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Closed-loop physiological control of the heart

  • Cardiovascular Control
  • Published:
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Abstract

The heart generates flow and pressure under four major controlling signals: end-diastolic volume (preload), ejection pressure (afterload), heart rate, and contractility. The control mechanism of each of these factors has been clarified by those investigators who first opened the hydraulic loop of circulation, studied the heart in a more or less isolated condition, but then put the acquired knowledge back in a proper perspective of the physiological closed-loop condition. Thus, combining Starling's law of the heart with the role of blood volume for venous return, cardiac surgeons began to use an aggressive infusion scheme for postsurgical patients. Recognition of the beneficial effect of reducing systolic pressure afterload has led cardiologists to carefully synchronized intraaortic balloon counterpulsation and, more recently, to an extensive use of vasodilator therapy. Ventricular pacing appropriately delayed from sensed atrial excitation, or even an automatic defibrillation, is now incorporated in an implantable pacer. The history indicates promising uses of closed-loop physiological control of cardiac contraction, including pharmacological closed-loop control of the contractility in the near future.

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  1. Department of Biomedical Engineering, The Johns Hopkins Medical School, 720 Rutland Avenue, 21205, Baltimore, Maryland

    Kiichi Sagawa

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Sagawa, K. Closed-loop physiological control of the heart. Ann Biomed Eng 8, 415–429 (1980). https://doi.org/10.1007/BF02363443

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