[清华大学北京协和医学院生理课件]心泵.ppt

Ventricular function curve reflects the relationship between preload and pumping function. The curves do not have downward branch The mechanisms of Frank-Starling law: (1) The effective overlapping degree of thick filaments and thin filaments of the sarcomere; (2) The affinity of troponin to Ca2+ depends on the length of muscle. The preload is affected by venous retuning volume and end systolic ventricular volume: Four factors determine the venous retuning volume: ventricular filling time venous blood retuning speed The pressure of pericardial cavity The compliance of the ventricle Afterload （后负荷） Cardiac afterload can be reflected by the stretching force of the ventricular wall at systole, or the peripheral resistance (外周阻力）. An increase in afterload will decrease cardiac output 　 Cardiac contractility （心肌收缩能力） An intrinsic factor Affected by neurohormonal factors Independent of pre- or afterload 　 Heart rate （心率） 　 正常心脏 心脏扩大 Role of atria in the pumping funtion of heart 1. As a tract of blood returning Increased ventricular pressure Dysfunction of atrial contraction Decrease in atrial compliance ↓ Decrease in veinous blood retuning ↓ Increase in atrial pressure 2. As a primary pump (初级泵) (主动充盈作用, 在心室被动充盈障碍时尤为重要) * * * * Chapter 10 The heart as a pump Section 1 The contractility of the heart The ultrastructure of cardiac muscle Sarcomere is similar with skeletal muscle Intercalated disks, gap junctions between cells Rich in mitochondria Under-developed sarcoplasmic reticulum (SR), contraction is dependent on [Ca2+]o (CICR) 2. The excit