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Research Article Free access | 10.1172/JCI107074

The Anrep Effect Reconsidered

R. G. Monroe, W. J. Gamble, C. G. Lafarge, A. E. Kumar, J. Stark, G. L. Sanders, C. Phornphutkul, and M. Davis

Department of Pediatrics, Harvard Medical School, Boston, Massachusetts 02115

Department of Cardiology, Children's Hospital Medical Center, Boston, Massachusetts 02115

Department of Radiology, Children's Hospital Medical Center, Boston, Massachusetts 02115

Find articles by Monroe, R. in: JCI | PubMed | Google Scholar

Department of Pediatrics, Harvard Medical School, Boston, Massachusetts 02115

Department of Cardiology, Children's Hospital Medical Center, Boston, Massachusetts 02115

Department of Radiology, Children's Hospital Medical Center, Boston, Massachusetts 02115

Find articles by Gamble, W. in: JCI | PubMed | Google Scholar

Department of Pediatrics, Harvard Medical School, Boston, Massachusetts 02115

Department of Cardiology, Children's Hospital Medical Center, Boston, Massachusetts 02115

Department of Radiology, Children's Hospital Medical Center, Boston, Massachusetts 02115

Find articles by Lafarge, C. in: JCI | PubMed | Google Scholar

Department of Pediatrics, Harvard Medical School, Boston, Massachusetts 02115

Department of Cardiology, Children's Hospital Medical Center, Boston, Massachusetts 02115

Department of Radiology, Children's Hospital Medical Center, Boston, Massachusetts 02115

Find articles by Kumar, A. in: JCI | PubMed | Google Scholar

Department of Pediatrics, Harvard Medical School, Boston, Massachusetts 02115

Department of Cardiology, Children's Hospital Medical Center, Boston, Massachusetts 02115

Department of Radiology, Children's Hospital Medical Center, Boston, Massachusetts 02115

Find articles by Stark, J. in: JCI | PubMed | Google Scholar

Department of Pediatrics, Harvard Medical School, Boston, Massachusetts 02115

Department of Cardiology, Children's Hospital Medical Center, Boston, Massachusetts 02115

Department of Radiology, Children's Hospital Medical Center, Boston, Massachusetts 02115

Find articles by Sanders, G. in: JCI | PubMed | Google Scholar

Department of Pediatrics, Harvard Medical School, Boston, Massachusetts 02115

Department of Cardiology, Children's Hospital Medical Center, Boston, Massachusetts 02115

Department of Radiology, Children's Hospital Medical Center, Boston, Massachusetts 02115

Find articles by Phornphutkul, C. in: JCI | PubMed | Google Scholar

Department of Pediatrics, Harvard Medical School, Boston, Massachusetts 02115

Department of Cardiology, Children's Hospital Medical Center, Boston, Massachusetts 02115

Department of Radiology, Children's Hospital Medical Center, Boston, Massachusetts 02115

Find articles by Davis, M. in: JCI | PubMed | Google Scholar

Published October 1, 1972 - More info

Published in Volume 51, Issue 10 on October 1, 1972
J Clin Invest. 1972;51(10):2573–2583. https://doi.org/10.1172/JCI107074.
© 1972 The American Society for Clinical Investigation
Published October 1, 1972 - Version history
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Abstract

Evidence is presented supporting the hypothesis that the positive inotropic effect after an abrupt increase in systolic pressure (Anrep effect) is the recovery from subendocardial ischemia induced by the increase and subsequently corrected by vascular autoregulation of the coronary bed. Major evidence consists of data obtained from an isolated heart preparation showing that the Anrep effect can be abolished with coronary vasodilation, and that with an abrupt increase in systolic pressure there is a significant reduction in the distribution of coronary flow to subendocardial layers of the ventricle. Furthermore, the intracardiac electrocardiogram shows S-T segment and T wave changes after an abrupt increase in ventricular pressure similar to that noted after coronary constriction. Major implications are that normally there may be ischemia of the subendocardial layers tending to reduce myocardial contractility which may account, in part, for the positive inotropic effect of various coronary vasodilators; that with an abrupt increase in ventricular pressure the subendocardium is rendered temporarily ischemic, placing the heart in jeopardy from arrhythmias until this is corrected; and that end-diastolic pressure and the intracardiac electrocardiogram may provide a means of evaluating the adequacy of circulation to subendocardial layers in diseased ventricles when systolic pressure is abruptly increased.

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