Left Ventricular Systolic Time Intervals as Indices of Postural Circulatory Stress in Man

The effects of graded increments of passive head-up tilt on the duration of the systolic time intervals corrected for heart rate were investigated in 15 normal subjects. Head-up tilt caused a prolongation of the pre-ejection period and a shortening of the left ventricular ejection time, while total electromechanical systole diminished minimally. The lengthening of the pre-ejection period and abbreviation of the left ventricular ejection time increased progressively with stepwise increments of head-up tilt. The application of venous occlusive tourniquets produced changes in the systolic intervals directionally similar to those observed with head-up tilt. In contrast to the normal subjects, three patients with congestive heart failure demonstrated no change in the systolic time intervals during head-up tilt. After diuresis in two of the patients with heart failure, the responses of their systolic time intervals to head-up tilt returned toward normal.