Cardiovascular physiology:

The Cardiac Cycle and Cardiac

Output
Dr Muma
 Objectives
1. Describe the mechanical events, pressure and
volume changes that occur during a cardiac cycle
2. Relate the timing of hearts sounds to the ECG waves
and pressure changes during systole and diastole
3. Define cardiac output
4. Describe the factors that affect regulation of stroke
volume
5. Outline the factors that affect the regulation of
heart rate.
 The Cardiac Cycle
• A single cardiac cycle • Simply put
includes all the events – One cardiac cycle results
associated with one in one heartbeat which
heartbeat. is a result of the
contraction and dilation
• It consists of systole and (relaxation) of the atria
diastole of both atria and ventricles
and ventricles.
– Systole = contraction
– Diastole = dilation or
expansion
Mechanical Events of the Cardiac Cycle
1. Atrial systole
2. Atrial diastole
3. Ventricular Systole • The cardiac cycle is
4. Ventricular diastole associated with
pressure and volume
changes within the
heart
 Atrial Systole
• During this period
– the atria are contracting
– the ventricles are relaxed
• On the ECG this is indicated by
the P wave
• It lasts 0.1 sec
• Blood moves from the atria to the
ventricles
• About 25ml of blood is moved
into the ventricles during atria
systole
• The end of atria systole marks the
end of ventricular diastole
• Each ventricle contains about
130mls at the end of this period
 Ventricular Systole
• Ventricle are contracting
during this period
• As ventricle begin
contracting the pressure
inside them rises causing
the AV valves to close ( 1st
heart sounds)
• For about 0.05 sec, both
AV and SL valve remain
closed while the
ventricles are contracting
• this period is known as
isovolumetric contraction
 Ventricular Systole
• As the contraction
continues the pressure in
the ventricles will rise
beyond the pressure in the
pulmonary trunk and aorta
causing the SL valves to
open and blood is ejected
(stroke volume)
• Volume of blood remaining
in each ventricle at the end
of systole is end-systolic
volume
• On the ECG- this is marked
by the QRS complex
 Relaxation period (Diastole)
• Atria diastole is over
shadowed by ventricular
systole
– The time the ventricles are
contracting the atria are
relaxing and starting to fill with
blood
• Ventricular diastole
– Ventricle are relaxing
– This is the time they fill with
blood
– Pressure within chambers falls
causes the SL to shut (2nd heart
sound)
– Then follows isovolumetric
relaxation
 Relaxation period (Diastole)
• The pressure in the
ventricles continues to
fall until it’s less than
the pressure in the atria
• AV valves open and
blood flows into the
ventricles
• At the end of diastole
the ventricles are 3
quarters filled (105
mls)
 Heart Sounds
• Produced by closure of
valves
• During each cardiac cycle
there are four heart sounds
• In a normal heart only two
sounds can be heart with a
stethoscope (S1 and S2)
• First heart sound (lubb) =
closure of AV valves
• Second heart sound (dupp)
= closure of SL valves
• S3 and S4 not loud enough
 Cardiac Output
• Cardiac Output (CO) is the • A typical resting adult
volume of blood ejected male, stroke volume is
from the ventricles each 70ml/beat, heart rate is
minute. 75 beats/min. Cardiac
CO = SV X HR Output is
CO – cardiac output
SV – stroke volume
CO = SV X HR
HR – Heart rate
= 70 X 75
• Stroke volume is volume
of blood ejected by the = 5250 ml/min
ventricle during each beat = 5.25 L/min
 Regulation of Stroke Volume
• Three factors regulate 1. Preload
stroke volume – Degree of stretch on
1. Preload heart before it
2. Contractility contracts
3. Afterload – The muscles stretch as
the chambers fill with
blood (end-diastolic
volume)
– Frank-Starling law
 Cont…
• The greater the EDV 2. Contractility
(end-diastolic volume), • Strength of contraction
the more forceful the at any given preload
next contraction – Substances that increase
• Two factors determine contractility are positive
EDV inotropic agents
– Duration of ventricular – Those that decrease
diastole contractility are negative
inotropic agents
– Venous return
 Cont…
3. Afterload – Increase in afterload
– Ejection of blood from causes stroke volume to
the heart begins when decrease.
the pressure in ventricles
exceeds the pressure in
the (pulmonary trunk
and aorta)
– The pressure that must
be overcome before the
semilunar valves open is
termed AFTERLOAD.
 Regulation of the Heart Rate
1. Nervous system- 3. Others
Cardiovascular center – Age, gender, physical
located in the medulla fitness, body
oblongata temperature influences
HR
– Sympathetic increases HR
– Parasympathetic
decreases HR
2. Chemical regulation
– Hormones e.g adrenaline,
thyroid hormones
THANK YOU