Cardiac mechanical energy and effects on the arterial tree.

Energi mekanis jantung dan efeknya terhadap percabangan arteri.

Clicks: 336
ID: 12715
1997
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Abstract
Blood flow pulsatility is the result of the heart's activity as a pump unable to develop steady flow, and its interaction with the arterial tree. Thus, the heart is a cyclic energy generator whose adequate function requires the two phases of this cycle to be normal. Diastolic properties determine the degree of filling of the ventricles and the strength of the following systole. Systole, in turn, must generate enough energy to overcome forces opposing ejection. These can be divided into internal (the mechanical characteristics of the ventricle itself) and external loads (the characteristics of the arterial tree). As a result, hydraulic energy is imparted to blood (external ventricular work) that manifests itself as blood pressure and flow. Given the cyclic nature of cardiac activity, the external ventricular work has steady and pulsatile components. The steady component is energy lost during steady flow because of vascular resistance, and the pulsatile work is that lost in arterial pulsations and mainly depends on the aortic impedance. Thus, the characteristics of the arterial tree will determine the relative contribution of these two components to blood flow and the efficency of the heart. In addition, the arterial tree modifies the different waves (pressure and flow) traveling in the circulation. These modifications have important consequences for cardiac function. The ventricle and the arterial tree constitute a coupled biological system, and its overall performance is a function of the behavior of each unit at any given moment.
Pulsatilitas aliran darah merupakan hasil dari aktivitas jantung sebagai pompa yang tidak mampu menghasilkan aliran tunak, serta interaksinya dengan pohon arteri. Oleh karena itu, jantung merupakan generator energi siklik yang fungsi memadainya mensyaratkan kedua fase dari siklus ini berjalan normal. Sifat-sifat diastolik menentukan derajat pengisian ventrikel dan kekuatan sistol berikutnya. Sistol, pada gilirannya, harus menghasilkan energi yang cukup untuk mengatasi gaya-gaya yang menentang ejeksi. Gaya-gaya ini dapat dibagi menjadi beban internal (karakteristik mekanis dari ventrikel itu sendiri) dan beban eksternal (karakteristik pohon arteri). Sebagai hasilnya, energi hidraulik diteruskan ke darah (kerja ventrikel eksternal) yang bermanifestasi sebagai tekanan dan aliran darah. Mengingat sifat siklik dari aktivitas jantung, kerja ventrikel eksternal memiliki komponen tunak dan pulsatil. Komponen tunak adalah energi yang hilang selama aliran tunak akibat resistansi vaskular, sedangkan kerja pulsatil adalah energi yang hilang dalam pulsasi arteri dan terutama bergantung pada impedansi aorta. Dengan demikian, karakteristik pohon arteri akan menentukan kontribusi relatif dari kedua komponen ini terhadap aliran darah dan efisiensi jantung. Selain itu, pohon arteri memodifikasi berbagai gelombang (tekanan dan aliran) yang merambat dalam sirkulasi. Modifikasi ini memiliki konsekuensi penting bagi fungsi jantung. Ventrikel dan pohon arteri membentuk suatu sistem biologis terkopel, dan kinerja keseluruhannya merupakan fungsi dari perilaku masing-masing unit pada setiap waktu tertentu.
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Authors Muñoz, H R;Sacco, C M;
Journal journal of cardiothoracic and vascular anesthesia
Year 1997
DOI
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