Key result
The healthy heart may not sense or control a specific optimal cardiac output, suggesting the need for a new overarching principle to explain the combined effects of preload, afterload, and contractility.
This conceptual paper challenges the traditional physiological view that the heart regulates a specific target cardiac output, calling for a new interpretation of normal cardiac function.
The current evidence suggests that the healthy heart does not sense the optimal cardiac output (Q̇) because the different organ systems that influence cardiac function do not interact to adjust their individual responses toward a specific Q̇. Consequently, it is conceivable that the complex cycle of cardiac contraction and relaxation must occur for reasons other than to produce a specific target Q̇ and that there is likely a yet undiscovered overarching principle in the cardiovascular system that explains the combined effects of the prevailing preload, afterload, and contractility. Future research should embrace the possibility of a different purpose to cardiac function than previously assumed and examine the biological capacity of this fascinating organ accordingly.
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Eric J. Stöhr (2022) conducted an editorial in Normal cardiac function. The healthy heart may not sense or control a specific optimal cardiac output, suggesting the need for a new overarching principle to explain the combined effects of preload, afterload, and contractility.
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