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Related Concept Videos

Cardiac Output II: Effect of Stroke Volume on Cardiac Output01:22

Cardiac Output II: Effect of Stroke Volume on Cardiac Output

Cardiac output (CO), the amount of blood the heart pumps per minute, is a parameter in cardiovascular physiology determined by stroke volume and heart rate. Stroke volume, the amount of blood pushed from one of the ventricles per heartbeat, is influenced by preload, afterload, and contractility.
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...
Regulation of Stroke Volume01:27

Regulation of Stroke Volume

The regulation of stroke volume, which is the amount of blood the heart pumps out during each heartbeat, is critical for maintaining a healthy circulatory system. Stroke volume is influenced by three main factors: preload, contractility, and afterload.
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
Cardiac Output and Stroke Volume01:11

Cardiac Output and Stroke Volume

Cardiac output (CO) is an integral aspect of human physiology, reflecting the heart's efficiency and responsiveness to the body's needs. It represents the volume of blood that the left or right ventricle ejects into the aorta or pulmonary trunk each minute. The CO is calculated by multiplying the heart rate (HR)—the number of heartbeats per minute—by the stroke volume (SV)—the amount of blood pumped out with each heartbeat.
In an average resting adult male, the typical cardiac output averages...
Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...

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Related Experiment Video

Updated: Jun 23, 2026

Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge
09:32

Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge

Published on: January 20, 2023

[Cardiac preload and central venous pressure].

A Weyland1, F Grüne

  • 1Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Klinikum Oldenburg gGmbH, Rahel-Straus-Str. 10, 26133 Oldenburg, Deutschland. weyland.andreas@klinikum-oldenburg.de

Der Anaesthesist
|April 23, 2009
PubMed
Summary

Central venous pressure (CVP) is an indirect measure of cardiac preload and often fails to predict fluid responsiveness. More direct measures of ventricular volume or dynamic parameters are better indicators of preload and fluid responsiveness in patients.

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Last Updated: Jun 23, 2026

Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge
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Area of Science:

  • Cardiology
  • Physiology
  • Critical Care Medicine

Context:

  • Cardiac contractility depends on myocardial fiber length, determined by end-diastolic ventricular volume.
  • Filling pressures, like central venous pressure (CVP), are indirect preload parameters.
  • Ventricular pressure-volume relationships are non-linear and variable, limiting direct preload assessment from pressure alone.

Purpose:

  • To evaluate the utility of central venous pressure (CVP) as a reliable parameter of cardiac preload.
  • To compare CVP with other preload estimation methods regarding their ability to predict fluid responsiveness.
  • To highlight the limitations of CVP in clinical settings.

Summary:

  • Central venous pressure (CVP) is influenced by various factors and does not accurately reflect end-diastolic ventricular volume, thus serving as an unreliable indicator of cardiac preload.
  • Studies show CVP is a poor predictor of fluid responsiveness, unlike variables directly assessing end-diastolic volume or dynamic parameters like pulse pressure variation.
  • While CVP has limitations as a preload surrogate, it remains important for reflecting downstream systemic venous pressure.

Impact:

  • Identifies the limitations of CVP in assessing cardiac preload and predicting fluid responsiveness.
  • Suggests alternative, more valid parameters for preload estimation, including intrathoracic blood volume and end-diastolic ventricular area.
  • Emphasizes the superiority of dynamic preload parameters in ventilated patients for predicting volume responsiveness.