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Cardiac Output and Influencing Factors

Sep 4, 2025

Overview

This lecture explains cardiac output, how it is calculated, and the factors that affect it, including preload, contractility, and afterload.

Definition and Formula of Cardiac Output

  • Cardiac output (CO) is the amount of blood pumped by the left ventricle in one minute.
  • CO measures blood sent to body tissues per minute, providing them with oxygen and nutrients.
  • The formula: Cardiac Output = Heart Rate (HR) × Stroke Volume (SV).
  • Heart Rate is the number of heartbeats per minute.
  • Stroke Volume is the amount of blood ejected from the left ventricle with each contraction.

Factors Influencing Cardiac Output

  • Anything that alters heart rate or stroke volume will change cardiac output.
  • Increased heart rate (e.g., during exercise) raises cardiac output; decreased heart rate (e.g., at rest) lowers it.
  • Stroke volume is calculated as SV = End Diastolic Volume (EDV) − End Systolic Volume (ESV).
  • EDV is the blood in the left ventricle at the end of diastole (filling); ESV is the blood left in the ventricle after systole (contraction).

Preload, Contractility, and Afterload

  • Preload is determined by venous return; higher preload increases EDV, raising stroke volume and cardiac output.
  • Contractility is the force of heart contraction; increased contractility lowers ESV, raising stroke volume and cardiac output.
  • Afterload is the back pressure the heart must overcome to eject blood; higher afterload (as in hypertension) increases ESV, lowering stroke volume and cardiac output.

Effects of Preload, Contractility, and Afterload on Cardiac Output

  • Increased preload (more blood returning to heart) → increased EDV → increased SV → increased CO.
  • Decreased preload → decreased EDV → decreased SV → decreased CO.
  • Increased contractility (stronger heart squeeze) → decreased ESV → increased SV → increased CO.
  • Decreased contractility → increased ESV → decreased SV → decreased CO.
  • Increased afterload (e.g., high blood pressure) → increased ESV → decreased SV → decreased CO.
  • Decreased afterload (normal/lowered blood pressure) → decreased ESV → increased SV → increased CO.

Key Terms & Definitions

  • Cardiac Output (CO) — Blood volume pumped by left ventricle per minute.
  • Heart Rate (HR) — Beats per minute.
  • Stroke Volume (SV) — Blood pumped per beat by left ventricle.
  • End Diastolic Volume (EDV) — Blood volume in left ventricle at end of diastole.
  • End Systolic Volume (ESV) — Blood volume in left ventricle at end of systole.
  • Preload — The degree of stretch/volume from venous return before contraction.
  • Contractility — Strength of heart muscle contraction.
  • Afterload — Resistance/back pressure the heart must overcome to eject blood.

Action Items / Next Steps

  • Review formulas for cardiac output and stroke volume.
  • Prepare to discuss how hypertension affects afterload and cardiac output in upcoming blood pressure exercises.