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Cardiac Output
Factors Controlling CO
Four factors control CO; heart rate, myocardial
contractility, preload, and afterload.
Heart rate and contractility are intrinsic factors,
characteristics of cardiac tissues, influenced by neural
and humoral mechanisms.
Preload and afterload depend on the characteristics of
both the heart and the vascular system.
Myocardial Contractility
Consider the equilibrium values for CO and Pv are
designated by point A.
Cardiac sympathetic nerve stimulation would abruptly raise
CO to point B before Pv would change appreciably.
However, this high CO would increase the net transfer of
blood from the venous to the arterial side of the circuit.
Consequently, Pv would begin to fall (point C).
CO would continue to fall until a new equilibrium point
(D) was reached.
Peripheral Resistance
Predictions concerning the effects of changes in peripheral
resistance are complex because both the cardiac and
vascular function curves shift.
With increased peripheral resistance, the vascular function
curve is moves counterclockwise.
The cardiac function curve is also shifted downward
because (1) as peripheral resistance increases, arterial
pressure tends to rise; and (2) at any given Pv, the heart is
able to pump less blood against a greater afterload.
Whether point B will fall directly below point A or will lie
to the right or left of point A depends on the magnitude of
the shift in each curve.
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