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Cardiovascular physiology, pathophysiology, and monitoring 

Cardiovascular physiology, pathophysiology, and monitoring
Chapter:
Cardiovascular physiology, pathophysiology, and monitoring
Author(s):

Philip J. Peyton

DOI:
10.1093/med/9780199653478.003.0003
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date: 15 October 2019

Comprehensive assessment of haemodynamic status requires measurement of pressure and flow, to calculate vascular resistance. Systolic and diastolic function are both key determinants of cardiac function. Critical neurohormonal pathways are activated in heart failure, leading to activation of the sympathetic nervous system, the renin-angiotensin-aldosterone pathway, and vasopressin release from the hypothalamus. While these pathways are antagonized by the release of natriuretic peptides, which promotes systemic and pulmonary vasodilation, sodium and water retention increase circulating blood volume and cardiac preload to passively maintain stroke volume via the Frank-Starling relationship. The pulmonary vascular system is a low-pressure, low-resistance and low-volume system, whose primary function is to achieve adequate exchange of respiratory gases across the alveolar-capillary interface. Most processes can be monitored and measured during and after cardiothoracic surgery.

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