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Preload and Afterload

- The Frank-Starling law states that the force of contraction of the heart muscle is proportional to the initial length of the cardiac muscle fibers, so that increased venous return (preload) results in increased cardiac output. - Afterload refers to the pressure against which the ventricles must eject blood into the arteries. Increased afterload decreases stroke volume by decreasing the velocity of fiber shortening. - Factors that influence cardiac output include preload (venous return), which matches cardiac output between the two sides of the heart, and afterload (arterial blood pressure), as cardiac output is inversely related to blood pressure.

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3K views28 pages

Preload and Afterload

- The Frank-Starling law states that the force of contraction of the heart muscle is proportional to the initial length of the cardiac muscle fibers, so that increased venous return (preload) results in increased cardiac output. - Afterload refers to the pressure against which the ventricles must eject blood into the arteries. Increased afterload decreases stroke volume by decreasing the velocity of fiber shortening. - Factors that influence cardiac output include preload (venous return), which matches cardiac output between the two sides of the heart, and afterload (arterial blood pressure), as cardiac output is inversely related to blood pressure.

Uploaded by

api-19916399
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd

Cardiac muscle contractility

1) Preload: the load that is given to the

muscle prior to its contraction.

2) Afterload: the load that is given to

the muscle after the beginning of the

contraction.
1) Effects of preload
Frank-starling law:

Energy of heart contraction is

proportional to the initial length of

cardiac muscle fiber.


The Frank-Starling
law means that the
greater the heart
muscle is stretched
during filling, the
greater the force of
contraction and the
greater the quantity
of blood pumped into
the aorta.
What is the explanation of the Frank-
Starling mechanism?

When an extra amount of blood flows


into the ventricles, the cardiac muscle
itself is stretched to greater length. The
ventricle, because of its increase pumping,
automatically pumps the extra blood into
the arteries.
Under most conditions the amount of

blood pumped by the heart each minute is

determined almost entirely by the rate of

blood flow into the heart from the veins,

which is called venous return.


That is, each peripheral tissue of the
body controls its own local blood flow, and the
total of all the local blood through all the
peripheral tissues flowing by way of the veins
to the right atrium. The heart in turn
automatically pumps this incoming blood into
the systemic arteries, so that it can flow
around the circuit again.

Therefore, preload is proportional


to the venous return.
Importance of Heterometric
Autoregulation

1. It is responsible for the precise, beat-to-beat


balance between the outputs of the right and
left ventricles.
2. It thus insures that the total blood volume
remains distributed in the proper way between
the systemic circulation and pulmonary
circulation.
3. Without this precise balance, blood would pool in
the lungs causing pulmonary edema. 
Just remember: "What goes in must come out."
2) Effects of afterload
Afterload can be viewed
as the "load" that the
heart must eject blood
against
　 In simple terms, the
afterload is closely
related to the aortic
pressure.
Briefly, an increase in afterload decreases
the velocity of fiber shortening, resulting
a decrease in SV.
With the rising of blood pressure, the

afterloads become to increase, which make

the heart to beat with more energy and

more difficulty. That is to say, cardiac

output is inverse proportion to blood

pressure.
BP ↑ → Afterload↑→The ventricle will have to

generate increased pressure→ decreases the

velocity of cardiac fibers shortening→The ejection

velocity after the valve opens will be

reduced→less blood will be ejected→SV↓

→ESV↑+venous return→EDV↑→Adjust

By Frank-Starling law.
SUMMARY
 Preload of the ventricles is provided by
venous pressure (VP)
 Afterload is provided by arterial blood
pressure.
 SV (or SW) is proportional to the initial fiber
length ( Starling’s law).
 The mechanism underlying Starling’s law is
the degree of overlap of muscle filaments.
 Operation of Starling’s law matches CO
from both sides of the heart.
Cardiac Output
Ask Yourself:
1. Were the ranking of your reclining,
sitting, standing, and active cardiac
output measurements the same as your
predictions? Explain.
2. What factors influence your cardiac
output?
3. Compare your resting and active cardiac
output. What is your cardiac reserve?
See background notes.
4. Compare your cardiac output measurements with four other
classmates . Are they the same-why or why not? Explain:
 
5. Compare the cardiac output measurements of males and
females. Can you make a statement based on your
observations about gender and cardiac output?
 
 
 6. Cardiac functions such as cardiac output are
regularly recorded for the astronauts during their
space flight. Is it important to have each
astronaut's "earth normal" or pre-flight
measurements? Why?

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