Ventricular/Vascular Coupling: Clinical, Physiological, and by Michael F. O’Rourke, Albert P. Avolio, Wilmer W. Nichols

By Michael F. O’Rourke, Albert P. Avolio, Wilmer W. Nichols (auth.), Frank C. P. Yin (eds.)

Physiologists have lengthy been attracted to the interplay, or coupling, among the guts and the vasculature. The early literature is composed as a rule of phenomenological descriptions of cardiac changes caused by particular interventions within the vasculature. thousands of reviews, for instance, describe sensible points of hypertrophied myocardium linked to the over the top vascular loading produced by way of a number of kinds of experimental high blood pressure. lately, the ideas of ventricular/vascular interplay have came upon very important medical software. The common use of vaso­ dilators and of intraaortic counterpUlsation balloons for unloading an ov­ erburdened, diseased center is a chief instance. regardless of the curiosity during this box, till as lately as two decades in the past we weren't capable of describe ventricular or vascular functionality in a framework appropriate for quantitatively expressing the interplay among those advanced platforms. 3 significant developments-description of ventricular functionality when it comes to either the time-varying elastance and the pump functionality graph and quantification of vascular functionality when it comes to impedance­ have replaced this. those useful descriptions now permit structures en­ gineers, bioengineers, physiologists, and clinicians to handle very particular quantitative elements of ventricular/vascular interplay and feature ended in a flurry of papers and symposia dedicated to this subject.

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Mean Circulatory, Systemic, and Pulmonary Pressures The mean circulatory pressure is the pressure in the circulation when, in the absence of changes in arterial or venous tone, the pressure is equal everywhere. Guyton, Jones, and Coleman (1973) initially measured the mean circulatory pressure by fibrillating the heart and rapidly pumping volume from the arteries into the veins so that pressures were equalized everywhere within 7 to 10 seconds. In the dog they found the mean circulatory pressure to be 7 mm Hg, a remarkably constant value.

189:609-615. Johnson, P. , and Hanson, K. M. 1963. Relation between venous pressure and blood volume in the intestine. Am. 1. Physiol. 204:31-34. Levy, M. N. 1979. The cardiac and vascular factors that determine systemic blood flow. Circ. Res. 44:739-746. Lindsey, A. , Banahan, B. , Cannon, R. , and Guyton, A. C. 1957. Pulmonary blood volume of the dog and its changes in acute heart failure. Am. 1. Physiol. 190:45. Lindsey, A. , and Guyton, A. C. 1959. Continuous recording of pulmonary blood volume, and pulmonary pressure and volume changes during acute right or left ventricular failure.

2). Once the plateau level is reached, this parameter is meaningless, as venous return has reached a maximum. We conclude from these studies that venoconstriction in the whole circulation increases the venous resistance but elevates the plateau. This has been confirmed in conscious dogs by Appleton and co-workers (1985). Caldini and colleagues (1974) first proposed that the venous circulation might consist of more than one compartment, with capacitance and resistance parameters that could not be added in a linear fashion.

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