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October 27, 1962

Clinical Science

JAMA. 1962;182(4):339-343. doi:10.1001/jama.1962.03050430013004

Relationship of Heart Rate to Cardiac Output, Work, Power, and Tension in Man  George E. Burch, M.D., New OrleansTHE HEART varies its rate to meet changes in demands of the tissues for blood. When a normal person exercises, increases his metabolic rate, and increases his needs for blood, the heart rate increases smoothly and effectively by mechanisms that are little understood. As the exertion declines and the metabolic needs decrease, the heart rate gradually decreases to reduce cardiac output and eliminate excess cardiovascular work. Although these phenomena are well known, the clinician is concerned only about patients whose hearts are driven at high rates due to disturbances in cardiac function.It is known that under certain circumstances a rapid ventricular rate, especially for a long period of time, can result in congestive heart failure and death. The mechanism for the failure, as well as many aspects of the changes