Abstract
The dynamic interaction between the heart and the systemic circulation allows the cardiovascular system to be efficient in providing adequate cardiac output and arterial pressures necessary for sufficient organ perfusion [1]. The cardiovascular system provides adequate pressure and flow to the peripheral organs in different physiological (rest and exercise) and pathological conditions because of the continuous modulation of the arterial system compliance, stiffness and resistance with respect to left ventricular (LV) systolic performance [2]. Cardiac output is the final result of this dynamic modulation. Because LV stroke volume depends on myocardial contractility and loading conditions (preload and afterload), both cardiac and arterial dysfunction can lead to acute hemodynamic decompensation and shock.
Highlights
The dynamic interaction between the heart and the systemic circulation allows the cardiovascular system to be efficient in providing adequate cardiac output and arterial pressures necessary for sufficient organ perfusion [1]
Because left ventricular (LV) stroke volume depends on myocardial contractility and loading conditions, both cardiac and arterial dysfunction can lead to acute hemodynamic decompensation and shock
Conclusion the management of shock patients has traditionally been based on advanced hemodynamic monitoring, the role of echocardiography in the evaluation of patients with acute hemodynamic decompensation has been progressively expanding in the last decades
Summary
The dynamic interaction between the heart and the systemic circulation allows the cardiovascular system to be efficient in providing adequate cardiac output and arterial pressures necessary for sufficient organ perfusion [1]. Acute systolic cardiac dysfunction results in both a low ejection fraction and increased filling pressures in the attempt to maintain a sufficient stroke volume For this reason, the LV ESPVR is shifted downward and rightward, and Ees decreases. The association between the inotropic and vasopressor action seems to improve cardiovascular performance by matching Ea and Ees. Cardiac surgery Cardiogenic shock is the most severe clinical manifestation of perioperative acute heart failure after cardiac surgery and leads to systemic hypoperfusion and organ dysfunction that generally requires either pharmacological or mechanical support. Despite the severe hemodynamic dysfunction, Ea/Ees can be normally coupled in patients with septic shock (Ea/Ees = 1) In these cases, the proper interaction between LV performance and arterial system function can depend on both a normal cardiac function and on a proper therapeutic approach with fluid administration, inotropes and vasoconstrictors. Pulmonary artery catheterization and cardiac magnetic resonance may be useful in determining RV V-A coupling [48,49]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
