Heart Sounds

cardiac Physiology
Physiology -i
DPT
 Notes
• Home / ABA Keyword Categories / LV filling physiology
• LV filling physiology
• Definition
• LV filling occurs during diastole, which has 4 phases: (1) isovolumic relaxation; (2) rapid
filling phase; (3) slow filling, or diastasis; and (4) final filling during atrial systole (atrial ki
ck.)
• Cardiac Cycle
• Isovolumic relaxation – this phase occurs after the aortic valve closes and the mitral valv
e is still closed. LV relaxation is energy dependent, requiring ATP. Calcium first dissociate
s from Troponin C, allowing actin to dissociate from myosin. Calcium is then taken back i
nto the sarcoplasmic reticulum by SERCA-2. There are also elastic recoiling forces of prot
eins such as titin that aid in relaxation.
• Rapid filling – this begins after left atrial pressure has exceeded the pressure within the L
V and the mitral valve opens, allowing passive blood flow into the LV. This phase contrib
utes the largest volume during filling.
• Slow filling – occurs as the LV pressure approaches the L atrial pressure. It contributes 5
% of total diastolic volume. The L atrium acts as a conduit during this phase, allowing ve
nous return to flow through the LA into the LV. LV pressures can decrease to sub-atmosp
heric pressures, causing a diastolic suction phenomenon.
• Atrial systole – Last 15% (on average) of LV volume is delivered as the atria contract. This
is more important with high heart rates and LV hypertrophy
Causes