伽利略启迪我们质疑Frank-Starling心脏定律

Galileo edifies us to query the Frank-Starling law of heart

心室舒张末期容积(EDV)越大心脏收缩力越强,即著名的Frank-Starling心脏定律,是心脏生理学中的重要理论。伽利略启迪我们发现该定律存在着逻辑矛盾:如果增高的心室充盈压力伸展心室肌壁超过通常的舒张末期位置(心脏"扩张",EDV"增加")还在其生理限度范围内时,按照该定律原理,"增加"的EDV将引起每搏量和心输出量增加,心脏收缩末期心室腔内的残余血量就会减少,"扩张"的心室肌壁将自动恢复原来的体积。换言之,在正常生理条件下,心脏"扩张"(EDV"增加")是不存在的;心脏"扩张"的存在,表明其收缩力业已减低。这样,按照Frank-Starling心脏定律原理进行的逻辑推理,结果是否定了该定律自身——EDV在生理限度范围的"增加"是心脏收缩力减低的表现。据此,笔者质疑Frank-Starling心脏定律。

The greater the end-diastolic volume （EDV）, the stronger the cardiac contractility, namely, Frank- Starling law of the heart （FSLH）, is an important theory in physiology of the heart. Galileo edifies us to quesry the FS- LH. According to the FSLH, if the EDV is increased by the increased ventricular filling pressure, leading to the change in the ventricular walls beyond the usual scope of the end-diastolic state （＂dilation＂, ＂increased EDV＇） within physiological limits, the increased EDV will increase the contractility to increase the stroke volume and cardiac output, resulting in the amount of the residual blood in ventricles to decrease. And so, the dilation of the ventricular walls will automatically be regulated returning to the original size little by little. In other words, under normal physiological conditions, the ＂dila- tion＇（EDV increasing） does not exist; the ＂dilation＂ within the physiological limits indicates that the contractility has already decreased. In this way, according to the principles of the FSLH carried out in logical reasoning, the result is the rejection of the FSLH itself -- the ＂EDV increasing＂ within physiological limits is the manifestation of the decrease in the contractility. Therefore, the authors oppugn the FSLH of the truth.