Cardiac PV Loops Flashcards

1
Q

cardiac output

A

CO

total volume of blood pumping into the aorta and pulmonary artery in 1 minute

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2
Q

equation for CO

A

CO = SV x HR

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3
Q

is cardiac output in the RV >< or = LV

A

equal

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4
Q

stroke volume

A

amount of blood ejected with each beat

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5
Q

cardiac index

A

cardiac output indexed to body size

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6
Q

what are measures of cardiac performance

A

volume
pressure
flow (echocardiogram)

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7
Q

right vs left heart pressure

A

right: lower pressure system b/c PA is lower pressure than aorta

left: higher pressure system b/c aorta is higher pressure than PA

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8
Q

pressure volume loops

A

shows the relationship between pressure and volume during 1 cardiac cycle

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9
Q

PV Loop: marker A

A

end-systolic volume; volume remaining after contraction

AV: open (begins filling)
SL: closed

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10
Q

PV Loop: marker B

A

end-diastolic volume; volume in ventricles after filling

AV: close (allows pressure to rise)
SL: closed

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11
Q

PV Loop: marker C

A

pressure generated in ventricle prior to contraction

AV: closed
SL: opens –> ejection of blood

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12
Q

PV Loop: marker D

A

pressure remaining after emptying ventricle

AV: closed
SL: close –> prevent regurg

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13
Q

diastole on PV loop

A

ventricular relaxation and filling

A (early) –> B (late)

volume INCREASES
pressure NO CHANGE

low pressure phase allows for passive filling (atrial > ventricular contraction)

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14
Q

what is compliance

A

stretch of the ventricle walls that allows for minimal change in pressure during filling

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15
Q

isovolumetric contraction on PV loop

A

closing of AV valves

B (EDV) –> C

volume NO CHANGE
pressure INCREASES

moderate pressure phase - ventricular pressure rises until it exceeds aortic pressure

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16
Q

systole on PV loop

A

ventricular contraction nad ejection

C –> D

volume DECREASES
pressure INCREASES

high pressure phase (ventricular > aortic to allow for blood flow out of ventricles, then ventricular decreases until < aortic)

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17
Q

isovolumetric relaxation on PV loop

A

closing of SL valves

D (ESV) –> A

volume NO CHANGE
pressure DECREASES

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18
Q

does the ventricle completely empty after systole

A

NO - always some blood remaining in ventricle (end systolic volume)

19
Q

equation for stroke volume

A

SV = EDV - ESV

20
Q

ejection fraction

A

fraction of blood in the ventricles that gets ejected with every beat

21
Q

equation for ejection fraction

A

EF = stroke volume / EDV

EF = (EDV - ESV) / EDV

22
Q

what are the two determinants of cardiac output

A
  1. heart rate
  2. stroke volume
23
Q

how does HR affect SV

A

increase HR = increase CO BUT only up to a point

once HR gets too high –> reduced time to fill during diastole –> less blood available to eject –> decreased CO

also effected by contractility

24
Q

what 4 components of stroke volume affect CO

A
  1. preload
  2. afterload
  3. contractility (inotropy)
  4. relaxation (lusitropy)
25
Q

preload

A

diastolic wall stress - the stress put on the ventricular walls by blood entering during diastole

26
Q

how does preload affect cardiac output

A

increase preload = increase CO

heart wants to return to the same ESV –> must get rid of more blood if preload increases –> increases CO

27
Q

what is the main determinant of preload

A

blood volume/venous return

28
Q

afterload

A

systolic wall stress - the pressure required to generate a strong enough contraction to push blood out against aortic pressure

“impedance to ejection”

29
Q

how does afterload affect cardiac output

A

increase afterload = decrease CO

too much pressure in aorta –> heart can’t push out as much blood –> decrease CO

30
Q

what is the main determinant of afterload

A

systemic vascular resistance/blood pressure

(hypertension –> high pressure in aorta –> high afterload –> low CO)

31
Q

Laplace’s law

A

measures the amount of wall stress

wall stress = (pressure x radius) / (2 x wall thickness)

32
Q

what does Laplace’s law show

A

the heart can accommodate to increased wall stress by increasing wall thickness to lower wall stress back to baseline

proven by L ventricle wall being thicker than R ventricle

33
Q

contractility (inotropy)

A

degree that muscle fibers shorten

34
Q

how does contractility affect cardiac output

A

increase inotropy = increase CO

stronger contraction results in more blood being ejected per beat

35
Q

how does inotropy affect the PV loop

A

increases the slope of the ESPVR curve

results in a lower ESV (because more blood ejected)

does NOT affect load

36
Q

does inotropy depend on load

A

NO - regulated by ANS to alter Ca influx and sensitivity

37
Q

relaxation (lusitropy)

A

ventricular compliance and diastolic function

38
Q

how does lusitropy affect cardiac output

A

increase lusitropy = increase cardiac output

increased compliance allows for greater filling (increase EDV) –> increased CO

39
Q

how does diastolic dysfunction affect CO

A

decreases relaxation –> decreased compliance –> decreased CO

40
Q

equation for ventricular compliance

A

deltaV / deltaP

41
Q

equation for ventricular stiffness

A

deltaP / deltaV

42
Q

myocardial oxygen demand

A

MVO2; the amount of oxygen required by the myocardium to function

43
Q

what is MVO2 dependent on

A
  1. heart rate (inc HR = inc MVO2)
  2. wall stress/pressure (inc pressure = inc MVO2)
  3. contractility (inc inotropy = inc MVO2)
44
Q

when do the coronary arteries delivery oxygenated blood to the heart

A

during diastole