanical lag appears to be relatively constant and about 0.035 second in man. End-diastolic pressure is probably an accurate guide to the initial state of only those fibers which begin the contractile process. The rise in pressure so induced stretches further the uncontracted parts and thus changes favorably the initial tension and length of the fibers which contract later. The mechanical advantage of this process, which involves original contraction of the thinner muscle bundles and utilization of the pressure so generated to increase further the stretch and, hence, the force of shortening of the late-contracting thicker bundles, is indicated." @default.
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• W2078497965 date "1961-07-01" @default.
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• W2078497965 title "Movement of the heart during the period between the onset of ventricular excitation and the start of left ventricular ejection" @default.
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• W2078497965 doi "https://doi.org/10.1016/0002-8703(61)90486-0" @default.
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