Cardiac Mechanics and Function

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Questions and Answers

Which factor is NOT an important mechanism for changing the force of cardiac contraction?

  • The availability of Ca2+
  • The synchrony of activation
  • The resting muscle stretch
  • The % of activated muscle cells (correct)

Which factor primarily regulates the contractility of the heart?

  • The sympathetic nervous system (correct)
  • The synchrony of activation
  • The % of activated muscle cells
  • The availability of Ca2+

Which factor determines the overlap of actin and myosin in cardiac muscle?

  • The resting muscle stretch (correct)
  • The availability of Ca2+
  • The synchrony of activation
  • The % of activated muscle cells

What is the molecular makeup of the muscle that can influence the mechanical properties of the heart?

<p>The contractile protein isoform expression (D)</p> Signup and view all the answers

Which factor can change the mechanical properties of the twitch contraction in the heart?

<p>The duration of the active state (A)</p> Signup and view all the answers

Which factor is an important determinant of ventricular force generation?

<p>The synchrony of activation (C)</p> Signup and view all the answers

What determines the size of the Ca transient in the heart?

<p>The availability of Ca2+ (B)</p> Signup and view all the answers

Which type of muscle is easily stretched at short muscle lengths?

<p>Cardiac muscle (B)</p> Signup and view all the answers

What is the protective mechanism in the whole heart that prevents overfilling?

<p>All of the above (D)</p> Signup and view all the answers

What are isometric contractions in cardiac muscle?

<p>Contractions where the muscle develops force but is prevented from shortening (C)</p> Signup and view all the answers

What determines the force generating capabilities of striated muscle?

<p>The number of actin-myosin crossbridges (D)</p> Signup and view all the answers

What is the relationship between resting length and cardiac function called?

<p>The Frank Starling relationship (D)</p> Signup and view all the answers

What is the sarcomere length beyond which it is very difficult to stretch resting cardiac muscle?

<p>2.2 microns (C)</p> Signup and view all the answers

What is the primary factor that regulates force development in cardiac muscle?

<p>The number of actin-myosin crossbridges (C)</p> Signup and view all the answers

What is the characteristic of resting cardiac muscle compared to skeletal muscle at sarcomere lengths near the peak of the length-active force relationship?

<p>Resting cardiac muscle is significantly stiffer (B)</p> Signup and view all the answers

What are the factors that regulate force development in cardiac muscle?

<p>Resting muscle length and the number of actin-myosin crossbridges (B)</p> Signup and view all the answers

Which phase of the cardiac cycle is represented by the bottom side of the pressure-volume loop?

<p>Ventricular filling (A)</p> Signup and view all the answers

What does the width of the pressure-volume loop represent?

<p>Stroke volume (B)</p> Signup and view all the answers

Which event occurs at the time represented by the corner of the pressure-volume loop labeled 'AC'?

<p>Aortic valve closure (A)</p> Signup and view all the answers

What determines the rate and magnitude of shortening in cardiac muscle?

<p>The afterload and contractility (A)</p> Signup and view all the answers

What happens to the velocity and magnitude of shortening as the afterload increases?

<p>They decrease (C)</p> Signup and view all the answers

Which type of muscle only functions on the 'ascending limb' of the length-tension relationship?

<p>Cardiac muscle (D)</p> Signup and view all the answers

What is the name of the loop that can be used to plot the instantaneous pressures and volumes throughout the cardiac cycle?

<p>Pressure-volume loop (A)</p> Signup and view all the answers

When does the muscle shorten at a maximal rate?

<p>When the afterload is zero (D)</p> Signup and view all the answers

Which one of these is true about the relationship between afterload and the velocity of shortening in cardiac muscle?

<p>As afterload increases, the velocity of shortening decreases (D)</p> Signup and view all the answers

What is the diastolic pressure-volume relationship (DPVR) in cardiac muscle?

<p>The relationship between ventricular pressure and volume during filling (D)</p> Signup and view all the answers

A decrease in diastolic ventricular compliance is represented by what?

<p>Upward shift in the diastolic PVR (B)</p> Signup and view all the answers

What can cause a decrease in diastolic ventricular compliance in cardiac muscle?

<p>All of the above (D)</p> Signup and view all the answers

What does the end-systolic pressure-volume relationship (ESPVR) represent in cardiac muscle?

<p>The maximum pressure that the ventricle can develop at any volume (D)</p> Signup and view all the answers

How is the end-systolic pressure-volume relationship (ESPVR) derived in cardiac muscle?

<p>By allowing the ventricle to contract but not eject blood at different end-diastolic volumes (D)</p> Signup and view all the answers

What happens to the maximum capability of the ventricle to develop pressure as the volume of the ventricle decreases in cardiac muscle?

<p>It decreases (C)</p> Signup and view all the answers

What happens to the velocity and magnitude of shortening as the afterload increases in cardiac muscle?

<p>They decrease (B)</p> Signup and view all the answers

Which of the following is true about compliance in cardiac muscle?

<p>Compliance is greatest at low volumes (B)</p> Signup and view all the answers

What is the relationship between ventricular ejection and the end-systolic pressure-volume relationship (ESPVR)?

<p>Ventricular ejection ends when the ventricular volume intersects the ESPVR (C)</p> Signup and view all the answers

What is contractility in cardiac muscle?

<p>The ventricle's ability to develop pressure independent of load (B)</p> Signup and view all the answers

Which of the following is true about the regulation of contractility in cardiac muscle?

