Left-Ventricular-Pressure-Volume-Loops左心室压力容积环ppt课件

Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Left Ventricular Pressure-Volume Loops,Left Ventricular Pressure-Vol,Left VentricularPressure-Volume Loops,Pressure-volume loop plots LV pressure against LV volume through one complete cardiac cycle,Factors affecting:,Preload,Afterload,Contractility,IHSS,Valvular problems,Left VentricularPressure-Volu,Left-Ventricular-Pressure-Volume-Loops左心室压力容积环ppt课件,Left VentricularPressure-Volume Loops,KNOW,:,When the mitral and aortic valves are open and closed during each phase,When systole begins(B)and ends(D),When diastole begins(D)and ends(B),Diastolic filling occurs between points A and B,Ejection occurs between points C and D,Left VentricularPressure-Volu,Left VentricularPressure-Volume Loops,Acute changes in preload,Increased preload,:,Filling increases,SV increases,Decreased preload,:,Filling decreases,SV decreases,*NOTE:the ventricle empties to the same end-systolic volume after either an increase or decrease in preload,Left VentricularPressure-Volu,Left VentricularPressure-Volume Loops,Left VentricularPressure-Volu,Left VentricularPressure-Volume Loops,Cardiac tamponade,Unique loop,Left VentricularPressure-Volu,Left VentricularPressure-Volume Loops,Acute changes in Afterload,Increased afterload,:,Ventricle empties less completely,SV decreases,Increase in BP,(shifts up and right),Decreased afterload,:,Ventricle empties more completely,SV increases,Decrease in BP,(shifts down and left),Left VentricularPressure-Volu,Left VentricularPressure-Volume Loops,Left VentricularPressure-Volu,Left VentricularPressure-Volume Loops,Altered contractility,Increased contractility,:,Ventricle empties more completely,SV increases,BP increases,(shifts up and left),Decrease,d contractility,:,Ventricle empties less completely,SV decreases,BP decreases,(shifts down and right),Left VentricularPressure-Volu,Left VentricularPressure-Volume Loops,Left VentricularPressure-Volu,Left VentricularPressure-Volume Loops,Summary of concepts:,Alterations in preload,:end-diastolic volume increases or decreases,but the amount of blood in the chamber at end-systole does not change,Stroke volume falls,:result of either an increase in afterload or a decrease in contractility,the volume of blood in the LV chamber increases(chamber dilates),Stroke volume increases,:result of a decrease in afterload or an increase in contractility,the volume of blood in the LV chamber decreases(chamber shrinks),Left VentricularPressure-Volu,Left VentricularPressure-Volume Loops,IHSS,UNIQUE,P-V loop is shifted to,smaller volumes,and,larger pressures,(due to outflow tract obstruction),ONLY IHSS,causes this type of combined shift,Left VentricularPressure-Volu,Left VentricularPressure-Volume Loops,Chronic Aortic Stenosis,(increased afterload),Concentric hypertrophy permits the LV to generate greater pressure,LV,volumes,remain about normal,P-V loop shifts upward,Left VentricularPressure-Volu,Left VentricularPressure-Volume Loops,Mitral Stenosis,(Decreased preload),LV filling is diminished,P-V loop reflects a,decreased preload,Emptying is about normal,Left VentricularPressure-Volu,Left VentricularPressure-Volume Loops,Acute Aortic Insufficiency,(regurgitation),Volume in the LV chamber increases during early diastole,P-V loop is small,No isovolemic relaxation,Left VentricularPressure-Volu,Left VentricularPressure-Volume Loops,Chronic Aortic Insufficiency,(Eccentric hypertrophy),LV chamber dilates,P-V loop is large because the SV is large,No isovolemic relaxation,Left VentricularPressure-Volu,Left VentricularPressure-Volume Loops,Be able to identify a P-V loop that shows aortic insufficiency,Be able to identify whether the loop reflects acute or chronic aortic insufficiency,Left VentricularPressure-Volu,Left VentricularPressure-Volume Loops,Acute Mitral Regurgitation,P-V loop is small,No isovolemic contraction,Left VentricularPressure-Volu,Left VentricularPressure-Volume Loops,Chronic Mitral Regurgitation,LV hypertrophies(eccentric),LV chamber dilates,P-V loop is large because the SV is large,No isovolemic contraction,Left VentricularPressure-Volu,Left VentricularPressure-Volume Loops,A=Normal,B=Mitral stenosis,C=Aortic stenosis,D=mitral regurgitation(chronic),E=aortic regurgitation(chronic),Left VentricularPressure-Volu,