Use of the frank-starling mechanism during exercise is linked to exercise-induced changes in arterial load

Paul D. Chantler, Vojtech Melenovsky, Steven P. Schulman, Gary Gerstenblith, Lewis C. Becker, Luigi Ferrucci, Jerome L. Fleg, Edward G. Lakatta, Samer S. Najjar

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Effective arterial elastance(E A) is a measure of the net arterial load imposed on the heart that integrates the effects of heart rate(HR), peripheral vascular resistan-ce(PVR), and total arterial compliance(TAC) and is a modulator of cardiac performance. To what extent the change in Ea during exercise impacts on cardiac performance and aerobic capacity is unknown. We examined E A and its relationship with cardiovascular performance in 352 healthy subjects. Subjects underwent rest and exercise gated scans to measure cardiac volumes and to derive EA[end-systolic pressure/ stroke volume index(SV)], PVR[MAP/(SV*HR)], and TAC(SV/pulse pressure). Ea varied with exercise intensity: the AEa between rest and peak exercise along with its determinants, differed among individuals and ranged from -44% to +149%, and was independent of age and sex. Individuals were separated into 3 groups based on their AEaI. Individuals with the largest increase in AEA(group 3;AEa^0.98 mmHg.m 2/ml) had the smallest reduction in PVR, the greatest reduction in TAC and a similar increase in HR vs. group 1(AEa<0.22 mmHg.m 2/ml). Furthermore, group 3 had a reduction in end-diastolic volume, and a blunted increase in SV(80%), and cardiac output(27%), during exercise vs. group 1. Despite limitations in the Frank-Starling mechanism and cardiac function, peak aerobic capacity did not differ by group because arterial-venous oxygen difference was greater in group 3 vs. 1. Thus the change in arterial load during exercise has important effects on the Frank-Starling mechanism and cardiac performance but not on exercise capacity. These findings provide interesting insights into the dynamic cardiovascular alterations during exercise.

Original languageEnglish (US)
Pages (from-to)H349-H358
JournalAmerican Journal of Physiology - Heart and Circulatory Physiology
Issue number1
StatePublished - Jan 2012


  • Arterial elastance
  • Cardiovascular performance

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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