A critical analysis of the view that right atrial pressure determines venous return

被引:72
作者
Brengelmann, GL [1 ]
机构
[1] Univ Washington, Dept Physiol & Biophys, Seattle, WA 98195 USA
关键词
cardiac output; cardiovascular equilibrium; mean systemic pressure; peripheral vasculature; vascular function curves;
D O I
10.1152/japplphysiol.00868.2002
中图分类号
Q4 [生理学];
学科分类号
071003 ;
摘要
A. C. Guyton pioneered major advances in understanding cardiovascular equilibrium. He superimposed venous return curves on cardiac output curves to reveal their intersection at the one level of right atrial pressure (Pra) and flow simultaneously consistent with independent properties of the heart and vasculature. He showed how this point would change with altered properties of the heart (e.g., contractility, sensitivity to preload) and/or of the vasculature (e.g., resistance, total volume). In such graphical representations of negative feedback between two subdivisions of a system, one input/output relationship is necessarily plotted backward, i.e., with the input variable on the y-axis (here, the venous return curve). Unfortunately, this format encourages mistaken ideas about the role of Pra as a "back pressure," such as the assertion that elevating Pra to the level of mean systemic pressure would stop venous return. These concepts are reexamined through review of the original experiments on venous return, presentation of a hypothetical alternative way for obtaining the same data, and analysis of a simple model.
引用
收藏
页码:849 / 859
页数:11
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