Canonical Question
Cardiac output
Master answer
Myocardial contractility
- Ability of myocardium to contract (or myofibrils to shorten) against a given afterload, with a given preload
dP/dT
- Change in pressure / change in time
- Measure of contractile force exerted by the myocardium at the start of systole
- One of the oldest measures of global myocardial contractility
- Measured via doppler analysis of mitral regurgitant jet
- Limited by
- Requirement for MR jet
- Affected by preload, afterload and contractility
ESPVR
- Line created with a series of LV pressure volume loops where preload was varied with a fixed afterload. The point at which aortic valve closure occurred was plotted.
- This is a surrogate for contractility on the pressure-volume loop.
- Invasive and impractical
EF
- Fraction of end-diastolic volume which is ejected (stroke volume / end-diastolic volume)
- 60% in normal heart (70ml/120ml)
Sakurai 2016
Exam appearances
| Exam | Exact wording | Relationship | Success |
|---|---|---|---|
| 2012B Q04 | Define myocardial contractility and briefly describe dP/dT, the end systolic pressure volume (ESPV) relationship and the ejection fraction (EF). | historical_member | — |