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Cardiovascular I > Cardiac performance > Flashcards

Cardiac performance Flashcards

1
Q

What is the relationship between afterload and velocity of shortening?

A

The greater the afterload the slower the velocity of shortening

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2
Q

How does preload affect the force-velocity relationship?

A

If preload is increase there will be a greater velocity of shortening at a given afterload

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3
Q

How does preload affect the length-tension relationship?

A

If preload is increased there is an increase in active tension development

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4
Q

Does changing the preload affect Vmax?

A

No

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5
Q

What is directly proportional to the volume of blood in vena cavae and venous tone?

A

Central venous pressure

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6
Q

What will occur to central venous pressure in hypovolemia or venodilation?

A

It will decrease

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7
Q

What will occur with central venous pressure in hypervolemia or venoconstriction?

A

It will increase

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8
Q

What is the use of pulmonary capillary wedge pressure?

A

It provides an estimate of LV end-diastolic pressure and LA pressure

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9
Q

What does a PCWP of >20 mmHg indicate?

A

Pulmonary edema

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10
Q

What are factors that increase preload?

A

Increased ventricular compliance
Decreased venous compliance/venoconstriction
Increased force of atrial contraction
Reduced HR
Increased aortic pressure
Increased venous return

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11
Q

What are factors that decrease preload?

A

Decreased venous blood pressure from hypovolemia
Impaired atrial contraction
Increased HR
Decreased ventricular afterload
Decreased ventricular compliance
AV valve stenosis

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12
Q

What is another name for decreased ventricular compliance?

A

Ventricular diastolic failure

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13
Q

What increases end-systolic volume?

A

Increased afterload
Decreased contractility

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14
Q

What increases end-diastolic volume?

A

Increased venous return
Increased preload

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15
Q

What is the equation for wall stress?

A

Wall stress = (P x r)/(2 x wall thickness)

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16
Q

What is the equation for law of LaPlace?

A

T = P x r

17
Q

How does the LV compensate for increased afterload?

A

Hypertrophy

18
Q

What are factors that can increase afterload?

A

Aortic valve disease
Increased vascular resistance

19
Q

What is the average stroke volume in healthy persons?

A

70 mL

20
Q

What is the equation for SV?

A

SV = EDV - ESV

21
Q

What is the most important determinant of stroke volume?

A

EDV

22
Q

What increases SV?

A

Increased contractility
Increased preload
Decreased afterload

23
Q

What are the only mechanisms that can alter force generation in the heart?

A

Changes in fiber length
Changes in inotropy

24
Q

What occurs with increased cardiac inotropy?

A

Increases velocity of fiber shortening with increases the rate of ventricular pressure development

25
Q

What is a reliable marker for contractility?

A

Rate of pressure change = deltaP/deltat

26
Q

How does inotropy affect the force-velocity relationship?

A

Increase in inotropy results in an increase in Vmax and Fmax (maximal isometric force)

27
Q

What is the equation for stroke work?

A

Stroke work = aortic pressure x SV

28
Q

What is represented by the area within a pressure-volume loop?

A

Stroke work

29
Q

What is the primary energy source for stroke work?

A

Fatty acids

30
Q

What will change in a PV loop from exercise?

A

Increased EDV
Decreased ESV
Increased SV
Increased LV pressure

31
Q

What will change in a PV loop in AV shunts?

A

Increased EDV
Increased SV
Decreased LV pressure
ESV stays the same

32
Q

What will change in a PV loop associated with aortic stenosis?

A

Increased LV pressure
Increased ESV
Decreased SV from increased afterload

33
Q

What is the equation for ejection faction?

A

EF = SV/EDV = (EDV-ESV)/EDV

34
Q

What is a normal EF?

A

Greater than or equal to 55%

35
Q

What is EF an index of?

A

Ventricular contractility

36
Q

What is the difference in EF between diastolic and systolic HF?

A

EF decreases in systolic HF and stays normal in diastolic HF

37
Q

What factors are directly proportional to EF?

A

Preload
Contractility/inotropy

38
Q

What is the relationship between afterload and EF?

A

Inversely proportional

Cardiovascular I (20 decks)

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