Frank-Starling Principle

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The Frank-Starling law of the heart explains the factors which control stroke volume and the heart's ability to respond to changes in demand for cardiac output. The ability of the heart muscle to generate force is dependent on the initial length or stretch of the muscle cells prior to contraction. The degree of stretch (also called preload) of the cardiac muscle cells before they contract determines stroke volume. The amount of blood returning to the chambers and distending the ventricles is an important factor in stretching the cardiac muscle cells. The greater the end diastolic volume the more the muscle fibers are stretched leading to a greater stroke volume.

There are two mechanisms which may explain this phenomenon. First, the stretching of muscle fibers beyond their normal physiological limits results in a greater length-tension relationship. Resting cardiac muscle cells are normally shorter than their optimal length, thus, any increase in the length of cardiac muscle cells from stretching results in a dramatic increase in contractile force.

Secondly, the stretching of muscle fibers increases the number of active cross bridges between the actin and myosin filaments. When contraction occurs these increased numbers of cross bridges yield a greater force of contraction.


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