HLSC 3P90 Lecture Notes - Lecture 14: Ejection Fraction, Pulmonary Vein, Afterload
15 Dec 2019
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Document Summary
Heart failure with reduced ejection fraction (ef): systolic dysfunction. Heart failure with preserved ef: diastolic dysfunction. Impaired contractility destruction of myocytes, abnormal myocyte function or fibrosis. The end-systolic pressure volume relation is shifted down and right from line 1 to 2. This results in an increase in esv. As normal venous return is added to blood remaining in the ventricle because of incomplete emptying a higher than normal edv results. This results in an increase in preload (pressure) which acts as a compensatory function by partially elevating sv towards normal by the frank-starling mechanism. More volume and venous return coming in you will have more filling. However, the impaired contractility and ejection fraction causes esv to remain elevated. Chronically elevated lv pressure during diastole transmitted to left atrium and pulmonary veins and capillaries = pulmonary congestion. Pulmonary congestion: blood gets backed up to the lungs.