<p>Contractility is regulated by the sympathetic nervous system (C)</p> Signup and view all the answers

What are some indices used to estimate changes in contractility?

<p>Emax and dP/dt (A)</p> Signup and view all the answers

What happens to stroke volume when contractility increases with no change in preload or afterload?

<p>Stroke volume increases (A)</p> Signup and view all the answers

How can contractility be modified in cardiac muscle?

<p>By humoral and pharmacologic agents (D)</p> Signup and view all the answers

What happens to contractility in cardiac diseases?

<p>Contractility decreases (D)</p> Signup and view all the answers

What causes reduced myofilament Ca binding affinity in cardiac muscle?

<p>Ischemia (C)</p> Signup and view all the answers

What is associated with reduced levels of SERCa2 and 'depressed' Ca handling in cardiac muscle?

<p>Pathological cardiac hypertrophy (C)</p> Signup and view all the answers

Which of the following is true about failing hearts?

<p>They have increased sympathetic reflexes (A)</p> Signup and view all the answers

What is preload in the context of the heart?

<p>The stretch on the myocardial wall at the end of diastole (A)</p> Signup and view all the answers

How is preload best represented?

<p>End-diastolic volume (EDV) (D)</p> Signup and view all the answers

What happens when there is an increase in preload (EDV)?

<p>The ventricle moves higher on the Starling curve (C)</p> Signup and view all the answers

What physiological factors can alter preload?

<p>All of the above (D)</p> Signup and view all the answers

What is the problem with using end-diastolic pressure (EDP) as a measure of preload when diastolic compliance is changing?

<p>EDP is not a reliable indicator of preload, IF THE DIASTOLIC COMPLIANCE IS CHANGING (D)</p> Signup and view all the answers

What can happen when + inotropic drugs are used to correct abnormal contractility in human heart failure?

<p>They can worsen arrhythmias (A)</p> Signup and view all the answers

What is the effect of an increase in end-diastolic volume (EDV) on the PV loop?

<p>It displaces the right side of the PV loop to the right (A)</p> Signup and view all the answers

What is the term for the reduced contractility in failing hearts?

<p>Contractility reserve (A)</p> Signup and view all the answers

Why is correcting abnormal contractility in human heart failure not easily accomplished?

<p>It can worsen arrhythmias (A)</p> Signup and view all the answers

Which of the following is a measure of afterload in the heart?

<p>Systolic ventricular wall stress (B)</p> Signup and view all the answers

What is the formula for mean blood pressure (MBP)?

<p>MBP = CO X TPR (D)</p> Signup and view all the answers

In patients with hypertension, increased afterload is primarily due to what factor?

<p>High blood pressure (D)</p> Signup and view all the answers

What happens to stroke volume when afterload is increased, while preload and contractility are held constant?

<p>Stroke volume decreases (D)</p> Signup and view all the answers

What is the formula for cardiac output (CO)?

<p>CO = stroke volume * heart rate (A)</p> Signup and view all the answers

What controls heart rate in normal people?

<p>Sympathetic and parasympathetic nervous systems (A)</p> Signup and view all the answers

What effect does increased sympathetic nerve activity have on heart rate?

<p>Increases heart rate (B)</p> Signup and view all the answers

What is the formula for calculating systolic ventricular wall stress?

<p>S = (P x r) / 2 Th (B)</p> Signup and view all the answers

What happens to the velocity of muscle fiber shortening when afterload is increased?

<p>Velocity of muscle fiber shortening decreases (A)</p> Signup and view all the answers

Which of the following is true about congestive heart failure (CHF)?

<p>CHF is characterized by the inability of the heart to pump sufficient blood (B)</p> Signup and view all the answers

What is the result of decreased parasympathetic nerve activity near the SA node?

<p>Increased frequency of action potentials (B)</p> Signup and view all the answers

What happens to stroke volume, cardiac output, and blood pressure when the time available for ventricular filling is reduced?

<p>They decrease (B)</p> Signup and view all the answers

What is the primary cause of congestive heart failure (CHF)?

<p>Ischemic heart disease (C)</p> Signup and view all the answers

What is the effect of increased end-diastolic volume (EDV) on the pressure-volume loop?

<p>Dilated ventricles (A)</p> Signup and view all the answers

What is the characteristic of the failing cardiac myocytes in congestive heart failure (CHF)?

<p>Reduced contractility (A)</p> Signup and view all the answers

What is the relationship between heart rate and time for ventricular filling?

<p>Inverse relationship (B)</p> Signup and view all the answers

What happens to the pressure generating capability of the ventricle as it dilates?

<p>It decreases (D)</p> Signup and view all the answers

What is the result of increased end-diastolic pressure (EDP)?

<p>Systemic edema (A)</p> Signup and view all the answers

What is the effect of increased exercise intensity on cardiac output?

<p>It increases (D)</p> Signup and view all the answers

Which of the following is a cause of increased afterload in patients with hypertension?

<p>A and B (D)</p> Signup and view all the answers

What happens to stroke volume when afterload is increased?

<p>It decreases (B)</p> Signup and view all the answers

Why does decreased stroke volume occur when afterload is increased?

<p>Stroke volume is reduced because increased afterload reduces the velocity of muscle fiber shortening and the velocity by which the blood is ejected. (B)</p> Signup and view all the answers

Which of the following can be used to assess afterload in the heart?

<p>All of the above (D)</p> Signup and view all the answers

Which of the following represents the pressure which the ventricle must overcome to begin ejection in the heart?

<p>The diastolic pressure (A)</p> Signup and view all the answers

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