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Cardiac Output. Prof. K. Sivapalan. Cardiac output. Stroke volume:- volume of blood pumped in one beat. SV = End diastolic volume – End systolic volume. Ejection fraction = stroke volume / end diastolic volume x 100 = 65 %. Heart rate :- number of heart beats per minute.
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Cardiac Output Prof. K. Sivapalan Cardiac output
Cardiac output. • Stroke volume:- volume of blood pumped in one beat. • SV = End diastolic volume – End systolic volume. • Ejection fraction = stroke volume / end diastolic volume x 100 = 65 %. • Heart rate :- number of heart beats per minute. • Cardiac output is the volume of blood pumped by each ventricle in one minute. • CO is equal for both ventricles but stroke volume could vary between ventricles. Cardiac output
Cardiac index. • Cardiac index = cardiac output per minute per square meter body surface. • 3.2 L / min / M2. • Useful to compare individuals. Cardiac output
Factors affecting C.O. Cardiac output depends on, • Venous return [Frank Starling law]. • Benefit for transplant patients. • Heart rate [ventricular filling]. • Catecholamines [force of contraction]. Within physiological range, cardiac out put isnot affected by peripheral resistance. Cardiac output
Cardiac metabolism. • Oxygen consumption [metabolism] of • myocardium (stopped)- 2 ml / 100 g / min. • skeletal muscle 0.2 ml / 100 g / min. • Beating heart at rest- 9 ml / 100 g / min. • Energy requirement depends on, • Heart rate • Intra myocardial tension • Contractile state of myocardium • Intra myocardial tension [wall] generates intra cardiac pressure according to the law of Laplace. Cardiac output
Intra mural pressure and wall tension. Cardiac output
Contractile state of myocardium. • Sympathetic and parasympathetic impulses. • Circulating catecholamines.. • Hypoxia, hypercapnoea, acidosis. • Loss of myocardium. • Drugs- depressants and stimulants. • Intrinsic depression. Cardiac output
Cardiac work. • In heart, P = TW/r • [P- pressure, T-tension, W- thickness, r- radius.] • When pressure is same and radius increased, tension also increased. – disadvantage in cardiac dilatation. • But increase in thickness is beneficial. • Mechanical work per beat: =QR + MV2 / 2G [G = 9.8 g.m.] (Q-Stroke volume, R- Mean arterial pressure, M- mass of blood pumped, V- mean velocity in aorta. • R in systemic circulation is 7 times more than in pulmonary circulation. • Increase in pressure work [after load] causes higher increase in oxygen consumption than with volume work [preload]. Cardiac output