1 Dr. abbas Foroutan Cardiac Mechanics Heart Physiology Heart as a pump 1384-85Oct.2005 By: Dr. Abbas Foroutan Shaheed Beheshti Univ. Med. Sci.

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Heart PhysiologyHeart PhysiologyHeart as a pumpHeart as a pump

1384-851384-85Oct.2005Oct.2005

By: Dr. Abbas ForoutanBy: Dr. Abbas ForoutanShaheed Beheshti Univ. Med. Sci.Shaheed Beheshti Univ. Med. Sci.

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Part 1Part 1

AnatomyAnatomy

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HeartHeart

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Part 2Part 2

Cardiac Cardiac CycleCycle

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Animation\echo\1-Echo3-n.swfAnimation\echo\1-Echo3-n.swf

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Cardiac OutputCardiac Output

CO = SV * HRCO = SV * HRPreloadPreloadContractilityContractilityAfterloadAfterloadHRHR

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Part 3Part 3

PreloadPreload Frank –StarlingFrank –Starling

LawLaw

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No spatial summationNo spatial summation No Time domain summation (no No Time domain summation (no

tetanus)tetanus)

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P1 P2P1 P2

QQ

Blood FlowBlood Flow

Q = P1 – P2 * Ca

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Laplac Law Laplac Law T= P* T= P* r/2hr/2h

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Part 4Part 4

ContractilitContractilityy

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Part 5Part 5

AfterloadAfterload

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Blood volume Venous tone

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Part 6Part 6

Heart rateHeart rate

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Part 6Part 6

ExerciseExercise

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CARDIOVASCULAR CHANGES CARDIOVASCULAR CHANGES DURINGDURING

EXERCISE EXERCISE Cardiac outputCardiac output

heart rate heart rate ( ( sympathetic adrenergic and sympathetic adrenergic and parasympathetic parasympathetic activity)activity)

stroke volume stroke volume ( ( CVP; inotropy; lusitropy) CVP; inotropy; lusitropy) Mean arterial pressureMean arterial pressure and and pulse pressurepulse pressure

CO increases more than SVR decreaseCO increases more than SVR decrease stroke volume increases pulse pressurestroke volume increases pulse pressure

Central venous pressureCentral venous pressure Venous constriction Venous constriction ( ( sympathetic adrenergic activity) sympathetic adrenergic activity) Muscle pump activityMuscle pump activity Abdominothoracic pumpAbdominothoracic pump

Systemic vascular resistanceSystemic vascular resistance Metabolic vasodilation in active muscle and heartMetabolic vasodilation in active muscle and heart Cutaneous vasodilation Cutaneous vasodilation (( sympathetic adrenergic activity) sympathetic adrenergic activity) Vasoconstriction in splanchnic, nonactive muscle, and renal Vasoconstriction in splanchnic, nonactive muscle, and renal

circulationcirculation ( ( sympathetic adrenergic activity) sympathetic adrenergic activity)CVP, central venous pressure; CO, cardiac output; SVR, systemic vascular resistanceCVP, central venous pressure; CO, cardiac output; SVR, systemic vascular resistance

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Return of blood to the heart through veins from the extremities occurs by low ∆P, but also, as in lymphatics, by one-way valves, "milking action" of skeletal muscles, and — within the torso — by lowered thoracic pressure each time the diaphragm is lowered (no valves within torso).