Effective performance of the left ventricle requires the maintenance of a cardiac output as demanded by the systemic circulation without a high hemodynamic cost or pressure in the pulmonary capillary bed and without a high metabolic cost or oxygen demand by the left ventricular myocardium. An analysis of the performance of the left ventricle requires an understanding of (1) the mechanical performance of cardiac muscle, (2) the mechanical performance of the left ventricle and (3) the relation between mechanical performance of the myocardium and its oxygen consumption. Even though our knowledge in each of these areas is still far from complete, many advances have been made and these are presented. In addition, newly developed technics which should increase our understanding of this subject are discussed.
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