1D

r. abbas Foroutan

Cardiac M

echanics

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.

2D

r. abbas Foroutan

Cardiac M

echanics

Part 1Part 1

AnatomyAnatomy

3D

r. abbas Foroutan

Cardiac M

echanics

HeartHeart

4D

r. abbas Foroutan

Cardiac M

echanics

5D

r. abbas Foroutan

Cardiac M

echanics

6D

r. abbas Foroutan

Cardiac M

echanics

7D

r. abbas Foroutan

Cardiac M

echanics

8D

r. abbas Foroutan

Cardiac M

echanics

Part 2Part 2

Cardiac Cardiac CycleCycle

9D

r. abbas Foroutan

Cardiac M

echanics

10D

r. abbas Foroutan

Cardiac M

echanics

11D

r. abbas Foroutan

Cardiac M

echanics

12D

r. abbas Foroutan

Cardiac M

echanics

13D

r. abbas Foroutan

Cardiac M

echanics

14D

r. abbas Foroutan

Cardiac M

echanics

15D

r. abbas Foroutan

Cardiac M

echanics

16D

r. abbas Foroutan

Cardiac M

echanics

17D

r. abbas Foroutan

Cardiac M

echanics

18D

r. abbas Foroutan

Cardiac M

echanics

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

19D

r. abbas Foroutan

Cardiac M

echanics

20D

r. abbas Foroutan

Cardiac M

echanics

Cardiac OutputCardiac Output

CO = SV * HRCO = SV * HRPreloadPreloadContractilityContractilityAfterloadAfterloadHRHR

21D

r. abbas Foroutan

Cardiac M

echanics

Part 3Part 3

PreloadPreload Frank –StarlingFrank –Starling

LawLaw

22D

r. abbas Foroutan

Cardiac M

echanics

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

tetanus)tetanus)

23D

r. abbas Foroutan

Cardiac M

echanics

24D

r. abbas Foroutan

Cardiac M

echanics

25D

r. abbas Foroutan

Cardiac M

echanics

26D

r. abbas Foroutan

Cardiac M

echanics

27D

r. abbas Foroutan

Cardiac M

echanics

28D

r. abbas Foroutan

Cardiac M

echanics

29D

r. abbas Foroutan

Cardiac M

echanics

30D

r. abbas Foroutan

Cardiac M

echanics

P1 P2P1 P2

QQ

Blood FlowBlood Flow

Q = P1 – P2 * Ca

31D

r. abbas Foroutan

Cardiac M

echanics

32D

r. abbas Foroutan

Cardiac M

echanics

33D

r. abbas Foroutan

Cardiac M

echanics

34D

r. abbas Foroutan

Cardiac M

echanics

35D

r. abbas Foroutan

Cardiac M

echanics

36D

r. abbas Foroutan

Cardiac M

echanics

37D

r. abbas Foroutan

Cardiac M

echanics

38D

r. abbas Foroutan

Cardiac M

echanics

39D

r. abbas Foroutan

Cardiac M

echanics

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

40D

r. abbas Foroutan

Cardiac M

echanics

41D

r. abbas Foroutan

Cardiac M

echanics

42D

r. abbas Foroutan

Cardiac M

echanics

43D

r. abbas Foroutan

Cardiac M

echanics

44D

r. abbas Foroutan

Cardiac M

echanics

Part 4Part 4

ContractilitContractilityy

45D

r. abbas Foroutan

Cardiac M

echanics

46D

r. abbas Foroutan

Cardiac M

echanics

47D

r. abbas Foroutan

Cardiac M

echanics

48D

r. abbas Foroutan

Cardiac M

echanics

49D

r. abbas Foroutan

Cardiac M

echanics

Part 5Part 5

AfterloadAfterload

50D

r. abbas Foroutan

Cardiac M

echanics

51D

r. abbas Foroutan

Cardiac M

echanics

52D

r. abbas Foroutan

Cardiac M

echanics

53D

r. abbas Foroutan

Cardiac M

echanics

54D

r. abbas Foroutan

Cardiac M

echanics

55D

r. abbas Foroutan

Cardiac M

echanics

56D

r. abbas Foroutan

Cardiac M

echanics

57D

r. abbas Foroutan

Cardiac M

echanics

58D

r. abbas Foroutan

Cardiac M

echanics

59D

r. abbas Foroutan

Cardiac M

echanics

Blood volume Venous tone

60D

r. abbas Foroutan

Cardiac M

echanics

Part 6Part 6

Heart rateHeart rate

61D

r. abbas Foroutan

Cardiac M

echanics

62D

r. abbas Foroutan

Cardiac M

echanics

63D

r. abbas Foroutan

Cardiac M

echanics

64D

r. abbas Foroutan

Cardiac M

echanics

65D

r. abbas Foroutan

Cardiac M

echanics

66D

r. abbas Foroutan

Cardiac M

echanics

67D

r. abbas Foroutan

Cardiac M

echanics

68D

r. abbas Foroutan

Cardiac M

echanics

69D

r. abbas Foroutan

Cardiac M

echanics

70D

r. abbas Foroutan

Cardiac M

echanics

Part 6Part 6

ExerciseExercise

71D

r. abbas Foroutan

Cardiac M

echanics

72D

r. abbas Foroutan

Cardiac M

echanics

73D

r. abbas Foroutan

Cardiac M

echanics

74D

r. abbas Foroutan

Cardiac M

echanics

75D

r. abbas Foroutan

Cardiac M

echanics

76D

r. abbas Foroutan

Cardiac M

echanics

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

77D

r. abbas Foroutan

Cardiac M

echanics

78D

r. abbas Foroutan

Cardiac M

echanics

79D

r. abbas Foroutan

Cardiac M

echanics

80D

r. abbas Foroutan

Cardiac M

echanics

81D

r. abbas Foroutan

Cardiac M

echanics

82D

r. abbas Foroutan

Cardiac M

echanics

83D

r. abbas Foroutan

Cardiac M

echanics

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).