西安交通大学医学院循环系统疾病课件 Introduction of Cardiac Function.pptVIP

Introduction of Cardiac Function Theoretical Considerations of Cardiac Function The cardiovascular system supplies the tissues with oxygen and metabolic substrates and removes carbon dioxide and other waste products. This requires the integration of all its components (venous circulation, right side of the heart, lungs and pulmonary vascular system, left side of the heart, arterial circulation, and blood). Theoretical Considerations of Cardiac Function Most circulatory dysfunction of cardiac origin in adults is due to abnormalities of the left ventricle. Thus, the clinical evaluation of cardiac function predominately concerns the performance of the left ventricle. Levels of Integration Myocardium, Pump, Cardiac Output The performance of the left ventricle as a pump depends on the contraction of the sarcomeres in the myocardium as well as on the organization and configuration of the left ventricular chamber, valvular function, and loading conditions. Ultimately, the interaction of the left ventricle, the other cardiac chambers, and the arterial, pulmonary, and venous circulations results in the cardiac output. Levels of Integration Thus, cardiac function can be evaluated at several levels of integration: (1) myocardial function (2) chamber (usually left ventricular) pump performance (3) integrated cardiac output It is important to recognize at which level of integration cardiac function is being evaluated. Factors Controlling Myocardial Function (1) preload (2) afterload (3) the myocardial contractile state (contractility) (4) heart rate and cardiac rhythm. Measurement of Key Variables Pressures The intracardiac, arterial, and venous pressures are important variables used in assessing cardiac function. These pressures have been traditionally measured using fluid-filled catheters. Arterial pressure can be obtained noninvasively by sphygmomanometry Measurement of Key Variables Noninvasive Pressure Measurement Cuff sphygmomanometry arterial sy